Antidepressants Flashcards

0
Q

Fluoxetine

A

Selective serotonin reuptake inhibitor (SSRI)

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1
Q

Selective serotonin reuptake inhibitors (SSRIs)

A
Fluoxetine
Citalopram
Escitalopram
Paroxetine
Sertraline
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2
Q

Citalopram

A

Selective serotonin reuptake inhibitor (SSRI)

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3
Q

Escitalopram

A

Selective serotonin reuptake inhibitor (SSRI)

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4
Q

Paroxetine

A

Selective serotonin reuptake inhibitor (SSRI)

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5
Q

Sertraline

A

Selective serotonin reuptake inhibitor (SSRI)

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6
Q

Selective serotonin reuptake inhibitor (SSRI)

Mechanism of action

A

Highly selective blockade of serotonin transporter (SERT), little effect on norepinephrine transporter (NET)

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7
Q

Highly selective blockade of serotonin transporter (SERT), little effect on norepinephrine transporter (NET)

A

Selective serotonin reuptake inhibitor (SSRI)

Mechanism of action

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8
Q

Selective serotonin reuptake inhibitor (SSRI)

Effects

A

Acute increase of serotonergic synaptic activity, slower changes in several signaling pathways and neurotrophic activity

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9
Q

Acute increase of serotonergic synaptic activity, slower changes in several signaling pathways and neurotrophic activity

A

Selective serotonin reuptake inhibitor (SSRI)

Effects

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10
Q

Selective serotonin reuptake inhibitor (SSRI)

Clinical applications

A

Major depression, anxiety disorders, panic disorder, obsessive-compulsive disorder, post-traumatic stress disorder, perimenopausal vasomotor symptoms, eating disorder (bulimia)

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11
Q

Major depression, anxiety disorders, panic disorder, obsessive-compulsive disorder, post-traumatic stress disorder, perimenopausal vasomotor symptoms, eating disorder (bulimia)

A

Selective serotonin reuptake inhibitor (SSRI)

Clinical applications

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12
Q

Selective serotonin reuptake inhibitor (SSRI)

Pharmacokinetics, Toxicities, Interactions

A

Half-lives from 15-74 h, oral activity, TOXICITY: well tolerated but cause sexual dysfunction, risk of serotonin syndrome with MAOs, INTERACTIONS: some CYP inhibition (fluoxetine 2D6, 3A4; fluvoxamine 1A2; paroxetine 2D6)

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13
Q

Half-lives from 15-74 h, oral activity, TOXICITY: well tolerated but cause sexual dysfunction, risk of serotonin syndrome with MAOs, INTERACTIONS: some CYP inhibition (fluoxetine 2D6, 3A4; fluvoxamine 1A2; paroxetine 2D6)

A

Selective serotonin reuptake inhibitor (SSRI)

Pharmacokinetics, Toxicities, Interactions

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14
Q

Serotonin-norepinepherine reuptake inhibitors (SNRIs)

A

Duloxetine

Venlafaxine

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15
Q

Duloxetine

A

Serotonin-norepinepherine reuptake inhibitor (SNRI)

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16
Q

Venlafaxine

A

Serotonin-norepinepherine reuptake inhibitor (SNRI)

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17
Q

Duloxetine
Venlafaxine

Mechanism of action

A

Moderately selective blockade of NET and SERT

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18
Q

Moderately selective blockade of NET and SERT

A

Duloxetine
Venlafaxine

Mechanism of action

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19
Q

Duloxetine
Venlafaxine

Effects

A

Acute increase of serotonergic and adrenergic synaptic activity, otherwise like SSRIs

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20
Q

Acute increase of serotonergic and adrenergic synaptic activity, otherwise like SSRIs

A

Duloxetine
Venlafaxine

Effects

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21
Q

Duloxetine
Venlafaxine

Clinical applications

A

Major depression, chronic pain disorders, fibromyalgia, perimenopausal symptoms

22
Q

Major depression, chronic pain disorders, fibromyalgia, perimenopausal symptoms

A

Duloxetine
Venlafaxine

Clinical applications

23
Q

SNRIs

Pharmacokinetics, Toxicities, Interactions

A

TOXICITY: Anticholinergic, sedation, hypertension (venlafaxine) INTERACTIONS: Some CYP2D6 inhibition (duloxetine, desvenlafaxine)

