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1390-59 Intro to Pharmacology > Chapter 14 > Flashcards

Chapter 14 Flashcards

1
Q

bipolar mood disorder

A

mood disorder where episodes of mania and depression occur alternately

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2
Q

depression

A

mental state characterized by depresssed mood, with feelings of frustration and hopelessness

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3
Q

exogenous, or reactive, depression

A

depression caused by external factors or life events

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4
Q

lithium

A

an element similar to sodium that is used in the treatment of mania and bipolar mood disorder

reduces hyperactivity and excitement

allows better organization of thought patterns

MOA- chemical properties are similar to sodium

decreases nerve tissue excitability

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5
Q

major depressive disorder (MDD)

A

depression that arises from within an individual and requires psychotherapy and drug treatment

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6
Q

mania

A

mental state of excitement, hyperactivity, and excessive elevation of mood

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7
Q

MAOIs

A

monoamaine oxidase inhibitors, antidepressant drugs that inhibit MAO

decrease the amounts of norepinephrine and serotonin that are destroyed

permit the levels of norepinephrine and serotonin in the brain to increase

ex- isocarboxazid
phenelizine
tranycypromine

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8
Q

monoamine oxidase (MAO)

A

enzyme that inactivates (breaks down)norepinephrine and serotonin

found in adrenergic and serotonergic nerve endings

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9
Q

monoamine theory of mental depression

A

theory that mental depression is caused by low brain levels of norepinephrine and serotonin (monamines)

high levels may result in mania

  • endocrine and neurotropic deficiencies can also play a role in mental depression
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10
Q

psychomotor stimulant

A

amphetamine or related drug that increases mental and physical activity

not true anti depressant and have limited use in depression

MOA- helps our bodies make more norepinephrine and dopamine by stimulating the CNS (produce mood elevation)

Increase neurotransmitter activity by inhibiting neuro transmitter reuptake

produce drug tolerance and drug dependence

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11
Q

SNRIs

A

serotonin-norepinephrine reuptake inhibitors, a class of antidepressant drugs

MOA- Block the reuptake of noepinephrine and serotonine

ex- desvenlafaxine
duloxetine
venlafaxine

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12
Q

SSRIs

A

selective serotonin reuptake inhibitors, a class of antidepressant drugs

MOA- block the reuptake of serotonin into the serotonergic nerve endings

increase stimulation of seretonin receptors

drugs vary in the degree of activation

ex- fluozetine, fluvoxamine, paroxetine,sertraline, escitalopram, citalapram

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13
Q

TCAs

A

tricyclic anti depressants, a class of antidepressant drugs

MOA- block reuptake of norepinephrine and serotonin into the neuronal nerve endings

increased serotonin and noepinephrine levels contributed to the anti depressant effect

ex- nortriptyline
amitriptyline
doxepin
imipramine
desipramine
clomipramien
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14
Q

Anti Depressants increase levels of what?

A

norepinephrine or serotonin

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15
Q

Lithium and Anticonvulsant drugs

A

used to treat depression/bipolar disorder

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16
Q

Clinical Indications of SSRIS

A

preferred therapy for treatment of jamor depression and most anxiety disorders

administered 1-2 times a day

treatment for PTSD and OCD

premenstural dysphoric disorder

ex - fluoxetine and sertraline

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17
Q

Adverse Effects

A

GI disturbances (nausea, diarrhea, dry mouth and anorexia

sexual dysfunction

CNS effects (head ache, nervousness, insomnia and tremors)

overdose leads to serotonin syndrome (confusion, fever, tremor agitation,restlessness and occasionally, seizures

sudden discontinuation may lead to discontinuation syndrome (dizziness, nausea, anxiety and insomnia-patients must be tapered off med

18
Q

Clinical Features of SNRIs

A

venlafazine- moderately activating
desvenlafazxine- active metabolite of venlafazine
duloxetine- causes low incidences of CNS activation
other uses- treatment of GAD, chronic pain disorders, and fibromyalgia

19
Q

Adverse effects of SNRIs

A

increased blood pressure, heart rate, and CNS stimulation

sudden discontinuation can lead to discontinuation syndrome

20
Q

What are the major differences between SSRIS and SNRIS?

