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Pharm 4 > Antideprerssants > Flashcards

Antideprerssants Flashcards

1
Q

Which TCA class block Serotonin > Nepi?

A

3-TCAs

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2
Q

Which SSRI is considered a CAT D/X?

A

Paroxetine

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3
Q

Which TCA class block Nepi > Serotonin

A

2-TCAs

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4
Q

Which SSRI are the most sedating (Dose in the PM)

A

Paroxetine

Fluvoxamine

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5
Q

Which TCA sub-classes have more SE’s?

A

3-TCAs

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6
Q

What is average T 1/2 of SSRI

A

About 1 day

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7
Q

What type of CNS SE’s are associated with SSRI?

A 
Agitation
Anxiety
Tremor
Panic
Activating (insomnia)
Sedating
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8
Q

Which SSRI is not a sincere of developing withdrawal if D/C rapidly?

A

Fluoxetine

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9
Q

WHich two SSRI is associated w/ QT prolongation

A

Citalopram - worst

Escitalopram - minor

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10
Q

Which SSRI is FDA Approved for OCD only?

A

Fluvoxamine

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11
Q

Which two SSRI can D/C rapidly

A

Fluoxetine

Vortioxetine - HAs, muscle tension

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12
Q

What NT does MAOI block reup?

A

Serotonin only

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13
Q

Which SSRI is good to TXT premenstrual dysmorphic d/o

A

Fluoxetine (SARAFRAM)

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14
Q

Onset of SSRI

A

3-8 weeks

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15
Q

Does TCAs req freq dose adjusting and why?

A

Yes - Inconsistent bioavail

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16
Q

What does all SSRI have in common with DI except
Citalopram
Escitalopram

A

CYP450 interactions

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17
Q

What is Serotonin syndrome triad?

A

Cog dysfunction
NM dysfunction
Autonomic dysfunction

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18
Q

Which SSRI are used to txt Panic D/O

A

Paroxetine

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19
Q

Which SSRI has the least DI

A

Citalopram

Escitalopram

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20
Q

What are other SE’s associated with SSRI other than GI and CNS?

A

Wgt Gain
Sex dysfx
Withdrawal (if rapid DC)

21
Q

When should TCA’s be dosed?

A

At night

22
Q

How are TCAs a serious life threat?

A

Excess causes

  • Arrythmia
  • Delerium
  • Coma
  • Seizure
  • Pyschosis
23
Q

What are TCA’s onset

A

2-4wk

24
Q

What is the MC antidepressant overdose?

A

TCAs - Blackbox

25
Q

CI to TCA use?

A 
Suicidals
CV conditions
Closed angle Glaucoma
Urinary retention
Prostate hypertrohy
26
Q

MC drug used to TXT depression

A

SSRI

27
Q

WHich SSRI are used to treat MDD

A

Fluoxetine
Sertraline
Paroxetine
Vortioxetine

28
Q

Which SSRIs are used to TXT PTSD

A

Fluoxetine
Sertraline
Paroxetine

29
Q

What cautions should you look out for with SSRI use

A

SIADH
EPS SE’s (parks/dystonia)
Serotonin syndrome

30
Q

Which SSRI are the most activating (Dose in AM to avoid insomnia)

A

Fluoxetine

Sertraline

31
Q

Which SSRI is CI in children due to suicidal ideas?

A

Paroxetine

32
Q

What are common DI associated with SSRI?

A

ASA/NSAID - bld risk
CYPs
MAOI’s - Serotonin syndrome

33
Q

What type of GI SE’s are associated with SSRI?

A

N/V

Constipation

34
Q

MOA of TCA

A 
Increase Monoamine conc in synapse by blocking reup of Serotonin/Nepi
Also blocks 
Alpha Adrenergic
Histamine
Muscarinic - Anticholinergic SEs
35
Q

Is TCA used 1st line for depression?

A

No

36
Q

How can you mitigate sexual dysfx SE’s with SSRI’s?

A

Lower the dose
Switch to Bupropion
Add ED rx
Wait/see

37
Q

What are some adverse efx of TCAs?

A 
Anticholinergic - dry mouth/wgt gain
Alpha1 antag - ortho hotn
AH - sedation
CV arrythmia - like quinidine
Withdrawal
38
Q

Which classes all around increase DBP?

A

SNRI

39
Q

MOA of SNRI

A

Increase NEPI and Sero by inhibiting reuptake

40
Q

CI/DI to venlafaxine

A

MAOI
Triptins
Serotonin syndrome

41
Q

When SSRI fail what is a drug you can use as second line to SSRI?

A

Venlafaxine

42
Q

What is first line txt for PTSD?

A

SNRI - Venlafaxine

43
Q

Which two SNRI are used for severe/refrac depression?

A

Venlafaxine

Duloxetine

44
Q

Which SNRI has renal and liver cautions?

A

Duloxetine

45
Q

Which antidepressant is useful for smoking cessation?

A

Bupropion

46
Q

MOI of bupropion

A

Dopa/nepi reup inhib at high doses

47
Q

CI to bupropion

A

Seizure risks
Nervosa Anorexia/bulemia
Benzo/Etoh withdrawal

48
Q

DI of bupropion

A

MAOI - allow 14d pre/post initiation

Pharm 4 (3 decks)

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