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Neuro Quiz 2 > AntiDepressants > Flashcards

AntiDepressants Flashcards

1
Q

SSRI means

A

Serotonin-Selective Reuptake Inhibitors

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2
Q

SSRI MOA

A

Selectively inhibit reuptake of serotonin from synaptic cleft and increase levels of 5-HT

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3
Q

SSRI time of action

A

8 weeks

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4
Q

***SSRI Side Effects

A 
No anticholinergic toxicity
No "cheese syndrome" 
Mainly just serotonin syndrome
Can push a suicidal person over the edge
Agitation, anxiety, panic attacks
Restlessness, psychomotor retardation, mild PD
Rapid muscle movement at night
***Sexual dysfunction (COMMON)
N/V
Diarrhea, GI cramps 
HYPONATREMIA
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5
Q

SSRI work on

A

Negative affect pts: depressed mood, guilt, disgust, anxiety, irritability
- Dont relieve symptoms of decreased positive affect

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6
Q

Positive affect means

A

Joy, happiness, enthusiasm, alertness, self confidence

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7
Q

So if you have not enough 5HT then you see

A

Depression, OCD, panic, bulimia

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8
Q

If you have too much serotonin, then you see

A

Anxiety, insomnia, sexual dysfunction, GI probs, serotonin syndrome (fever, tremor, seizures) and possibly cardiac valve stuff

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9
Q

Serotonin Syndrome can happen more often if

A

SSRI + MAOI

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10
Q

Who is at higher risk for hyponatremia with SSRIs

A 
Older
Female
Lower Na
Diuretics use
Lower weight
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11
Q

SSRI Serious ADRs

A

NE Reuptake blockade and DA reuptake blockade

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12
Q

Fluoxetine Brand

A

Prozac

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13
Q

Fluoxetine classes

A

SERT (serotonin transporter) Reuptake Blockade

5HT 2C antagonism

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14
Q

What does fluoxetine do through 2c blockade?

A

Dis-inhibits NE And DA (increase their levels) which leads to energizing and fatigue reducing effects
Also anorexia and anti-bulimia effects (high dose)

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15
Q

High dose inhibition and other inhibitions with Fluoxetine (Prozac)

A

NET and 2D6/3A4 (many drug interactions)

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16
Q

Sertraline

A

Zoloft

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17
Q

Sertraline classes

A

DA Reuptake Blockade (weakly)

Sigma 1 Agonist

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18
Q

What does sertraline’s classes mean it does?

A

DA - improve energy and motivation (weak activating)

Signma- Anxiolytic effect

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19
Q

Paroxetine

A

Paxil

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20
Q

Paroxetine effects

A

Anxiolytic

Weak NET inhibition (good to fight depression)

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21
Q

Down sides to paroxetine

A

Inhibits 2D6
Blocks NOS (sexual dysfunction)
Big withdrawal symptoms!

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22
Q

Fluvoxamine

A

Luvox

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23
Q

Fluvoxamine treats

A

OCD and anxiety

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24
Q

Fluvoxamine class

A

Sigma 1 agonists (anxiolytic)

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25
Q

***Down sides to Fluvoxamine

A

Metabolized by 3A4 and 1A2 which are induced in smokers

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26
Q

Citalopram

A

Cipramil

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27
Q

Citalopram classes

A

SERT

Mild H1 blocker

28
Q

Pros of citalopram

A

Better tolerated

29
Q

Cons of citalopram

A

Mild 2D6 inhibition

30
Q

S-Citalopram

A

Escitalopram

31
Q

S-Citalopram class and pros

A

No anti H1
No 2D6
PURE SERT inhibitor (SSRI)

32
Q

SSRI Problems with Dosing

A 
Delayed effects
Difficult to monitor
Long half life and active metabolites
Inter-individual variations
Interactions!
CI with MAOIs
33
Q

SNRI means

A

Serotinin NE Reuptake Inhibitors

34
Q

Venlafaxine

A

Effexor

35
Q

Down sides to venlafaxine

A

Substrate for 2D6 and primary metabolite is also 2D6 (desvenlafaxine)

36
Q

Venlafaxine side effects

A

Nausea
Sexual dysfunction
SSRI-like

37
Q

Levomilnacipran

A

Fetzima

38
Q

Levomilnacipran potency

A

NERT more than SERT

No DA

39
Q

Levomilnacipran SE

A 
Nausea
Constipation
Hyperhidrosis
Tachycardia
Sexual dysfunction
Vomiting
40
Q

NDRI means

A

NE Dopamine Reuptake Inhibitors

41
Q

Buprioprion

A

Wellbutrin

42
Q

Buprioprion works how?

A

Poorly defined

Weak inhibitor of both NET/DAT but metabolites are more potent

43
Q

Goldilocks drug solution?

A

CNS activating and stimulating

Also anti-smoking drug

44
Q

Down side to bupropion

A

2D6

45
Q

Buproprion use

A

Pts who cannot tolerate serotonin side effects of SSRI or whose depression does not respond to 5HT boosting

46
Q

Duloxetine

A

Cymbalta

47
Q

Duloxetine

A

5HT and NE uptake

48
Q

Duloxetine down side

A

2D6 inhibitor

49
Q

Duloxetine used for

A

Chronic pain

Pain with depression

50
Q

NRI means

A

NE Selective Reuptake Inhibitors

51
Q

Examples of NRI

A

Atomoxetine (Strattera)

Viloxazine (vivalan)

52
Q

SARI means

A

Serotonin Antagonist Reuptake Inhibitor

53
Q

SARI MOA

A

Combination of SERT inhibition and 2A/2C blockade

54
Q

2A/2C antagonisms + SET inhibition means

A

Makes serotonin output more inhibitory
Potentiates gene expression stimulated by 1A
Potentiates inhibitory action of 1A on glutamate release

55
Q

Trazodone

A

Desyrel

56
Q

Trazodone is used for

A

Short acting sedative antidepressant (3-6 hrs)

57
Q

Down side to trazodone

A

3A4

58
Q

NaSSA

A

Noradrenergic-Specific Serotonergic Antidepressant

59
Q

NaSSA MOA

A

Release more serotonin and don’t stop releasing

60
Q

Mirtazapine

A

Remeron

61
Q

Mirtazapine class

A

H1 (strong sedative)
Alpha2 (enhances NE)
Blocks H1, 5HT2 and 5HT3

62
Q

Typical AE

A

Weight gain

63
Q

Vilazadone

A

Viibryd

64
Q

Vilazadone class

A

SSRI

65
Q

Vilazadone up side

A

Improved mood within one week
No reduction in sexual functioning
No weight gain

66
Q

St. John’s Wort

A

Hypericum perforatum

- 3A4 and can cause serotonin syndrome with other antidepressants

67
Q

Major depression is a result of

A

neuronal loss in hippocampus and prefrontal cortex and drugs stimulate neurogenesis

Neuro Quiz 2 (4 decks)

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