Antidepressants

Question 1

Monoamine hypothesis of depression

Answer 1

depression is due to decrease monoamine function

Question 2

p11

Answer 2

interacts with serotonin receptors upregulating them and also reducing them. Its for synaptic remodling, and dendritic spine formation

Question 3

MOA of TCA

Answer 3

block SERT NET (increase synaptic concentration of the nt)

antagonist of 5-ht1, alpha 1, NMDA, H1, M1, na channels, Ltype calcium

Question 4

SE of TCA

Answer 4

increase symphathetic activity
sedation
CV effects
urinary retention, constipation, hallucinations

Question 5

Non selective irreversible MAO i

Answer 5

iproniazid

isocarboxazid

Question 6

selective reversible MAOi

Answer 6

MAO-Ai : moclobemide

MAO-Bi: selegiline, rasagiline

Question 7

Since not depression what do we use TCA for

Answer 7

chronic pain, diabetic neuropathy, PTSD

Question 8

Where do TCS accumulate

Answer 8

cardiac tissue leading to high cardiotoxic effects

Question 9

moclobemide inhibits the cytochrome 2c19 which is responsible for its own metabolism

Answer 9

true

Question 10

MAO-B is not present in the periphery so theres no cheese effect

Answer 10

TRUE

Question 11

name SSRI

Answer 11

citalopram
fluvoxetime
sertraline

Question 12

name SNRI

Answer 12

venlafaxine

duloxetine

Question 13

name SARI and MOA

Answer 13

trazodone
nefazodone
MOA: inhibition of serotonin transporter (SERT)
5-HT1A agonist
5-HT2A antagonist

Question 14

name NDRI

Answer 14

bupropion

Question 15

when do antidepressants cause serotonin syndrome

Answer 15

• drugs competing for the same cytochrome P450 lead to a decrease in drug metabolism and elimination
• they inhibit other enzymes for metabolism of other drugs
  (MAOI and SSRI)

Question 16

TX plan for depression

Answer 16

first line: SSRI monotherapy

if pt has psychotic features use psychotic drugs and benzodiazepines

Question 17

Ketamine and memantine MOA

Memantine is for

Answer 17

block NMDA on GABAergic neurons, causing disinhibition of pyramidal cells, resulting in increase glutamate transmission, which results in depolarization down the line with increase BDNF
memantine is for alzheimers disease