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Pharm 2 (AB) > Antidepressants > Flashcards

Antidepressants Flashcards

1
Q

MAOI (Monoamine oxidase inhibitor) SE

A 
Tremor
Weakness
Dizziness
HA
HTN

For these reasons, MAOIs are not commonly used.

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2
Q

When using MAO inhibitors what foods must you avoid?

Potential SE

A

Those with tyramine (aged cheese, soy products, red wine, meats, raisins)

GI MAO is essential for the breakdown of tyramine. Using an MAO inhibitor will not allow for breakdown.

Potential SE: HTN emergency and fatal accelerated HTN

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3
Q

What are the typical anti-cholinergic SE?

What class of anti-depressants are these common in?

A 
Dry mouth
Constipation
Urinary hesitancy
Orthostatic hypotension
Sedation

Tricyclic antidepressants (Amitriptyline/Elavil)

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4
Q

What is a serious SE of tricyclic antidepressants?

A

Low therapeutic index.

Fatal in doses as little as 10x the daily dose.

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5
Q 
Amitriptyline/Elavil
Class
Ind
MOA
Char
A

Amitriptyline/Elavil
Class: Tricyclic antidepressant (TCA)
Ind: Depression, insomnia, migraine HA, chronic pain
MOA: CNS modulation of serotonin and norepinephrine
Char: PO and IM. Taken at bedtime to minimize SE

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6
Q

Amitriptyline/Elavil

SE

A

Dizziness/drowsiness

Anticholinergic effects: dry mouth, constipation, urinary hesitancy, blurred vision

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7
Q

What can happen with abrupt withdrawal of Amitriptyline/Elavil?

A

Discontinuation syndrome

Nausea
HA
Dizziness
Lethargy
Flu-like symptoms
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8
Q

Trazodone/Desyrel
Class:
Ind:
MOA:

A

Trazodone/Desyrel
Class: Tetracyclic antidepressant SARI: serotonin antagonist and reuptake inhibitor
Ind: Depression, anxiety (anxiolytic), insomnia (hypnotic), panic disorder
MOA: Serotonin reuptake inhibitor and partial antagonist

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9
Q

Trazodone/Desyrel SE

A

Sedation, orthostatic hypotension, fatigue, cardiac dysrhythmias, mania (in bipolar disorder), increased risk of suicide

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10
Q

SSRI’s common SE

A 
Dizziness
Nausea
HA
Fatigue
Diarrhea
Anxiety
Insomnia
Weight gain
Impotence
Suicide (after abrupt discontinuation, especially in adolescents)
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11
Q

Fluoxetine/Prozac
Class:
Ind:
MOA:

A

Fluoxetine/Prozac
Class: SSRI
Ind: Major depressive disorder, OCD, bulimia, panic disorder
MOA: decreased serotonin reuptake at presynaptic cleft

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12
Q

Fluoxetine/Prozac
Char:
Additional SE:

A

Fluoxetine/Prozac
Char: PO, once daily. 1/2 life of 48-72 hours. Takes weeks to achieve desired effect.

Additional SE: potential for serotonin syndrome - fever, agitation, diarrhea, elevated BP, sexual dysfunction

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13
Q

What may interfere with the use of SSRIs like Prozac?

A

NSAIDs : may compound the risk of GI bleeds caused by SSRI use.

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14
Q

Duloxetine/Cymbalta
Class:
Ind:
MOA:

A

Duloxetine/Cymbalta
Class: SNRIs (Serotonin and norepinephrine reuptake inhibitors)
Ind: Major depressive disorder, GAD, painful peripheral neuropathy and fibromyalgia
MOA: Blocks reuptake of serotonin and norephinephrine

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15
Q

Duloxetine/Cymbalta SE

A 
HA
Somnolence
Fatigue
Nausea
Xerostomia (dry mouth)
Insomnia
Erectile dysfunction
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16
Q

What antidepressant is known to treat neuropathic pain?

A

Duloxetine/Cymbalta

17
Q

Bupropion/Wellbutrin
Class:
Ind:
MOA:

A

Bupropion/Wellbutrin
Class: Norepinephrine and dopamine reuptake inhibitors (NDRI) and nicotine receptor antagonist
Ind: Major depression, bipolar disorder, ADD, smoking cessation
MOA: Blockade of norepinephrine and dopamine reuptake

18
Q

Bupropion/Wellbutrin

SE

A 
HA
Insomnia
Dry mouth
Tremors
Restlessness
Agitation
Anxiety
Sweating
Dizziness
19
Q

Bupropion/Zyban (name for smoking cessation)

Char

A

Zyban
Char: Start one week before smoker’s target quit date.

150 mg/day for 3 days then 150 mg BID; tx for 7-12 weeks

20
Q

Depression may be associated with what deficiency?

A 
Folate deficiency
Levomefolic acid (5-MTHF: active form of folic acid)
21
Q

What is Methyltetrahydrofolate’s role in depression?

A

Methyltetradydrofolate (5-MTHF) acts a co-enzme modulator in the synthesis of three monoamines: dopamine, serotonin and norepinephrine.

Supplementing folic acid, MTHF or folinic acid with SSRI tx may be beneficial.

22
Q

How is MTHF marketed in the US?

A

Medicinal food

Brand name: Deplin (7.5 or 15 mg)

Pharm 2 (AB) (8 decks)

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