anti-depressants Flashcards
Tranylcypromine and moclobemide share some characteristics, including:
a. headaches as a side effect
b. selectivity for MAOA
c. irreversible inhibition of MAO
d. raising levels of 5HT
d. raising levels of 5HT
tranylcypromine: irreversible MAO inhibitor
moclobemide: reversible MAO inhibitor
Which of the following is associated with the greatest risk of cardiovascular complications?
a. Nefazadone
b. Moclobemide
c. Fluoxetine
d. Desipramine
d. desipramine (TCA)
nefazadone (serotonin antagonist and reuptake inhibitor)
moclobemide (reversible monoamine oxidase inhibitor)
fluoxetine (selective serotonin reuptake inhibitor)
Fluoxetine:
a. Has anxiety as an initial acute side effect
b. Blocks both 5-HT and noradrenaline uptake
c. Acts as an antagonist at alpha-1-adrenoceptors, muscarinic and histamine receptors
d. Is able to improve mood within a 2 day period
a. Has anxiety as an initial acute side effect (SSRI)
b. TCAs, SARIs
c. TCAs
Why are Selective Serotonin Reuptake Inhibitors (SSRIs) preferred over Tricyclic antidepressants (TCAs) in the present practice?
a. Increased efficacy and decreased toxicity
b. Multiple target mediated action
c. Improved bioavailability
a. Increased efficacy and decreased toxicity
what is desipramine?
tricyclic anti-depressants
what is fluoxetine?
SSRI
which antidepressant can provoke manic episodes in bipolar patients?
SSRIs
why do SSRIs not result in cardiac problems?
only target 5HT transporter –> no effect on NA receptor
what is Tranylcypromine?
irreversible monoamine oxidase inhibitors (MAOIs)
what drug is associated with serotonin syndrome?
SSRIs (fluoxetine)
MAO(A) breaks down ___ and ___
MAO(B) breaks down ____
5HT and NA
dopamine
what is the cheese reaction?
associated with which drug?
irreversible MAOIs (tranylcypromine)
inhibit MAO in gut and liver –> prevent breakdown of tyramine –> displace large quantities of NA from nerve terminals –> release of NA from all sympathetic nerves in periphery –> hypertensive crisis
what is moclobemide?
reversible MAOI
why is there no cheese reaction in reversible MAOIs?
drug selectively targets MAO(A) enzyme
what is nefazodone?
serotonin antagonist and reuptake inhibitor (SARI)
what class of drug shares 5HT and NA reuptake blockade of classical TCAs without α1-adrenoceptor, muscarinic receptor and H1 receptor blockade?
name an example
Serotonin and noradrenaline reuptake inhibitors (SNRIs)
example: venlafaxine
give an example of a SNRI?
Venlafaxine
what is lithium indicated in?
bipolar disorder to stabilise mood
what drugs are considered if bipolar patient no longer responds to lithium?
anti-epileptics (eg. valproate)
what is Reboxetine?
NA reuptake inhibitor
what is Mianserin?
α2-adrenoceptor antagonist
what are the causes of depression?
1. Deficiency of _____transmitters
2. Abnormal upregulation of _____ receptors
- monoamine (NA/5HT)
- monoamine
what is amitriptyline?
tricyclic antidepressant
The beneficial effect of antidepressant drugs occurs when:
a. levels of 5-HT rise
b. levels of NA stabilise
c. receptors are blocked
d. receptors become downregulated
d. receptors become downregulated
Desipramine:
a. enhances the synthesis of noradrealine
b. can block D2 receptors
c. is an irreversible inhibitor of MAO
d. raises noradrenaline levels in the brain
d. raises noradrenaline levels in the brain
Tranylcypromine causes the following side effects. Which one is not caused by moclobemide?
a. insomnia
b. postural hypotension
c. nausea
b. postural hypotension
Lithium is the only drug that is used to treat mania. The mechanism of action is unclear. Which is not a side effect?
a. tremor
b. diabetes insipidus
c. GIT disturbances
d. nephritis
e. oedema
c. GIT disturbances