24
Q

TOXICITY: Anticholinergic, sedation, hypertension (venlafaxine) INTERACTIONS: Some CYP2D6 inhibition (duloxetine, desvenlafaxine)

A

SNRIs

Pharmacokinetics, Toxicities, Interactions

25
Q

Tricyclic antidepressants (TCAs)

A

Imipramine

Many others

26
Q

Imipramine

A

Tricyclic antidepressant (TCA)

27
Q

Imipramine (TCA)

Mechanism of action

A

Mixed and variable blockade of NET and SERT

28
Q

Mixed and variable blockade of NET and SERT

A

Imipramine (TCA)

Mechanism of action

29
Q

Imipramine (TCA)

Effects

A

Like SNRIs plus significant blockade of autonomic nervous system and histamine receptors

30
Q

Like SNRIs plus significant blockade of autonomic nervous system and histamine receptors

A

Imipramine (TCA)

Effects

31
Q

Imipramine (TCA)

Clinical applications

A

Major depression not responsive to other drugs, chronic pain disorders, incontinence, obsessive-compulsive disorder (clomipramine)

32
Q

Major depression not responsive to other drugs, chronic pain disorders, incontinence, obsessive-compulsive disorder (clomipramine)

A

Imipramine (TCA)

Clinical applications

33
Q

Imipramine (TCA)

Pharmacokinetics, Toxicities, Interactions

A

Long half-lives, CYP substrates, active metabolites, TOXICITY: Anticholinergic, Alpha-blocking effects, sedation, weight gain, arrhythmias, and seizures in overdose, INTERACTIONS: CYP inducers and inhibitors

34
Q

Long half-lives, CYP substrates, active metabolites, TOXICITY: Anticholinergic, Alpha-blocking effects, sedation, weight gain, arrhythmias, and seizures in overdose, INTERACTIONS: CYP inducers and inhibitors

A

Imipramine (TCA)

Pharmacokinetics, Toxicities, Interactions

35
Q

5-HT2 antagonists

A

Nefazodone

Trazodone

36
Q

Nefazodone

A

5-HT2 antagonist

37
Q

Trazodone

A

5-HT2 antagonist

38
Q

Nefazodone
Trazodone

Mechanism of action

A

Inhibition of 5-HT2A receptor, nefazodone also blocks SERT weakly

39
Q

Inhibition of 5-HT2A receptor, nefazodone also blocks SERT weakly

A

Nefazodone
Trazodone

Mechanism of action

40
Q

Nefazodone
Trazodone

Effects

A

Trazodone forms a metabolite (m-cpp) that blocks 5-HT2A,2C receptors

41
Q

Trazodone forms a metabolite (m-cpp) that blocks 5-HT2A,2C receptors

A

Nefazodone
Trazodone

Effects

42
Q

Nefazodone
Trazodone

Clinical applications

A

Major depression, sedation and hypnosis (trazodone)

43
Q

Major depression, sedation and hypnosis (trazodone)

A

Nefazodone
Trazodone

Clinical applications

44
Q

Nefazodone
Trazodone

Pharmacokinetics, Toxicities, Interactions

A

Relatively short half-lives, active metabolites, TOXICITY: Modest Alpha-and H1-receptor blockade (trazodone) INTERACTIONS: Nefazodone inhibits CYP3A4

45
Q

Relatively short half-lives, active metabolites, TOXICITY: Modest Alpha-and H1-receptor blockade (trazodone) INTERACTIONS: Nefazodone inhibits CYP3A4

A

Nefazodone
Trazodone

Pharmacokinetics, Toxicities, Interactions

46
Q

Tetracyclics, unicyclic

A

Bupropion
Amoxapine
Maprotiline
Mirtazapine

47
Q

Bupropion

A

Tetracyclics, unicyclic

48
Q

Amoxapine

A

Tetracyclics, unicyclic

49
Q

Maprotiline

A

Tetracyclics, unicyclic

50
Q

Mirtazapine

A

Tetracyclics, unicyclic

51
Q

Mirtazapine
Bupropion

Mechanism of action

A

Increased norepinephrine and dopamine activity (bupropion)

NET>SERT inhibition ( amoxapine, maprotiline) increased release of norepinephrine, 5-HT (mirtazapine)

52
Q

Increased norepinephrine and dopamine activity (bupropion)

NET>SERT inhibition ( amoxapine, maprotiline) increased release of norepinephrine, 5-HT (mirtazapine)

A

Mirtazapine
Bupropion

Mechanism of action