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Psych > Anti-Depressants and Mood Stblz > Flashcards

Anti-Depressants and Mood Stblz Flashcards

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1
Q

major concern with St john’s wart

A

CYP inducer

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2
Q

resistance mechs for anti-depressants

A

inc ACB1 cassetes = MDR1 and P-gp

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3
Q

anti-depressants that are substrates for MDR1

A

citalopram, venlafaxine, paroxetine, amitriptyline

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

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4
Q

anti-depressants that are non-substrate for MDR1

A

mirtazapine and fluoxtine

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5
Q

gold std for treatment resistant MDD

A

TCAs: amitriptylin, Imipramine, Nortriyline

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6
Q

first line treatment for MDD

A

SSRIs: citalopram, fluoxetine, paroxetine, sertraline, fluvoxamine

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7
Q

when are MAOIs used to treat MDD

A

unresponsive to SSRIs, TCS, and ECT

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8
Q

treatment choices for bipolar disorder

A

lithium is higher efficacy but valproate and carbamazapine have inc response

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9
Q

MOA amoxamine

A

?

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10
Q

MOA maprotilline

A

SNRI

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11
Q

MOA mirtazepine

A

a2 antagonist + inc release of 5HT and NE

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12
Q

MOA Trazodone and Neftazodone

A

SSRI

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13
Q

MOA bupropion

A

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

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14
Q

MOA venlafaxine

A

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

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15
Q

most potent SNRI

A

duloxetine

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16
Q

metabolized by demethylation

A

TCAs: amitriptyline, imipramine, nortriptyline

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17
Q

inactivated by acetylation

A

MAOIs: tranyclpromine

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18
Q

induces its own metabolism

A

carbamazapine

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19
Q

inhibits its own metabolism (UGT) to inc drug conc

A

valproate

20
Q

block the action of clonidine

A

TCAs: amitriptyline, imipramine, nortriptyline

21
Q

interacts with alpha blockers and cause acute HTN reaction

A

MAOIs

22
Q

do not use with diuretics or NASIDs

A

Lithium

23
Q

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

A

MAOIs

24
Q

displaces phenytoin from plasma proteins

A

valproate

25
Q

may decrease efficacy of OCPs

A

carbamazapine

26
Q

do not use this anti0depressants with ETOH or other sedatives

A

TCAs: amitriptyline, imipramine, nortriptyline

27
Q

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

A

carbamazapine

**recall, induces its own metabolism

28
Q

low therapeutic index

A

TCAs: amitriptyline, imipramine, nortriptyline

29
Q

symptoms pf TCA overdose

A

arrythmias, heart failure (worsen CHF)

30
Q

may cause Parkinsonism

A

Amoxamine (DA antagonism)

31
Q

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

A

Buproion

32
Q

ADE of small sustained HTN

A

venlafaxine

33
Q

only is 50% bioavailable

A

Duloxetine

34
Q

teratogens

A

SSRIs: Citalopram, Fluoxetine, Paroxetine, Sertraline, Fluvoxamine

Lithium

35
Q

may cause rash

A

carbamazapine

36
Q

formulated for weekly administration

A

Norfluoxetine (SSRI)

37
Q

decreases libido

A

SSRIs

38
Q

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

A

MAOIs

39
Q

Symptoms of SSRI overdose

A

hyperthermia, tremor, myoclonus, shivering, N/V

40
Q

interacts with tyramine (in cheese)

A

MAOIs (tranylcypromine)

41
Q

very narrow therapeutic window

A

lithium

42
Q

ADEs of lithium

A 
LMNOP
Lithium side effects:
Movement (tremor) -- give beta blockers
Nephrogenic DI
hypOthyroid 
Pregnamncy problems
43
Q

irreversible enzyme inhibition is MOA

A

MAOIs

44
Q

many cause acne + psoriasis

A

lithium

45
Q

ADE of aplastic anemia

A

carbamazapine

46
Q

may cause sick-sinus syndrome

A

lithium (brady and tachy cardia)

Psych (10 decks)

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