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Pharamcology > Antidepressants > Flashcards

Antidepressants Flashcards

1
Q

What are the three hypothesis’ That have been proposed for pathogenesis of depression

A
  1. Decreased level or function of monoamines (NE, DA, 5-HT) in cortical lambic system
  2. Decrease in brain derived neurotrophic factor
  3. Abnormalities in HPA axis, thyroid function and sex steroid levels
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2
Q

Classify antidepressants

A
  1. Tricyclic antidepressants
  2. selective serotonin reuptake inhibitors
  3. serotonin and noradrenaline reuptake inhibitors
  4. atypical anti-depressants
  5. MAO-A inhibitors
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3
Q

Name tricyclic antidepressants

A
  1. Amitriptyline
  2. Amoxapine
  3. Nortriptyline
  4. Trimipramine
  5. Imipramine
  6. Doxepin
  7. Desipramine
  8. Dothiepin
  9. Protriptyline
  10. clomipramine
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4
Q

Name selective serotonin reuptake inhibitors

A
  1. Fluoxetine
  2. fluvoxamine
  3. citalopram
  4. escitalopram
  5. sertraline
  6. peroxentine
  7. dapoxetine
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5
Q

Name serotonin and noradrenaline reuptake inhibitors

A
  1. Duloxetine
  2. venlafaxine
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6
Q

Name atypical antidepressants

A
  1. Trazodone
  2. mirtazapine
  3. Bupropion
  4. Mianserin
  5. Atomixetine
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7
Q

Name MAO-A inhibitors

A
  1. Moclobemide
  2. Clorgyline
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8
Q

What are the adverse effects of tricyclic antidepressants

A
  1. Atropine like side effects (Dry mouth, blurry vision, constipation, Urinary retention)
  2. alpha-1 adrenergic blocking effects (Tachycardia, arrhythmias, postural hypotension)
  3. H-1 blocking effects (sedation and confusion)
  4. Increased appetite and weight gain
  5. May precipitate convulsions
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9
Q

What are the contraindications of tricyclic antidepressant

A
  1. Glaucoma
  2. epilepsy
  3. ischaemic heart disease
  4. enlarged prostate
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10
Q

What is the mechanism of action of serotonin reuptake inhibitors

A

Block serotonin transporter by blocking it’s reuptake. This increases the availability of serotonin at the receptors

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11
Q

Which selective serotonin reuptake inhibitors produce active metabolites

A

Fluoxetine
sertraline

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12
Q

What is the longest acting selective serotonin reuptake inhibitor? What is it half life

A

Fluoxetine.
48 to 72 hours

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13
Q

What are the adverse effects of selective serotonin reuptake inhibitors

A
  1. G.I. symptoms (nausea, vomiting, diarrhoea)
  2. headache, insomnia
  3. sexual disfunction, impotence, loss of libido
  4. inhibit drug metabolizing enzymes
  5. Drug interactions
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14
Q

Which SSRIs Have less potential for drug interactions

A

Sertraline
citalopram
escitalopram

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15
Q

Why are the adverse effects of serotonin and norepinephrine reuptake inhibitors

A
  1. Nausea, sweating, sexual disfunction, anxiety
  2. Hypertension
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16
Q

What is the MAO of SNRIs 

A

Inhibitory uptake of serotonin and noradrenaline into the neuron

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17
Q

Which Atypical antidepressant inhibits the reuptake of dopamine and norepinephrine in the neuron?

A

Bupropion

18
Q

Which a typical antidepressant is useful for smoking sensation

A

Bupropion

19
Q

What are the adverse effects of bupropion

A

Dry mouth, tremor, sweating, convulsions

20
Q

What is the mechanism of action of mirtazapine

A
  1. Blocks alpha-2 auto receptors
  2. Blocks hetero receptors on 5HT neurons
  3. Increases norepinephrine and 5HT release
  4. Blocks H-1 receptors
21
Q

Which atypical antidepressant may cause weight gain and sedation

A

Mirtazapine

22
Q

What is the mechanism of action of trazodone

A
  1. Blocks 5HT reuptake
  2. 5HT-2 antagonist
  3. blocks alpha-1 receptors
23
Q

What are the adverse effects of trazodone

A
  1. Sedation
  2. hypotension
  3. priapism (painful erection of penis)
24
Q

What is the mechanism of action of mianserin

A

Increases norepinephrine release by blocking presynaptic alpha-2 receptors

25
Q

What are the side effects of mianserin

A
  1. Can cause seizures
  2. antianxiety action
  3. anticholinergic
  4. cardiac side effects
  5. causes sedation
26
Q

What are the two types of MAO inhibitors and what is their selectivity

A

MAO-A : Metabolism of norepinephrine, serotonin, tyramine
MAO-B: metabolism of dopamine

27
Q

What is moclobemide

A

Selective and reversible inhibitor of MAO-A

28
Q

What is the interaction between tricyclic antidepressants and MAO inhibitors

A
  1. Hypertensive crisis
  2. hyperpyrexia
  3. Coma
  4. convulsions 
29
Q

What is the interaction between TCA and alcohol

A

Potentiation of CNS depressant effects

30
Q

When SSRI and MAO inhibitors are given together it causes serotonin syndrome which is increased serotonin what are the undesirable effects

A
  1. Coma
  2. tremor
  3. restlessness
  4. muscle rigidity
  5. hyperthermia
  6. sweating, shivering
  7. seizures
31
Q

The metabolism of which drugs is inhibited by SSRIs 

A
  1. TCAs
  2. antipsychotics
  3. Beta blockers
  4. phenytoin
  5. carbamazepine
  6. Others
32
Q

What is cheese reaction

A

It’s when MAO inhibitors are taken by a patient and they consume food rich in tyramine this causes fatal hypertensive crisis and cerebrovascular accidents.

33
Q

How do you treat cheese reactions

A

IV Phentolamine

34
Q

Why are SSRIs preferred over TCAs

A
  1. Better tolerance
  2. less side effects
  3. longer duration of action
35
Q

Which drugs can be used in OCD

A

Clomipramine
fluvoxamine

36
Q

Which drugs can be used in ADHD

A
  1. TCAs
  2. Atomoxetine
  3. Methylphenidate
  4. Dextroamphetamine
37
Q

Which drug is used in nocturnal enuresis

A

Imipramine

38
Q

Which drug is used in the prophylaxis of migraine

A

Amitriptyline

39
Q

Which drugs are useful in chronic pain inducing neuroglias

A
  1. TCAs are effective in trigeminal, herpetic, post-herpetic neuralgias
  2. Venlafaxine and duloxetine Used in the treatment of fibromyalgia
40
Q

Which drugs are useful for atopic dermatitis

A

Topical doxepin

41
Q

Which drugs are used for premature ejaculations

A

SSRIs and TCAs 

42
Q

What are the uses of antidepressants

A
  1. Depression
  2. anti-anxiety
  3. OCD
  4. ADHD
  5. nocturnal enuresis
  6. prophylaxis of migraine
  7. chronic pain inducing neuroglias
  8. Atopic dermatitis
  9. premature ejaculation

Pharamcology (15 decks)

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