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MJ- P2 E2 > Antidepressants 2 > Flashcards

Antidepressants 2 Flashcards

1
Q

Names of SSRIs

A

Citalopram

Escitalopram

Fluoxetine

Paroxetine

Sertraline

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2
Q

Lithium, TCAs, warfarin alprazolam, theophylline cause Increased blood levels

PK and drug interactions of which drug?

A

SSRIs

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3
Q

What toxicity is associated with SSRIs?

A

sexual dysfunction

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4
Q

Doses greater than 40 mg/day not recommended due to QT prolongation

maximum daily dosage = 20mg for CYP2C19 poor metabolizers

which drug?

A

Citalopram

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5
Q

What ADR is common to all antidepressants and what must you monitor for due to this?

A

ADR: suicidality

Monitor: behavioral changes, mental status

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6
Q

What is the black box warning on all antidepressants?

A

caregivers should be alerted to monitor for acute changes in behavior (especially early in treatment)

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7
Q

Which additional ADRs are common to all SSRIs?

A

Anxiety or nervousness

Insomnia

Nausea

Serotonin syndrome

Sexual dysfunction

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8
Q

Which SSRI may be more activating (keeping you awake)?

A

Fluoxetine

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9
Q

Which SSRIs may be more sedating?

A

fluvoxamine

paroexetine

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10
Q

What is the main ADR of citalopram?

A

OT interval prolongation

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11
Q

What is the main ADR of fluoxetine?

A

anorexia

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12
Q

What is the main ADR of fluvoxamine?

A

somnolence

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13
Q

What is the main ADR of paroxetine?

A

anticholinergic effects

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14
Q

Indications of SNRIs?

A

MDD

GAD

Pain disorders: neuropathies and fibromyalgia

Stress urinary incontinence

Vasomotor symptoms of menopause

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15
Q

What are the 4 SNRIs?

A

Venlafaxine

Desvenlafaxine

Duloxetine

Levomilnacipran

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16
Q

What is the toxicity of venlafaxine?

A

HTN

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17
Q

What is the main ADR common to all SNRIs?

A

CV changesL inc. BP; hearr rate

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18
Q

What is the main ADR to Desvenlafaxine?

A

dose-related hyperlipidemia

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19
Q

What is the main ADR to venlafaxine?

A

dose-related HTN

20
Q

Indications for 5-HT2 receptor antagonists?

A

MDD

hypnotic

21
Q

Combo SSRI & 5-HT1A

which drug?

A

Vilazodone

22
Q

Inhibits 5-HT, a 5-HT1A agonist and a 5-HT3 receptor antagonist

which drug?

A

Vortioxetine

23
Q

What mixed 5-HT would you use for depressed pts with anxiety?

A

Vilazodone

24
Q

Which mixed 5-HT should you use with pt with depression & cognitive difficulties?

A

Vortioexetine

25
Q

Bupropion is an _____.

A

Bupropion is an NDRI (norepinephrine and dopamine reuptake inhibitor)

26
Q

Mirtazapine is a ___________

A

serotonin and alpha 2 receptor antagonist

27
Q

What are the 4 heterocyclics?

A

amoxapine

bupropion

maprotiline

mirtazepine

28
Q

What heterocyclic can you use for smoking cessation?

A

bupropion

29
Q

PK of heterocyclics

A

hepatic metabolism

30
Q

Which 2 heterocyclics lower seizure threshold (toxicity)?

A

amoxapine, bupropion

31
Q

WHich heterocyclic causes sedation & weight gain?

A

mirtazepine

32
Q

ADR of Nefazodone

A

Liver toxicity

Clitoral priapism (case report)

33
Q

ADRs of trazodone

A

orthostatic hypotension

priapism in males

34
Q

ADRs of Vilazodone

A

serotonin syndrome

male decreasd libido

35
Q

ADR of vortioxetine

A

GI & sexual dysfunction

36
Q

What 9 things should you keep in mind when choosing an antidepressant?

A

Indication

Cost

Availability

Adverse effects

Potential drug interactions

Patient’s history of response or lack

Patient preference

Age and gender

Medical status

37
Q

T/F: When medication and psychotherapy are not effective in treating severe depression or depression with psychosis, ECT can be highly effective.

A

True

38
Q

T/F: ECT involves transmitting short electrical impulses into the brain.

A

True

39
Q

T/F: ECT does cause some side effects, including some memory loss, but it is much safer than methods used in the past.

A

True

40
Q

a type of brain stimulation that uses a magnet instead of an electrical current to activate the brain

It is a relatively new treatment for people whose depression has not responded to medication or psychotherapy

What treatment is this?

A

Repetitive Transcranial Magnetic Stimulation (rTMS)

41
Q

T/F: Eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) omega-3 fatty acids cannot be used as augmentation in the treatment of MDD.

A

False

Eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) omega-3 fatty acids can be used as augmentation in the treatment of MDD.

42
Q

T/F: EPA alone or the combination of EPA/DHA is likely more effective than DHA alone

A

True

43
Q

Lack of consensus regarding use in the treatment of MDD

Induces hepatic metabolic enzymes and is associated with significant drug interactions

APA Task Force conservatively states that this may be reasonable for some individuals with mild to moderate MDD

Which herb?

A

St. Johns Wort

44
Q

The use of this has received a favorable review by the APA Task Force

However, the final consensus was that more rigorous studies need to confirm the efficacy of this for treating MDD

What supplement?

A

SAMe

45
Q

What are the 3 components in folate?

A

folic acid

folinic acid

5-MTHF

46
Q

What does the task force state about folate?

A

The task force states that augmentation with these compounds is reasonable, but more work is needed to clarify which subgroup of patients may achieve the greatest response.

47
Q
A

MJ- P2 E2 (19 decks)

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