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Pharmacology > Antidepressants > Flashcards

Antidepressants Flashcards

1
Q

Types of antidepressants

A 
TCA
TeCAs
Unicyclic antidepressants 
MAOI
SSRI
SNRI
SSNRI
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2
Q

Tricyclic antidepressants (TCA) general info and indication

A

1950s

Largely replaced by newer antidepressant

GAD
SOCIAL PHOBIA
OCD 
PANIC DISORDER
PTSD
BODY DYSMOROHIC DISORDER
ANOERXIA 
BULIMIA
BORDERLINE
ADHD 
PARKINSONS 
ADJUNCT IN SCHIZOPHRENIA
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3
Q

Side effects of TCA

A

Many side effects are related to anti-muscarinic properties of TCA.

Dry mouth, nose (m)
Blurry vision
Constipation (m)
Urinary retention 
Memory impairment 
Increased body temp 
Drowsiness 
Anxiety
Confusion
Restlessness 
Dizziness
Akathisia
Hypersensitivity 
Weight gain 
Sweating 
Sexual dysfunction 
Sedation (H1)
Hypotension 
Tachycardia (m)
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4
Q

Mode of action for TCA

A

Primarily blocking SERT and NET

In addition they can be antagonists at 5-HT2,6 and 7, a1 and NMDA Receptors.

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5
Q

TCAs

A

Imipramine (5-HT/NE); used to control night bed wetting, strong anti-cholinergic effect

Desipramine (NE)

Amitriptyline (5-HT/NE); neuropathic pain and migraine

Nortryptiline (5-HT/NE)

Clomipramine (5-HT)

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6
Q

TCAs

A 
Imipramine 
Desipramine
Amitriptyline 
Nortryptiline 
Clomipramine 
Doxepin 
Dosulepin
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7
Q

Tetracyclic antidepressants (TeCAs)

A

Maprotiline (NE)

Mianserin

Mirtazapine

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8
Q

Mode of action of TeCAs

A

Do not inhibit reuptake of serotonin (except amoxapine), but they do inhibit NE.

Block 5-HT2, a1, H1

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9
Q

Unicyclic antidepressants

A

Bupropion

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10
Q

Buproprion

A

DA receptor inhibitor; ME-DA REUPTAKE INHIBITOR

Antidepressant and smoke cessation

Can be alone or add-on to SSRI

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11
Q

Side effects of bupropion

A 
Dry mouth
Trouble sleeping 
Agitation 
Suicidal ideation
Headache 
Risk for epileptic seizures 
Weight loss
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12
Q

Indication for bupropion

A 
Depression 
Smoke cessation 
ADHD 
Sexual dysfunction 
Obesity
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13
Q

Bupropion is contraindicated in

A 
Epilepsy
Anorexia
Bulimia
Active brain tumors 
Alcohol withdrawal 
Liver damage 
Kidney disease 
Severe hypertension
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14
Q

MAO Inhibitors indication

A 
Panic disorder w/ agoraphobia
Social phobia
Atypical depression 
Mixed anxiety disorder 
Depression 
Bulimia 
PTSD 
Borderline
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15
Q

MAOI side effects

A

Orthostatic hypotension, insomnia, irritability, sexual disturbance, seizures, weight gain

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16
Q

Cheese effect

A

MAO inactivates tyramine present in cheese, wine and more. If MAO is inhibited this inactivation will be decreased. Tyramine can cause release of large amounts of stored catecholamines from nerve terminals resulting in hypertensive crisis, occipital headache, stiff neck, tachycardia, nausea, hypertension, arrhythmia, seizure and death

17
Q

MAO-a

A

Delaminates serotonin, melatonin, epinephrine and norepinephrine

18
Q

MAO-b

A

Deaminates phenethylamine abs certain trace amines

19
Q

Non-selective MAOIs

A

Used in USA
Severe depression

Isocarboxazid 
Nialamide
Phenelzine 
Hydracarbazine
Tranylcypromine
20
Q

Selective MAO-a inhibitors

A

Moclobemid (reversible)
Pirlindole
Toloxatone
Bifemelane

21
Q

Selective MAO-b inhibitors

A

Rasagiline
Selegiline (irreversible)
Safinamide

22
Q

RIMA (reversible inhibitors of monoamine oxidase a)

A

Moclobemide
Minaprine
Toloxatone
Metralindole

23
Q

SSRI (selective serotonin reuptake inhibitors) indication

A 
Depression 
GAD
Panic disorder
PTSD 
OCD 
Bulimia 
Chronic pain

2 weeks to function

24
Q

Side effects of SSRI

A 
Nausea
Anxitogenic in the beginning 
Weight gain (SIADH may occur)
Decreased appetite 
Sexual dysfunction 
Photosensitive 
Platelet dysfunction 
Serotonin syndrome 
Etc
25
Q

Serotonin syndrome

A

Hot flash, sweating/hyperhydrosis, increased muscle rigidity, dyskinesia, hypertension, increased hr, dilated pupils

26
Q

SSRIs drugs

A 
Fluoxetine (Prozac)
Paroxetine
Fluvoxamine
Citalopram
Escitalopram
Sertraline (Zoloft)
Dapoxetine
27
Q

NRIs indication

A 
ADHD
narcolepsy 
Obesity
Antidepressant 
Anxiety
28
Q

NRIs drugs

A

Reboxetine

Atomoxetine

29
Q

SSNRIs indication

A 
MDD
OCD
ADHD 
Anxiety 
Chronic neuropathic pain 
Menopausal symptoms

Not responding to SSRI

30
Q

Types of SSNRIs

A

Venlafaxine; low dose = SSRI, high dose = SSNRI

Duloxetine

Milnacipran

31
Q

Receptor antagonists (antidepressants)

A

Nefazodone (5-HT2a)

Trazodone (5-HT)

Mirtazapine and mianserine (5-HT2a); highly sedative

Vortioxetine (5-HT reuptake inhibitor, 3a and 7 antagonist, 1b and 1a agonist)

Agomelatine (M1 and M2 agonist)

Tianeptine (AMPA, NMDA)

Pharmacology (14 decks)

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