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PPI-2 > Antidepressants and anxiolytics > Flashcards

Antidepressants and anxiolytics Flashcards

1
Q

What is the mechanism of action of TCAs?

A

Inhibits SERT and NERT: increases levels of serotonin and norepinephrine

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2
Q

What are the “typical” side effects of TCAs?

A
  1. From increased NE: tachycardia, hypertension, agitation, and insomnia
  2. From increased 5-HT: stomach upset, sexual dysfunction, serotonin syndrome, increased bleeding
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3
Q

What are special side effects of TCAs?

A

Cardiovascular toxicity: reflex tachycardia and QT prolongation

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4
Q

T/F: TCAs are preferred in suicidal patients

A

False, they have the highest risk of death in overdose due to cardiac effects

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5
Q

What are names of TCAs?

A

Amitriptyline, desipramine, nortriptyline

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6
Q

What is the mechanism of SSRIs?

A

Inhibit SERT and increase serotonin

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7
Q

What are common side effects of SSRIs?

A

From increased 5-HT: Stomach upset (GI issues), sexual dysfunction, serotonin syndrome, increased bleeding

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8
Q

What drugs are SSRIs?

A

Fluoxetine, fluvoxamine, paroxetine, escitalopram, citalopram, sertraline

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9
Q

What is the mechanism of action of SNRIs?

A

Inhibit SERT and NET: increase serotonin and norepinephrine

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10
Q

What are common side effects of SNRIs?

A
  1. From increased NE: tachycardia, hypertension (check bp) , agitation, and insomnia
  2. From increased 5-HT: Stomach upset (GI issues), sexual dysfunction, serotonin syndrome, increased bleeding
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11
Q

What is a special side effect of SNRIs?

A

They can cause really bad high blood pressure because they have no off target effects (no alpha 1 blockade)

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12
Q

What drugs are SNRIs?

A

Duloxetine, venlafaxine, desvenlafaxine

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13
Q

What is the mechanism of action of NDRI’s?

A

Inhibits DAT and NET: increase dopamine and norepinephrine

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14
Q

What are the side effects of NDRI’s?

A
  1. From increased dopamine: psychosis and increased risk of seizures
  2. From increased NE: tachycardia, hypertension, agitation, and insomnia
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15
Q

What are special fun facts about NDRI’s?

A
  • It does not cause sexual dysfunction
  • It decreases appetite and can actually cause weight loss
  • It is contraindicated in patients with seizure disorders (BBW)
  • When combined with naltrexone, it is approved as a weight management drug (contrave)
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16
Q

What drug is an NDRI?

A

Bupropion

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17
Q

Mirtazapine MOA?

A

alpha 2 antagonist & 5-HT2A antagonist

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18
Q

Mirtazapine side effects GO…

A

Sedation and weight gain due to H1-antagonism

19
Q

Trazodone MOA?

A

Inhibits NET and SERT; 5-HT2 antagonist & H1-antagonist

20
Q

Trazzie side effects

A

Sedation and weight gain due to H1-antagonism; priapism

21
Q

Nefazodone MOA?

A

Inhibits NET and SERT; 5-HT2 antagonist

22
Q

Nefazodone side effects

A

Sedation, weight gain, and hepatotoxic (BBW)

23
Q

Nefazodone side effects

A

Sedation, weight gain, and hepatotoxic (BBW)

24
Q

T/F: There is less sexual dysfunction with atypical antidepressants

A

True

25
Q

T/F: MAO-inhibitors are first line antidepressants

A

False ya dummy- They are only used for treatment-resistant depression now bc

26
Q

MOA Inhibitors mechanism of action?

A

Inhibit MAO(A) and increase serotonin and norepinephrine

27
Q

What are common adverse effects seen with MAO-Is?

A
  1. From increased NE: tachycardia, hypertension (and orthostatic hypotension d/t octopamine), agitation, and insomnia
  2. From increased 5-HT: Stomach upset (GI issues), sexual dysfunction, serotonin syndrome, increased bleeding
28
Q

What are fun facts you should know about MAO-Is?

A

Drug food interactions can lead to hypertensive crisis so avoid tyramine-containing foods (wine and cheese)

29
Q

What are examples of MAO-I’s?

A

Selegiline, phenelzine, tranylcypromine

30
Q

What classes are good treatment options for anxiety?

A

SSRI, SNRI, TCA, BDZ, buspar, propanolol

31
Q

What can SSRIs be used for?

A

generalized anxiety disorder, panic disorder, social anxiety disorder, OCD, and PTSD

32
Q

What can SNRIs be used for?

A

generalized anxiety disorder, panic disorder, social anxiety disorder

33
Q

What can TCAs be used for?

A

OCD (clomipramine)

34
Q

What can benzodiazepines be used for?

A

Generalized anxiety disorder and panic disorder

35
Q

What can buspirone be used for?

A

Generalized anxiety disorder

36
Q

T/F: SSRIs are the agents of choice for long term treatment of anxiety related disorders

A

True

37
Q

What is paroxetine used for?

A

generalized anxiety disorder, panic disorder, social anxiety disorder, OCD, and PTSD

38
Q

What can sertraline be used for?

A

panic disorder, social anxiety disorder, OCD, and PTSD

39
Q

What can fluoxetine be used for?

A

Panic disorder and OCD

40
Q

What can fluvoxamine be used for?

A

OCD only

41
Q

What can escitalopram be used for?

A

GAD

42
Q

Buspirone

A
  • Only anxiolytic activity
  • Least effective tx for anxiety
  • Most effective after 1-4 weeks of treatment
43
Q

What is the MOA of buspar?

A

It is a partial agonist at 5-HT2A receptors

44
Q

What are side effects of buspirone?

A

Dizziness and non-specific chest pain

PPI-2 (7 decks)

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