Brainscape's Knowledge GenomeTM

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


See full index

Pharm II Test 1 > Anti-Depressants, Anxiety, Bipolar > Flashcards

Anti-Depressants, Anxiety, Bipolar Flashcards

1
Q

Tricyclic Antidepressants- Available Drugs

A 
Imipramine
AMITRYPTYLLINE
DOXEPIN
DESIPRAMINE (ACTIVE METABOLITE OF IMIPRAMINE)
NORYPTYLLINE
CLOMIPRAMINE
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Tricyclic Antidepressants- Mech of Action

A

block reuptake of serotonin and NE from nerve terminals

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

Tricyclic Antidepressants- Adverse Effects/ contraindications

A 
ANTI-HISTAMINE= SEDATING
ANTICHOLINERGIC EFFECTS
ANTI-ALPHA1 ADRENERGIC= ORTHOSTATIC HYPERTENSION
WEIGHT GAIN
SEXUAL DYSFUNCTION

CONTRAINDICATED IN ELDERLY

ADDITIVE EFFECT WHEN USED WITH OTHER CNS DEPRESSANTS

EASY TO OVERDOSE

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

SSRIs- Available Drugs

A 
FLUOXETINE (least 5-HT selective)
Sertraline
Paroxetine (highest 5-HT affinity)
Citalopram (most selective racemate)
Escitalopram (S+ isomer of Citalopram, more selective than citalopram)
Fluvoxamine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

SSRIs- Mech of Action

A

Selective, but not exclusive, blockade of 5-HT reuptake receptor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

SSRIs- Adverse Effects/ contraindications

A

SIDE EFFECTS BEFORE REACHING THERAPEUTICALLY EFFECTIVE DOSE
SEXUAL DYSFUNCTION
DISCONTINUATION SYNDROME (LESS COMMON W/ FLUOXETINE)

WITHDRAWAL SYMPTOMS IN NEWBORNS
INCREASED SUICIDAL THOUGHTS IN YOUNG PATIENTS

CAN BE LETHAL WHEN COMBINED W/ MAOIs

FLUOXETINE & FLUVOXAMINE INHIBIT MANY CYP ENZYMES= MANY DRUG INTERACTIONS

PAROXETINE= HEART DEFECTS IN PREGNANCY

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

SNRIs- Available Drugs

A

Venlafaxine
Desvenlafaxine
Duloxetine

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

SNRIs- Mech of Action

A

inhibit serotonin and NE reuptake

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

SNRIs- Side Effects/ Contraindications

A

Fewer side effects than TCAs

Venlafaxine-
HYPERTENSION
SEXUAL DYSFUNCTION
nausea, anxiety, dizziness

Duloxetine-
SEXUAL DYSFUNCTION
elevated liver enzymes, dizziness

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

Mixed Action/Atypical- Available Drugs

A

Mirtazapine
Vilazodone
Bupropion
Nefazodone

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

Mirtazapine- Mech of Action

A

Alpha2 receptor antagonist, thus prevents synaptic feedback inhibition

Also blocks 5-HT2a/2c serotonin receptor and H1 histamine receptor (also blocking feedback inhibition)

Net result: increases activity of NE, 5-HT, and histamine

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

Mirtazapine- Side Effects/Contraindications

A

HIGHLY SEDATING AT LOW DOSES
NO SEXUAL DYSFUNCTION
stimulatory at high doses
weight gain

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

Vilazodone- Mech of Action

A

Blockade of 5-HT transporters

Partial agonist of 5-HT1A

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

Vilazodone- Side Effects/Contraindications

A 
NO SEXUAL DYSFUNCTION
diarrhea
nausea
vomiting
insomnia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Bupropion- Mech of Action

A

may desensitize 5-HT1A and alpha-2 adrenergic receptor

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

Bupropion- Side Effects/ Contraindications

A 
NO SEXUAL DYSFUNCTION
NO ANTICHOLINERGIC OR ANTIADRENERGIC EFFECTS
WEIGHT LOSS
STIMULATORY EFFECTS
seizure risk at high doses
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Nefazodone- Mech of Action

A

5-HT reuptake inhibitor

5-HT2A receptor antagonist

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

Nefazodone- Side Effects/Contraindications

A

NO SEXUAL DYSFUNCTION

NAME BRAND REMOVED FROM MARKET FOR LIVER TOXICITY, GENERIC STILL AVAILABLE

19
Q

MAOIs- Available Drugs

A

Irreversible:
Phenelzine
Tranylcypromine
Selegeline

Reversible:
Meclobemide

20
Q

MAOIs- Mech of Action

A

Inhibit MAO-A, MAO-B that metabolize monoamines and tyramine

21
Q

MAOIs- Side Effects/ Contraindications

A

AGITATION
SLEEP DISTURBANCE
SEROTONIN SYNDROME
HYPERTENSIVE CRISIS

POTENTIALLY FETAL INTERACTIONS W/ DRUGS OR FOODS RICH IN TYRAMINE

SSRIs

22
Q

Anti-Anxiety Drugs- Available Drugs

A

Buspirone

Benzodiazepines

23
Q

Buspirone- Mech of Action

A

5-HT1A partial agonist

24
Q

Benzodiazepines- Mech of Action

A

Bind BZ1 and BZ2 benzodiazepine receptors on the GABAa receptor complex= increases affinity of GABA for GABAa receptor= open chloride channel= hyperpolarization, inhibition

