Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

DEN 2026 - Pharmacology > Antidepressants, Anxiolytics and Parkinson's Disease > Flashcards

Antidepressants, Anxiolytics and Parkinson's Disease Flashcards

1
Q

What is depression?

A

A pathological mood state with persistent and pervasive symptoms present for at least 2 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Describe the possible role for serotonin (5-HT) in depression

A
  • Serotonin is neurotransmitter
  • Pathways widespread in brain
  • Primary involved in expression and emotion regulation
  • Abnormal levels in depression
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Describe a simple version of the monoamine hypothesis

A

Depression is caused by a functional deficiency of monoamines

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Give 2 examples of monoamines

A
  1. Serotonin

2. Noradrenaline

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Name 5 categories of antidepressants

A
  1. SSRIs (selective serotonin reuptake inhibitors)
  2. SNRIs (serotonin and noradrenaline reuptake inhibitors)
  3. NaSSAs (noradrenergic and specific serotinergic antidepressants)
  4. Tricyclic Antidepressants
    MAOIs (monoamine reuptake inhibitors)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Name 4 examples of SSRI drugs

A
  1. Sertraline
  2. Fluoxetine
  3. Citalopram
  4. Escitalopram
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Describe SSRIs mode of action

A
  • Prevent reuptake of serotonin back into presynaptic bulb
  • Increases volume of serotonin in cleft
  • Increase post synaptic firing
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Give an overview of the adverse effects of SSRIs

A
  • Generally well tolerated
  • Relatively safe in overdose
  • First line treatment (NICE)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Name 5 side effects of SSRIs

A
  1. Nausea / vomiting
  2. Headache
  3. Agitation / anxiety
  4. Hyponatraemia
  5. Insomnia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Name 3 types of drugs SSRIs interact with

A
  1. St John’s Wort
  2. Other antidepressants
  3. CYP enzyme inhibitors
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is a possible effect of a drug interaction of citalopram / escitalopram?

A

QT prolongation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Name 2 examples of SNRI drugs

A
  1. Venlafaxine

2. Duloxetine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Describe SNRIs mode of action

A
  • Prevent reuptake of serotonin and noradrenaline back into presynaptic bulb
  • Increases volume of serotonin and noreadrenaline in cleft
  • Increase post synaptic firing
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Name 5 side effects of SSRIs

A
  1. Nausea / vomiting
  2. Headache
  3. Agitation / anxiety
  4. Hyponatraemia
  5. Insomnia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Name 3 types of drugs SSRIs interact with

A
  1. St John’s Wort
  2. Other antidepressants
  3. CYP enzyme inhibitors
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Name an example of an NaSSA drug

A

Mirtazapine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is the function of homeostatic autoreceptors?

A

Regulate release of neurotransmitter into synaptic cleft

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Describe 2 mechanisms of action for NaSSAs

A
  1. NaSSAs block α-2 auto receptors blocking negative feedback mechanism which increases noradrenaline release
  2. Antagonises 5-HT2 and 5-HT3 receptors which increases agonism at 5-HT1 receptors
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Name 4 common side effects of mirtazapine

A
  1. Drowsiness
  2. Increased appetite / weight gain
  3. Dizziness
  4. Potential for blood dyscrasia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Name 4 tricyclic antidepressants

A
  1. Amitriptyline
  2. Clomipramine
  3. Lofepramine
  4. Dosulepin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Describe the mode of action of tricyclic antidepressants

A
  • Prevent reuptake of serotonin and noradrenaline back into presynaptic bulb by blocking reuptake transporters
  • Increases volume of serotonin and noradrenaline in cleft
  • Increase post synaptic firing
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Give a general overview of tricyclic safety profile

A
  • Less well tolerated than other antidepressants
  • Potentially fatal in overdose
  • Not recommended first line
  • Dangerous in combination with other antidepressants or St John’s Wort
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Name 3 general side effects of tricyclics

