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Pharma > Anti-Depressants > Flashcards

Anti-Depressants Flashcards

1
Q

Inhibits SERT increases concentration of 5HT at synaptic membrane

A

SSRIs

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2
Q

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

A

SSRIs

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3
Q

SSRIs (4)

A

Fluoxetine
Paroxetine
Sertraline
Citalopram

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4
Q

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

A

Paroxetine

Sertraline

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5
Q

SSRI SE (5)

A 
Hyponatremia
Inc SIADH
Dec sexual dysfunction
Weight gain
Drowsiness
Insomnia
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6
Q

Inhibits presynaptic reuptake of NE and 5HT

A

SNRIs

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7
Q

Apart from GAD, MDD, PTSD this relieves pain disorders

A

SNRIs

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8
Q

SNRI examples (2)

A

Venlafaxine

Duloxetine

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9
Q

Used for diabetic neuropathy

A

Venlafaxine

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10
Q

Used for chronic, neuropathic pain, OA, LBP

A

Duloxetine

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11
Q

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

A

May cause HTN and HR

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12
Q

SSRI and SNRIs take how long to take effect

A

1-2 months

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13
Q

Wait for how long before dismissing as inadequate treatment response

A

8-12 w

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14
Q

AE of SSRIs ans SNRIs toxicity

A

Serotonin Syndrome

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15
Q

Serotonin syndrome sx (5)

A 
Autonomic instability
Agitation
Hyperkalemia
Hyperreflexia
Clonus
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16
Q

Neuroleptic Malignant Syndrome (2) by dopamine blocking agents

A

Hyporeflexia

Rigidity

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17
Q

Serotonin syndrome antidote

A

Cryoheptadine

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18
Q

Blocks NET and SERT at the presynaptic membrane during reuptake

A

TCA

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19
Q

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

A

TCAs

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20
Q

TCAs (5)

A 
Imipramine
Desipramine
Clomipramine
Amitryptiline
Nortryptiline
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21
Q

Amine with less anticholinergic effect (2)

A

Desipiramine

Nortryptiline

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22
Q

Tx for OCD

A

Clomipramine

23
Q

Tx for migraine with most potent anticholinergic effect

A

Amitryptiline

24
Q

TCA use (3)

A

Depression resistant to tx
Migraine prevention
Pain disorder

25
Q

TCA SE (4)

A

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

26
Q

Ventricular arrhythmia (torsade, widened QRS) from TCA antidote

A

Na bicarbonate

27
Q

TCA poison:

A

Seizure antagonist

28
Q

Increases transmission of norepinephrine, serotonin and dopamine

A

MOA Inhibitors

29
Q

MAO Inhibitors MOA (2)

A

MAO A - deaminates serotonin, NE and dopamine

MAO B - demaminates dopamine preferentially

30
Q

MAOIs are especially used for depression with (2):

A

1 hyperphagia

2 hypersomnia

31
Q

MAOI examples (4)

A

Tranylcypromine
Phenelzine
Isocarboxazid
Selegiline

32
Q

Non selective, irreversible MAOI

A

Tranylcypromine
Phenelzine
Isocarboxazid

33
Q

Selective inhibtor of MAO B useful in PD

A

Selegiline

34
Q

Discontinue SSRIs and SNRIs at least weeks before giving MAOI

A

2 week wash off period

35
Q

MAO I SE (3)

A

orthostatic hypotension
weight gain
Most sexually debillitating

36
Q

MAOIs should not be taken with rich food

A

tyramine

37
Q

Tyramine interacts with MAOIs by

A

MAOIs prevent metabolism of tyramine increasing risk for sympathomimetic effects

38
Q

Antidote HTN induced by tyramine toxicity

A

Phentolamine

39
Q

Phentolamine MOA

A

alpha 1 and 2 block

40
Q

Used for MDD resistant with first and second lines

A

Atypical antidepressant

41
Q

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

A

Bupropion

42
Q

User in depression with hypersomnolence, low energy and in tobacco dependence

Nicotine dependence and withdrawal symptoms

A

Bupropion

43
Q

Bupropion has no SE

A

sexual dysfunction

weight gain

44
Q

Bupropion is CI in

A

Bulemics

45
Q

Bupropion SE

A

seizure

46
Q

a2 blocker in presynaptic membrane used in depression with insomnia

post synaptic serotonin blocking activity

antihistamine activity

Inc noradrenergic and serotonergic neurotransmission

A

Mirtazipine

47
Q

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

A

weight gain

48
Q

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

Antagonist at H1

Antagonist at a1 postsynaptic

A

Trazodone

Nefazodone

49
Q

May cause priapism due to vasodilatory effect

A

Mirtazipine

50
Q

Persistent erection of >4 hours not associated with sexual dysfunction

A

Priapism

51
Q

Trazodone should be used cautiously in patients with (2)

A

Sickle cell disease

Multiple myeloma

52
Q

Trazodone specifically blocks the

A

5ht2A receptor

53
Q

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

A

Lithium

54
Q

Activation of GSK 3 is associated with

A

Bipolar disorder

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