antidepressants Flashcards
list 5 excitatory neurotransmitters
noradrenaline dopamine serotonin (5-HT) acetylcholine glutamine
name 2 inhibitory neurotransmitters
GABA
glycine
explain the mechanism of action for anxiolytic drugs
end aim - to increase GABA (inhibitory neurotransmitter) in the brain
anxiolytics cause inhibitory neurone to release GABA at synapse - this makes post synaptic neurone less excitable and neurones less easily activated
what are the disadvantages of hypnotics?
dependence
respiratory depression
benzodiazepines interact with alcohol
cross placenta
how do antidepressants work in the nervous system?
increase levels of excitatory neurotransmitters in the brain
name three types of antidepressants
tricyclic antidepressants (TCAs) selective serotonin re-uptake inhibitors (SSRIs)monoamine oxidase inhibitors (MAOIs)
what is the mechanism of action of tricyclic antidepressants (TCAs) and selective serotonin re-uptake inhibitors (SSRIs) antidepressants?
inhibit re-uptake of NADR (noradrenaline), 5-HT (serotonin) or DA (dopamine) into the presynaptic receptor
what is the mechanism of action of monoamine oxidase inhibitors (MAOIs) antidepressants?
inhibits enzyme breakdown of 5-HT (serotonin) and NADR (noradrenaline)
give three examples of tricyclic antidepressants (TCAs)
imipramine - depression
amitriptyline - depression
doxepin - depression anxiety
what are the side effects of tricyclic antidepressants (TCAs)?
dry mouth blurred vision constipation urinary retention arrhythmias mental confusion and sedation
give 4 examples of selective serotonin re-uptake inhibitors (SSRIs) antidepressants
fluoxetine - depression / OCD
citalopram - depression
sertraline - depression / panic attacks
paroxetine - “ “
what are the side effects of selective serotonin re-uptake inhibitors (SSRIs)?
headache nausea dizziness diarrhoea convulsions
give 2 examples of monoamine oxidase inhibitors (MAOIs) antidepressants
phenelzine - depression / bipolar
tranylcypromine - severe depression
what are the side effects of monoamine oxidase inhibitors (MAOIs) antidepressants?
hypersensitivity food interactions inhibition of cytochrome p450 nausea dizziness insomnia sedation
what do monoamine oxidase inhibitors (MAOIs) antidepressants interact with?
tyramine-containing foods (red wine, cheese, marmite)
what is monoamine oxidase?
an enzyme which breaks down amine neurotranimitters
how does inhibiting monoamine oxidase alter mood?
inhibiting the break down of neurotransmitters keeps them in the brain for longer
name 2 next generation antidepressants
buprofion
venlafaxine
what is the mechanism of action for next generation antidepressants?
non- selective reuptake inhibitors - targeting corticotropic releasing hormone
name 4 mood stabilisers
lithium carbonate
lithium citrate - both prophylaxis and treatment of acute mania
carbamazepine - mania / epilepsy
valproate - mania / epilepsy
what are the side effects of mood stabilizers?
dizziness headache confusion hair loss oedema cardiac dysrhythmia nephrotoxicity withdrawal birth defects
what are the contraindications of mood stabilizers?
renal dysfunction
leukaemia
dehydration
sodium depletion
name 3 classes of anxiolytics
sedative / hypnotic
benzodiazepines
non - barbiturates
name 3 drugs which are barbiturate sedative / hyponotics
thiopental - prep for surgery
secobarbital - insomnia / anxiety
phenobarbital - insomnia / anxiety / seizures
what is zolpidem?
a sedative / hypnotic which is not a barbiturate
what are the caustions of sedative / hyponotics?
avoid CNS depression check for suicide drowsiness dependence / intolerance not under 18s / pregnant
name 4 benzodiazepines
end:PAM diazepam - anxiety / seizures alprazolam - anxiety / panic disorders temazepam - insomnia lorazepam - anxirty / epilepsy / preop / amnesia
what are the side effects of benzodiazepines?
anticholinergic: headache dry mouth dizziness blurred vision memory loss hypotension GI disturbance
what is buspirone?
a non benzodiazepine - related to structure of serotonin rather than GABA receptors
what is buspirone used for?
short term treatment of anxiety and depression
what are the cautions of buspirone?
avoid CNS depressants
never with MOAIs
name 4 typical antipsychotics / neuroleptics
chlorpromazine - psychosis & schizophrenia
fluphenazine - psychosis & schizophrenia
haloperidol - psychosis and severe behavioural probs
loxapine - mood disorders & schizophrenia
what is the mechanism of action of typical antipsychotics / neuroleptics?
antagonist of dopamine receptors
only affects ‘positive’ symptoms
what are the side effects of typical antipsychotics / neuroleptics
parkinsonism dyskinesia sedation hypotension neuroleptic malignant syndrome
what are the contra indications of typical antipsychotics / neuroleptics?
CNS depressants anticonvulsants antihypertensive antacids * all can affect break down of anti psychotics
name 4 atypical anti psychotics
clozapine
amisulpride
risperidone
olanepine- all mange schizophrenia
what is the mechanism of action of atypical anti psychotics?
block dopamine receptors but have lower affinity than typical antipsychotics - reduce movement disorders
also antagonises 5-HT
which schizophrenic symptoms do atypical anti psychotics treat?
positive and negative
what are the side effects of atypical anti psychotics?
weight gain risk of neuroleptic malignancy headache blurred vision photosensitivity insomnia nervousness dizziness
