Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pharm II Exam 4 > Antidepressants > Flashcards

Antidepressants Flashcards

1
Q

Which emerging drug has been found to result in rapid relief of SI?

A

Ketamine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What do we think major depressive disorders result from?

A

Deficiency of NE or 5-HT

Changes in trophic factors & hormones play a role

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

When NTs bind to a specific receptor, what occurs?

A

Coupling –> cascade of events

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

NTs are ______ back into nerve cells by reuptake pumps (transporter molecules)

A

reabsorbed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the primary MOA of antidepressants?

A

Inhibit transporter molecules & allow more NT to remain in the synapse

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Depression is a/w changes in ______ or _______

A

serotonin

norepinephrine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Most antidepressants cause changes in ______

A

amine signaling

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is a/w more severe forms of major depression?

A

Abnormal HPA axis

Elevated cortisol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are other neuroendocrine factors seen in depression?

A

Thyroid dysregulation

Estrogen deficiency

Testosterone deficiency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Describe the acute phase in the tx of MDD

What is the goal?

A

Lasts 6-12 wks

Goal = remission

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Describe the continuation phase in the tx of MDD

What is the goal?

A

Lasts 4-9 months after remission is achieved

Goal = eliminate residual sx or prevent relapse

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Describe the maintenance phase in the tx of MDD

What is the goal?

A

12-36 months

Goal = prevent recurrence

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Which types of medications are a/w drug-induced depressive sx?

A 
Acne tx
Anticonvulsants
Antimigraines 
CV meds
Hormone therapy 
Immunologic agents 
Smoking cessation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are the different classes of antidepressants?

A 
TCAs 
MAO inhibitors
SSRIs, SNRIs 
5-HT2
Heterocyclic
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are 4 characteristics of antidepressants?

A

Rapid oral absorption

Tightly bound to plasma proteins

Undergoes hepatic metabolism

Renally cleared

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Which group of antidepressants can also be used for chronic pain & enuresis?

A

TCAs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are examples of TCAs?

A 
Amitriptylline (prototype) 
Imipramine 
Desipramine 
Doxepine 
Nortriptyline
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Which drug class is also used to treat Selegiline-Parkinson’s disease?

A

MAOIs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What are examples of MAOIs? (3)

A

Phenelzine
Tranylcypromine
Selegiline

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What are ADEs/drug interactions of MAOIs?

A

Combined w/ tyramine & sympathomimetics –> HTN

Combined w/ SSRIs –> serotonin syndrome

Toxicity: hypotension, insomnia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What are sx of serotonin syndrome?

A

Range from mild to lethal & include cognitive, autonomic & somatic effects

22
Q

What foods should be avoided w/ MAOIs?

A 
Cheese 
Beer 
Soy 
Sausage 
*All contain high tyramine
23
Q

What drug class does warfarin interact w/?

A

SSRIs

24
Q

What is an ADE of SSRIs?

A

Sexual dysfunction

25
Q

Which SSRI is not used in pregnancy? Why?

A

Paroxetine

Has NE & anticholinergic activity

26
Q

Which SSRI can cause QT prolongation?

A

Citalopram

Therefore doses > 40mg/day are not recommended

27
Q

When can you increase escitalopram (SSRI) to max daily dose?

A

After 1 week if needed

28
Q

What is important to know in regards to fluoxetine (SSRI) dosing?

A

Doses > 20mg/day may be given in a single daily dose or divided BID

29
Q

How much do you titrate paroxetine (SSRI) weekly?

A

10 mg/day OR

  1. 5 mg/day
    * Depends on max daily dose
30
Q

How much do you titrate sertraline (SSRI) weekly?

A

25 mg/day

31
Q

What is an ADE common to all antidepressants?

A

Suicidality

*Monitor behavior changes & mental status

32
Q

What is an ADE of venlafaxine (SNRI)?

A

HTN

*Dose reductions may be required if sustained HTN occurs

33
Q

Is there a benefit of exceeding 50 mg/day of desvenlafaxine (SNRI)?

A

No - ADE’s are increased & no additional benefit has been shown

34
Q

Are doses exceeding 60 mg/day of duloxetine (SNRI) more efficacious?

A

No - not shown to provide increased efficacy

35
Q

Besides major depression, what else are 5-HT2 antagonists & 5-HT reuptake inhibitors used for?

A

Depressed pts w/ anxiety

Depression w/ cognitive difficulties

36
Q

How should daily doses of nefazodone (Mixed 5-HT) be taken?

A

Divided BID

37
Q

How should daily doses of trazodone (Mixed 5-HT) be taken?

A

Divided TID

38
Q

What is the highest dose of vilazodone (Mixed 5-HT) that has been assessed?

A

40 mg/day

39
Q

What are 2 examples of other heterocyclics?

A

Bupropion (NE & dopamine reuptake inhibitor - NDRI)

Mirtazepine (serotonin & alpha2-receptor antagonist)

40
Q

What is the MOA of other heterocyclics?

A

Mirtazepine blocks presynaptic alpha2

Buproprion - NET> SERT

41
Q

Besides major depression, what else are other hertocyclics used for?

A

Smoking cessation (bupropion)

Sedation (mirtazepine)

42
Q

What are ADEs of bupropion?

A

Lowers seizure threshold

*Seizures are dose-related, & may be increased by predisposing factors (hx of seizures, alcohol withdrawal, head trauma, CNS tumor)

43
Q

What are ADEs of mirtazepine?

A

Sedation & wt gain

44
Q

How often can you increase the dose of mirtazapine?

A

No more than every 1-2 wks

45
Q

What is the MOA of folate?

A

Synthesis of NTs, s/a 5-HT

46
Q

In regards to folate, the task force states that…

A

augmentation w/ folate is reasonable, but more work is needed to clarify which subgroup of pts may achieve the greatest response

47
Q

What is the MOA of TCAs?

A

Block reuptake transporters of NE & serotonin

48
Q

What ADEs are common to all SNRIs?

A 
CV changes
Insomnia
Nausea
Serotonin syndrome
Sexual dysfunction
49
Q

What ADE is unique to desvenlafaxine (SNRI)?

A

Dose-related HLD

50
Q

What ADE is unique to duloxetine (SNRI)?

A

Orthostatic hypotension

Pharm II Exam 4 (14 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions