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Pharm Exam > Antidepressants > Flashcards

Antidepressants Flashcards

1
Q

Bipolar disorder is characterized by

A

Mood swings of mania and depression

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2
Q

Bipolar mood swings are…

A

Not always controlled by the environment

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3
Q

Bipolar mood swings usually occur…

A

In alternation of mania/depression but both can happen at the same time

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4
Q

What is the monoamine theory of bipolar disorder?

A

Depression = decreased monoamine transmission

Mania = overactive monoamine transmission

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5
Q

What are monoamines?

A

(Norepinephrine, serotonin 5-HT, dopamine)

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6
Q

What are single-drug treatments for bipolar disorder?

A

Mood stabilizers (lithium) and antipsychotics

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7
Q

What are multiple medication treatments for bipolar disorder?

A

A combination of antidepressants, antipsychotics, and lithium

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8
Q

What does lithium do?

A

It may increase serotonin and GABA

it may decrease NE, Dopamine and glutamate transmission

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9
Q

What does lithium do to IP3 and DAG?

A

Lithium decreases production of precursors for IP3 and DAG

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10
Q

What are the 2 treatments for depression?

A

Therapy and medication

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11
Q

Lithium works better in which phase of bipolar disorder?

A

It is better at stabilizing the manic phase

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12
Q

What are the different types of antidepressants?

A

Amine reuptake blockers and Monoamine oxidase inhibitors

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13
Q

What are the 2 categories of amine reuptake-blocking drugs?

A

Nonselective and selective reuptake inhibitors

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14
Q

What is an example of a nonselective amine reuptake blocker?

A

Tricyclic Antidepressants

Ex. Impiramine

Prevents reuptake of NE and serotonin

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15
Q

How effective is Imipramine

A

Imipramine (TCA) is effective in approx 70% of patient

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16
Q

Is imipramine a first-line treatment?

A

No, the adverse effects and drug-drug effects make it worse than other options for first line

17
Q

What are the adverse effects of TACs?

A

Tricyclic antidepressant adverse effects inc.

Block cardiac sodium channels
Antagonize muscarinic receptors (dry mouth, constipation)
Antagonize H1 and Alpha 1 receptors (Sleepiness)

18
Q

What is an example of a selective serotonin reuptake inhibitor? (SSRI)

A

Fluoxetine (PROZAC)

19
Q

What is fluoxetine used for?

A

Depression, panic disorders, OCD, bulimia

20
Q

What are the common side effects of SSRIs?

A

Insomnia and sexual dysfunction

Increased suicide rate

21
Q

Are SSRIs dangerous?

A

Not typically unless combined with other antidepressants (inhibits CYP2D6 which metabolizes MAO inhibitors)

Can cause serotonin syndrome?

22
Q

What is serotonin syndrome?

A

A condition caused by too much brain serotonin

Symptoms:

Tachycardia, shivering, seizures, diarrhea

23
Q

How is serotonin syndrome cured?

A

Benzodiazepines to help with muscle contractions

Cyproheptadine to block serotonin production

24
Q

What are newer class antidepressants?

A

Includes drugs like SNRIs and NRIs

25
Q

What is an example of an atypical antidepressant?

A

Bupropion

26
Q

What does bupropion do?

A

Bupropion inhibits DA and NE reuptake

27
Q

What is special about bupropion?

A

It has fewer side effects than TCAs but still inhibits CYP2D6

28
Q

What are MAO inhibitors?

A

Monoamine oxidase inhibitors are drugs which inhibit monoamine oxidase, an enzyme that breaks down monoamines.

29
Q

What is an example of an MAO?

A

Phenelzine

30
Q

When are Monoamine oxidase inhibitors prescribed?

A

When TCAs arent an efficient treatment option

31
Q

What are the toxicities of MAOs?

A

Shouldn’t be taken with other antidepressants, can lead to serotonin syndrome

Hypertensive crisis can occur if tyramine-containing foods are ingested.

32
Q

What monoamine levels do MAOs increase?

A

inhibiting MAO-A = increased NE, Serotonin, Tyramine

inhibiting MAO-B = increased dopamine

33
Q

Why are SSRIs usually prescribed first?

A

They have less side effects and can’t OD on them easily

34
Q

Antidepressant therapy usually starts with a ___ dose and can take _____ weeks to show effects

A

Antidepressant therapy usually starts with a low dose and can take 3-8 weeks to show effects

35
Q

Why do antidepressants take so long to show observable effects?

A

The adaptive brain changes are likely more important than the immediate chemical changes

36
Q

Long-term treatment with antidepressants has been reported to…

A

alter the brains sensitivity levels to various CNS receptors

these changes may “cure the depression”

37
Q
A

Pharm Exam (11 decks)

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