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Pharmacology block 8 > Antidepressants > Flashcards

Antidepressants Flashcards

1
Q

SSRI medications

A

Fluoxetine (Prozac), Paroxetine (Paxil), Citalopram (Celexa), Escitalopram (Lexapro), Sertraline (Zoloft)

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2
Q

Fluoxetine (Prozac)

A

SSRI, 5HT reuptake inhibitor
SFx: sex dysfunction, GI, insomnia, anorexia/weight loss, cause weight gain (long term), discontinuation syndrome, 5HT syndrome w MAOIs
inhibits cytP450
Uses: anxiety, depression, migraine prophylaxis, bulimia

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3
Q

Paroxetine (Paxil)

A

SSRI, 5HT reuptake inhibitor,
SFx: sex dysfunction, GI, insomnia, anorexia/weight loss weight gain, discontinuation syndrome, 5HT syndrome w MAOIs
Pregnancy: contraindicated, CV malformation
Inhibits cytP450
Uses: depression, SAD, PMS/PMDD/hot flashes

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4
Q

Citalopram (Celexa)

A

SSRI, 5HT reuptake inhibitor
SFx: sex dysfunction, GI, insomnia, anorexia/weight loss/ weight gain. QT prolongation, discontinuation syndrome, 5HT syndrome with MAOIs
low potential for cytP450 inhibition
Uses: depression

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5
Q

Sertraline (Zoloft)

SQUIRTraline

A

SSRI, 5HT reuptake inhibitor
SFx: sex dysfunction, GI, insomnia, anorexia/weight loss/ weight gain. QT prolongation, discontinuation syndrome, 5HT syndrome with MAOIs, diarrhea
low potential for cytP450 inhibition
Uses: depression

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6
Q

SNRI medications

A

Venlafaxine (Effexor), Duloxetine (Cymbalta)

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7
Q

V(EN)lafaxine (Effexor)

A

SNRI, 5HT and NE reuptake inhibitor (some DM)
SFx: Sex dysfunction, insomnia, GI, discontinuation syndrome, dose related inc. in BP
Uses: depression, anxiety, neuropathic pain

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8
Q

Duloxetine (Cymbalta)

DULL-oxetine

A

SNRI, 5HT and NE reuptake inhibitor (some DM)
SFx: Sex dysfunction, insomnia, GI, discontinuation syndrome, dose related inc. in BP
Uses: depression, fibromyalgia, diabetic peripheral neuropathy, GAD
Contradiction: chronic liver disease/hepatic insufficiency

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9
Q

TCA medications

A

Nortriptyline (Aventyl), Amitriptyline (Elavil)

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10
Q

Nortriptyline (Aventyl)

A

SNRI+TCA, 5ht and Ne reuptae inhibitor, (mACh, alpha1, H1 elevated in Elavil)
SFx: fatal in overdose (hyperpyrexia, HTN, tachy,anticholinergic effects, convulsions), cardiotoxic (QT prolong, ventricular block, arrhythmias), lower seizure threshold, antagonist activity on other receptors- not specific
weight gain
Uses: depression- last resort in refractory depression

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11
Q

Amitriptyline (Elavil)

A

SNRI+TCA, 5ht and Ne reuptae inhibitor, (mACh, alpha1, H1 elevated in Elavil)
SFx: fatal in overdose (hyperpyrexia, HTN, tachy,anticholinergic effects, convulsions), cardiotoxic (QT prolong, ventricular block, arrhythmias), lower seizure threshold, antagonist activity on other receptors- not specific
weight gain
Uses: depression- last resort in refractory depression, migraine prophylactic

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12
Q

Buproprion (Wellbutrin)

A

Dopamine reuptake inhibitor, some NE block
SFx: restlessness, insomnia, agitation, weight loss, anorexia, inc. seizure risk, may cause psychotic episodes NO SEX SIDE EFFECTS
Uses: depression, Zyban for smoking cessation
Contra: ppl with seizure disorders and eating disorders

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13
Q

Agonist/Antagonist activity at specific 5HT and NE receptors

A

Mirtazepine (Remeron), Trazodone (Desyrel), Vilazodone (Vibryd)

