Antidepressants

Question 1

What type of drug is Amitriptyline?

Answer 1

Tricyclic antidepressant (TCA)

Question 2

What is the mode of action for TCAs

Answer 2

Stops re-uptake of serotonin & noradrenaline at pre-synaptic terminal

Question 3

Most significant S/E of TCAs

Answer 3

Heart problems (incr QT / tachycard / postural hypotension)
V dangerous in OD

Question 4

Contraindications for TCAs (4)

Answer 4

Cardiac probs
Narrow angle glaucoma
Prostatism
Epilepsy

Question 5

Phenelzine, Isocarboxazid, Tranylcypromine are types of what antidepressant?

Answer 5

Monoamine oxidase inhibitors (MOAIs)

Question 6

Interactions of MOAIs? (4)

Answer 6

Blue cheese
Beer
Yeast / soy
Pickled herring

Question 7

S/E of MOAIs (3)

Answer 7

Postural hypot
Wt gain
Insomnia / hallucinations

Question 8

Sertraline, Citalopram, Fluoxetine, Paroxetine are types of which antidepr?

Answer 8

SSRIs (Selective serotonin reuptake inhibitors)

Question 9

What is mech of action of SSRIs

Answer 9

Block reuptake of serotonin at pre synaptic membrane

Question 10

Important SE of SSRIs (3)

Answer 10

Incr QT
GI irritation / bleed (avoid NSAIDs)
Hyponatraemia

Question 11

Why should under 18s not get SSRIs?

Answer 11

Increased risk of suicide

Question 12

What type of antid. are Mirtazapine & Trazodone?

Answer 12

Receptor blockers

Question 13

What is the mech of action for receptor blockers?

Answer 13

Block alpha 2 noradrenaline receptor or serotonin rec. at presyn membrane - cell doesnt get reuptake signal, thinks not enough being produced so produces more noradrenaline and serotonin

Question 14

Are receptor blockers very cardiotoxic or dangerous in OD?

Answer 14

No

Question 15

Mild SE of receptor blockers (2)

Answer 15

Sedative & wt gain

Question 16

Venlafaxine and Duloxetine are what type of antid.

Answer 16

Serotonin & noradrenaline, Non selective reuptake inhibitors

Question 17

Is venlafaxine dangerous in od?

Answer 17

Yes very

Question 18

What is 5 hydroxytriptamine another name for?

Answer 18

Serotonin

Question 19

Where is Serotonin produced

Answer 19

Raphe nuclei throughout whole brainstem

Question 20

Where is Acetylcholine produced

Answer 20

Forebrain & CNS motor neurones

Question 21

Where is Dopamine produced

Answer 21

Substantia nigra and ventral tegmental area of mid brain

Question 22

What does loss of the ventral tegmental area and subst nigra lead to (which disease)

Answer 22

Parkinsons (loss of dopamine)

Question 23

Where is noradrenaline produced

Answer 23

Locus coeruleus (Pons) and adrenal medulla

Question 24

Where is histamine produced

Answer 24

Hypothalamus & mast cells

Question 25

Where are enterochromaffin cells that store large amounts of serotonin in body? What does excess production by these cells cause (symptom?)

Answer 25

Line the gut - cause nausea if excess serotonin produced

Question 26

How does ondasetron reduced nausea

Answer 26

Blocks serotonin receptor 5HT3

Question 27

What are six things serotonin is implicated in the body?

Answer 27

``` Sleep Sexual arousal Depression Appetite Nausea Analgesia ```

Question 28

What hallucinogenic drug activates 5HT 2a receptor

Answer 28

LSD

Question 29

What antipsychotic blocks 5HT 2a

Answer 29

Clozapine

Question 30

What neurotransmitter is often lost in alzheimers?

Answer 30

Acetylcholine

Question 31

What function does dopamine play in body

Answer 31

Reward, novelty, motivation

Question 32

What 4 drugs as well as adrenaline target noradrenaline receptors

Answer 32

Cocaine Amphetamine TCAs Ritalin

Question 33

Name three major types of opiods

Answer 33

Endorphins (morphine, codeine, tramadol, heroin) Enkephalins Dynorphins

Question 34

What is main role of opiods in body system

Answer 34

neuromodulators - regulate release of other neurotransmitters

Question 35

What are CYCLIZINE and CHLORPHENAMINE

Answer 35

Anti histamines