Antidepressants Flashcards
Tricyclic Antidepressants
Imipramine
Amitryptyline
SSRIs
Fluoxetine
Escitalopram
Paroxetine
Sertraline
SNRIs
Duloxetine
Venlafaxine
Serotonin 5HT2 Antagonists
Nafazodone
Trazodone
Heterocyclic Antidepressants
Amoxapine
Bupropion
Maprotiline
Mirtazapine
TCA
Blocks NE and 5HT transporters
Backup drug for MDD
Additive depression of the CNS with other central depressants
Drug?
Imipramine
Clomipramine, Desipramine, AMITRYPTILINE, Nortryptiline
TCA:
Toxic Dose: _____
Lethal Dose: _____
7mg/kg (7 tabs Imipramine 75mg)
15mg/kg (14 tabs Imipramine 75mg)
3 Cs of TCA Overdose
Cardiotoxicity
Coma
Convulsions
Tx of TCA Overdose
Supportive Therapy (Fluid resuscitation, activated charcoal, benzodiazepines) Bicarbonate to reverse cardiotoxicity
SSRI
First line for MDD
SE: Erectile dysfunction, withdrawal syndrome
Serotonin Syndrome when used with MAOIs
Fluoxetine
Paroxetine, Citalopram, Escitalopram, Sertraline, Fluvoxamine
SSRIs that are CYP450 inhibitors
Fluoxetine
Fluvoxamine
Drugs that cause erectile dysfunction
SORE PEnis Still Fucks Hard SSRIs Opiates Risperidone Ethanol Propranolol Estrogen Spironolactone Finasteride Hydrochlorothiazide
Life-threatening syndrome characterized by severe muscle rigidity, myoclonus, hyperthermia, cardiovascular instability, and marked CNS stimulatory effects including seizures
Serotonin Syndrome
SNRI
Alternative to SSRIs for MDD
SE: Hypertension, Hepatotoxicity, Withdrawal
Venlafaxine
Duloxetine, Desvenlafaxine
SNRI that is a CYP450 inhibitor
Venlafaxine
Serotonin antagonist that blocks 5HT2 receptors
SE: orthostatic hypotension, priapism, hepatotoxicity
Can cause arrhythmia in pxs with pre-existing cardiac disease
Trazodone
Nefazodone
Drugs to cause Priapism
Tigas Penis QU AyaW Bumaba Trazodone Papaverine Sildenafil Quetiapine Alprostadil Warfarin Bupropion
Tetracyclic antidepressants
Strong epinephrine reuptake inhibitor, weak serotonin reuptake inhibitor, Blocks Dopamine D2
SE: Akathisia, Parkinsonism, Amenorrhea-Galactorrhea Syndrome, Seizures, Cardiotoxicity
Lowers Seizure Threshold
Amoxapine
Increases amine release from nerve endings by antagonism of presynaptic alpha2 adrenoceptors, blocks 5HT2 receptors
Drug for major depression, appetite stimulation
SE: Weight gain, marked sedation
Mirtazapine
TCA Inhibits neuronal reuptake of Dopamine Drug for smoking cessation SE: Weight loss, seizures, priapism Lowers seizure threshold
Bupropion
MAOI
Inhibits monoamine oxidase type A and type B
Drug for Parkinsons
SE: Insomnia, Orthostatic hypotension
Hypertensive crisis when taken with Tyramine (sympathomimetic in cheese/wine)
Serotonin syndrome when taken with SSRIs
Phenelzine
Tranylcypromine, Selegiline
Sx of Serotonin Syndrome
FAT CHD (KID) Fever Agitation Tremor Clonus Hyperreflexia Diaphoresis
Precipitating drug for Malignant Hyperthermia
Succinylcholine
Onset/Pathophysio of Malignant Hyperthermia
Within Minutes
Massive Ca release from SR
First Line Tx for Malignant Hyperthermia
Dantrolene
Participating drug for Serotonin Syndrome
MMMSST
MAOI Meperidine MDMA SSRIs St. John's Wort TCA
Onset/Pathophysio of Serotonin Syndrome
Within Hours
Excess Serotonin
First line Tx for Serotonin Syndrome
Sedation
Paralysis
Intubation
Ventilation
Precipitating drug for Neuroleptic Malignant Syndrome
Antipsychotics
Onset and Pathophysio of Neuroleptic Malignant Syndrome
1-3 days
Dopamine antagonism
First line Tx for Neuroleptic Malignant Syndrome
Diphenhydramine