25
Q

Benzodiazepines- Adverse Effects/Contraindications

A

SEDATION
ANTEROGRADE AMNESIA
REBOUND ANXIETY
confusion, ataxia, physical dependence, tolerance

26
Q

Lithium- Mech of Action

A

unknown
effects on second messenger systems that mediate NT action
inhibit enzymes involved in inositol recycling= depletion of PIP2 for IP3 and DAG
increasing evidence for role of GSK-3

GOLD STANDARD FOR BIPOLAR DISORDER

27
Q

Lithium- Side Effects/Contraindications

A 
SLURRED SPEECH
ATAXIA
FINE TREMORS
EXCESSIVE THIRST/URINATION
RENAL TOXICITY
INHIBITION OF THYROID HORMONE
TOXICITY IN NEWBORNS
edema
28
Q

Anticonvulsants- Available Drugs

A

Valproic Acid
Carbamazepine
Lamotrigine

29
Q

Valproic Acid- Mech of Action

A

Facilitate GABA synthesis and block its reuptake
Influence GSK-3
Blocks sustained high frequency neuronal firing rates

30
Q

Valproic Acid- Side Effects/ Contraindications

A 
FINE TREMOR
WEIGHT GAIN
HEPATOTOXICITY
TERATOGENIC
BLOOD DYSCRASIAS
nausea, vomiting, abdominal pain, heart burn, increased appetite, hair loss
31
Q

Carbamazepine- Mech of Action

A

Reduce Na and K conductance
Reduce release of NE and excitatory AA (glutamate)
Adenosine receptor agonist (caffeine is the antagonist)

32
Q

Carbamazepine- Side Effects/Contraindications

A 
DERMATOLOGIC CONDITIONS
ATAXIA
SUICIDALITY
NEURAL TUBE DEFECTS
RARE BLOOD DYSCRASIAS
FDA ALERT FOR STEVEN JOHNSON
GI reactions
rash
33
Q

Lamotrigine- Side Effects/Contraindications

A

EFFECTIVE IN 2/3 OF PEOPLE THAT HAVEN’T RESPONDED TO OTHER DRUGS
MORE ANTI-DEPRESSIVE THAN OTHER BIPOLAR DRUGS

RELATIVELY BENIGN SIDE-EFFECTS
TERATOGENIC- CLEFT LIP/PALATE
dizziness, headache, double vision, blurred vision, unsteadiness, sleepiness, rash, vomiting; side effects increased w/ EtOH, may also cause Steven Johnson

34
Q

Atypical Antipsychotics- Available Drugs

A 
Risperidone
Ziprasadone
Olanzapine
Quetiapine
Aripipazole
35
Q

Risperidone- Mech of Action

A

D2, 5-HT2, 5-HT7 receptor antagonist

36
Q

Risperidone- Side Effects/Contraindications

A

DROWSINESS
FATIGUE
WEIGHT GAIN
anxiety, low BP, muscle stiffness/pain

side effects are common

37
Q

Ziprasadone- Mech of Action

A

D2, 5-HT2, ALPHA1, H1 antagonist

38
Q

Ziprasadone- Side Effects/Contraindications

A

SLEEPY
TREMOR
SHUFFLING
upset stomach, constipation, dizzy, rash, restlessness

39
Q

Quetiapine- Mech of Action

A

D2, D1, 5-HT2, 5HT1A, Alpha1, H1 Antagonist

40
Q

Quetiapine- Side Effects/Contraindications

A

Common- SEDATION, dry mouth, constipation
Less common: dizziness, upset stomach, abnormal liver tests, tardive dyskinesia
Rare- LIFE THREATENING NEUROLIPTIC MALIGNANT SYNDROME (NMS)- AUTONOMIC INSTABILITY

41
Q

Aripipazole- Mech of Action

A

partial agonist of D2 and 5-HT1a

5-HT2 antagonist

42
Q

Aripipazole- Side Effects/Contraindications

A

RARE: NEUROLEPTIC MALIGNANT SYNDROME (NMS)= HYPERPYREXIA, MUSCLE RIGIDITY, AUTONOMIC INSTABILITY

no appreciable anticholinergic effects
Common: akathesia, headach, tiredness, weakness, nausea, constipation, trouble sleeping, blurred vision

CYP DRUG INTERACTIONS

43
Q

Symbax (olanzapine + fluoxetine)- Side Effects/Contraindications

A

WEIGHT GAIN
dizziness, drowsiness, diarrhea, dry mouth, constipation, increased appetite, trouble sleeping

POSSIBLY FATAL INTERACTION WITH PIMOZIDE, SIBUTRAMINE, THIORIDAZINE, MAOIs

Pharm II Test 1 (4 decks)

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