Antidepressants drug names and facts Flashcards
6 anti-depressant categories
- Cyclic Antidepressants
- MOAI’s
- SSRI’s
- Serotonin and Norepinephrine Reuptake Inhibitors
- Norepinephrine Reuptake Inhibitors
- Atypical antidepressants
MAOI’s Action
- inhibits monamine oxidase (MAO)- an enzyme used to break down catecholamines (norepinephrine, dopamine, serotonin) in neurons
- bond cannot be broken, function only returns when new enzymes are made
Tricyclic Antidepressants
- metabolized in the liver
- highly bound to plasma protein
- can easily become toxic if another drug is admin. that is also highly protein bound, very difficult to remove drug from body
First Generation
Tricyclic and MAOI’s
Second Generation
SSRI’s
Heterocyclics
Tofranil
imipramine
- Tricyclic
- powerful sedation and anticholinergic effects
Elavil
amitriptyline
- Tricyclic
- powerful sedation and anticholinergic effects
Anafranil
clomipramine
- Tricyclic
- powerful sedation and anticholinergic effects
- originally for depression, has anti-obsessional effects
- now primarily used for OCD (also depression, anxiety, panic, ADHD)
- can also be administered through injection
Sinequan
doxepin
- Tricyclic
- powerful sedation and anticholinergic effects
Palemor
nortriptyline
Tricyclic antidepressant and nerve pain medication
- lower sedation and aniticholinergic effects
- metabolite of Elavil
- NE and Seretonin reuptake inhibitor
- metabolized in liver
- excreted in urine and feces
- highly protein bound
- long half life (28-31 hrs)
- SE: nausea, drowsiness, sedation, worsening of symptoms, dry mouth, blurred vision
- slow onset, leads to elevated mood, better sleep
Tricyclic Uses
- depressive symptoms (especially for resistant or long term depression)
- chronic pain
- anxiolytic effects
- analgesic effects
Nopramin
desipramine
- metabolite of Tofranil
Tricyclic Mechanism of Action
- block presynaptic reuptake transporter for NE and/pr seretonin (aka NET nd SERT)
- block postsynaptic receptors for histamine, acetylcholine, and norepinephrine (why you get mroe side effects- not specific)
Tricyclic Pharmocokinetics
- given orally, easily absorbed
- long half life, in body longer
- taking at bedtime relieves sedation SE - metabolized in liver
- clinical effects are longer in elderly
- crosses placenta
Tricylcic Therapeutic Effects
- no dependence potential
- slow onset of action
- wide array of effects on CNS
- elevate mood
- increase physical activity
- improve appetite and sleep
Tri. Side Effects
- Dirty- reacts with many receptor side
- dry mouth ,blurred vision, dilated pupils
- confusion, disorientation, agitation
- sedation
- most side effects subside over time