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Boards And Beyond Psychiatry > Antidepressants > Flashcards

Antidepressants Flashcards

1
Q

Depression is associated with decreases in

A

Serotonin, norepinephrine, and dopamine

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2
Q

Most antidepressants increase levels of

A

Serotonin, NE, and DA

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3
Q

The anti-histamine effects of antidepressants often causes

A

Sedation and dry mouth

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4
Q

An NE blockade can cause

A

Hypotension (alpha-1)

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5
Q

Results in tachycardia and urinary retention

A

Muscarinic blockade

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6
Q

Old antidepressants that blocked reuptake of 5-HT and NE

A

Tricyclic Antidepressants (TCAs)

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7
Q

Is a broad spectrum antidepressant with anti-histaminergic, anti-muscarinic, and alpha-1 blocking properties

A

TCA’s

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8
Q

What are the three anti-histaminergic side effects of TCAs?

A

Sedation, weight gain, confusion (especially in elderly)

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9
Q

What are the 4 anti-muscarinic (anti-cholinergic) effects of TCAs

A

Blurry vision, constipation, dry mouth, and urinary retention

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10
Q

When a patient is taking TCAs, we need to monitor ECG for

A

Increased QRS interval

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11
Q

Block cardiac sodium channels

A

TCAs

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12
Q

The most prominent manifestation of TCA toxicity

A

Increased QRS interval

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13
Q

What is the treatment for TCA overdose?

  • provides excess Na+
  • also increased pH favors inactive form of drug
A

Sodium bicarbonate

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14
Q

Also used for OCD, diabetic neuropathy, chronic pain, and prevention of migraines

A

TCAs

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15
Q

Inhibits monoamine oxidase, which decreases the breakdown of monoamines

A

MAO inhibitors

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16
Q

Responsible for the breakdown of dopamine, serotonin, and norepinephrine

A

MAO-A

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17
Q

Responsible fo the breakdown of Dopamine only

A

MAO-B

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18
Q

Tranylcypromine, phenelzine, and isocarboxazid are the three forms of

A

Non-selective MAO inhibitors

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19
Q

Rarely used in the modern era, but can be used for refractory depression and anxiety

A

MAO inhibitors

20
Q

An MAO-B selective inhibitor that is used in Parkinson’s

A

Selegilline

21
Q

Often caused by MAOi plus another serotonin drug

A

Serotonin syndrome

22
Q

If an MAOi is given with any drug that increases serotonin activity, we can see

A

Serotonin syndrome

23
Q

Naturally occurring monoamine that causes sympathetic activation

A

Tyramine

24
Q

Patients on MAOI’s have tyramine in the blood and can have a hypertensive crisis if they eat

A

Cheese, red wine, some meats

“Cheese effect”

25
Q

Inhibits 5-HT reuptake by neurons

-leads to increased 5-HT in synaptic cleft

A

SSRIs

26
Q

how long does it take for SSRIs to have their effect?

A

4-8 weeks

27
Q

A major side effect of SSRIs is

-Due to increased serotonin effects in the spinal cord

A

Sexual dysfunction

28
Q

Commonly cause GI upset, drowsiness, and weight gain

A

SSRIs

29
Q

Inhibits 5-HT AND NE reuptake by neurons

-takes 4-8 weeks to have effects

A

SNRIs

30
Q

SNRI used in fibromyalgia

A

Duloxetine

31
Q

SNRI used in diabetic neuropathy

A

Venlafaxine

32
Q

Due to it’s NE effects, SNRIs may increase

A

Blood Pressure

33
Q

The SNRI with the highest rate of sexual dysfunction is

A

Venlafaxine

34
Q

Blocks reuptake of NE and dopamine and increased presynaptic release of catecholamines

A

Bupropion

35
Q

Bupropion has no effects on

A

Serotonin

36
Q

Used in depression and smoking cessation

-May improve sexual dysfunction of SSRIs

A

Bupropion

37
Q

Bupropion toxicity is related to its stimulant effects and results in

A

Anxiety, insomnia, and seizures

38
Q

Blocks PREsynaptic alpha-2 receptors resulting in more norepinephrine and serotonin release

A

Mirtazapine

39
Q

Mirtazapine also blocks

A

POSTsynaptic 5-HT2 and 5-HT3 serotonin receptors

40
Q

Has anti-histamine side effects such as sedation, dry mouth, and increased appetite

A

Mirtazapine

41
Q

Trazodone, vilazodone, and vortioxetine are the three

-Minimal effects on NE or DA

A

Serotonin modulators

42
Q

Weak serotonin reuptake inhibitor

-affects 5-HT2A and 5-HT2C receptors

A

Trazodone

43
Q

No longer used as an antidepressant and its main clinical use is insomnia

A

Trazadone

44
Q

Partial agonist at postsynaptic 5-HT1A receptors

-blocks reuptake of serotonin

A

Vilazodone

45
Q

Can cause diarrhea (28%), sexual dysfunction, and serotonin syndrome

A

Vilazodone

46
Q

Functions as a full and partial agonist and antagonist of various serotonin receptors

A

Vortioxetine

Boards And Beyond Psychiatry (18 decks)

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