Anti-depressants Flashcards
What transporters do TCA’s inhibit?
SERT (serotonin reuptake transporter) and NET (norepinephrine transporter).
List the ADRs associated with TCA’s and what receptors are responsible for these actions.
H1 histamine receptor block: sedation, hunger, weight gain.
Alpha 1 adrenoceptors: vasodilation, orthostatic hypotension, reflex tachycardia.
Muscarinic receptor block: anti-cholinergic effects: dry mouth, urinary retention, constipation.
Na+ channel block: decreased NT and HR.
Increased serotonin: insomnia, mania, increased motivation.
Increased noradrenaline: increased HR, hypertension and tremors.
What anti-depressant is predominantly used for neuropathic pain?
Amitriptyline (TCA).
Name an example of an SSRI.
Zoloft/Sertraline.
Why are SNRIs safer to use instead of TCAs?
SNRIs have less off target effects as they only act on SERT and NET, therefore they have a decreased risk of ADRs than TCAs.
What neurotransmitter(s) concentration does a monoamine oxidase inhibitor increase?
Serotonin, noradrenaline and dopamine.
Name an atypical anti-depressant.
Mirtazapine
What anti-depressant acts directly on the 5-HT2C and 5-HT3 receptors?
Mirtazapine.
List 3 reasons why serotonin toxicity may occur with anti-depressants.
- High dose of a single drug.
- More than one agent used together.
- Inadequate washout period (not letting a drug clear before administering another).
Explain the Cheese Reaction.
Occurs with foods containing tyramine and MAOi’s. MAOi’s inhibit MAO which is responsible for metabolising tyramine. An increase in tyramine increases the release and concentration of noradrenaline. By combining a MAOi and consuming tyramine rich foods this can cause a significant increase in tyramine concentration which may cause a hypertensive crisis.
What compound does Lithium look like?
Sodium
What drug is classified as a mood stabiliser drug?
Lithium
What aspect of a diet can significantly decrease lithium concentrations?
A high salt diet.
Does baclofen act on GABA-a or GABA-b receptors?
GABA-b
Benzodiazepines are an agonist at what receptor?
GABA-a
