antidepressants

Question 1

tricyclic antidepressants (1st gen)

Answer 1

resemble phenothiazine antipsychotics

Question 2

tricyclic antidepressant ADME

Answer 2

first pass effect
lipid soluble
bound to plasma proteins
slow elimination
active metabolites

Question 3

tricyclic antidepressant MOA

Answer 3

inhibit NE and 5HT reuptake
block muscarinic ACh receptors
block alpha1 NE receptors

2-3wk to start seeing effect
8-10wks for max effect

changes in neurogenesis

Question 4

tricyclic antidepressant effects

Answer 4

sedation
CNS depressants
promote sleep
mood elevation (may feel worse first)
high dose: seizure
antimuscarinic effects
arrhythmias
orthostatic hypotension

Question 5

imipramine

Answer 5

tricyclic AD

bed-wetting

Question 6

desipramine

Answer 6

tricyclic AD

Question 7

amitryptyline

Answer 7

tricyclic AD

most commonly used

Question 8

clomipramine

Answer 8

tricyclic AD

OCD

Question 9

nortriptyline

Answer 9

tricyclic AD

Question 10

tricyclic antidepressant SE

Answer 10

orthostatic hypotension
arrhythmias
weight gain
withdrawal
OD: fatal

Question 11

all antidepressant BBW

Answer 11

increase risk of suicidal thinking/behavior in children, adolescents, and young adults

Question 12

tricyclic antidepressant Rx interactions

Answer 12

potentiate other CNS depressants
potentiate hypertensive effects
monoamine oxidase inhibitors
additive effects

Question 13

mirtazapine

Answer 13

2nd gen AD

blocks 5HT2 and a2 adrenergic receptors

SE: weight gain

Question 14

trazodone

Answer 14

2nd gen AD

inhibits 5HT uptake
blocks 5HT2 receptors

SE: priapism (hella big dick…stay away)

Question 15

buproprion

Answer 15

2nd gen AD

weak inhibitor of reuptake

use: smoking cessation

SE: seizures

DONT GIVE IF SEIZURES OR EATING DISORDERS

Question 16

Selective Serotonin Reuptake Inhibitor use

Answer 16

anxiety disorders

Question 17

SSRI SE

Answer 17

nausea
GI upset
HA
insomnia
nervousness
sexual dysfunction
withdrawal

Question 18

fluoxetine

Answer 18

SSRI

Question 19

paroxetine

Answer 19

SSRI

Question 20

fluvoxamine

Answer 20

SSRI

Question 21

sertraline

Answer 21

SSRI

Question 22

citalopram

Answer 22

SSRI

Question 23

escitalopran

Answer 23

SSRI

Question 24

vilazodone

Answer 24

SSRI

inhibits 5HT reuptake
5HT1 receptor partial agonist

Question 25

vortioexetine

Answer 25

SSRI

inhibits 5HT reuptake
agonist/partial agonist/antagonist at different 5HT receptors

Question 26

Serotonin/Norepinephrine Reuptake Inhibitor use

Answer 26

anxiety disorders

Question 27

SNRI SE

Answer 27

hypertension

withdrawal

Question 28

Duloxetine

Answer 28

SNRI

chronic pain

Question 29

Venlafaxine

Answer 29

low dose: blocks 5HT reuptake
high dose: blocks 5HT and NE reuptake

SE: insomnia

Question 30

Desvenlafaxine

Answer 30

SNRI

Question 31

Levomilnacipran

Answer 31

SNRI

Question 32

Monoamine Oxidase Inhibitors Rx interactions

Answer 32

hypertensive crisis if sympathomimetic amines are given or tyramine ingested

stroke/death

potentiate tricyclic antidepressants, CNS depressants, opiates

Question 33

serotonin syndrome

Answer 33

MAO inhibitors and L-Trp interacts with SSRI’s causing excessive 5HT neurotransmission

AMS
seizures
coma

Tx: stop all serotonergic drugs

Question 34

mood stabilizers use

Answer 34

bipolar disorder

Question 35

lithium use

Answer 35

mania

mood stabilizer in bipolar disorder

Question 36

lithium effects

Answer 36

calms mania
dampens mood swings
leukocytosis

Question 37

lithium ADME

Answer 37

rapid absorption
not metabolized
renal excretion

Question 38

lithium SE

Answer 38

low therapeutic index
fine tremor (Tx: propanolol)
thyroid enlargement
cardiac arrhythmias
inhibits ADH action
sodium retention
weight gain

Question 39

lithium Rx interactions

Answer 39

diuretics decrease renal clearance