A
  1. Nausea
  2. Vomiting
  3. Headache
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Name 2 side effects of tricyclics caused by action at histamine receptor

A
  1. Sedation

2. Hangover

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Name 3 side effects of tricyclics caused by α-1 receptor antagonism

A
  1. Postural hypotension
  2. Tachycardia
  3. Arrhythmia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Name 4 side effects of tricyclics caused by action as an anticholinergic

A
  1. Dry mouth
  2. Blurred vision
  3. Constipation
  4. Urinary retention
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Name a reversible MAOI

A

Moclobemide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Name 2 irreversible MAOIs

A
  1. Phenylzine

2. Tranylcypromine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Describe the mode of action of MAOIs

A
  • Inhibition of MAO enzymes which break down noradrenaline and serotonin in synaptic cleft
  • Increases volume of serotonin and noradrenaline in cleft
  • Increase post synaptic firing
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Name a dietary interaction of MAOIs

A

Tyramine containing foods

31
Q

Name 2 pharmacological interactions of MAOIs

A
  1. Other antidepressants

2. St John’s Wort

32
Q

Why do MAOIs interact with tyramine containing foods?

A
  • Tyramine is normally inactivated by MAO enzymes in GIT
  • Tyramine cannot be metabolised
  • Causes release of catecholamines
  • Leads to tachycardia, hypertension, arrhythmias and strokes
33
Q

Name 5 side effects of MAOIs

A
  1. Postural hypotension
  2. Drowsiness
  3. Anticholinergic effects
  4. Weight gain
  5. Parathesia
34
Q

Name 4 antidepressants which may cause QT prolongation

A
  1. Escitalopram (SSRI)
  2. Citalopram (SSRI)
  3. Venlafaxine (SNRI)
  4. Mirtazapine (Tricyclic)
35
Q

Describe NICE guidelines for prescribing antidepressants

A
  1. SSRI 1st line
  2. Switch to alternative SSRI or another class of antidepressant
  3. Augment (lithium, antipsychotic, mirtazapine)
36
Q

Name 5 common anxiety disorders

A
  1. Generalized anxiety disorder
  2. Panic disorder
  3. Social phobia
  4. OCD
  5. PTSD
37
Q

Name a common self medicated anxiolytic

A

Alcohol

38
Q

Name 5 treatments used in anxiety

A
  1. SSRIs (usually first line)
  2. Benzodiazepines / Z drugs
  3. Pregabalin
  4. Buspirone
  5. Antipsychotics
39
Q

What receptor is important for benzodiazepines and Z-drugs?

A

GABA-A receptor

40
Q

Describe the GABA-A receptor

A
  • Ionotropic (chloride channel)

- 5 subunits cause of 16 isoforms

41
Q

How do benzodiazepines and Z-drugs affect GABA-A receptor?

A

Increase affinity for GABA and therefore enhance inhibitory effect

42
Q

Name 5 uses of benzodiazepines

A
  1. Anxiolytic
  2. Hypnotic
  3. Muscle relaxant
  4. Anti convulsant
  5. Amnestic
43
Q

Name 5 side effects of benzodiazepines

A
  1. Headaches
  2. Confusion
  3. Ataxia
  4. Dysarthria
  5. Disinhibition
44
Q

Name 4 uses of diazepam

A
  1. Anxiety
  2. Muscle spasms
  3. Seizures
  4. Alcohol withdrawal
45
Q

Name 4 routes of administration of diazepam

A
  1. Orally
  2. IV
  3. Rectally
46
Q

How is diazepam excreted?

A

Glucuronide conjugates excreted in the urine

47
Q

Describe the main differences between lorazepam and diazepam

A
  • Faster acting
  • Shorter half life (no active metabolites)
  • More potent
48
Q

Describe Z drugs

A
  • Different chemical structure to benzodiazepines
  • Acts on benzodiazepine site at GABA-A receptor
  • Short onset of action
  • Side effects similar to benzodiazepines
49
Q

Name an example of a barbiturate drug

A

Phenobarbital

50
Q

Why can barbiturates act synergistically with benzodiazepines?

