Brainscape's Knowledge GenomeTM

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


See full index

Year 4: Psychiatry > Antidepressant Drugs > Flashcards

Antidepressant Drugs Flashcards

1
Q

what is prescribed for all levels of depression

A

Psychotherapy

  • CBT
  • lifestyle changes
  • establishing routine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

when starting an antidepressant, how long do you wait to see if it improves symptoms

A

4 weeks

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

if there has been no improvement after 4 weeks, what do you do?

A

change the drug

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

if there as been some improvement after 4 weeks, what do you do?

A

re-evaluate after another 4 weeks

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

how long should you stay on an antidepressant after improvement

A

at least 6 months - 1 year

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

which antidepressant is usually first line

A

SSRIs

selective serotonin reuptake inhibitors

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

mechanism of action of SSRIs

A

block reuptake of serotonin into presynaptic cell – increase serotonin in the synaptic cleft

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

examples of SSRIs

A

fluoxetine
citalopram
sertraline
paroxetine

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

how long do SSRI’s take to work

A

2-3 weeks

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

which SSRI is best in adolescents

A

fluoxetine

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

what pathway does fluoxetine block

A

CYP450

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

which SSRI is best in epileptic patients

A

citalopram

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

which SSRI is safest in cardiac patients

A

sertraline

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

what drugs are contraindicated with SSRIs

A

triptans
NSAIDS
aspirin
warfarin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

side effects of SSRI’s

A 
GI upset 
nausea
headache 
insomnia 
sweating 
sexual dysfunction 
vivid dreams 
worsened anxiety for first few days
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

risk of SSRIs in younger patients

A

can increase risk of self harm in first few weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

side effect of SSRIs in the elderly

A

hyponatraemia

confusion, lethargy, nausea, headache, seizures

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

when should SSRIs be taken and why

A

in the morning to reduce the effect on insomnia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

mode of action of TCAs (tricyclic antidepressants)

A

block the reuptake of serotonin + noradrenaline into presynaptic terminals

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

which receptors do TCAs also block

A

muscarinic receptors , alpha adrenoreceptors and histamine receptors — leads to unwanted side effects

21
Q

examples of TCAs

A

amitriptyline
imipramine
lofepramine

22
Q

anticholinergic side effects of TCAs

A 
blurred vision 
dry mouth 
constipation 
urinary retention
weight gain
23
Q

cardiovascular effects of TCAs

A

tachycardia
arrhythmia – prolonged QT
cardiotoxicity in overdose

24
Q

when are TCAs taken and why

A

at night due to side effect of sedation

25
Q

why should TCAs be avoided in patients with suicidal attempt

A

very dangerous in overdose – cardiotoxicity

26
Q

anti-adrenergic side effect of TCAs

A

postural hypotension

27
Q

what ECG changes can be seen with TCAs

A

Long QT interval

ST elevation

28
Q

contraindications for TCAs

A 
recent MI
arrythmias 
severe liver disease
mania 
high risk of overdose
29
Q

mode of action of MAOIs (monoamine oxidase inhibitors)

A

slows breakdown of noradrenaline, serotonin and dopamine by inhibiting the mitochondrial enzymes monoamine oxidase A and B

30
Q

which MAOI displays irreversible inhibition

A

phenelzine

31
Q

which MAOI displays reversible inhibition

A

moclobemide

32
Q

when are MAOIs used

A

atypical depression

3/4th line in resistant depression

33
Q

side effects of MAOIs

A

hypertensive crisis

serotonin syndrome

34
Q

what leads to a hypertensive crisis with use of a MAOI

A

MAOIs inhibit MAO-A in the gut and the liver - the enzyme usually breaks down dietary tyramine
build up of tyramine (from diet) increases noradrenaline causing vasoconstriction – hypertension

35
Q

symptoms of hypertensive crisis

A

headache, SOB, flushing, high BP, anxiety, arrhythmia

36
Q

treatment of hypertensive crisis

A

alpha blockade – phentolamine

37
Q

what foods must patients avoid on a MAOI

A

foods rich in tyramine

  • cheese
  • yoghurt
  • alcohol
  • meat
  • yeast
38
Q

what causes serotonin syndrome

A

if a MAOI is combined with another anti-depressant

39
Q

signs of serotonin syndrome

A

neuromuscular abnormalities
altered conscious level
autonomic instability

40
Q

contraindications of MAOIs

A

cerebrovascular disease
pheochromocytoma
hepatic impairment

41
Q

examples of serotonin noradrenaline reuptake inhibitors (SNRIs)

A

venlafaxine

duloxetine

42
Q

what can duloxetine be used for other than depression

A

neuropathic pain

stress incontinence

43
Q

example of an NaSSA

A

mirtazapine

44
Q

when is mirtazapine used

A

first line if patient has a poor appetite / insomnia

45
Q

side effects of mirtazapine

A 
increased appetite 
weight gain
sedation 
tremor 
peripheral oedema
46
Q

what is given with sexual dysfunction caused by SSRI

A

trazodone

47
Q

prior to starting ECT, how should antidepressant doses be adjusted

A

decrease dose gradually before starting ECT

48
Q

short term side effects of ECT

A

headache
nausea
short term memory impairment
cardiac arrhythmias

49
Q

complications of SSRIs used in

  • 1st trimester
  • 3rd trimester
A

1st trimester = congenital heart defects

3rd trimester = persistent pulmonary HTN

Year 4: Psychiatry (22 decks)

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