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Nurs 5229 Clinical Pharmacotherapeutics > Antidepressant Deck 2 > Flashcards

Antidepressant Deck 2 Flashcards

1
Q

TCA are

A

very sedating and are lethally in overdose.

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2
Q

SSRIs

A

most common

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3
Q

SSRIs work at what bases

A

1st, 2nd, and 3rd

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4
Q

SSRI LEA…P effects

A

L: Decrease libido and sleep
E: Neutral effect on energy*
A: Neutral effect on addiction and craving

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5
Q

Which SSRI can you stop abruptly and why

A

fluoxetine due to it’s long half life.

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6
Q

SSRI P in LEAP

A

y P: Differences within class
y Some may “poop out (just stops working)” (Celexa)
y Sedating and activating properties
y Weak anticholinergic and dopaminergic
y Fluoxetine activating, Paroxetine sedating

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7
Q

Fluoxetine is

A

activating

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8
Q

paraoxetine is

A

sedating

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9
Q

NSRI act on what bases

A

Act at 1st, 2nd, 3rd, home plate and pitcher’s mound

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10
Q

NSRI exampels

A

Venlafaxine (Effexor) and Duloxetine (Cymbalta)

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11
Q

NSRI effects

A

y Libido reduced
y Energy increased
y Addiction/craving neutral to helpful

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12
Q

NSRI “P”

A

May increase GI upset, may increase BP

y Titrate slowly

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13
Q

SNDRIs

A

Triple reuptake inhibitor results in increase in serotonergic, adrenergic and dopaminergic neurotransmission

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14
Q

SNDRI LEAP

A

L:More neutral effect on libido (blocks 5HT2a)
E:Decreases energy
A:Neutral effect on addiction/craving
P: Enzyme system 2D6: slow metabolizers may build up stimulate 5HT2 and stimulate 5HT2a and cause increased sleep
y Alpha 1 blocker: postural hypotension risk

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15
Q

SNDRI examples

A

Mazindol (Sanorex) anorectic
Nefazodone (Serzone) antidepressant*
Nefopam ( Nefadol, Silentan) analgesic
Sibutamine (Meridia) anorectic

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16
Q

TCA bases

A

Act primarily at 1st base, some 2nd and home plate

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17
Q

TCA LEAP

A 
y L: decrease libido
y E: increase energy*
y A: Neutral effect
y P: May stimulate HT3
y Anticholinergic effects (Elderly especially)
y High risk of OD
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18
Q

at a high dose TCA is

A

sedating

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19
Q

TCA should not be used in

A

elderly population due to anticholinergic effects

20
Q

Which has greater side effects amytriptaline or nortriptaline

A

amytriptaline

21
Q

Mirtazepine (Remeron) LEAP

A

L:Neutral effect on libido
E:Decreases energy
A: Neutral on addiction/craving
P: Alpha 1 blocker: postural hypotension risk

22
Q

Mirtazepine (Remerone) acts at what bases

A

Acts at 1st, 2nd, 3rd base, and homeplate

23
Q

Remerone is a

A

alpha 1 blocker : postual hypotension risk

24
Q

Bupropion (wellbutrin acts to

A

to inhibit reuptake of NE, DA, and serotonin

25
Q

Bupropion (Wellbutrin) uses

A

Depression, seasonal affective disorder, treats sexual dysfunction
relative to SSRI therapy, smoking cessation

26
Q

Bupropion (Wellbutrin) has a

A

long half life

27
Q

Bupropion (Wellbutrin) lowers

A

seizure threshold

28
Q

SSRI population

A

Post-MI
DM
General

29
Q

SNRI populations

A

General
SSRI not
tolerated

30
Q

Important to do what with SNRI

A

Monitor blood pressure

31
Q

Wellbutrin population

A

SSRI not tolerated
Smokers
Wellbutrin does not effect libido. So people with this consideration

32
Q

TCA population

A

young addults

33
Q

Depression with anxiety drugs

A

SSRI

SNRI

34
Q

Depression with decreased libido

A

Welbutrin

35
Q

Depression with Insomina

A

SSRI

TCA

36
Q

MAOI are used when

A

all else falis; atypical depression

37
Q

MAOI have

A

multiple drug intreacions

38
Q

make sure what before starting maoi

A

fully weaned off SSRI

39
Q

allow time between stopping ___ and starting ___

A

antidpressant and MAOI

40
Q

Mood stabilizers example

A

Bipolar: Lithium, lamotrigine, depakote, oxcarbazepine, gabapentin

41
Q

Psychotropics

A

aripiprazole, risperidone, olanzapine, ziprasidone,

clozapine

42
Q

gabapentin can be used for

A

chronic pain

43
Q

Young

A

SSRIs and TCA

44
Q

Old

A

TCA have anticholingeric effects

45
Q

Young precautions

A

SSRI (black box warning for SI) TCA overdose

46
Q

Pregnancy

A

All are mostly contraindicated. If you need to use, use an SSRI

Nurs 5229 Clinical Pharmacotherapeutics (78 decks)

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