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Psychiatry drugs > Antidepressants > Flashcards

Antidepressants Flashcards

1
Q

What are the major categories of antidepressants?

A

SSRI
TCAs
MAOIs
Miscellaneous

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2
Q

What are common withdrawal phenomenon?

A 
dizziness 
headaches
nausea
insomnia 
malaise
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3
Q

Why are SSRIs the most commonly prescribed antidepressants?

A

Low side effects
no food restriction s
much safter in overdoes

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4
Q

What are examples of SSRIs?

A 
Fluoxetine (Prozac)
Sertraline (Zoloft)
Paroxetine ( Pazil)
Fluvoxamine (Luvox)
Citalopram ( Celexa) 
Escitalopram ( Lexapro)
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5
Q

Which SSRI has the longest half life?

A

Fluoxetine

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6
Q

Which SSRI does not need to be tapered and why?

A

Fluoxetine because of its long half life

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7
Q

Which SSRI is safe in pregnancy and approved for use in children

A

Fluoxetine

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8
Q

Which SSRI has the highest risk for GI disturbances?

A

Sertraline

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9
Q

Which SSRI has several drug interactions due to its highly protein bound structure?

A

Paroxetine

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10
Q

Which SSRI has a short half life and leads to withdrawal phenomena?

A

Paroxetine

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11
Q

what are the side effects present with Paroxetine?

A

sedation
constipation
weight gain

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12
Q

Which SSRI is only approved for use in OCD?

A

Fluvoxamine

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13
Q

What are the two SSRI that have fewer secual side effects and side effects?

A

Citalopram

Escitalopram

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14
Q

How can the sexual side effects of SSRIs be treated?

A

buproprion
changing to a non SSRI antidepressant
add medications like sildenafil

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15
Q

What are side effects of SSRIs

A 
sexual dysfunction 
GI disturbances
insomnia 
headache 
anorezia 
restlessness
seizures
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16
Q

What is the black box warning against all SSRIs?

A

increased suicidal thinking and behavior

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17
Q

What are symptoms of serotonin syndrome?

A 
fever 
diaphoresis 
shivering 
tacycardia 
hypertension 
delirium 
neuromuscualar excitability 
death
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18
Q

What are two serotonin -norephinephrine reuptake inhibitors?

A

Venlafaxine

Duloxetine

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19
Q

When is venlafaxine used?

A

GAD

ADHD

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20
Q

What type of patients should Venlafaxine not be used?

A

Patients with untreated or labile BP

21
Q

When is duloxetine used for?

A

depression with neuropathic pain

fibromalgia

22
Q

What are the side effects of buproprion?

A

Seizures
psychosis
anxiety

23
Q

Why is buproprion better then SSRI

A

lack of sexual side effects

24
Q

What types of patients is buproprion contraindicated in??

A

patients with seizures
active eating disorders
MAOI users

25
Q

What are two types of serotonin receptor antagonists/ agonist?

A

Trazodone

Nefazodone

26
Q

When is trazadone and nefazodone used?

A

tx of refractory major depression
major depression with anxiety
insomnia

27
Q

What are the side effects associated with trazodone?

A

prapism

28
Q

What is the black box warning for nefazodone>

A

serious liver failure

29
Q

What type of drug is mirtazapine ( remeron)

A

alpha 2 andrenergic receptor antagonist

30
Q

When is mirtazapine used?

A

refractory major depression especially those who need to gain weight

31
Q

What is the MOA of the TCAs?

A

inhibits the reuptake of NE and Serotonin?

32
Q

Why are TCAs never first line?

A

higher incidence of side effects requite greater monitoring of dosing and can be lethal in overdose

33
Q

What are the tertiary TCAs?

A

amitriptyline (Elavil)
Impramine (Tofranil)
Clomipramine ( Anafranil)
Doxepin ( Sinequan)

34
Q

What are the secondary TCAs?

A

Nortriptyline ( Pamelor, Acentyl)

Desipramine (NORPRAMIN)

35
Q

What is the difference in tertiary and secondary amines?

A

Tertiary amines are highly anticholinergic, more sedating, and have greater lethality in overdose than secondary

36
Q

What is amitriptyline (Elavil) used for?

A

chronic pain, migraines, insomnia

37
Q

What is imipramine (Tofranil) used for?

A

IM form

useful in enuresis and panic disorder

38
Q

What is Clomipramine (Anafranil) used for?

A

tx of OCD

39
Q

What is doxepin ( sinequan) used for?

A

tx of chronic pain

40
Q

Which TCA is lease likely to cause orthostatic hypotension?

A

Nortriptyline

41
Q

Which TCA is least sedating?

A

desipramine

42
Q

What is the mainstay treatment of TCA overdose?

A

IV sodium bicarbonate

43
Q

Why do TCAs interact with other medications?

A

TCAs are highly protein bound an lipid soluble

44
Q

What are side effects of TCAs?

A 
antihistaminic 
antiadrenergic 
antimuscarinic effect 
seizures 
serotonergic effects
45
Q

What are the major complications of TCAs?

A

cardiotoxicity
COnvulsion s
COma

46
Q

What types of depression are MAOIs used for?

A

atypical
refractory depression
refractory panic/anxiety

47
Q

Phenelzine, transylcypromine, and isocarboxazid are what type of drugs?

A

MAOIs

48
Q

What are two side effects to look out for with MAOIs?

A

Serotonin syndrom e

hypertensive crisis

48
Q

What TCA can be used for enuresis?

A

Imipramine

Psychiatry drugs (5 decks)

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