Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

424 Pharmacology > Antidepressants > Flashcards

Antidepressants Flashcards

1
Q

SSRis

A

Fluoxetine, olanzapine-fluoxetine, paroxetine, sertraline, fluvoxamine, citalopram, escitalopram

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

Nonselective norepinephrine-serotonin reuptake inhibitors

Tricyclic:

A

amitriptyline, nortriptyline, imipramine, doxepin, trimipramine maleate, amoxapine, desipramine, protriptyline hydrochloride, clomipramine

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

Serotonin-norepinephrine reuptake inhibitors (SNRIs)

A

Venlafaxine (Effexor), duloxetine, (Cymbalta), milnacipran (Savella), desvenlafaxine (Pristig)

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

Tricyclic antidepressants:

amitriptyline pharmacodynamics

A

Act on neurotransmitters, serotonin, and norepinephrine (NE), block reuptake in presynaptic neuron.
and histamine and acetylcholine

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

Tricyclic antidepressants:

amitriptyline ADRs

A

paradoxical diaphoresis, causing anticholinergic effects (dry mouth), orthostatic hypotension, sedation, drowsiness

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

Tricyclic antidepressants:

amitriptyline patient education

A

Do not discontinue abruptly; avoid OTC medications that stimulate, insomnia or drowsiness.

Must let provider know if having myocardial infarction, glaucoma . avoid in glaucoma

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

Tricyclic antidepressants:

amitriptyline caution and contraindications

A

cardiovascular disease

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

Tricyclic antidepressants:

amitriptyline monitoring

A

Must report any chest pain
Reassess patient after 2 to 4 weeks of starting medications: suicide, ADRs
Baseline electrocardiography (EKG).

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

SSRI pharmacodynamics

A

All SSRIs have selective inhibitory effects on presynaptic serotonin reuptake and weak effects on NE and dopamine neuronal uptake.

Other wording:
affect the serotonin neurotransporter system in the synaptic cleft by blocking the serotonin transporter from returning remaining serotonin to the presynaptic cell. So through this mechanism, more serotonin is available to bind with the postsynaptic receptors.

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

SSRI ADRs & BBW

A

CNS, n/v/d, sexual dysfunction
Serotonin syndrome , upper GI bleed, hyponatremia, QTC prolongation, headache

BBW: increased risk of suicidal thinking/behavior in childre, adolescent and young adults.
Major depressive disorder and other psych disorders/

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

SSRI patient education

A

May take 2-6 weeks to see maximum effects
Pregnancy: evaluate risk v. benefit
Pediatrics: fluoxetine first line
Withdrawal symptoms if abruptly discontinued

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

SSRI patient monitoring

A

Never give more than 4 weeks on first prescription.

Monitor target symptoms.

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

SNRI indications:

duloxetine, venlafaxine

A

Major depressive disorder, general anxiety disorder, neuropathy pain, fibromyalgia

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

SNRI pharmacodynamics

A

Inhibit reuptake of both norepinephrine and serotonin.

boost dopamine in prefontal cortex

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

SNRI ADRs

A

Headache, somnolence, dizziness, insomnia, fatigue, dry mouth, constipation, orthostatic hypotension, erectile dysfunction, ejaculation failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

SNRI patient education

A

Adherence, suicide ideation, avoidance of OTC medications that stimulate, insomnia or drowsiness, suicide ideation

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

SNRI monitoring

A

May increase serum transaminase levels: Watch in patients with liver disease.
Monitor suicide risk, activation of hypomanic or manic symptoms

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

atypical antidepressants:
buproprion (wellbutrin, zyban) and Mirtazapine (remeron)

pharmacodynamics

A

Exact mechanism of action unknown

Mirtazapine is a antagonist of 5-HT2, 5-HT3 and histamine (H1) receptors

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

buproprion (wellbutrin, zyban) and Mirtazapine (remeron) contraindications

A

seizure disorder

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

buproprion (wellbutrin, zyban) and Mirtazapine (remeron) ADRs

A

Bupropion may cause insomnia.

Mirtazapine causes drowsiness, greater at 15 mg/ day than at 30 mg/day.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

buproprion (wellbutrin, zyban) and Mirtazapine (remeron) monitoring

A

depression and suicide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

buproprion (wellbutrin, zyban) and Mirtazapine (remeron) patient education

A

Take mirtazapine before bedtime because it may cause drowsiness
Wellbutrin does not have the sexual dysfunction side effect like SSRIs.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

typical antipsychotics

A

Phenothiazine: chlorpromazine (Thorazine), prochlorperazine.

