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CNS I > Antidepressant Drugs > Flashcards

Antidepressant Drugs Flashcards

(PH-1) List the prototype antidepressant drugs for the following classes of drugs: tricyclics, SSRI’s, SNRI’s, and MAO inhibitors. (PH-2) Describe the mechanism of action for the prototype tricyclic, SSRI, SNRI, and MAO inhibitor antidepressants, list their appropriate clinical uses, and their major side effects and contraindications. PH-3) Describe the mechanism of action of amoxapine, bupropion, mirtazapine and trazodone, list their appropriate clinical uses, and their major side effects and

1
Q

TCA prototypes (3)

A

inipramine, amitriptyline, clomipramine

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2
Q

TCA MOA

A

block 5-HT, and NE reuptake

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3
Q

side effects of TCA

A

anticholerginic (dry mouth, blurred vision, constpation, urinary retention, worseing glaucoma, delerium)

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4
Q

current clinical uses of TCA

A

less for depression, more for sleep and neuropathic pain

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5
Q

toxicity of TCAs

A

can cause cardiac conduction problems

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6
Q

MOA of MAOis

A

blocks the action of intracellular monoamine oxidase

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7
Q

prototype MAOi (3)

A

tranylcypromine, phenelzine, isocarboxazid

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8
Q

length of effect of MAOi after drugs are stopped

A

2 weeks

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9
Q

main cause for ineffectiveness of antidepressant meds

A

insufficent time taking meds and/or inadequate doses

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10
Q

time to effect of antidepressant

A

4-8 weeks

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11
Q

possible lethal SE of MAOi

A

hypertensive crisis and sertonin syndrome

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12
Q

foods that can cause hypertensive crisis with MAO

A

cheese,beer, chanti, femented sausages, sauerkraut, soy sauce

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13
Q

sx of serotonin syndrome

A

tremors, hyperreflexia, clonus, fever, agitation, diaphoresis, possibly death

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14
Q

MAO can interact with which drugs to cause serotonin syndrome

A

serotonic ADs, some opioids (fentanyl, tramadol)

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15
Q

parkinson’s drugs that interact with MAOi

A

selegiline, rasagiline

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16
Q

antibiotics that interact with MAOi

A

isoiazid and linezoid

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17
Q

non-lethal SE of ADs

A

orthostatic hypotension, sexual dysfunction, weight gain

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18
Q

clinical use of MAOi

A

refractory depression

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19
Q

MOA of SSRI

A

bock the presynaptic serotonin reuptake pump

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20
Q

SSRI protypes (6)

A

fluoxetine, setralline, paroxetine, fluvoxamine, citalopram, escitalopram

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21
Q

SE of SSRIs

A

agitation, insommnia, sexual dysfunction, n/v

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22
Q

advantages of SSRI

A

cheap, few side effects, more effective

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23
Q

longest t 1/2 SSRI

A

fluoxetine,

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24
Q

SSRI that can be used for people who tend to skip doses

A

fluoxetine

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25
Q

time after stopping that fluoxetine can interact with other drugs

A

up to 5 weeks

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26
Q

SSRI that tends toward nausea

A

setraline

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27
Q

SSRI that is most sedating

A

paroxetine

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28
Q

drug that can cause severe withdrawal (2)

A

paroxetine, SNRIs

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29
Q

drug that can cause prolonged QT intervals

A

citalopram

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30
Q

SSRI that can interact with PPIs

A

citalopram

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31
Q

SSRI that can cause problems with CYP2C19

A

citalopram

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32
Q

SNRI prototypes (2)

A

venlafaxine and duloxetine

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33
Q

MOA of SNRI (moderate doses)

A

inhibits 5-HT and NE

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34
Q

MOA of SNRI (high doses)

