Anti-Depressants and Mood Stblz

Question 1

major concern with St john’s wart

Answer 1

CYP inducer

Question 2

resistance mechs for anti-depressants

Answer 2

inc ACB1 cassetes = MDR1 and P-gp

Question 3

anti-depressants that are substrates for MDR1

Answer 3

citalopram, venlafaxine, paroxetine, amitriptyline

AMI’s PARrott VENtures into the CITy to get out of the CNS

Question 4

anti-depressants that are non-substrate for MDR1

Answer 4

mirtazapine and fluoxtine

Question 5

gold std for treatment resistant MDD

Answer 5

TCAs: amitriptylin, Imipramine, Nortriyline

Question 6

first line treatment for MDD

Answer 6

SSRIs: citalopram, fluoxetine, paroxetine, sertraline, fluvoxamine

Question 7

when are MAOIs used to treat MDD

Answer 7

unresponsive to SSRIs, TCS, and ECT

Question 8

treatment choices for bipolar disorder

Answer 8

lithium is higher efficacy but valproate and carbamazapine have inc response

Question 9

MOA amoxamine

Answer 9

?

Question 10

MOA maprotilline

Answer 10

SNRI

Question 11

MOA mirtazepine

Answer 11

a2 antagonist + inc release of 5HT and NE

Question 12

MOA Trazodone and Neftazodone

Answer 12

SSRI

Question 13

MOA bupropion

Answer 13

metabolite is an SNRI and is a weak DA, 5HT, and NR blocker

Question 14

MOA venlafaxine

Answer 14

SSRI, SNRI w/ NO anti-histamine, anti-Ach, and anti-adrenergic properties

Question 15

most potent SNRI

Answer 15

duloxetine

Question 16

metabolized by demethylation

Answer 16

TCAs: amitriptyline, imipramine, nortriptyline

Question 17

inactivated by acetylation

Answer 17

MAOIs: tranyclpromine

Question 18

induces its own metabolism

Answer 18

carbamazapine

Question 19

inhibits its own metabolism (UGT) to inc drug conc

Answer 19

valproate

Question 20

block the action of clonidine

Answer 20

TCAs: amitriptyline, imipramine, nortriptyline

Question 21

interacts with alpha blockers and cause acute HTN reaction

Answer 21

MAOIs

Question 22

do not use with diuretics or NASIDs

Answer 22

Lithium

Question 23

SSRIs cannot be used concurrently with ___ for fear of inducing serotonin syndrome

Answer 23

MAOIs

Question 24

displaces phenytoin from plasma proteins

Answer 24

valproate

Question 25

may decrease efficacy of OCPs

Answer 25

carbamazapine

Question 26

do not use this anti0depressants with ETOH or other sedatives

Answer 26

TCAs: amitriptyline, imipramine, nortriptyline

Question 27

CYP met of this drug leads to 10, 11 epoxide (active metabolite)

Answer 27

carbamazapine | **recall, induces its own metabolism

Question 28

low therapeutic index

Answer 28

TCAs: amitriptyline, imipramine, nortriptyline

Question 29

symptoms pf TCA overdose

Answer 29

arrythmias, heart failure (worsen CHF)

Question 30

may cause Parkinsonism

Answer 30

Amoxamine (DA antagonism)

Question 31

ADE is that it increaseses monoamines which may cause restlessness, anxiety, and seziures

Answer 31

Buproion

Question 32

ADE of small sustained HTN

Answer 32

venlafaxine

Question 33

only is 50% bioavailable

Answer 33

Duloxetine

Question 34

teratogens

Answer 34

SSRIs: Citalopram, Fluoxetine, Paroxetine, Sertraline, Fluvoxamine Lithium

Question 35

may cause rash

Answer 35

carbamazapine

Question 36

formulated for weekly administration

Answer 36

Norfluoxetine (SSRI)

Question 37

decreases libido

Answer 37

SSRIs

Question 38

increases delerium and risk of death when taken with dectromehorphan or merperidine

Answer 38

MAOIs

Question 39

Symptoms of SSRI overdose

Answer 39

hyperthermia, tremor, myoclonus, shivering, N/V

Question 40

interacts with tyramine (in cheese)

Answer 40

MAOIs (tranylcypromine)

Question 41

very narrow therapeutic window

Answer 41

lithium

Question 42

ADEs of lithium

Answer 42

``` LMNOP Lithium side effects: Movement (tremor) -- give beta blockers Nephrogenic DI hypOthyroid Pregnamncy problems ```

Question 43

irreversible enzyme inhibition is MOA

Answer 43

MAOIs

Question 44

many cause acne + psoriasis

Answer 44

lithium

Question 45

ADE of aplastic anemia

Answer 45

carbamazapine

Question 46

may cause sick-sinus syndrome

Answer 46

lithium (brady and tachy cardia)