A

SSRIs are preferred for the treatment of major depression, there are lower incidences of adverse and toxic effects with SSRIs. SSRIS do not cause significant anticholinergic alpha adrenergic blocking, or histaminic reactions. this is the main reason why they are preferred over TCAs

TCAs and MAO inhibitors are used as alternatives when SSRIS and SNRIS are contradicted or ineffective

21
Q

Pharmacological Actions of TCAs

A

produce varying degrees of sedation, anticholinergic effects, and alpha-adrenergic blockade

drug effects are evident for 2 weeks after the termination of drug therapy

22
Q

Adverse and toxic effects of TCAs

A

anticholinergic- dry mouth constipation, urinary retention and rapid heartbeat

alpha-blocking-postural hypotenion blurred vision and drowsiness

toxic effects may be produced in the heart and liver

overdosing can result in lethal cardiac arrhythmia, seizures, and death

23
Q

Interactions with TCAs

A

alcohol- increaded sedation

24
Q

TCAs interactions with amphetamines

A

amphetamines-increased CNS stimulation

25
Q

TCAs interactions with Anticholinergics,

A

dry mouth constipation, urinary retention, blurred vision

26
Q

TCAs interactions with Anticonvulsants

A

increased possibility of seizures

27
Q

TCAs interactions with Bariturates

A

increased metabolism of tricyclics (decreased effectiveness) increased sedation

28
Q

TCAs interactions with MOA inhibitors

A

increased CNS stimulation, hyperpyrexia, seizures

29
Q

TCAs interactions with Phenothiazines

A

anticholinergic effects, CNS depression

30
Q

TCAs interactions with SSRIs, SNRIs

A

increased CNS stimulation, serotonin syndrome

31
Q

Drug Interactions with MAOIs

A

caution must be exercised with the use of other drugs

32
Q

Dietary Restrictions with MAOIs

A

foods contain tyramine (wine beer herring and certain cheeses)

sympathetic drugs used to treat cold symptoms must be avoided- decongestants and bronchodilators

33
Q

Adverse Effects of MAOIs

A

dry mouth, urinary retention, constipation, blurred vision, hypotension, weight gain, sexual dysfunction and CNS disturbances

34
Q

Nefazodone and Trazadone

A

week inhibitors of seotonin and norepinephrine reuptake

effectively antagonized 5HT2A serotonin receptors

35
Q

bupropion

A

useful in the treatment of bipolor disorder

reduces CNS effect of nicotine withdrawal

36
Q

mirtazapine

A

antagonises serotonin 5HT2 and 5HT3 receptors

acts as a sedative

37
Q

why do we use psychomotor stimulants

A

because MAOIS and tricyclic antidepressants have a delayed therapeutic response psychomotor stimulates are occasionally used to elevate mood and increase psychomotor activity

amphetamines
used to treat narcolepsy and hyperkinesis in children

can calm down hyper activity

stimulate motor or physical activity

38
Q

Adverse and Toxic Effects of psychomotor stimulants

A

dry mouth, rapid heartbeat, increased blood pressure, restlessness and insomnia

toxic doses may produce severe agitation and psychosis

39
Q

Pharmacokinetics of lithium

A

administered as a salt, lithium carbonate

blood levels are regularly measured

decreased sodium intake and hyponatremia can lead to toxicity

40
Q

Adverse and toxic effects

A

nausea, tremors, and disturbances of the thyroid gland

overdose can cause vomiting, diarrhea, drowsiness. loss of equilibrium, ringing in the ears, and frequent urination

toxic levels can lead to development of cardiac arrythmias or nephritits

occasionally produces disturbances of the contraindicated in patients with an existing thyroid condition

pregnancy category D

should not be used in pregnancy

41
Q

Preferred therapy for Depression, Mania, and Bipolor Disorder

A

major depression is treated using SSRIs

lithium and valproate are considered first-line mood stabilizers

valporate, carbamazepine, lurasidine and lamotrigine are used to treat bipolor disorder

1390-59 Intro to Pharmacology (17 decks)

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