A

inhibits reuptate of 5-HT, NE and dopamine

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35
Q

non AD uses of duloxetine

A

diabetic neuropathy, fibromyalgia, stress urinary incontenince

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36
Q

SE of SNRI

A

(noradrenigic) insomnia, sweating, dry mouth, constipation, worseing of glaucoma

37
Q

starting SE of SNRI

A

nausea

38
Q

can cause withdrawal sx in a single dose

A

SRNIs

39
Q

nefazodone/trazodone MOA

A

block 5-HT2 receptors

40
Q

advantages of nefazodone/trazodone over SSRI

A

no sexual dysfunction, agitation or sleep dyfunction issues

41
Q

nefazodone toxicity

A

liver failure (rare)

42
Q

rare, but serious SE of trazodone

A

priapism

43
Q

buproprion MOA

A

inhibits NE and DA uptake

44
Q

helps with nicotine cessation

A

burprprion

45
Q

advantages of buproprion

A

no sexual side effects, has stimulant effect

46
Q

contraindicated in people with seziures, eating disordersm or EtoH/benzo withdrawal

A

buproprion

47
Q

SE of buproprion

A

constipation, dry mouth, insomnia, sweating

48
Q

mirtazapine MOA

A

blocks presynnaptic a-2 receptors on 5HT neurons - increasing 5-HT at synapse

49
Q

advantages of mirazapine

A

less sexual/sleep.agitation effects and less nausea

50
Q

SE of mirazapine

A

sedating and weight gain

51
Q

AD used in oncology and in geriatric pts

A

mirazapine

52
Q

uses of ECT

A

severe-drug resistant depression, bipolar and schizophrenia

53
Q

remission rate in ECT

A

86%

54
Q

potent CYP2D6 inhibitors

A

paroxetine and fluxetine

55
Q

cancer drug that can interact with SSRIs

A

tamoxifen

56
Q

SSRI indicated for kids

A

fluoxetine

57
Q

AD for panic disorder

A

TCA

58
Q

AD for OCD

A

clomipramine

59
Q

AD for ADHD

A

desipramine

60
Q

AD for panic disorder.social phpbia

A

MAOi

61
Q

AD used for premenstral dysphoric disorder/bullimia. trichotillimania

A

SSRI

62
Q

AD drug for neuropathy and fibromyalgia

A

SNRI

63
Q

amine hypothesis of depression

A

functional decrease of NT amines (NE, serotonin) causes depression

64
Q

fluoxetine + (lithium/TCA/warfarin)

A

increased levels of second drug

65
Q

fluvoxamine + (alprazolam, theophylline, TCA, warfarin)

A

increased levels of second drug

66
Q

MAOis + (sympathopmimetics+tyramine+SSRI)

A

hypertensive crisis/serotonin syndrome

67
Q

nefazodone+ alprazolam/triazolam

A

increased levels of second drug

68
Q

paroxetine + procyclidine, theophylline/TCA/warfarin

A

increased levels of second drug

69
Q

sertraline +(TCA/warfarin)

A

increased effects of both

70
Q

TCA+ CNS depressents

A

additive CNS depression

71
Q

TCA+ central acting HBP meds

A

decreased effect of HBPs

72
Q

Causes dose dependent hypertension

A

Venlafaxine

73
Q

Imipramine class

A

TCA

74
Q

Amitripyline class

A

TCA

75
Q

Desipramine class

A

TCA

76
Q

Nortriptyline class

A

TCA

77
Q

Clomipramine

A

TCA

78
Q

Amoxapine

A

TCA

79
Q

Setraline class

A

SSRI

80
Q

Fluoxetine

A

SSRI

81
Q

citalopram

A

SSRI

82
Q

Venlafaxine

A

SNRI

83
Q

Duloxetine

A

SNRI

84
Q

Phenelzine class

A

MAOI

85
Q

Tranylcypromine

A

MAOI

86
Q

Isocarboxazid

A

MAOI

87
Q

Selegiline

A

MAOI

88
Q

ANTIDEPRESSANT that causes weight gain

A

Mirtazapine

CNS I (36 decks)

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