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Top 100 drugs flashcards SET 3 > anxiety > Flashcards

anxiety Flashcards

1
Q

SSRI Indications

A
  1. moderate to severe depression 1st line, or 2nd line in mild.
  2. panic disorer
  3. OCD
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2
Q

MOA SSRI

A

Inhibit neuronal uptake of 5-HT from synaptic celft

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3
Q

SE SSRI

A
  • GI upset
  • appetite changes and weight up or down
  • Hypersensitivity reactions inc skin rash
  • hyponatraemia esp elderly
  • suicidal thoughts and behaviour
  • lower seizure threshold
  • prolonged qt by some e.g. citalopram
  • risk of bleeds
  • if high dose or combo with other serotonergic drugs e.g. other antidepressants or tramadol, cause serotonin syndrome - autonomic hyperactivity, altered mental state and neuromuscular excitation. = withdraw and support.

sudden withdrawal of ssri = flu like sx, gi upset and neuro and sleep disturbance

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4
Q

cautious prescribing to which patients for SSRIs

A
  • epilepsy
  • peptic ulcer disease
  • young people - increased risk of suicide
  • dose reduce in liver problems
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5
Q

what drugs do you not combine with ssri

A

MOA -i

cautious with other 5-ht drugs.
gastroprotect if taking aspirin/NSAIDs and SSRI.

  • bleeding risk high if already on anticoag so be careful
  • dotn combine with other drugs that increase QT
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6
Q

name some ssris

A

citalopram
fluoxetine
sertraline
escitalopram

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7
Q

typical starting dose of citalopram

A

20mg daily

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8
Q

minimum lenght of rx on SSRI

A

6 months

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9
Q

how to wean off SSRI

A

Reduce dose over 4 weeks

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10
Q

venlafaxine and mirtazapine indications

A
  • major depression where SSRIss are ineffective

- GAD - venlafaxine

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11
Q

MOA venlaflaxine

A

SNRI - increase avialability of monoamines for neurotransmission. weaker antagonist of muscarinic and h1 receptors than TCA

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12
Q

MOA mirtazapine

A

antagonist of inhibitory synpatic alpha 2 receptors. increase Monoamine for neurotransmision. potent antagonist of h1 but not muscarinic receptors so less SE

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13
Q

SE Venlafaxine and mirtazapine

A
  • GI upset
  • neuro effects e.g. headache, abnormal dreams, insomnia, confusion, convulsions
  • hyponatraemia and serotonin syndrome
  • suididal thought and behaviour increase
  • mirtazapine- sedation (take at night)
  • venlaflaxine = prolonged QT and higher risk of withdrawl effects
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14
Q

dose reduction of venlafaxine and mirtazapine in who

A
  • elderly
  • hepatic impairment
  • renal impairment
  • venlafaxine; careful in arrythmias
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15
Q

minimum lenght of time on venlafaxine or mirtazapine

A
  • 6 months
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16
Q

how to stop mirtazapine or venlafaxine

A
  • wean. dont stop suddenly. reduce dose slowly over last 4 weeks
17
Q

patient warnings about mirtazapine

A
  • seek advice if infection, such as sore throat, so blood test can be done.

mirtazapine is less sedative at higher doses

Top 100 drugs flashcards SET 3 (65 decks)

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