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14
Q

Mirtazapine (Remeron)

A

antag. Of central presyn alph2 adrenergic autoreceptors (neg feedback NE/5-HT), block 5-HT2 and 5-HT3
SFx: sedation, solomnence, dizziness, weight gain, stim appetite, few sex side fx

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15
Q

Trazodone (Desyrel)

trazoBONE

A 
ant. 5HT2
partial agonist 5-HT1a
blocks 5HT reuptake
SFx: drowsiness, dizziness,GI (nausea, vomiting) orthostatic hypotension, protracted erection
Uses: depression
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16
Q

Vilazodone (Vibryd)

A

partial agonist 5-HT1a receptor
blocks 5-HT reuptake
SFx: NO WEIGHT GAIN, NO SEX DYSFUNCTION, insomnia, GI disturbances
Uses: depression

17
Q

MAOIs

A

Selegiline (Eldepryl)- reversible inhibitor, Phenelzine (Nardil)- irreversible inhibitor

18
Q

Selegiline (Eldepryl)
(select-iline)
reversible inhibitor

A

blocks MAO (enz that converts NE, 5-HT and DM to inactive products) MOA-A-> NE
MOA-B-> DM
MOA-B for selegiline
SFx: anorgasmia, sexual impotence, CNS stim (restlessness, insomnia). Sleep disturbances, weight gain, orthostatic hypoTN
drug interactions with indirect sympathomimetics and tyramine-containing food, SSRIs and 5-HT receptor agonists
Uses: depression (refractory), last choice med due to HTN crisis, treat parkinsons

19
Q

Phenelzine (Nardil)

irreversible inhibitor

A

blocks MAO (enz that converts NE, 5-HT and DM to inactive products) MOA-A-> NE
MOA-B-> DM
SFx: anorgasmia, sexual impotence, CNS stim (restlessness, insomnia). Sleep disturbances, weight gain, orthostatic hypoTN
drug interactions with indirect sympathomimetics and tyramine-containing food, SSRIs and 5-HT receptor agonists
Uses: depression (refractory), last choice med due to HTN crisis, treat parkinsons

20
Q

Lithium

Eskalith-CR and Cibalith-S

A

MOA unknown, mood stabilizer
takes several weeks, neuroplastic changes, inhibits recycling of inositol substrates
SFx: small therapeutic range, drowsiness, slowed mentation, forgetfulness, GI (nausea, vomiting, diarrhea), polyuria, thirst, weight gain, mild tremor, degenerative kidney changes, depression of thyroid (goiter) due to iodine use, avoid in first timester of pregnancy and breast feeding
above 2.5 mEq/L: ataxia, gross tremor, arrhythmias, coma, convulsions–> death
elim by kidney- affect clearance= inc or dec of lithium stored in body
Uses:first line drug for acute mania, long term therapy to avert M&D episodes
not effective for rapid cyclers

21
Q

Anti-epileptic medications

mixed mania states

A 
Valproic Acid (Depakote)- good for rapid cyclers
Carbamazepine (Tegretol, Equetro)
22
Q

Valproic Acid (Depakote)

A

prolongs inactivated state of Na channels, reduces Ca entry via volt-dep T type Ca channels, inc GABA synth and dec GABA breakdown, inhibit GABA reuptake by GAT1
Uses: Good for rapid cyclers, more sedating than lithum

23
Q

Carbamazepine (Tegretol)

A

prolongs inactivated state of Na channels

see picmonic

24
Q

Atypical antipsychotics for bipolar for bipolar disorder

A

Quetiapine (Seroquel), Olanzapine (Zyprexa), Risperidone (Risperdal), Aripiprazole (Abilify), Lurasidone (Latuda), Asenapine (Saphris)- bipolar depression only

25
Q

Benzodiazepines

A

Lorazepam (Ativan)- acute mania and agitation

Clonazepam (Klonopin)

26
Q

Anti-epileptic drug- bipolar depression

A

Lamotrigine (Lamictal)

Pharmacology block 8 (2 decks)

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