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Psychiatry > Antidepressants > Flashcards

Antidepressants Flashcards

1
Q

SSRI:

  • Longest half-life –> No need to taper
  • Safe in pregnancy, children, and adolescents
  • SE:
    • Insomnia
    • Anxiety
    • Sexual dysfuntion
  • Can elevate levels of antipsychotics –> SEs
A

Fluoxetine (Prozac)

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2
Q

SSRI:

  • Higher risk for GI disturbances
  • Very few drug interactions
  • SE:
    • Insomnia
    • Anxiety
    • Sexual dysfunction
A

Sertraline (Zoloft)

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3
Q

SSRI:

  • Highly proetin bound –> Rx interactions
  • Short half-life –> withdrawal phenomena
  • SE:
    • Anticholinergic effects (Sedation, constipation, weight gain)
    • Sexual dysfunction
A

Paroxetine (Paxil)

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4
Q

SSRI:

  • Rx for OCD
  • Multiple Rx interactions due to CYP inhibition
  • SE:
    • Nausea and Vomiting
A

Fluvoxamine (Luvox)

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5
Q

SSRI:

  • Fewest Rx-Rx interactions
  • Dose dependent QTc prolongation
A

Citalopram (Celexa)

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6
Q

SSRI:

  • Levo-enantiomer of citalopram w/ similar efficacy and possible fewer side effects
  • Dose dependent QTc prolongation
A

Escitalopram (Lexapro)

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7
Q

SNRI:

  • Often used for depression, anxiety disorders like GAD and Neuropathic pain
  • Low Rx interaction
  • XR form for daily dosing
  • Increased BP w/ High-dose
A

Venlafaxine (Effexor)

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8
Q

SNRI:

  • Rx for Depression, Neuropathic pain, and Fibromyalgia
  • SE similar to SSRI
  • Dry Mouth and Constipation a/w Norepinephrine effects
  • Hepatotoxicity in pts. w/ Liver disease or Heavey Alcohol use
  • Expensive
A

Duloxetine (Cymbalta)

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9
Q

NorEpi-Dopamine Reuptake Inhibitor

  • Lack of Sexual SEs
  • Some efficacy in Rx for Adult ADHD
  • Rx for Smoking cessation
  • SE:
    • Anxiety
    • Risk of Seizures
    • Psychosis at High-doses
  • Contraindicated in pts. with Seizure or Eating disorders and those on current MAOI usage
A

Bupropion (Wellbutrin)

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10
Q

Serotonin Receptor Antagonists and Agonists (2)

  • Rx for Major Depression w/ Anxiety, Insomnia
  • No Sexual SEs
  • No change in Rapid Eye Movement (REM) sleep
  • SE:
    • Nausea and Dizziness
    • Orthostatic hypotension
    • Cardiac arrhythmias
    • Sedation
    • Priapism
A

Trazodone (Desyrel)

and

Nefazodone (Serzone)

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11
Q

A2-Adrenergic Receptor Antagonist

  • Rx for Major Depression w/ Significant Weight loss and/or Insomnia
  • SE:
    • Sedation
    • Weight Gain
    • Dizziness
    • Tremor
    • Dry mouth and Constipation
    • Agranulocytosis
    • Fewer Sexual SE
A

Mirtazapine (Remeron)

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12
Q

Rx for TCA overdose?

A

IV Sodium Bicarbonate

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13
Q

TCA:

  • Tertiary amine
  • Rx for Chronic pain, Migraine, and Insomnia
A

Amitriptyline (Elavil)

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14
Q

TCA:

  • Tertiary amine
  • Has IM form
  • Rx for Enuresis and Panic Disorder
A

Imipramine (Tofranil)

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15
Q

TCA:

  • Tertiary amine
  • Most Seretonin-specific –> Rx for OCD
A

Clomipramine (Anafranil)

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16
Q

TCA:

  • Tertiary amine
  • Rx for Chronic pain and use for Sleep-aid in Low dose
A

Doxepin (Sinequan)

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17
Q

TCA:

  • Secondary amine
  • Least likely to cause Orthostatic Hypotension
  • Rx in Chronic pain
A

