Antidepressants, Stimulants, Bipolar Drugs Flashcards

1
Q
What class:
Imipramine
Amoxapine
Nortiptyline
Amitriptyline
A

Tricyclic Antidepressants

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2
Q

Treat major depression, affect noradrenergic and serotonergic synapses

A

Tricyclic Antidepressants

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3
Q

Side effects d/t blockage of muscarininc, adrenergic, histamine receptors

A

Tricyclic Antidepressants

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4
Q

Therapeutic activity begins in >2 weeks

A

Tricyclic Antidepressants, SSRIs

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5
Q

10-40 hour half life

A

Tricyclic Antidepressants

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6
Q

Metabolized by hepatic enzymes

A

Tricyclic Antidepressants

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7
Q

Eliminated by kidneys

A

Tricyclic Antidepressants, SSRIs, SNRIs, MAOIs, lithium salts

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8
Q

Antimuscarinic Effects

A

Blurred vision, dry mouth, urinary retention, constipation, glaucoma/epilepsy aggravation

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9
Q

Side effects include antimuscarinic effects

A

Tricyclic Antidepressants

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10
Q

Side effects: antimuscarinic, hypotension, tachycardia, sedation, weight gain, sexual dysfunction, seizures, psychiatric

A

Tricyclic Antidepressants

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11
Q

Fluoxetine, Citalopram, Escitalopram, Sertraline

A

Selective Serotonin Reuptake Inhibitors

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12
Q

Most widely prescribed antidepressants

A

SSRIs

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13
Q

1-3 day half life

A

SSRIs

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14
Q

High first pass hepatic metabolism

A

SSRIs

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15
Q

Block several liver enzymes

A

SSRIs

drug interaction potential

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16
Q

Demethylated to norfluozetine (has a 30 day half-life)

A

Fluoxetine

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17
Q

Early onset side effects: Nausea, Anxiety, Insomnia

A

SSRIs

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18
Q

Late onset side effects: Anorexia, Sexual Dysfunction, Mania if BPD

A

SSRIs

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19
Q

Drug Interactions d/t hepatic enzymes CYP2D6, CPY1A2, CYP3A4

TCAs, haloperidol, antiarrhythmics, beta-aderenergic antagonists

A

SSRIs

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20
Q

Venlafaxine

Duloxetine

A

SNRIs

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21
Q

Inhibit reuptake of 5-HT, NE

A

SNRIs

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22
Q

Treat patients refractory to SSRIs

A

SNRIs

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23
Q

11-12 hour half life

A

SNRIs

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24
Q

High binding to plasma proteins

A

duloxetine, SSRIs, TCAs

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25
Q

Metabolized by CYP1A2 and CYP2D6

A

duloxetine

26
Q

Contraindicated if hepatic insufficiency

A

duloxetine

27
Q

Side effects: Nausea, Anxiety, Sleep disturbance, Sexual dysfunction, BP/HR if high dose

A

SNRIs

28
Q

Bupropion mechanism

A

inhibit dopamine reuptake

29
Q

Useful for rapid-cycling BPD

A

Burpropion

30
Q

Inhibit serotonin reuptake and blocks 5-HT2 receptors

A

Nefazodone

31
Q

Increases NE/5-HT by blocking alpha2 receptors

A

Mirtazapine

32
Q

Used in combo with TCAs

A

Atypical antidepressants bupropion, nefazodone, mirtazapine

33
Q

Side effects include headache, nausea, tinnitus, insomnia, nervousness

A

Atypical antidepressants bupropion, nefazodone, mirtazapine

34
Q

Irreversibly block monoamine oxidase

A

Phenelzine, Tranylcypromine, Selegiline

35
Q

Third line drug for depression

A

MAOIs

36
Q

Increase presynaptic concentration of monoamines

A

MAOIs

37
Q

MAOIs therapeutic effect requires

A

2-4 weeks

38
Q

Effects persist due to long-term irreversible blockage

A

MAOIs

39
Q

MAO-A deaminates

A

NE, 5-HT, DA

40
Q

Severe and unpredictable side effects (CNS + Cardiovascular)

A

MAOIs

41
Q

MAOIs + SSRIs –>

A

Serotonin Syndrome

42
Q

delirium, coma, hypertension, tachycardia, hyperthermia, hyperreflexia, tremor

A

Serotonin Syndrome

43
Q

Contain tyramine

A

cheese, liver, chicken, beer, wine

44
Q

Risk of Cheese effect

A

MAOIs (tyramine excess –> increase in catecholamines

45
Q

headache, tachycardia, hypertension, seizure, stroke

A

Cheese effect

46
Q

Decrease manic + depressive states in BPD

A

lithium salts

47
Q

Combine with antidepressants, neuroleptics, antiepileptics

A

lithium salts

48
Q

Several weeks for onset

A

lithium salts

49
Q

Very low therapeutic index

A

lithium salts
Effective dose: 0.6-1.4
Toxic dose: 1.6-2.0 mEq/L

50
Q

Sub for Na+ –> undesirable

A

lithium salts

51
Q

Block hydrolysis of inositol phosphate –> prevent formation of phosphatidylinositol

A

lithium salts

52
Q

Inhibit 5-HT1A, 5-HT1B

A

lithium salts

53
Q

20-24 hour half life

A

lithium salts

54
Q

CNS, cardiovascular, thyroid, renal, teratogenic, drug interaction side effects

A

lithium salts

55
Q

Drug interactions with thiazide diuretics, NSAIDs

A

lithium salts

56
Q

psychomotor stimulant

A

dextroamphetamine, methamphetamine

57
Q

prevent narcolepsy, ADHD

A

dextroamphetamine, methylphenidate

58
Q

Increase DA/NE in the brain

A

Stimulants: dextroamphetamine, methylphenidate, methamphetamine

59
Q

Euphoria, anxiety, vertigo, insomnia, confusion, paranoia, psychoses, suicidal/homicidal tendencies, arrhythmia, hypertension, nausea, diarrhea, addition

A

Stimulants side effects

60
Q

Phenelzine
Selegiline
Tranylcypromine

A

MAOIs