Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pharmacology > Anti-Depressants and Mood Stabilizers > Flashcards

Anti-Depressants and Mood Stabilizers Flashcards

1
Q

what are the safest depression drugs for pregnant patients?

A

setraline, citalopram, fluoxetine

all SSRIs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

MAO Inhibitors

A

two types - MAO-A and MAO-B

MOA-A is used for refractory depression

increases NE, Epi, 5-HT and DA
Tyramine - interaction

Phenelzine, tranylcypromine, isocarboxazid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what are the toxicities and interactions of MAOIs?

A

hypertensive crisis

because of tyramine - foods are aged cheese and cured meats, red wine, chocolate, avocado, soy sauce and sauerkraut

alpha1 agonist increase NE

serotonin syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what are the symptoms of hypertensive crisis?

A 
occipital headache 
stiff neck 
nausea/vomiting 
photophobia
palpitations
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

name the drugs that can cause serotonin syndrome?

A 
SSRIs
TCAs
Meperidine
dextromethorphan
tramadol
triptans
linezolid
St Johns Wort
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

TCA’s

A

Block NE and 5-HT reuptake - NET and SERT

Block alpha1, M and H1 receptors

CYP2D6 - slow metabolizers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

TCA Toxicities

A

serotonin syndrome

coma, convulsions and cardiotoxicity - give sodium bicarbonate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

symptoms of serotonin syndrome

A

rigidity, hyperthermia, hypertension, tachycardia, myclonus, delirium, confusion and GI symptoms

happens within 24 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

treatment of serotonin syndrome

A

benzodiazepines, cyproheptadine and ventilation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Imipramine

A

TCA

enuresis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

desipramine

A

TCA

least anticholinergic effects

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

clomipramine

A

TCA

for depression but also useful for OCD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

amytriptyline

A

TCA

also, used for neuropathic pain, migraine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Nortriptyline

A

TCA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Doxepin

A

TCA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Amoxapine

A

TCA that has some D2 blockade - parkinsonian like symptoms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Fluoxetine

A

SSRI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Fluvoxamine

A

SSRI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Paroxetine

A

SSRI

20
Q

Sertraline

A

SSRI

safer for pregnant patients

21
Q

Citalopram

A

SSRI

safer for pregnant patients

22
Q

Escitalopram

A

SSRI

23
Q

uses for SSRI’s

A 
depression 
OCD 
panic disorder 
bulimia 
anorexia
PTSD
prementrual dysphoric disorder
24
Q

characteristics of SSRI’s

A

5-HT specific

fewer ANS symptoms than TCAs
-less serious overdose symptoms

25
Q

SSRI toxicity

A

insomnia, headache, nausea and vomiting

bleeding abnormalities - platelets

impotence - use phosphodiesterase inhibitors

serotonin syndrome

weight gain - from block of 5-HT-2c

drug interactions - CYP 2D6 (most with fluoxetine)

26
Q

What are the SNRI’s

A

Duloxetine

Venlafaxine

Desvenlafaxine

Milnacipran

27
Q

SNRI’s characteristics

A

serotonin and norepinephrine reuptake inhibitors

no effect on H1, alpha1 or M receptors

used for depression, fibromyalgia and neuropathic pain

28
Q

bupropion - mechanism

A

inhibit DAT, NET and inhibits dopamine and norepinephrine

little M and H1 effects

29
Q

bupropion effects

A

no sexual effects

inhibits cyp 2D6

reduces seizure threshold - anorexia

noncompetitive antagonist of nicotinic receptor - smoking cessation

30
Q

mirtazapine

A

tetracyclic antidepressant

blocks alpha2 which increases NE and 5-HT release

weight gain - H1, 5-HT block (good for eating disorders) - sedation

no sexual dysfunction - blockade of 5-HT-2A

No nausea - blockade of 5-HT3

anxiolytic - stimulates 5-HT-1A

31
Q

trazodone

A

serotonin reuptake inhibitor and blocker

H1 blockade - sedation

alpha1 blockade - priapism

increased levels of trazodone with inhibitors CYP3A4

other drug is nefazodone - hepatotoxic

32
Q

drugs for treating acute mania

A

lithium

valproate

carbamazepine

lamotrifine

atypical antipsychotics

33
Q

lithium - mechanism and uses

A

blocks inosine 5-monophosphatase

lithium has a narrow TI

34
Q

lithium - interactions

A

Na+ loss promotes Li+ reabsorption meaning there is toxicities with diuretics

NSAIDs and ACE inhibitors facilitate Li+ reabsorption in proximal convoluted tubule

amiloride enhances Li+ excretion

35
Q

lithium - effects and toxicities

A

tremors - beta blocker

leukocytosis - not related to infection

polyuria and polydipsia because theres a loss of ADH response (amiloride)

hypothyroidism - main thing, reason to stop use, decreases T3/4 and increases TSH

ebstein anomaly - not for use in pregnancy

36
Q

valproate acid - MOA and uses

A

broad spectrum mechanism - Na+ and T-type calcium channel block, decrease glutamate NMDA receptors, increases GABA receptor action and increases GABA synthesis, block degradation of GABA

used for TC seizure, absonce and partial seizures, migraine prophalxis, alternative to lithium in bipolar disorder

37
Q

valproate acid toxicity and effect

A

valproate syndrome - includes spina bifida, neural tube defects, autism

weight gain

hepatitis - check liver enzymes ALT

inhibitor of CYP2D6 and CYP3A4

38
Q

carbamazepine

A

blocks sodium channels and NE reuptake

used for TC and partial seizures, trigeminal neuralgia and bipolar disorder

effects - water intox, aplastic anemia, tertaogen, stevenjohnson syndrome (HLA variant)

inducer of CYP3A4

39
Q

inducers of CYP3A4

A

carbemazepine

phenytoin

phenobarbital

rifampin

griseofulvin

40
Q

lamotrigine

A

potentiates GABA, blocks voltage-gated Na+ channels and glutamate blockade

41
Q

what are atypical antipsychotics used for in mood disorders?

A

they are approved for mania - aripiprazole, olanzapine, quetiapine, risperidone, and ziprasidone

42
Q

How do atypical antipsychotics work?

A

specific to 5-HT2

increase DA release which helps relieve the negative symptoms and some of the positive symptoms of psychosis

All prolong QT interval

43
Q

aripiprazole

A

partial D2 agonist

5-HT2A antagonist

Partial 5-HT1a agonist

44
Q

olanzapine

A

less ANS effects and fewer extrapyramidal effects

causes weight gain and sedation

approved for mania in combination with fluoxetine

binds 5-HT2A most strongly

45
Q

quetiapine

A

D2 blocker, binds for short period

minimal muscarinic, H1 and Alpha1

46
Q

risperidone

A

hypotension from alpha1 blockade

increase prolactin, hyperlipidemia and hyperglycemia

47
Q

ziprasidone

A

blocks 5-HT and NE uptake

skin reaction and eosinophilia

Pharmacology (23 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions