Anti-Depressants

Question 1

Inhibits SERT increases concentration of 5HT at synaptic membrane

Answer 1

SSRIs

Question 2

1st line agents for depression, GAD, OCD and Bulemia

Answer 2

SSRIs

Question 3

SSRIs (4)

Answer 3

Fluoxetine
Paroxetine
Sertraline
Citalopram

Question 4

Short acting SSRIs with discontinuation syndrome (flu like dizziness, fatigue, nausea 1-2d)

Answer 4

Paroxetine

Sertraline

Question 5

SSRI SE (5)

Answer 5

Hyponatremia
Inc SIADH
Dec sexual dysfunction
Weight gain
Drowsiness
Insomnia

Question 6

Inhibits presynaptic reuptake of NE and 5HT

Answer 6

SNRIs

Question 7

Apart from GAD, MDD, PTSD this relieves pain disorders

Answer 7

SNRIs

Question 8

SNRI examples (2)

Answer 8

Venlafaxine

Duloxetine

Question 9

Used for diabetic neuropathy

Answer 9

Venlafaxine

Question 10

Used for chronic, neuropathic pain, OA, LBP

Answer 10

Duloxetine

Question 11

Notorious AE of SNRI (also similar with SSRI) because of noradrenergic activity

Answer 11

May cause HTN and HR

Question 12

SSRI and SNRIs take how long to take effect

Answer 12

1-2 months

Question 13

Wait for how long before dismissing as inadequate treatment response

Answer 13

8-12 w

Question 14

AE of SSRIs ans SNRIs toxicity

Answer 14

Serotonin Syndrome

Question 15

Serotonin syndrome sx (5)

Answer 15

Autonomic instability
Agitation
Hyperkalemia
Hyperreflexia
Clonus

Question 16

Neuroleptic Malignant Syndrome (2) by dopamine blocking agents

Answer 16

Hyporeflexia

Rigidity

Question 17

Serotonin syndrome antidote

Answer 17

Cryoheptadine

Question 18

Blocks NET and SERT at the presynaptic membrane during reuptake

Answer 18

TCA

Question 19

2nd or 3rd line drug for MDD if unresponsive to others

Answer 19

TCAs

Question 20

TCAs (5)

Answer 20

Imipramine
Desipramine
Clomipramine
Amitryptiline
Nortryptiline

Question 21

Amine with less anticholinergic effect (2)

Answer 21

Desipiramine

Nortryptiline

Question 22

Tx for OCD

Answer 22

Clomipramine

Question 23

Tx for migraine with most potent anticholinergic effect

Answer 23

Amitryptiline

Question 24

TCA use (3)

Answer 24

Depression resistant to tx
Migraine prevention
Pain disorder

Question 25

TCA SE (4)

Answer 25

Sexual dysfunction Anticholinergic property Cardiotoxicity (depressant) Weight gain (antihistamine)

Question 26

Ventricular arrhythmia (torsade, widened QRS) from TCA antidote

Answer 26

Na bicarbonate

Question 27

TCA poison:

Answer 27

Seizure antagonist

Question 28

Increases transmission of norepinephrine, serotonin and dopamine

Answer 28

MOA Inhibitors

Question 29

MAO Inhibitors MOA (2)

Answer 29

MAO A - deaminates serotonin, NE and dopamine | MAO B - demaminates dopamine preferentially

Question 30

MAOIs are especially used for depression with (2):

Answer 30

1 hyperphagia | 2 hypersomnia

Question 31

MAOI examples (4)

Answer 31

Tranylcypromine Phenelzine Isocarboxazid Selegiline

Question 32

Non selective, irreversible MAOI

Answer 32

Tranylcypromine Phenelzine Isocarboxazid

Question 33

Selective inhibtor of MAO B useful in PD

Answer 33

Selegiline

Question 34

Discontinue SSRIs and SNRIs at least weeks before giving MAOI

Answer 34

2 week wash off period

Question 35

MAO I SE (3)

Answer 35

orthostatic hypotension weight gain Most sexually debillitating

Question 36

MAOIs should not be taken with rich food

Answer 36

tyramine

Question 37

Tyramine interacts with MAOIs by

Answer 37

MAOIs prevent metabolism of tyramine increasing risk for sympathomimetic effects

Question 38

Antidote HTN induced by tyramine toxicity

Answer 38

Phentolamine

Question 39

Phentolamine MOA

Answer 39

alpha 1 and 2 block

Question 40

Used for MDD resistant with first and second lines

Answer 40

Atypical antidepressant

Question 41

inhibits reuptake of Norepinephrine and Dopamine has no effect on serotonin but has CNS activating effect

Answer 41

Bupropion

Question 42

User in depression with hypersomnolence, low energy and in tobacco dependence Nicotine dependence and withdrawal symptoms

Answer 42

Bupropion

Question 43

Bupropion has no SE

Answer 43

sexual dysfunction | weight gain

Question 44

Bupropion is CI in

Answer 44

Bulemics

Question 45

Bupropion SE

Answer 45

seizure

Question 46

a2 blocker in presynaptic membrane used in depression with insomnia post synaptic serotonin blocking activity antihistamine activity Inc noradrenergic and serotonergic neurotransmission

Answer 46

Mirtazipine

Question 47

Mirtazipine can cause this se because of serotonin receptor 2, 3 blockade

Answer 47

weight gain

Question 48

Antagonist at serotonin 5HT2A post synaptic receptor and weakly inhibits serotonin reuptake Antagonist at H1 Antagonist at a1 postsynaptic

Answer 48

Trazodone | Nefazodone

Question 49

May cause priapism due to vasodilatory effect

Answer 49

Mirtazipine

Question 50

Persistent erection of >4 hours not associated with sexual dysfunction

Answer 50

Priapism

Question 51

Trazodone should be used cautiously in patients with (2)

Answer 51

Sickle cell disease | Multiple myeloma

Question 52

Trazodone specifically blocks the

Answer 52

5ht2A receptor

Question 53

Inhibits recycling of neuronal membrane inositol lipids (activation of PLC to IP3 and DAG) Inhibits inositol phosphatase enzymes that regenerates PIP2 Inhibits glycogen synthase kinase 3 (GSK3) mimicking Wnt pathway (inhibits axon remodelling, synapse formation and neurogenesis) For depression and bipolar disorder Narrow therapeutic index Mood stabilizer

Answer 53

Lithium

Question 54

Activation of GSK 3 is associated with

Answer 54

Bipolar disorder