antidepressants

Question 1

list 5 excitatory neurotransmitters

Answer 1

noradrenaline
dopamine
serotonin (5-HT)
acetylcholine
glutamine

Question 2

name 2 inhibitory neurotransmitters

Answer 2

GABA

glycine

Question 3

explain the mechanism of action for anxiolytic drugs

Answer 3

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

Question 4

what are the disadvantages of hypnotics?

Answer 4

dependence
respiratory depression
benzodiazepines interact with alcohol
cross placenta

Question 5

how do antidepressants work in the nervous system?

Answer 5

increase levels of excitatory neurotransmitters in the brain

Question 6

name three types of antidepressants

Answer 6

tricyclic antidepressants (TCAs)
selective serotonin re-uptake inhibitors (SSRIs)monoamine oxidase inhibitors (MAOIs)

Question 7

what is the mechanism of action of tricyclic antidepressants (TCAs) and selective serotonin re-uptake inhibitors (SSRIs) antidepressants?

Answer 7

inhibit re-uptake of NADR (noradrenaline), 5-HT (serotonin) or DA (dopamine) into the presynaptic receptor

Question 8

what is the mechanism of action of monoamine oxidase inhibitors (MAOIs) antidepressants?

Answer 8

inhibits enzyme breakdown of 5-HT (serotonin) and NADR (noradrenaline)

Question 9

give three examples of tricyclic antidepressants (TCAs)

Answer 9

imipramine - depression
amitriptyline - depression
doxepin - depression anxiety

Question 10

what are the side effects of tricyclic antidepressants (TCAs)?

Answer 10

dry mouth
blurred vision
constipation
urinary retention
arrhythmias
mental confusion and sedation

Question 11

give 4 examples of selective serotonin re-uptake inhibitors (SSRIs) antidepressants

Answer 11

fluoxetine - depression / OCD
citalopram - depression
sertraline - depression / panic attacks
paroxetine - “ “

Question 12

what are the side effects of selective serotonin re-uptake inhibitors (SSRIs)?

Answer 12

headache
nausea
dizziness
diarrhoea
convulsions

Question 13

give 2 examples of monoamine oxidase inhibitors (MAOIs) antidepressants

Answer 13

phenelzine - depression / bipolar

tranylcypromine - severe depression

Question 14

what are the side effects of monoamine oxidase inhibitors (MAOIs) antidepressants?

Answer 14

hypersensitivity
food interactions
inhibition of cytochrome p450
nausea
dizziness
insomnia
sedation

Question 15

what do monoamine oxidase inhibitors (MAOIs) antidepressants interact with?

Answer 15

tyramine-containing foods (red wine, cheese, marmite)

Question 16

what is monoamine oxidase?

Answer 16

an enzyme which breaks down amine neurotranimitters

Question 17

how does inhibiting monoamine oxidase alter mood?

Answer 17

inhibiting the break down of neurotransmitters keeps them in the brain for longer

Question 18

name 2 next generation antidepressants

Answer 18

buprofion

venlafaxine

Question 19

what is the mechanism of action for next generation antidepressants?

Answer 19

non- selective reuptake inhibitors - targeting corticotropic releasing hormone

Question 20

name 4 mood stabilisers

Answer 20

lithium carbonate
lithium citrate - both prophylaxis and treatment of acute mania
carbamazepine - mania / epilepsy
valproate - mania / epilepsy

Question 21

what are the side effects of mood stabilizers?

Answer 21

dizziness
headache
confusion
hair loss
oedema
cardiac dysrhythmia
nephrotoxicity
withdrawal 
birth defects

Question 22

what are the contraindications of mood stabilizers?

Answer 22

renal dysfunction
leukaemia
dehydration
sodium depletion

Question 23

name 3 classes of anxiolytics

Answer 23

sedative / hypnotic
benzodiazepines
non - barbiturates

Question 24

name 3 drugs which are barbiturate sedative / hyponotics

Answer 24

thiopental - prep for surgery
secobarbital - insomnia / anxiety
phenobarbital - insomnia / anxiety / seizures

Question 25

what is zolpidem?

Answer 25

a sedative / hypnotic which is not a barbiturate

Question 26

what are the caustions of sedative / hyponotics?

Answer 26

``` avoid CNS depression check for suicide drowsiness dependence / intolerance not under 18s / pregnant ```

Question 27

name 4 benzodiazepines

Answer 27

``` end:PAM diazepam - anxiety / seizures alprazolam - anxiety / panic disorders temazepam - insomnia lorazepam - anxirty / epilepsy / preop / amnesia ```

Question 28

what are the side effects of benzodiazepines?

Answer 28

``` anticholinergic: headache dry mouth dizziness blurred vision memory loss hypotension GI disturbance ```

Question 29

what is buspirone?

Answer 29

a non benzodiazepine - related to structure of serotonin rather than GABA receptors

Question 30

what is buspirone used for?

Answer 30

short term treatment of anxiety and depression

Question 31

what are the cautions of buspirone?

Answer 31

avoid CNS depressants | never with MOAIs

Question 32

name 4 typical antipsychotics / neuroleptics

Answer 32

chlorpromazine - psychosis & schizophrenia fluphenazine - psychosis & schizophrenia haloperidol - psychosis and severe behavioural probs loxapine - mood disorders & schizophrenia

Question 33

what is the mechanism of action of typical antipsychotics / neuroleptics?

Answer 33

antagonist of dopamine receptors | only affects 'positive' symptoms

Question 34

what are the side effects of typical antipsychotics / neuroleptics

Answer 34

``` parkinsonism dyskinesia sedation hypotension neuroleptic malignant syndrome ```

Question 35

what are the contra indications of typical antipsychotics / neuroleptics?

Answer 35

``` CNS depressants anticonvulsants antihypertensive antacids * all can affect break down of anti psychotics ```

Question 36

name 4 atypical anti psychotics

Answer 36

clozapine amisulpride risperidone olanepine- all mange schizophrenia

Question 37

what is the mechanism of action of atypical anti psychotics?

Answer 37

block dopamine receptors but have lower affinity than typical antipsychotics - reduce movement disorders also antagonises 5-HT

Question 38

which schizophrenic symptoms do atypical anti psychotics treat?

Answer 38

positive and negative

Question 39

what are the side effects of atypical anti psychotics?

Answer 39

``` weight gain risk of neuroleptic malignancy headache blurred vision photosensitivity insomnia nervousness dizziness ```