affective disorders

Question 1

describe tyramine toxicity

Answer 1

uptake of tyramine into the Adrenergic neuron via vmat into the synaptic vesicle where it displaces norepinephrine causing reverse transport of norepinephrine out of the neuron.

tyramine is an indirect sympathomimetic=HTN crisis

Question 2

What are some adverse effects SSRIs- fluoxetine/Prozac escitalopram/Lexapro?

Answer 2

GI distress
sexual dysfunction
serotonin syndrome

Question 3

Locus coeruleus is a target for PTSD. What receptors?

Answer 3

Locus coeruleus is a target for PTSD. What receptors?
Prazosin-a1
Clonidine a2
Dexmedetomidine a2

Decrease noradrenergic neurotransmission.

Question 4

all loose tigers are dangerous, send signal of fear renewal/adaptive to amygdala

Answer 4

prelimbic cortex/prefrontal cortex

Question 5

herb, used for treating depression, downregulation of beta receptors in the brain, probably increases norepinephrine, upregulate CYP enzymes, may cause photo sensitivity and neurotoxicity

Answer 5

Saint Johns wort

can also interact with prescription antidepressants and other drugs

Question 6

name two selective serotonin reuptake inhibitors

Answer 6

fluoxetine/Prozac

escitalopram/Lexapro

Question 7

Name two tricyclic antidepressant

Answer 7

Amitriptyline/Elavil

Desipramine/norpramin

Question 8

Adverse effects include-block sodium channels in the heart in the CNS which can lead to lethal conduction delays and seizures?

Answer 8

TCA
Amitriptyline/Elavil
Desipramine/norpramin

Question 9

Define affective disorder.

Answer 9

profound emotions without the appropriate situational context.
major depressive order
anxiety slash panic disorder
post-traumatic stress disorder

Question 10

First line treatment for major depression and anxiety, very selective, decrease side effects

Answer 10

ssri
fluoxetine/Prozac
escitalopram/Lexapro

Question 11

why don’t you mix SSRI MAOI and triptan(5HT agonist)

Answer 11

Serotonin syndrome-dangerous elevations in serotonin levels or serotonin neurotransmission causes hyperthermia muscle rigidity myoclonus and rapid fluctuations in vital signs

Question 12

Which MAO metabolizes dopamine?

Answer 12

MAO B for brain

Question 13

Serotonin-norepinephrine reuptake inhibitor

Answer 13

Cymbalta/duloxetine

Question 14

Used to treat patients that don’t respond to SSRI, also used to treat fibromyalgia, chronic neuropathic pain, and hot flashes

Answer 14

serotonin norepinephrine reuptake inhibitor

Cymbalta/duloxetine

Question 15

Major depressive disorder is likely due to decreased_______ and__________ while PTSD is likely due to increased________ and _______ with decreased ________.

Answer 15

major depressive disorder is likely due to decreased dopamine and norepinephrine
PTSD is likely due to increased norepinephrine and glutamate with decreased serotonin

Question 16

How would you manage a TCA overdose

5

Answer 16

Acls
Volume resuscitation
treat the seizure
treat cardiac arrhythmias with lidocaine
and some bicarb because TCAs are weak bases

Question 17

Blocks endocannaboid reuptake

Answer 17

Tylenol

Question 18

Selective irreversible Mao B inhibiter used to treat Parkinson?

Answer 18

Selegiline(eldepryl)

Question 19

CB1 receptor agonist, adjunct analgesics for neuropathic pain, anti emetic, appetite stimulant

Answer 19

Dronabinol/Marinol

Nabilone/cesamet

Question 20

MAO-A is responsible for the metabolism of what?

3

Answer 20

Tyramine, serotonin, norepinephrine

Question 21

name an A typical antidepressant

Answer 21

bupropion/Wellbutrin

Question 22

Selective MAO A inhibitor, reversible, hops on and off enzyme

Answer 22

Moclobemide (amira, auroix, clobemix)

Question 23

How does Wellbutrin/ bupropion work?

Answer 23

Wellbutrin/ bupropion
atypical
increases dopamine and serotonin extracellular levels by blocking transport DAT/SERT which displaces neurotransmitter from the nerve terminal

Question 24

Management of affective disorders. Increases NE, 5HT in neurons and vesicles. Increases tyramine concentration in blood, MAO-I –non selective, irreversible inhibitor

Answer 24

Phenlizine/nardil

Question 25

Phenlizine/nardil, iproniazid/marsilid, iprazid, ipronid are _______ _______ _____ _____ associated with tyramine toxicity

Answer 25

MAO-I –non selective, irreversible inhibitors

Question 26

an adverse effect of tyramine toxicity

Answer 26

Phenlizine/nardil

Question 27

these two drugs’ Adverse effects include blocking muscarinic receptors, histamine receptors and adrenergic receptors.

What signs and symptoms would blocking those receptors lead to

Answer 27

TCA
Amitriptyline/Elavil
Desipramine/norpramin

Muscarinic-dry mouth, blurred vision, confusion, tachycardia, urinary retention,

Histamine-sedation and confusion

Andrenergic-orthostatic hypotension, reflects tachycardia dizziness,

Question 28

How do monoamine oxidase inhibitors work as antidepressants?

Answer 28

Increase norepinephrine and serotonin via increased plasma tyramine

Question 29

Block norepinephrine and serotonin reuptake can also be used to treat chronic neuropathic pain, migraine, fatigue syndrome, not selective for transporters

Answer 29

TCA
Amitriptyline/Elavil
Desipramine/norpramin

Question 30

can be used to treat PTSD insomnia, nightmares, and reduce daytime flashbacks

Answer 30

Dronabinol/Marinol

Nabilone/cesamet

Question 31

How do TCA, SSRI, SNRI treat chronic pain?

Answer 31

Increase norepinephrine and serotonin neurotransmission in the dorsal horn

Question 32

caged tigers are not dangerous, sends signal to amygdala to suppress expression of fear in a no longer dangerous situation

Answer 32

infralimbic cortex/prefrontal cortex