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Pharmacology 2 (TCMC) > Antidepressants > Flashcards

Antidepressants Flashcards

1
Q

SNRIs (Serotonin & Norepinephrine Reuptake Inhibitors)

A

Venlafaxine (active metabolite: Desvenlafaxine); Duloxetine

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2
Q

Heterocyclic antidepressants (mostly tricyclics)

A

Imipramine (active metabolite: Despiramine)

Amitriptyline (active metabolite: Nortriptyline)

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3
Q

MAOIs (Monoamine oxidase inhibitors)

A

Isocarboxazid
Phenelzine
Tranylcypromine
Selegiline

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4
Q

Atypical antidepressants

A

Bupropion
Mirtazapine
Nefazodone
Trazodone

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5
Q

Characteristics general to all antidepressants

A

Equally effective in depressed patients
Similar delayed onset of therapeutic effects
Mostly work via direct/indirect increases in norepinephrine and/or serotonin levels in synaptic cleft

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6
Q

SSRI drugs

A

Fluoxetine
Citalopram (Escitalopram)
Paroxetine
Sertraline

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7
Q

Mirtazapine MOA

A

Blocks alpha-2 but not alpha-1 adrenergic receptors increasing serotonin & norepinephrine release in synaptic cleft
Strong anti-histaminergic effect- promotes drowsiness & stimulates appetite- useful in the elderly presenting w/ insomnia and weight loss

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8
Q

Mirtazapine adverse effects

A

Anti-histaminergic- sedation & weight gain

Mild anti-alpha-1 adrenergic & anti- cholinergic effects

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9
Q

Imipramine MOA

A

Antidepressant

Norepinephrine & serotonin reuptake inhibitor

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10
Q

Citalopram MOA

A

Antidepressant

Serotonin reuptake inhibitor

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11
Q

Fluoxetine MOA

A

Antidepressant
Serotonin reuptake inhibitor
Some norepinephrine reuptake inhibition

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12
Q

Duloxetine MOA

A

Antidepressant
Serotonin reuptake inhibitor
Mild norepinephrine reuptake inhibition

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13
Q

Venlafaxine MOA

A

Antidepressant
Serotonin reuptake inhibitor
Some norepinephrine reuptake inhibition

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14
Q

Receptor stimulation resulting in decreased norepinephrine/serotonin release

A

Pre-synaptic alpha-2-/5-HT10 auto- receptors on noradrenergic or serotonergic terminals

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15
Q

Receptor stimulation resulting in decreased serotonin release

A

Alpha-2 heteroreceptors on 5-HT nerve terminals

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16
Q

Receptor stimulation resulting in increase 5-HT activity

A

Alpha-1 adrenergic receptors on 5-HT neuronal dendrites

17
Q

Antidepressant drugs causing sexual dysfunction

A 
Decreasing order of potency: 
Fluoxetine 
Citalopram
Venlafaxine
Duloxetine
Bupropion
18
Q

Phenelzine MOA

A

Irreversibly inhibits MAO

19
Q

Monoamine oxidase (MOA)

A

Primary enzymatic mechanism for the degradation of monoamines (dopamine, epinephrine, norepinephrine & serotonin)

20
Q

MAO isoforms + role

A

MAO-A: primarily metabolizes norepinephrine & serotonin in the CNS
MAO-B: dopamine selective isoform

21
Q

MAOIs drug interactions

A

Interact with tyramine in food- potential for hypertensive crisis

Foods containing tyramine:
Fermented foods- cheese, yogurt, sour cream, etc.
Wine & beer, chocolate, coffee, preserved fish (sardines, herring), dried fruits

Drugs contraindicated:
Amphetamines including methylphenidate
Sympathomimetics
Many other drugs metabolized by MAO

22
Q

Bupropion MOA

A

Effective antidepressant
Structurally unrelated to other antidepressants
MOA is unknown
Also used in cessation smoking programs in combination with behavioral modification

23
Q

Bupropion adverse effects

A

Increased risk of seizures

24
Q

St. John’s Wart

A

Herbal treatment for depression
From plant Hypercium perforatum
Equally as effective as TCAs in short term treatment of mild to moderate major depression (1-3 months)

25
Q

St. John’s Wart adverse effect

A

Causes multiple drug interactions via induction of the cytochrome P450 enzyme CYP3A4, but also CYP2C9- Increase metabolism of affected drugs & decrease concentration & effect
Contributes to serotonin (5-HT) syndrome, a potentially life threatening adverse drug reaction in combination with other drugs which increase 5-HT levels in the CNS (such as antidepressants)

26
Q

Selegiline MOA

A

Relatively selective MOA-B inhibitor

Pharmacology 2 (TCMC) (5 decks)

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