Anti depressants

Question 1

amine hypothesis of depression

Answer 1

1) reserpine: depletes NE, 5HT, DA and causes severe depression
2) acute mech of antidepressants: increase NE and 5HT
3) biological lag: 4-6 wks

Question 2

neurotrophic hypothesis

Answer 2

BDNF needed for neuron survival and growth
BDNF found in CSF is decreased in depression
CREB, sprouts help neuron connection

Question 3

neuroendocrine factors

Answer 3

steroid and corticotropin - reloading hormone levels are increased in depression
thyroid dysregulation
estrogen def

Question 4

selective blockade of 5HT reuptake

no anti M, H1, alpha1 receptor

Answer 4

SSRIs

Question 5

SSRIs

Answer 5

fluoxetine
paroxetine - teratogenic
sertraline
citalopram
fluvoxamine
escitalopram

Question 6

used: DOC for MDD, OCD, bulimia, anxiety, PMDD

Answer 6

SSRIs

Question 7

toxicity - serotonin syndrome

potent inhibitors of hepatic microsomal oxidases p450

Answer 7

SSRIs

Question 8

sweating, rigidity, myoclonus, hyperthermia, ANS stability, seizures

Answer 8

serotonin syndrome SE

Question 9

TCAs

Answer 9

amitriptyline
imipramine
clomipramine

Question 10

nonspecific blockade of 5HT and NE reuptake

Answer 10

TCAs

Question 11

used: MDD, phobic and panic anxiety states, OCDs (clomipramine), neuropathic pain, enuresis (imipramine)

Answer 11

TCAs

Question 12

toxicity the 3 Cs of TCAs

Answer 12

coma
convulsions
cardiotoxicity

Question 13

hypertensive crisis with MAOI
serotonin syndrome
prevent antihypertensive action of A2 and guanethidine

Answer 13

drug interactions of TCAs

Question 14

SE of TCAs

Answer 14

A1
histamine blockade
anti cholinergic
seizures
Heart - quinidine - like actions: QRS widen, QT prolong, arrhythmias

Question 15

BPH, narrow angle glaucoma, recent MI, HB and epilepsy

Answer 15

CI of TCAs

Question 16

MAOI

Answer 16

phenelzineu
tranylcypromine
selegiline
moclobemide

Question 17

irreversible inhibition of MAO A and MAO B

Answer 17

MAOI

Question 18

used for atypical depression

Answer 18

MAOI

Question 19

tx for serotonin syndrome

Answer 19

stop current drug
cyproheptadine - 5HT2A antagonist
BZD agitation

Question 20

weight gain
restlessness
insomnia
hepatotoxicity 
orthostatic hypotension
HTN

Answer 20

SE of MAOIs

Question 21

for anti dep: breaks down 5HT, NE, DA

Answer 21

inhibit MAO - A

Question 22

anti Parkinsonism: breaks down DA

Answer 22

inhibit MAO -B

Question 23

drug interactions

1) cheese rxn
2) hypertension crisis
3) serotonin syndrome

Answer 23

DI of MAOI

Question 24

tx for hypertensive crisis

Answer 24

due to increase NE

tx with phentolamine, phenoxybenzoamine, label

Question 25

serotonin reuptake and 5HT2 antagonist and blocks A1 and histamine
extremely sedating and tx insomnia
assoc with cardiac arrhythmias and priapism (painful penile excretion)

Answer 25

trazodone

Question 26

DA and NE reuptake blocker
used in smoking cessation
increase risk of seizures

Answer 26

bupropion

Question 27

A2 and 5HT2 antagonist
used as sedative
SE: weight gain

Answer 27

mirtazapine

Question 28

serotonin and NE reuptake inhibitor and 5HT2 antagonist

SE: liver damage, orthostatic hypotension

Answer 28

nefazodone

Question 29

partial agonist of nicotinic receptors and is used in smoking cessation (DOC)

Answer 29

varenicline

Question 30

can boost monoamines

Answer 30

cocaine

Question 31

SNRIs

Answer 31

venlafaxine

duloxetine

Question 32

serotonin and NE reuptake inhibitors

Used: MDD, chronic pain (Dul), fibromyalgia (milnacipran), perimenopausal sx

Answer 32

SNRIs

Question 33

fxn as TCA
block NE reuptake & D2 receptor
used as antipsychotic - parkinsonian syndrome

Answer 33

amoxapine