Antidepressants

Question 1

What do monoamines do?q

Answer 1

NOT just refill actually..
synaptic plasticity
dendritic morphology
neurogenesis

Question 2

first generation antidepressants

Answer 2

TCA, MAO-I

Question 3

second generation antidep

Answer 3

SSRI, SNRI

Question 4

5 serotonin SSRIs

Answer 4

citalopram
escitalopram
fluoxteine
paroxteine
fluvoxamine

Question 5

serotonin TCA

Answer 5

clomlpramine

Question 6

NE SNRI

Answer 6

venlafaxine
desvenlafaxine
duloxetine

Question 7

NE TCA

Answer 7

nortyptillineimipramine
amitriptylline
desipramine

Question 8

DA NDRI

Answer 8

bupropion

Question 9

MAOI

Answer 9

phenelzine

tranylcipramine

Question 10

citalopram mech of action

Answer 10

blocks 5ht reuptake transporter so 5ht stays in synase

can also block DA and NE reuptake by binding to 5HT R

Question 11

citalopram also

Answer 11

bidnds to closely related 5HT receptors

histamine, DA, muscarinic (dryness), a and b adrenergic

Question 12

where are 5HT receptors mostly?

Answer 12

raphe nucleus

Question 13

side effects citalopram (celexa)

Answer 13

GI, sexual, sleep, sweating, Na_, mania

QT prolongation

Question 14

venlafaxine side effects

Answer 14

GI, sexual, sleep, sweating, Na_, mania

diastolic blood pressure increase

Question 15

why were tertiary amines bad?

Answer 15

they block Na+ channels in heart, so if you overdose you can get heart block, but secondary are better (all same but weaker side effects)

Question 16

different between teritary (imipramine/amitriptyline) and secondary (desipramine/nortriptyline) amines

Answer 16

react more with 5HT than NE

Question 17

tertiary amines work as

Answer 17

Class 1A anti-arhythmics

Question 18

nortriptyline side effects

Answer 18

wt gain, sedation, Ach, hypotension, arrhythmia, sexual, sweating

Question 19

nortriptyline is___in overdose

Answer 19

lethal

Question 20

chlomipramine is

Answer 20

highly specific to 5HT, so its better for OCD

Question 21

NDRI

Answer 21

NE-DA reuptake I

wellbutrin/bupropion

Question 22

side effects wellbutrin

Answer 22

insomnia
tremor
tinnitus
seizures

Question 23

how do MAOIs work?

Answer 23

suicide inhibitors; complelety kills enzyme; doesnt just block enzyme by occupying space, but gets rid of enzyme

Question 24

even if you stop an MAOI

Answer 24

2 weeks until body makes new enzyme

Question 25

Phenelzine (nardil)

Answer 25

developed as TB drug, sedating (MAOI)

Question 26

tranylcypromine (parnate)

Answer 26

developed as amphetamine- stimulating

Question 27

serotonin syndrome triad

Answer 27

MS seizures autonomic instablility neuromuscular signs

Question 28

clinically, 5ht syndorme..

Answer 28

hypertensive crisis seizure stroke

Question 29

hypertensive crisis

Answer 29

"cheese syndrome" | low tyramine diet needed (because tyramine is a precursor to D and NE)-->SS

Question 30

NaSSA

Answer 30

dual reuptake | Mirtazapine (remeron)

Question 31

do not combine Mirtazpine with

Answer 31

P450 drugs (other MAOIs)

Question 32

side effects Mirtazpine

Answer 32

sedating, wt gain (histamine)

Question 33

SARI

Answer 33

serotonin 2A antagonist dual reuptake Nefazodone trazodone *can combine with P450 drugs

Question 34

GABA drugs

Answer 34

benzodiazepines

Question 35

what are benzos good for

Answer 35

``` sedative anziolytic seizure control muscle relaxant anterograde amnesia ```

Question 36

benzos should never be

Answer 36

combined witha lcohol

Question 37

benzos act as

Answer 37

positive allosteric modulator - -increase R affinity for endogenous GABA - -increase frequency of opening of CL channel when activated by GABA (and Cl makes resting potential more negative--higher activation energy)

Question 38

Diazepam is...and binds tooo

Answer 38

nonselective | binds to all alpha R wherever they are in brain

Question 39

side effects diazepam (valium)

Answer 39

``` sedation depression amnesa ataxia dependence withdrawal ```

Question 40

valium/diazepam is metabolized by the

Answer 40

liver

Question 41

which benzo is renally cleared?

Answer 41

lorazapam

Question 42

Zolpidem

Answer 42

alpha 2 selective BZD agonist zolpidem zalapion eszopiclone

Question 43

zolpidem binds

Answer 43

preferentially to a1 receptors

Question 44

zolpidem is mostly for

Answer 44

sedation | forget what you did

Question 45

Buspirone/BuSPar

Answer 45

5HT1A partial agonist | for GAD/Augment MDD

Question 46

side effects buspirone

Answer 46

dizziness, sedation, nervous/restless

Question 47

how long for buspirone to work

Answer 47

4 weeks, but no withdrawal after