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Pharm 3 > Antidepressants > Flashcards

Antidepressants Flashcards

1
Q

What is the definition of MDD?

A

The mental state of excessive sadness characterized by persistently low mood or extensive loss of pleasure and interest

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2
Q

What is the neurotrophic hypothesis centered around for MDD?

A

BDNF

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3
Q

What is the monoamine hypothesis centered around for MDD?

A

5-HT, NE, and DA

Evidently this is the important one to remember

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4
Q

What is the hormonal hypothesis centered around for MDD?

A

HPA axis and glucocorticoids, hormones in general

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5
Q

What is the prevalence of minor depression versus major?

A

60 to 25%

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6
Q

What are three characteristics of TCA’s?

A

Three ring molecular core
Similair to phenothiazines
Most NE reuptake inhibitors-IDK what that means

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7
Q

What do tertiary amine TCA’s do?

A

Inhibit NE and 5-HT reuptake

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8
Q

What are the 4 tertiary amine TCA’s?

A

Imipramine
Amytriptyline
Trimipramine
Clomipramine

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9
Q

What does secondary amine TCAs do?

A

Selectively inhibit NE reuptake inhibitors

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10
Q

What are the two secondary amine TCAs?

A

Desipramine and nortryptyline-evidently not selective…

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11
Q

Does anticholinergic actions occur more in secondary or tertiary amines?

A

Tertiary amine have greater

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12
Q

What are TCA’s effects on alpha?

A

They have anti alpha selectivity for a1 mostly, causing hypotension

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13
Q

What are the side effects of TCAs?

A 
Anti cholinergic- GI specifically
Alpha 1 blocker- postural hypotentions
Depression to hypomania
Cardiac toxicity
Weight gain
Diaphoresis
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14
Q

What is the antuhypertensive that TCAs interfere with?

A

Guanethidine

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15
Q

What does TCAs and SSRI combined cause?

A

Serotonin sydrome

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16
Q

What is the serotonin syndrome triad?

A

Cognitive-delerium, coma
Autonomic-hypertension, tachycardia, diaphoresis
Somatic-myoclonus, hyperreflexia, tremor

17
Q

What is the treatment mentioned for serotonin syndrome?

A

Cyproheptadine

18
Q

What are two other uses for TCAs?

A

Enuresis and ADHA

19
Q

What are the common SSRIs?

A 
Fluoxetine
Citalopram
Escitalopram
paroxetine
Sertraline
20
Q

What the main side effects of SSRIs and SNRIs?

A

Sexual function and suicide

21
Q

What are the three SNRIs?

A

Venlafaxine, desvenlafaxine and duloxetine

22
Q

What is the one SNRI used for pain related to diabetuc neuropathy and fibromylagia?

A

Duloxetine

23
Q

What drug category is trazadone?

A

5-HT2 antagonist

24
Q

What drug category is buproprion and mirtazapine?

A

Unicyclic

Tetracyclic

25
Q

How does buproprion work

A

Blocks NE and DA reuptake

26
Q

How does mirtazapine work?

A

Presnynaptic a2 autoreceptor antagonist, causing release of NE and 5-HT

27
Q

What are the non selective MAOI’s?

A

Phenelzine and tranylcypromine

28
Q

What are the selective MAOI’s?

A

Selegiline and rasagiline

29
Q

What are the food/drug interactions with MAOI’s?

A

Impaired metabolism of CNS depressants
Increases indirect sympathomimetics-Causes HTN
Tyramine-Hypertensive crisis

30
Q

What is the newly approved antidepressant?

A

Esketamine

31
Q

What are the advantages and indications for esketamine?

A

Fast onset-just a couple hours or days

For MDD that havent responded to SSRIs

32
Q

Is lithium onset slow or fast?

A

Slow

33
Q

What are the two main mechanisms that lithium does?

A

Inhibits IP3 and DAG, and inhibits GSK-3

34
Q

Does lithium have a high or low therapeutic index?

A

Low

35
Q

What does lithium toxicity cause?

A

Tremor, hypothyroidism, diabetes insipidus

36
Q

What are the DDI with lithium?

A

Diuretics increae reabsorption of NSAIDS, but not tylenol or aspirin

Pharm 3 (6 decks)

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