Anti-depressants

Question 1

What are the most important ADRs of MAO inhibitors?

Answer 1

Cheese Reaction and Serotonin Syndrome

Question 2

What is the most important ADRs of TCAs?

Answer 2

1. Prolong QT because similar to quinidine / class 1a anti-arrhythmic in blocking fast VG Na+ channel in actived state and potassium channels in phase 3 2. anti-muscaurininc effects 3. anti-histamine 1 4. anti-alpha 1

Question 3

What is the MOA of TCAs?

Answer 3

Block re-uptake up serotonin and NE therefore increasing serotonin and NE in the cleft

Question 4

What are the 3 Cs of TCA OD?

Answer 4

Coma, convulsion (lower threshold in brain), and Cardiac toxicity

Question 5

What is the antidote to TCA OD?

Answer 5

There is no antidote so in order to save patients life must enhance elimination / clearance by hemoperfusion (preferred over hemodialysis bc TCAs are lipid soluble).

Question 6

What are important properties of drugs that allows for them to be eliminated / cleared faster by hemodialysis?

Answer 6

Have to have at 30% clearance of kidney, small in size, and water soluble ( < 8 L small Vd)

Question 7

What are important properties of drugs that allows for them to be eliminated / cleared faster by hemoperfusion?

Answer 7

Not cleared easily by kidney, large in size and lipid soluble

Question 8

What is the difference between hemoperfusion and hemodialysis?

Answer 8

Hemoperfusion uses activated carbon and does not have electrolyte / fluid exchanger. Hemodialysis has a fluid exchanger.