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pharm 2 2 > Antidepressants > Flashcards

Antidepressants Flashcards

1
Q

What are the ways for antidepressants to work?

A

Down regulation of receptors or increased concentration of neurotransmitters

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2
Q

How long does it take antidepressant to work?

A

3-4 weeks

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3
Q

What are they MAO-I names? What do they do to the level of awarness?

A

Phenelzine (sedating) and Tranycypromine (activating)

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4
Q

Are Phenelzine and Tranycypromine selective?

A

NO, non selective MAO

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5
Q

Major limitation of MAO-I?

A

HTN crisis (not first line therapy)

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6
Q

How do MAO-I work?

A

Block MAO, increasing NE, Epi, Dopamine within CNS synapses

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7
Q

What is tyramine?

A

Biologically active amine which is normally metabolized intestinally by MAO-A. It is a vasoactive peptide

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8
Q

What is precaution of MAO-I?

A

Alpha agonists

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9
Q

What should you avoid with MAO-I?

A

TCA, SSRI, Meperidine

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10
Q

What is the father of TCAs?

A

Imipramine, historically referred to as thymoleptics

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11
Q

Are TCAs effective?

A

Yes, and inexpensive, but dirty and toxic.

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12
Q

What came first, secondary or tertiary amines?

A

Tertiary, they are metabolized to the less toxic secondary amines.

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13
Q

A/E of TCAs?

A

Tonic Clonic seizures
Cardiac arrhythmias (QRS prolongation)
Anticholinergic

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14
Q

TCA overdose?

A

HCO3-

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15
Q

Use caution in what patients with TCA?

A

Seizure disorder, suicidal ideations

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16
Q

Off-label uses of TCA?

A
  • Insomnia
  • Neuopathic pain
  • Enuresis (bed wetting)
17
Q

How do SSRI work?

A

inhibit uptake of serotonin

18
Q

Benefit of SSRI over TCA?

A

Less anticholinergic, cardiovascular, and toxic effects of TCA (but more expensive)

19
Q

Common a/e of SSRI?

A

sexual dysfunction

20
Q

SSRIs also cause what?

A

CP450 (CPY) inhibition

21
Q

Big caution with what for SSRI

A

Serotonin syndrome

Sweating, fever, rigidity, tachy

22
Q

What is Bupropion?

A

Weak inhibitor of Dopamine uptake

NO effect on serotonin, NE, so few CV effects

23
Q

Most significant a/e of Bupropion?

A

seizures, may cause weight loss also

24
Q

Other use for Bupropion?

A

smoking cessation

25
Q

Trazodone works how?

A

Serotonin receptor antagonist and weak SSRI

26
Q

Common use for Trazodone?

A

insomnia because it is highly sedating

27
Q

Venlafaxine works how?

A

reuptake of serotonin and NE

28
Q

A/E of Venlafaxine?

A

HTN, tachy, increase serum lipids

29
Q

Who should not get Venlafaxine?

A

MI, CAD, unstable angina

30
Q

What is Duloxetine?

A

SSRI with NE blocking properties

31
Q

Duloxetine claims to fame therapy?

A

Peripheral neuropathy, fibromyalgia, incontinence

32
Q

What is Mirtazepine?

A

sedation

33
Q

St Johns Wort is what?

A

herbal, weak SSRI & weak MAO-I

34
Q

What antibiotic is a weak MAO-I?

A

Linezolid

pharm 2 2 (8 decks)

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