Nortriptyline (Pamelor, Aventyl)

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18
Q

TCA:

  • Secondary amine
  • More activating
  • Least sedating
  • Least anticholinergic
A

Desipramine (Norpramin)

19
Q

Tetracyclic

  • Metabolite of Antipsychotic Loxpine
  • May cause EPS
  • SE similar to Typical antipsychotics
A
20
Q

Nonspecific SE

  • Antihistamine: Sedation and Weight gain
  • Antiadrenergic: Orthostatic HypoTN, Dizziness, Reflex tachy, Arrhythmias, Widening QRS and QT, and PR intervals
  • Antimuscarinic: Dry mouth, Constipation, Urinary retention, Blurred vision, Tachy, Narrow angle glaucoma
  • Lethal Overdose: Agitation, Tremors, Ataxia, Arrhythmias, Delerium, Hypoventilation from CNS depression, Seizures
A

TCAs

21
Q

(3) Major Complications of TCAs - 3Cs?

A
  • Cardiotoxicity
  • Convulsions
  • Coma
22
Q

Rx class that prevents the inactivation of Biogenic Amines, such as norepinephrine, serotonin, dopamine, and tyramine (an intermediate in the conversion of tyrosine to norepinephrine)?

A

MAOIs

23
Q

Rx class that inhibit the reuptake of norepinephrine and serotonin, increasing the availability of monoamines in the synapse, because of long half-lives, most are dosed only daily?

A

TCAs

24
Q

Rx class that inhibits presynaptic serotonin pumps that take up serotonin, leading to increased availability of serotonin in synaptic clefts?

A

SSRIs

25
Q

Enzyme that preferentially deactivates Serotonin and Norepinephrine?

A

MAO-A

26
Q

Enzyme that preferentially deactivates Phenathylamine, Dopamine, and Tyramine?

A

MAO-B

27
Q

MAOI

  • Rx for Refractory Depression
  • Rx for Refractory Anxiety
A

Phenelzine (Nardil)

Tranylcypromine (Parnate)

Isocarboxazid (Marplan)

28
Q

Rx for pts with Pyridoxine deficiency who develop Numbness or Paresthesias while taking MAOIs?

A

B6 supplement

29
Q

Antidepressant Rx for OCD?

A

SSRI (High doses, Fluvoxamine)

TCAs (Clomipramine)

30
Q

Antidepressant Rx for Panic disorder?

A

SSRIs

TCAs (Imipramine)

MAOIs

31
Q

Antidepressant Rx for Eating disorders?

A

SSRIs (High Doses)

TCAs

A2-Adrenergic (Mirtazapine)

32
Q

Antidepressant Rx for Persistent Depressive Disorder (Dysthymia)?

A

SSRIs

SNRIs (Venlafaxine, Duloxetine)

33
Q

Antidepressant Rx for Social Anxiety Disorder
(Social Phobia)?

A

SSRIs

SNRIs

MAOIs

34
Q

Antidepressant Rx for Generalized Anxiety Disorder (GAD)?

A

SSRIs

SNRIs (Venlafaxine)

TCAs

35
Q

Antidepressant Rx for Postraumatic Stress Disorder (PTSD)?

A

SSRIs

36
Q

Antidepressant Rx for IBS?

A

SSRIs

TCAs

37
Q

Antidepressant Rx for Enuresis? (1)

A

TCAs (Imipramine)

38
Q

Antidepressants Rx for Neuropathic pain?

A

TCAs (Amitriptyline and Nortryptyline)

SNRIs

39
Q

Antidepressants Rx for Chronic pain?

A

SNRIs

TCAs

40
Q

Antidepressants for Fibromyalgia?

A

SNRIs (Duloxetine)

41
Q

Antidepressants Rx for Midgraine Headaches?

A

TCAs (Amitriptyline)

42
Q

Antidepressant Rx for Smoking cessation?

A

Bupropion

43
Q

Antidepressant Rx for Premenstrual Dysphoric Disorder?

A

SSRIs

44
Q

Antidepressant Rx for Insomnia?

A

Mirtazapine

Trazodone

TCAs (Doxepin)

Psychiatry (12 decks)

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