Non Phenothiazines: haloperidol (Haldol)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

atypical antipsychotics

A 
Aripiprazole (Abilify)
Clozapine (Clozaril)
Olanzapine (Zyprexa)
Olanzapine-fluoxetine: Symbyax
Quetiapine (Seroquel)
Risperidone (Risperdal)
Ziprasidone (Geodon)
25
typical antipsychotics Phenothiazines: chlorpromazine (Thorazine) Non Phenothiazine: haloperidol (Haldol) pharmacodynamics
Block dopamine receptors in the basal ganglia, hypothalamus, limbic system, and medulla
26
typical antipsychotics Phenothiazines: chlorpromazine (Thorazine) Non Phenothiazine: haloperidol (Haldol) side effects
Parkinsonism, prolactin elevation, and extrapyramidal symptoms (EPS); concurrent therapy with anticholinergic
27
typical antipsychotics Phenothiazines: chlorpromazine (Thorazine) Non Phenothiazine: haloperidol (Haldol) contraindications
Narrow-angle glaucoma, bone marrow depression, and severe liver or cardiovascular disease Black Box: increased mortality in older adult patients
28
typical antipsychotics Phenothiazines: chlorpromazine (Thorazine) Non Phenothiazine: haloperidol (Haldol) ADRs
Neuroleptic malignant syndrome (NMS), EPS, sedation, weight gain
29
typical antipsychotics Phenothiazines: chlorpromazine (Thorazine) Non Phenothiazine: haloperidol (Haldol) patient education
drug interactions, avoid sudden withdrawal, sun protection
30
typical antipsychotics Phenothiazines: chlorpromazine (Thorazine) Non Phenothiazine: haloperidol (Haldol) monitoring
Abnormal Involuntary Movement Scale (AIMS)
31
atypical antipsychotics pharmacodynamics
blocks serotonin receptors in the cortex
32
atypical antipsychotics contraindications
hepatic and renal disease
33
atypical antipsychotics ADRs
seizures, weight gain, diabetes, hyperprolactinemia, dizziness, orthostatic hypotension, Clozapine: fatal agranulocytosis
34
atypical antipsychotics patient education
ADRs, do not stop taking.
35
atypical antipsychotics monitoring
symptoms and ADRs
36
SSRI and other 2nd generation antidepressants are
more effective in pediatric anxiety but not pediatric depression.
37
fluoxetine is least likely to cause
weight gain. start low and titrate slow. long half life... meaning they wont feel bad if they miss a dose by accident
38
paroxetine (paxil) quickfacts
interacts with a lot of other medications. so try to avoid in the elderly. has significant withdrawal profile, patients will instantly get side effects. highest weight gain in all the antidepressants. can be sedating
39
citalopram (celeza) BBW
QTC prolongation
40
ecitalopram (lexapro)
eight neutral, neutral side effects. | geat choice for anxiety or depression.
41
venlafaxine / desvenlafaxine monitoring:
heart rate and bp.
42
mirtazepine
low doses causes sedation.. | as you increase the dose, it will decrease the sedative factor
43
bupropion (wellbutrin)
lowers seizure threshold. avoid in pts with seizure risk. avoid this in patients with anxiety because it spikes fight of flight response
44
TCAs quick facts
``` highly cardiotoxic. fatal in overdose. causes serious arrythmias narrow therapeutic index. weight gain is common orthostatic hypotension ```
45
MAOIs quick facts
rarely seen in primary care. interacts with tyramine. causes HTN crisis. dangerous in overdose
46
paroxetine, mirtazapine, amytriptaline
highest association of weight gain
47
paroxetine is the most
sedating antidepressant
48
fluoxetine is the most
energizing antidepressant
49
antidepressants in pregnancy
increased episodes of spontaneous abortion. | risk of stopping antidepressants for mother.
50
sertraline
ok for lactation
51
fluoxetine
ok in pregnancy
52
clinical use for SSRI
depressive, anxiety, panic, obsessive-compulsive disorder, body dysmorphic disorder, bulimia, premenstrual dysphoric disorder, post-traumatic stress disorder, and vasomotor symptoms of menopause.
53
what nonpharmacologic substances can contribute to serotonin syndrome?
St. John's wort, grapefruit, ergot, woodrose, SAMe, lithium over the counter
54
fluoxetine and ecitlopram
FDA approved for use in pediatrics
55
sertraline and lexapro
lowest dose that goes to baby, usually undetected. can be used in lactation
56
SSRI should be tapered how?
slowly
57
desvenfalaxine indications
used for major depression, vasomotor symptoms, fibromyalgia, generalized anxiety, social anxiety, panic disorders, PTSD, which is Post-Traumatic Stress Disorder, postmenstrual dysphoric disorder.
58
An 8-year-old has been diagnosed with major depression. Which medication is preferred for this patient?
fluoxetine

424 Pharmacology (11 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions