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Pharm III final > Antidepressant > Flashcards

Antidepressant Flashcards

1
Q

SIGECAPS questions for depression

A
  • Sleep disturbance
  • Interest
  • Guilt
  • Energy
  • Concentration difficulties
  • Appetite
  • Psychomotor agitation, retardation
  • Suicidal ideation
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2
Q

first line for depression

A
  • selective serotonin reuptake inhibitor (SSRIs)
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3
Q

which SSRI has the longest half-life

A
  • Fluoxetine
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4
Q

when should Fluoxetine be taken

A
  • in AM
  • can increase energy
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5
Q

side effects of SSRIs

A
  • imsomnia
  • decreased libido
  • nausea
  • dry mouth
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6
Q

which SSRI is most useful in nocturnal eating

A
  • Sertraline
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7
Q

List SSRIs

A
  • Fluoxetine
  • Sertraline
  • Parozetine
  • Citalopram
  • Escitalopram
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8
Q

unique side effect of Parozetine

A
  • weight gaine
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9
Q

Citalopram is only FDA indicated for

A
  • depression
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10
Q

escitalopram is FDA approved for tx of

A
  • depression
  • generalized anxiety disorder
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11
Q

List SNRIs

A
  • Venlafaxine
  • Desvenlafaxine
  • Duloxetine
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12
Q

SNRIs have what common side effects

A
  • adnergic side effects
    • nervousness
    • dizziness
    • diaphoresis
    • inc BP
  • nausea
  • sexual side effects
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13
Q

Venlafaxine should be taken how

A
  • with food
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14
Q

What should you remember when taking patients off of SNRIs

A
  • taper down gradually
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15
Q

Desvenlafaxine is only FDA approved for

A

depression

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16
Q

Duloxetine is contraindicated in patients with

A
  • liver disease
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17
Q

which SNRI can be used for GAD, diabetic neuropathy, and fibromyalgia

A
  • Duloxetine
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18
Q

MOA of Buproprion (wellbutrin)

A
  • dopamine-reuptake inhibitor
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19
Q

Buproprion (wellbutrin) has what effect on sexual function

A
  • less sexual side effects than SSRI
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20
Q

Buproprion (wellbutrin) should be avoided in what patients

A
  • seizure disorder
  • anorexia
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21
Q

side effects of Buproprion (wellbutrin)

A
  • weight loss
  • lower seizure threshold
  • nausea
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22
Q

Buproprion (wellbutrin) can be used for cessation of

A
  • smoking
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23
Q

MOA of Mirtazapine

A
  • presynaptic alpha 2 antagonist
    • enhances NE and serotonin transmission
24
Q

side effects of Mirtazapine

A
  • increased appetite, weight gain
  • increases cholesterol
  • sleepiness
25
Q

use of Mirtazapine

A
  • antidepressant
  • often used in elderly patients to help with depression, sleep, and or appetite/weight
26
Q

how long can it take for antidepressant to work

A
  • 2-8 weeks
  • side effects may occur during first days
27
Q

what is the recommended length of treatment

A
  • 4-9 months
  • pts with risk factors for recurrence: 1-3 yrs
28
Q

what is the recommended length of treatment for patients with a history of multiple episodes or comorbid psychiatric and general medical disorders

A
  • indefinitely
29
Q

when discontinuing antidepressants, do so over

A
  • at least 2-4 weeks
30
Q

when should pt be referred to psychiatrist

A
  • suboptimal effect from initial antidepressant
  • severe depression with thought disorder, bipolar, or suicidal ideation
  • co-morbid psychiatric (substance abuse) or medical condition
  • diagnosis in question
31
Q

when should patient with depression be hospitalized

A
  • suicidal or homicidal ideations
  • severe psychomotor retardation or agitation
  • associated psychosis
32
Q

List production sites of Serotonin

A
  • brainstem
33
Q

When the target site of serotonin is limbic lobe, the function is

A
  • mood
34
Q

When the target site of serotonin is throughout the hypothalamus, the function is

A
  • appetite
  • sleep
35
Q

When the target site of serotonin is throughout the cerebral cortex, the function is

A
  • sensation
  • perception
36
Q

mood disorders and OCD are associated with a decrease in release

A

serotonin

37
Q

Production site of NE

A
  • brainstem
38
Q

When target of NE is in the limbic lobe, the function is

A
  • mood
  • learning/memory
39
Q

When target of NE is in the cerebral cortex, the function is

A
  • arousal
40
Q

When target of NE is in the hypothalamus, the function is

A
  • appetite
41
Q

Mania is associated with increase in while bipolar disorder is asssociated with

A
  • mania: increase NE release
  • Bipolar: increased and decreased NE release
42
Q

List two production sites of dopamine

A
  • substantia nigra: midbrain
  • ventral tegmentum: midbrain
43
Q

when dopamine produced in substantia nigra, its target is

A
  • basal nuclei
44
Q

when dopamine produced in ventral tegmentum, its target is

A
  • nucleus accumbens/frontal cortex
45
Q

when dopamine is produced in substantia nigra, its function is

A
  • smooth movement
46
Q

when dopamine is produced in ventral tegmentum , its function is producing

A
  • pleasure/reward
47
Q

which dopamine pathway is common pathway for addiction

A
  • ventral tegmentum -> nucleus accumbens/frontal cortex
48
Q

List the frequency of symptoms of depression and associated score in PHQ-9

A
  • not at all = 0
  • several days = 1
  • more than one half of the days = 2
  • nearly every day = 3
49
Q

which medications are options for OCD

A
  • Fluoxetine
  • Sertraline
  • Parozetine
50
Q

which medications can be used in tx of Bulimia

A

Fluoextine

51
Q

which SNRI can be used in tx of diabetic neuropathy and fibromyalgia

A
  • duloxetine
52
Q

Which SSRIs can be used in tx of premenstrual dysphoric disorder

A
  • Fluoxetine
  • Sertraline
  • Parozetine
53
Q

Which SSRIs can be used in tx of PTSD

A
  1. Parozetine
  2. Sertraline
54
Q

modulation of neurotransmitter systems

A
  1. presynaptic modulation: NT release and reuptake
  2. Synaptic modulation: NT breakdown
  3. Postsynaptic modulation: receptor binding, signal transduction, genomic alterations
55
Q

diagnostic criteria of MDD

A
  1. has there ever been a period of time when you were not your usual self and ….
  2. if YES to more than one, have several of these ever happened during same period of time
  3. how much of a problem did any of these cause you (ex: unable to work, having family, money troubles, getting into fights)

Pharm III final (8 decks)

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