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depression medicine > antidepressants > Flashcards

antidepressants Flashcards

1
Q

tricyclic method of action?

A

TCAs inhibit the re-uptake of serotonin and noradrenaline at the pre synaptic neuron leaving more of the neuro transmitter to have action.
Also affects histamine, muscularinic and acetylcholine receptors.

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2
Q

Non selective TCAs?

A

AMITRIPTYLINE, Imipramine, clotmipramine

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3
Q

Noradrenaline selective TCAs?

A

NORTRITYLINE, Lofepramine

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4
Q

Other uses of Amitriptyline?

A

At low doses used as a seditive and as an long term analgesic

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5
Q

Adverse effects of TCA’s?

A

Weight Gain, Sedation, Postural hypotension, tachycardia, arrhythmias, Antimuscularinic (“can’t see, Can’t pee, can’t shit, can’t spit” Affects sight, voiding and saliva)

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6
Q

Contraindication of TCAs?

A

HEART ISSUES. to be used with caution in people w. Cardiovascular disease.
Recent M.I. and heartblock, glaucoma, prostatism,

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7
Q

TCAs in overdose?

A

Incredibly dangerous. Death is caused by acidosis, arrhythmia and low GCS. Treat with NaHCO3
“Red as a beet, Blind as a bat, dry as a bone, hot as a hare, mad as a wet ham”.

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8
Q

Example of a Irreverisble non-selective binding MAOI?

A

PHENZELZINE, isocarboxizid, tranycipromine. these drugs are to be administer under supervision and are not recommended.

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9
Q

Example of an reversible MAOI?

A

MACLOBEMIDE (most important MAOI)

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10
Q

Major interaction of MAOI’s?

A

Tyramine - Found in Cheese, beer, herring, soy + chocolate. Can cause a major hypertensive crisis.
Also, opiods and pethedine (sudafed)

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11
Q

MAOI adverse effects?

A

Postural hypotension, Drowsiness diziness, weight gain, Anticholinergic effect (although less than TCAs) CNS stimulation.

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12
Q

SSRI method of action?

A

Blocks serotonin re-uptake.

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13
Q

What are the first line Antidepressant?

A

SSRI’s, normally citalopram.

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14
Q

MAOI Cautions?

A

Major withdrawal symptoms. Aggitation, insomnia, irritability, ataxia, drowsiness, vivid dreams, cognitive impairment.

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15
Q

Major SSRI’s?

A

CITALOPRAM, FLUOXITINE, SERTRALINE, paroxetine, escitalopram.

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16
Q

SSRI common side effects?

A

Nausea, anorexia, Insomnia, GI bleeding

17
Q

When should you take SSRI’s?

A

Common side effect is insomnia so should be taken in the morning.

18
Q

Adverse effects of Citalopram and escitalopram?

A

Associated with prolonged QT syndrome. Half dose in those over 65 and with hepatic impairment.

19
Q

contraindication of SSRIs?

A

Not to be taken in those under 18. Raised risk of suicide.

20
Q

Which Antidepressant is used post MI?

A

Sertraline

21
Q

Why cant paroxetine be stopped abruptly?

A

Short half life results in withdrawl symptoms.

22
Q

Are Antidepressants addictive?

A

No, but there are withdrawl issues.

23
Q

Adverse effects of SSRIs?

A

HYPONATREAMIA! nausea and vomiting, GI disturbance, Sexual dysfunction, QT prologation.

24
Q

Signs of hyopnatreamia?

A

Diziness, lethargy, nausea, confusion, cramps, seizures.

25
Q

hyponatraemia treatment?

A

Withdraw antudepressant.
If serum Na+ >125mmol/l - monitor daily
If serum Na+

26
Q

Caution in Fluoxetine?

A

reduced antiplatlet effect of clopidogrel.

27
Q

Interactions of SSRIs?

A

Tramadol - “Serotonin syndrome” caused by excess serotonin. also, alcohol, MOAIs, NSAIDs and antiplatlet.

28
Q

Method of action for receptor blockers?

A

They block H1 receptors inhibiting the feedback loop that tells the neuron to stop releasing serotonin and noradrenalin. Binds to pre synaptic alpha receptor.

29
Q

examples of receptor blockers?

A

MIRTRAZIPINE, trazodone

30
Q

Adverse effects of receptor blockers?

A

Weight gain and increased appetite,postural hypotension, sedation.

31
Q

Reason to chose a receptor blocker over other antidepressants?

A

Less cardiotoxic than TCAs.

32
Q

Receptor blocker interactions?

A

Sedatives, alcohol and with trazodone, avoid other antidpressants.

33
Q

Non-selective re-uptake inhibitor method of action?

A

Inhibit neurotransmitter reuptake.

34
Q

Non-selective re-uptake inhibitor example?

A

veneflaxine.

35
Q

Non-selective re-uptake inhibitor adverse effects?

A

Raised blood pressure and to be avoided if there is a risk of arrhythmia. Also, weight changes, nausea, sexual dysfunction, nervousness.

36
Q

Non-selective re-uptake inhibitor risks?

A

High risk of Arrhythmia and uncontrolled hypotension. Also withdrawl symptoms

depression medicine (2 decks)

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