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Pharmacology > Antidepressants > Flashcards

Antidepressants Flashcards

1
Q

How long should one wait to evaluate a response to antidepressants?

A

6-8w

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2
Q

Give examples of SSRIs

A 
Fluoxetine
Citalopram
Escitalopram
Paroxetine
Sertraline
Fluvoxamine
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3
Q

Give examples of SNRIs

A

Venlaxafine
Desvenlafaxine
Duloxetine

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4
Q

Give examples of TCAs

A

Amitryptiline
Imipramine
Desipiramine

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5
Q

Give examples of MAOIs

A

Tranylcypromine

Moclobemide (RIMA)

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6
Q

Give examples of NDRIs

A

Bupropion

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7
Q

Give examples of SARIs

A

Trazadone

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8
Q

Give examples of NASSAs

A

Mirtazapine

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9
Q

Give examples of NRIs

A

Reboxetine

Atomoxetine

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10
Q

Name 8 drug classes classified as antidepressants

A 
SSRIs
SNRIs
NDRIs
NRIs
TCAs/TDAs
MAOIs
RIMAs
SARIs
NaSSAs
MAs
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11
Q

What does SSRI stand for?

A

Selective serotonin reuptake inhibitor

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12
Q

What does SNRI stand for?

A

Serotonin-norepinephrine reuptake inhibitor

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13
Q

What does TCA stand for?

A

Tricyclic antidepressant

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14
Q

What does MAOI stand for?

A

Monoamine oxidase inhibitors

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15
Q

What does NDRI stand for?

A

Norepinephrine-dopamine reuptake inhibitor

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16
Q

What does SARI stand for?

A

Serotonin antagonist and reuptake inhibitor

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17
Q

What does NaSSA stand for?

A

Noradrenergic and specific serotonergic antidepressants

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18
Q

What does NRI stand for?

A

Norepinephrine reuptake inhibitor

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19
Q

What kind of drug is reboxetine?

A

NRI

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20
Q

What kind of drug is trazadone?

A

SARI

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21
Q

What kind of drug is bupropion?

A

NDRI

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22
Q

What kind of drug is mirtazapine?

A

NaSSA

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23
Q

What kind of drug is atomoxetine?

A

NRI

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24
Q

What kind of drug is fluoxetine?

A

SSRI

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25
Q

What kind of drug is venlafaxine?

A

SNRI

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26
Q

What kind of drug is citalopram?

A

SSRI

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27
Q

What kind of drug is paroxetine?

A

SSRI

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28
Q

What kind of drug is tranylcypromine?

A

MAOI

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29
Q

What kind of drug is imipramine?

A

TCA

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30
Q

What kind of drug is sertraline?

A

SSRI

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31
Q

What kind of drug is duloxetine?

A

SNRI

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32
Q

What kind of drug is amitryptiline?

A

TCA

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33
Q

What kind of drug is deipramine?

A

TCA

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34
Q

What kind of drug is moclobemide?

A

MAOI

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35
Q

Give examples of antidepressant therapy

A 
Cognitive behavioural therapy
Interpersonal psychotherapy
Psychodynamic psychotherapy
Electroconvulsive therapy (ECT)
Transcranial magnetic stimulation (TMS)
Deep brain stimulation (DBS)
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36
Q

What kind of drug is alprazolam?

A

Benzodiazepine

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37
Q

Give options of drugs for ovulation suppression

A

GnRH analogue
Danazol
Transdermal estradiol patches
Selected OCP

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38
Q

Which drug class does maprotiline belong to?

A

Tricyclic antidepressants (TTADs?)

39
Q

Danazol in the luteal phase is ineffective for PMDD

True or false?

A

True

40
Q

What does RIMAs stand for?

A

Reversible inhibitors of monoamine oxidase

41
Q

What does MAs stand for?

A

Melatonin agonists

42
Q

Give the dose for fluoxetine

A

20-60mg po mane

43
Q

Give the dose for paroxetine

A

20-50mg po mane

44
Q

Give the dose for citaopram

A

20-40mg po mane

45
Q

Give the dose for escitaopram

A

10-20mg po mane

46
Q

Give the dose for sertraline

A

50-200mg po mane

47
Q

Give the dose for fluvoxamine

A

50-150mg po bd

48
Q

Name common side effects of SSRIs

A 
Sexual dysfunction
N+V
Diarrhoea
Headache
Insomnia
49
Q

1st line treatment for MDD?

A

SSRis

50
Q

2nd line treatment for MDD?

