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Pharm 3 > Antidepressants > Flashcards

Antidepressants Flashcards

0
Q

tertiary amines (2)

A

Amitriptyline (Flavil)

Imipramine (Tofranil)

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1
Q

tricyclic antidepressant MOA (2)

A

inhibit reuptake of NE & 5-HT

block a-adrenergic, histamine, & muscarinic receptors

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2
Q

Amitriptyline & Imipramine MOA & SE

A

primarily inhibit 5-HT uptake

more seizures, more sedating than secondary amines

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3
Q

secondary amines (2) and MOA

A

nortriptyline (Pamelor)
Desipramine (Norpramin)

primarily block NE reuptake

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4
Q

tricyclic antidepressants interactions (4)

A

MAOIs: Serotonin syndrome
compete w/ SSRIs –> toxic levels of TCAs
Amphetamines: HTN
potentiate alcohol, CNS depressants, anticholinergics

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5
Q

TCA SE (many, related to blockades)

A

histamine: drowsiness, fatigue, sedation
cholinergic: blurred vision, dry mouth, decr. urine, constipation, memory problems
a1: cardiac depression, arrhythmias, postural hypotension, dizziness, reflex tachy

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6
Q

Fluoxetine SE (3)

A

more drug interactions, most likely to inhibit 450
longer half-life
impairs glucose levels in diabetics

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7
Q

Sertraline (Zoloft) special use

A

least likely to interact w/ other drugs- good for the elderly

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8
Q

DOC depression

A

Citalopram (Celexa)

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9
Q

Citalopram (Celexa) use

A

DOC depression

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10
Q

SSRI side effects (5)

A 
nausea
weight gain or loss
CNS stimulation (anxiety, insomnia)- Prozac or Zoloft
sedation w/ other drugs
sexual disinterest/dysfunction
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11
Q

SSRI side effects related to CYP3A4 and 2D6 inhibition (2)

A

increased toxicity w/ TCAs, phenytoin, & carbamazepine

Warfarin: increased risk of bleeding

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12
Q

SSRI drug interactions (5)

A

increased toxicity w/ TCAs, phenytoin, & carbamazepine
Warfarin: increased risk of bleeding
MAOIs, St. John’s Wort, Amphetamines: Serotonin Syndrome
B-blockers: heart block, hypotension
Opioids: Fluoxetine inhibits conversion, no analgesia

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13
Q

SNRI uses (3)

A

depression
neuropathic pain
post-menopausal hot flashes

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14
Q

SNRIs (2)

A

Venlafaxine (Effexor)

Duloxetine (Cymbalta)

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15
Q

Venlafaxine (Effexor) SE

A

may increase BP

16
Q

Duloxetine (Cymbalta) SE (2)

A

hepatotoxicity

bilateral acute angle glaucoma

17
Q

MAO-A targets

A

metabolizes NE, DA, & 5-HT in both CNS & periphery (GI, liver)

18
Q

MAO-B targets

A

selectively metabolizes DA & tyramine in the CNS but not GI

19
Q

MAOI MOA

A

irreversibly inhibits MAO, which metabolizes NE, DA, 5-HT

20
Q

Phenelzine (Nardil) MOA & use

A

both MAO-A & B: increase NE & 5-HT

depression that hasn’t responded to other drugs- drug of last choice
actions persist longer than serum levels

21
Q

Selegiline (Deprenyl) MAO & use (2)

A

selectively inhibits MAO-B, increases DA

also used in Parkinson’s
fewer SE

22
Q

MAOI side effects (5)

A

hypertensive crisis- phenelzine. Avoid foods w/ tyramine
CNS excitement: tremors, sedation, excitation, insomnia
orthostatic hypotension
wt gain: common

23
Q

MAOI drug interactions (3)

A

OTC cough & cold: can cause severe HTN
opioids, DXM, TCAs, SSRIs: serotonin syndrome
affect metabolism of SSRIs, CCBs due to CYP450 inhibition

24
Q

foods to avoid on MAOIs (3)

A

red wine, beer, aged cheese

25
Q

Bupropion (Wellbutrin) MOA & uses (3)

A

inhibits DA, NE, and 5-HT (minimal) reuptake

ADHD, alcoholism (decr. craving)
smoking cessation (extended release- Zyban)
26
Q

Bupropion (Wellbutrin) SE (4)

A

seizures- contraindicated in hx seizures or head trauma
CNS excitation: anxiety, insomnia, restlessness…
tachycardia
sexual SE are rare

27
Q

Mirtazapine (Remeron) MOA (3)

A

blocks presynaptic a2 receptors, which normally inhibit NE & 5-HT release
blocks 5-HT2a & 5-HT3 receptors
blocks histamine receptors (–> drowsiness)

28
Q

Mirtazapine (Remeron) unique use

A

sometimes used for anxiety w/o depression

29
Q

Trazodone (Desyrel) MOA

A

5-HT2a receptor antagonist

30
Q

Trazodone (Desyrel) uses (2)

A

sleep aid

pain management

31
Q

Trazodone (Desyrel) unique SE

A

priapism

32
Q

Atomoxetine (Straterra) MOA, use, SE

A

selective NE reuptake inhibitor
nonstimulant ADHD tx
liver damage- rare but possible

33
Q

St. John’s Wort (hypericin) SE (3)

A

photosensitivity
Serotonin syndrome when combined w/ other antidepressants
may prolong general anesthesia

Pharm 3 (15 decks)

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