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Clin Mgt 2 DM & Psych > Antidepressant Meds > Flashcards

Antidepressant Meds Flashcards

1
Q

name the SSRIs

A
  • Fluoxetine (Prozac)
  • Paroxetine (Paxil)
  • Sertraline (Zoloft)
  • Fluvoxamine (Luvox)
  • Citalopram (Celexa)
  • Escitalopram (Lexapro)
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2
Q

name the serotinin targets iof each of these si/sx of SSRIs

HA

Somnolence

Sex Dysfunction

Weight Gain

N/V

Diarrhea

A

HA - 1

Somnolence - 2

Sex Dysfunction - 2

Weight Gain - 2c

N/V - 3

Diarrhea -4

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3
Q

what SSRI is most likely to cause sex dysfunction & weight gain

A

paroxetine

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4
Q

what SSRI is most anticholinergc

A

paroxetine

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5
Q

what SSRI has the greatest INC QTc risk

A

Citalopram

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6
Q

describe the targets of serotonin in serotonin syndrome

Tx?

A

5-HT1A and 5-HT2A overstimulation

Tx: 5-HT antagonist cyproheptadine

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7
Q

sertraline is most likelt to cause what adverse effects

A

diarrhea & HA

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8
Q

fluvoxamine is most likely to cause what adverse effect

A

somnolence & N/V

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9
Q

what SSRI has the greast risk of withdrawl -

A

fluvoxamine

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10
Q

name the SSRIs + (serotonin modulators)

A

Vilazodone (Viibryd)

Vortioxetine (Trintellix)

Trazodone

Nefazodone

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11
Q

MOI of Vilazodone (Viibryd)

A
  • SSRI
  • 5-HT 1 partial agonist
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12
Q

adverse effects of Vilazodone (Viibryd)

A
  • Nausea
  • Diarrhea
  • Dizziness
  • Sexual dysfunction = fluoxetine
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13
Q

MOI of Vortioxetine (Trintellix)

A
  • SSRI
  • 5-HT 1a agonist
  • 5-HT 7 antagonist
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14
Q

name difference in MOI b/w

Vilazodone (Viibryd)

Vortioxetine (Trintellix)

A

Vilazodone (Viibryd) - 5-HT 1 partial agonist

Vortioxetine (Trintellix) - 5-HT 1a agonist

  • 5-HT 7 antagonist
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15
Q

MOI of trazadone

A
  • 5-HT 2 antagonist
  • Antihistamine (severe)*
  • Alpha-1 antagonist
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16
Q

MOI of Nefazodone

A
  • 5-HT 2 antagonist
  • NE reuptake pump inhibitor
  • Antihistamine (moderate)
17
Q

compare / contrast MOI of

Trazodone

Nefazodone

A

BOTH: 5-HT 2 antagonist

Trazodone: Antihistamine (severe)*

  • Alpha-1 antagonist

Nefazodone: Antihistamine (moderate)

  • NE reuptake pump inhibitor
18
Q

name the SNRIs

A

Venlafaxine (Effexor)

Desvenlafaxine (Pristiq)

Duloxetine (Cymbalta)

Levomilnacipran (Fetzima)

Mirtazapine*

Bupropion (Wellbutrin)

19
Q

MOI of

Venlafaxine (Effexor)

Desvenlafaxine (Pristiq)

A

Block reuptake of serotonin, NE, & DA (dose dependent)

  • Low dose = serotonin
  • Mod dose = + NE
  • High dose = + DA

Desvenlafaxine (Pristiq): Worse on BP then Venlafaxine - slightly more ↑NE

20
Q

MOI of

Duloxetine (Cymbalta)

Levomilnacipran (Fetzima)

A

Duloxetine (Cymbalta): Block reuptake of ↑serotonin > ↓NE

Levomilnacipran (Fetzima): Block reuptake of ↓serotonin < MORE ↑NE (less potent)

21
Q

which SNRI is hepatotoxic?

A

Duloxetine (Cymbalta)

22
Q

Mirtazapine is assoc w/ what 3 adverse side effects

A
  • ­ appetite (INC weight gain)
  • Hyperglycemia (C/I in DM)*
  • Hypertriglyceridemia*
23
Q

which SNRIs has a side effect of urinary hesitancy

A

Duloxetine (Cymbalta)

Levomilnacipran (Fetzima)

24
Q

which antidep dec seiure threshold

25
Q

MOI of Mirtazapine

A
  • Alpha-2 antagonist (indirect ­ iINC 5-HT & NE)*
  • 5-HT 2 antagonist
  • 5-HT 3 antagonist (antiemetic)
26
Q

which SNRIs has shown to elevate BP significantly?

A

Venlafaxine (Effexor)

Desvenlafaxine (Pristiq) - worse for BP

27
Q

which antidep is CI in DM

A

Mirtazapine*

28
Q

MOI of BZD

A

­ INC effect of GABA

29
Q

MOI of Buspirone (Buspar)

indication?

A

5-HT1 partial agonist - anxiety

30
Q

benefits of Buspirone (Buspar)

A
  • No sedation
  • No cognitive impairment
  • No respiratory depression
  • No abuse potential
31
Q

adjuvants to anxiety

A

Buspirone (Buspar)

Antiepileptics: Pregabalin

Atypical antipsychotics: (not recc) Quetiapine

Hydroxyzine

Propranolol

Clonidine

32
Q

adjuvants to dep

A

Selegiline transdermal patch

Esketamine – nasal inhalation

Brexanolone

Atypical antipsychotics:

  • •Aripiprazole – fewer side effects
  • •Olanzapine w/ fluoxetine
  • •Quetiapine
33
Q

what antidep has a risk for Hypertensive crisis

A

Selegiline transdermal patch

34
Q

whixh SNRI is good for

  • Good w/ ADD & depression
  • Neuropathic Pain & depression

notable adverse effect?

A

Levomilnacipran (Fetzima)

tachycardia

35
Q

antidep serotonin targets

goal agonist

goal antagonist

A

5-HT 1* (goal: agonist)

5-HT 2*(goal: antagonist)

36
Q

Nefazodone had what notable adverse effect

A

Hepatotoxicity

37
Q

name TCAs and their MOI

A

Inhibit reuptake of serotonin & NEà same as SNRI (BUT a lot of side effects)

  • •Block muscarinic
  • •histamine 1
  • •Alpha
  • Imipramine
  • Amitriptyline
  • Desipramine
  • Nortriptyline
  • Clomipramine
38
Q

notable side effects of TCAs

A

Arrythmia

•Anticholinergic effects - avoid in elderly

Clin Mgt 2 DM & Psych (3 decks)

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