A

SNRIs
NDRIs
TADs

For MDD augmentation, resistance and prominent pain symptoms

51
Q

Give the dose for venlafaxine

A

75-300mg po mane

52
Q

Give the dose for desvenlafaxine

A

50-400mg po mane

53
Q

Give the dose for duloxetine

A

60-120mg po mane

54
Q

Name common side effects of SNRIs

A 
GIT discomfort
Sexual dysfunction
Sedation
Hypotension
Headache
Dry mouth
55
Q

Explain the role of NRIs in depression

A

Mostly ineffective as antidepressant

For augmentation in MDD

56
Q

Give the dose for reboxetine

A

4-5mg po bd

57
Q

Name the common side effects of NRIs

A 
Urinary hesitancy
Constipation
Headache
Nasal congestion
Perspiration
Dry mouth
Dizziness
Decreased libido
Insomnia
58
Q

Explain the role of NRIs in MDD

A

Mostly ineffective as antidepressant

For augmentation in MDD

59
Q

Give the dose for bupropion

A

150-300mg po mane

60
Q

Name the common side effects of NDRIs

A

Headache
Insomnia
Nausea

61
Q

Which antidepressant carries the risk of lethal arrythmia with overdose?

A

TADs

62
Q

Explain the role of NDRIs in MDD

A

Augmentation
Prominent hypersomnia and fatigue
Sexual dysfunction

63
Q

Give the dose for clomipramine

A

10-250mg po nocte

64
Q

Give the dose for imipramine

A

10-200mg po nocte

65
Q

Give the dose for trimipramine

A

30-300mg po nocte

66
Q

Give the dose for lofepramine

A

140-210mg po nocte

67
Q

Give the dose for maprotiline

A

75-200mg po nocte

68
Q

Name the most common side effects of TADs

A

Anticholinergic
Sedation
Orthostatic hypotension
Cardiac arrythmias

69
Q

Name anticholinergic side effects

A

Constipation
Urinary retention
Dry mouth
Blurred vision

70
Q

Give the dose for tranylcipromine

A

5-100mg po bd

71
Q

Give the dose for moclobemide

A

75-300mg po bd

72
Q

Which antidepressant class can cause tyramine-induced hypertensive crisis?

A

MAOIs

RIMAs

73
Q

Give examples of tyramine-containing foods

A 
Aged cheese
Fish
Biltong
Marmite
Sauerkraut
Beer
Chiati wine
Liquer
74
Q

Explain the role of NaSSAs

A

1st/2nd line
Augmentation
Prominent insomnia

75
Q

Give the dose for mirtazapine

A

15-45mg po nocte

76
Q

Name common side effects of NaSSAs

A

Sedation
Weight gain
Increased appetite
Dry mouth

77
Q

Explain the role of NaSSAs in MDD

A

1st/2nd line
Augmentation
Prominent insomnia

78
Q

Name common side effects of NaSSAs

A

Sedation
Weight gain
Increased appetite
Dry mouth

79
Q

Explain the role of SARis

A

Mostly ineffective in MDD

Prominent insomnia

80
Q

Give the dose for trazadone

A

75-300mg po bd

81
Q

Name the common side effects of SARIs

A 
Sedation
Orthostatic hypotension
Dizziness
Headache
Nausea
82
Q

What is the role of MAs in MDD?

A

Prominent insomnia

83
Q

Give examples of MAs

A

Agomelatine

84
Q

Give the dose for agomelatine

A

25-50mg po nocte

85
Q

Name common side effects of MAs

A

Dizziness

Nausea

86
Q

Give the dose for vorioxetine

A

5-20mg po daily

87
Q

Name the most common side effects of vortioxetine

A 
Constipation
Nausea
Vomiting
Serotonin syndrome
Abnormal bleeding
Hyponatremia
88
Q

What is the most common drug combination that causes serotonin syndrome

A

SSRI + MAOI OR lithium

89
Q

Name the symptoms of serotonin syndrome as they appear

A
  1. DIarrhoea
  2. Restlessness
  3. Extreme agitation, hyperreflexia, autonomic instability
  4. Myoclonus, seizures, hyperthermia, uncontrollable shivering, rigidity
  5. Delirium, coma, status epilepticus, CVS collapse
  6. Death
90
Q

Give pharmacological treatment options for serotonin syndrome

A 
Nitroglycerin
Cyproheptadine
Chlorpromazine
Dantrolene
BZDs
Anticonvulsants
91
Q

Which drugs most commonly cause discontinuation syndrome?

A

SSRIs

Short half life eg paroxetine

92
Q

Give the symptoms of discontinuation syndrome

A 
Dizziness
Weakness
Nausea
Rebound depression
Anxiety
Insomnia
Poor concentration
Headache
Migraine-like
Parasthesias
URT symptoms
93
Q

When do discontinuation syndrome symptoms appear and resolve?

A

6 weeks after discontinuation

Resolve after 3 weeks

94
Q

Which drug is best if patient was on an SSRI before presenting with discontinuation syndrome and why?

A

Fluoxetine

Long half life

Pharmacology (32 decks)

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