Anti depressants Flashcards

1
Q

Depression Symptom pneumonic

A

SIGECAPS- sleep, interest, guilt, energy, concentration, appetite, psychomotor, suicidal

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2
Q

Serotonin Syndrome

A

mental status changes, autonomic instablity, neuromuscular aberrations, GI symptoms, ocular clonus, mydriasis

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3
Q

SSRI MOA

A

blocks presynaptic serotonin transporter, leaves serotonin available for use

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4
Q

SSRI ADR

A

NV, insomnia, weight gain, HA, Bruxism, Erectile dysfunction, diaphoresis, Orthostatis, Akathasia, Osteopenia, GI Bleed, some anticholinergic

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5
Q

SSRI and pregnancy

A

some cardiac defects in 1st trimester, low birth weight, permaturity, neonatal withdrawal, pulmonary hypertension in 3rd trimester

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6
Q

SSRIs

A

Fluvoxamine, Fluoxetine, Paroxetine, Citalopram, Escitalopram, Sertraline, Vortioxetine

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7
Q

Fluoxetine

A

MDD, OCD, PD, bulimia

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8
Q

Fluoxetine drug interactions

A

CYP2d6 inhibitor

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9
Q

Paroxetine

A

MDD, OCD, SAD, GAD

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10
Q

Paroxetine peals

A

most sedating, most weight gain, sexual dysfunction, anticholinergic AE

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11
Q

Sertraline

A

MDD, OCD, PD, PTSD, PMDD, SAD

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12
Q

Sertraline pearls

A

fewer drug interactions, good for CV disease

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13
Q

Sertraline ADR

A

dry mouth, sedation, insomnia, tremor, dizziness, sexual dysfunction

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14
Q

Escitalopram

A

MDD, GAD

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15
Q

Escitalopram ADR

A

N, sedation, insomnia, sexual side effects

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16
Q

Citalopram pearls

A

lowest sexual side effects

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17
Q

SNRIs MOA

A

serontonin neuroepi repuptake inhibitors. Bind 5-HT and NE transporter

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18
Q

SNRI indications

A

depression, anxiety disorder, neuropathic pain, chronic pain, fibromyalgia

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19
Q

SNRI ADR

A

HTN, hyperlipidemia, dry mouth, HA, sexual dysfunction, insomnia, NV, akathasia, diaphoresis, weight changes

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20
Q

SNRI drug interactions

A

other serotonin drugs, MAOIS, platelet inhibitors, strong 3A4 inhibitors, 2D6 inhibitors

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21
Q

SNRIs

A

Venlafaxine, Desvenlafaxine, duloxetine, Milnacipran, levomilnacipran.

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22
Q

Mirtazipine

A

major depressive disorder

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23
Q

Mirtazipine MOA

A

increases central NE and 5-HT activity. 5-HT antagonist,

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24
Q

Mirtazipine ADR

A

sedation, somnolence, dizziness, orthostasis, weight gain, elevated cholesterol and LFT, agranulocytosis

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25
Q

Bupropion

A

MDD, smoking cessation

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26
Q

Bupropion MOA

A

weak NE and DA reuptake inhibitor

27
Q

Bupropion ADR

A

agitation, anxiety, weight loss, insomnia, psychosis, hallucinations, HTN, NV, HA, dry mouth

28
Q

Bupropion contraindications

A

Seizure disorders

29
Q

Tricyclic antidepressants MOA

A

SNRI, anitcholinergic, alpha-adrenergic, membrane stabilizing on myocardium

30
Q

TCA indications

A

depression, anxiety, bipolar disorder, OCD, neuropathic pain, migraine prophylaxis

31
Q

TCA drug interactions

A

CYP 2D6 substrate, MAOI, anitcholinergics, sympathomimetics, cimetidine

32
Q

TCA ADR

A

anitcholinergic, arrhythmia, sexual dysfunction, fall risk, diaphoresis

33
Q

Trazodone

A

depression

34
Q

Trazdone MOA

A

5-HT receptor antogonist and reuptake inhibitor

35
Q

Trazedone ADR

A

sedation, somnolence, HA, dizziness, dry mouth, orthostasis, long QT, arrythmia, priapism

36
Q

Vilazodone MOA

A

5-HT receptor antagonist and reuptake inhibitor

37
Q

Vilazodone ADR

A

sedation, somnolence, HA, dizziness, dry mouth, orthostasis, long QT, arrhythmia, priapism

38
Q

MAOI indications

A

last line for depression

39
Q

MAOI MOA

A

increase levels of 5-HT, NE, DA. nonselective monoamine oxidase inhibitor

40
Q

MAOI contraindications

A

HTN, CV disease, other MAOI, sympathomimetics, CNS depressants, anti HTN, buproprion, cheese, or other foods with high tyramine

41
Q

MAOI ADR

A

serotonin syndrome, sexual dysfunction, myoclonus, orthostasis, HTN crisis, dizziness, drowsiness, constipation, dry mouth, weight gain

42
Q

St Johns wort MOA

A

modulates 5-HT. NE, DA

43
Q

ST johns wort interactions

A

potent P450 inducer. 3A4, 2C19, 1A2. increases OCP estrogen, reduces digoxin, imatinib, irinotecan levels

44
Q

St. Johns wort ADR

A

insomnia, vivid dreams, restlessness, anxiety, agitation, diarrhea, dry mouth, dizziness, HA, rash, hypoglycemia, parasthesias

45
Q

APA 2010 guidelines

A

SSRI, SNRI, bupropion, mirtazapine

46
Q

APA 2016 guidelines

A

Cognitive behavioral therapy or Second generation SSRI

47
Q

Drugs that cause anxiety

A

bupropion, clonidine, nictotine, albuterol, prednisone, amphetamines, caffeine, pesudoephedrine, levothyroxine

48
Q

Benzodiazepines MOA

A

binds gamma subunit of GABA-A receptor in addition to GABA–>facilitates inhibitory effect of GABA

49
Q

Benzodiazepine ADR

A

lipophilicity, sedation, confusion, disorentation, euphoria, excitement, irritability, respiratory depression, Hypotension

50
Q

Benzodiazepine withdrawal symptoms

A

insomnia, restlessness, muscle tension, irritability

51
Q

BDZ alerts

A

elderly patients-increased fat, increased risk of AE and increased risk of fall, pregnancy and lactation cat D

52
Q

Buspirone MOA

A

partial agonist at 5HT-1A receptors

53
Q

Buspirone

A

anxiety

54
Q

Buspirone advantages

A

lack of dependency, less sedation, minimal DDI

55
Q

Buspirone disadvantages

A

slow onset, dosed BID-TID, not effective for depression

56
Q

Buspirone ADR

A

dizziness, nausea, headache

57
Q

first line GAD

A

SSRI, SNRI, pregabalin

58
Q

second line GAD

A

buspirone

59
Q

last line

A

BDZ

60
Q

OCD first line

A

SSRI

61
Q

SAD first line

A

SSRI, venlafaxine

62
Q

PTSD first line

A

fluoxetine, sertraline

63
Q

PTSD second

A

venlafaxine