A

Bind to different sites on GABA-A receptors

51
Q

Why can barbiturates be toxic at high doses?

A

Act as agonist in the absence of GABA

52
Q

What is flumazenil used for?

A

Treat overdose of benzodiazepines

53
Q

How does flumazenil work?

A

Competitive antagonist on benzodiazepine binding site

54
Q

Name 3 clinical indications of pregabalin

A
  1. Anticonvulsant
  2. Anxiolytic
  3. Neuropathic pain
55
Q

Describe the mechanism of action of pregabalin

A
  • Inhibitory action at α-2 delta subunit of presynaptic voltage gated calcium channels
  • Modulates release of excitatory neurotransmitters
56
Q

Describe the mechanism of action of buspirone

A
  • Agonist at presynaptic 5HT-1A receptor
  • Partial agonist of postsynaptic 5HT-1A receptors
  • Supresses serotinergic tranmission
  • Enhances dopaminergic and noradrenergic transmission
57
Q

Describe the mechanism of action of alcohol

A
  • Acts like benzodiazepine at GABA-A receptor

- Antagonist at glutamate receptor

58
Q

Describe 2 components of the dependence of alcohol

A
  • Upregulation of NMDA

- Downregulation of GABA receptors

59
Q

What causes Parkinson’s disease?

A
  • Imbalance of dopamine and acetylcholine neuronal function in extrapyramidal system
  • Loss of dampening of movement causing both muscle groups to contract
  • Leads to rigidity and stiffness
60
Q

Name 4 types of dopamine enhancing drugs

A
  1. Levodopa + carbidopa
  2. Dopamine agonists
  3. COMT inhibitors
  4. MAO-B inhibitors
61
Q

How do COMT inhibitors increase dopamine transmission?

A

Allow more levodopa to cross blood brain barrier

62
Q

How do MAO-B inhibitors increase dopamine transmission?

A

Less dopamine is broken down in synaptic cleft so more is available for post synaptic firing

63
Q

What is levodopa?

A

Precursor of dopamine given instead of dopamine as it crosses the blood brain barrier

64
Q

Why is levodopa given with carbidopa?

A

Carbidopa is a dopa decarboxylase inhibitor which allows more levodopa to cross into the brain

65
Q

Name 3 psychiatric adverse effects of levodopa

A
  1. Confusion
  2. Anxiety
  3. Impulse control disorders
66
Q

Name 4 peripheral adverse effects of levodopa

A
  1. Nausea / vomiting
  2. Hypotension
  3. Arrhythmias
  4. Sweating
67
Q

What is dementia?

A

Symptoms associated with decline in memory and thinking of a degree sufficient to impair functioning in daily living

68
Q

Describe 4 presentations of dementia

A
  1. Early changes in mood and memory
  2. Gradual decline in short term memory
  3. Loss of ability to conduct complex tasks
  4. Impaired concentration
69
Q

What is the main type of dementia?

A

Alzheimer’s disease

70
Q

Describe 4 components of the pathology of dementia

A
  1. Gliosis / loss of neurones
  2. Reduction of cerebral cortex subcortical white matter
  3. Depletion of cholinergic neurones
  4. Excessive gluatmatergic transmission
71
Q

Name 2 types of drugs used to treat dementia

A
  1. Acetylcholinesterase inhibitors

2. NMDA receptor antagonist

72
Q

Name 3 acetylcholinesterase inhibitors

A
  1. Donepezil
  2. Rivastigmine
  3. Galantamine
73
Q

Name an NMDA receptor antagonist

A

Memantine

74
Q

Name 4 side effects of acetylcholinesterase inhibitors

A
  1. Nausea / vomiting
  2. Bradycardia
  3. Heart block
  4. Muscle cramps

DEN 2026 - Pharmacology (22 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions