CNS II- Antidepressants, Bipolar/ADHD, Antipsychotics Flashcards by MARIAH VACA

Monoamine MOA

MOA: essentially all available drugs work to increase NA, 5HT

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Tricyclic antidepressants

MOA: block reuptake of norepinephrine and serotonin, action at H1, AcH, 5HT2a, alpha NE receptors plus NE and 5Ht uptake

Amitriptyline (elavil)
- nortriptyline, imipramine

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Tricyclic antidepressants AE

sedation, CV effects: tachycardia, orthostatic hypotension, antimuscarinic effects, weight gain, panic disorder, enuresis, ADD, IBS

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Antimuscarinic AE

blurred vision
dry eyes, mouth
tachycardia
dyspepsia
constipation
retention

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SSRI- selective serotonin reuptake inhibitors (3)

fluoxetine (prozac)
sertraline (zoloft)
citalopram (celexa)

Uses: anxiety disorders, GAD, panic disorders, OCD, eating disorders, PTSD

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SSRI’s AE

agitation
confusion
sweating
tremors
fever
produce restlessness
insomnia
N/V
decreased libido, sexual function

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SNRI- serotonin/norepinephrine reuptake inhibitors (2)

venlafaxine (effexor)

duloxetine (cymbalata)
uses: GAD, diabetic and neuropathic pain, hot flashes, PTSD, autism

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Bupropian

antidepressant
MOA not clear

uses: nicotine addiction, prevention of SAD, neuropathic pain, weight loss, depression in bipolar

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Bupropian AE

increase libido and sexual function
weight loss
seizures
insomnia

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mirtazepine

MOA: 5-HT and NE by blockade of presynaptic receptors

uses: antidepressant, weight gain, minimal sexual dysfunction

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monamine oxidase inhibitors (MAOI) (1)

MOA: inhibit enzyme that degrades catecholamines and serotonin in nerve terminals

selegine (emsam)- transdermal antidepressant

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MAOI AE

anxiety, insomnia
orthostatic hypotension
food interaction can cause HTN crisis

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Lithium

used for bipolar disorder, mood stabilizer
MOA unknown

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Other mood stabilizer

valproic acid (depakote)- acute mania
olanzapine - severe mania, or symptoms of psychosis
resperidone - severe mania, or symptoms of psychosis

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Methylxanthines

MOA: probably antagonist at adenosine receptors, nonspecific stimulants

uses: stimulant
caffeine, theophylline, theobromine

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Methylxanthines AE

withdrawal headdaches
excess timualtion
GI irritation

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Amphetamines

MOA: blocks reuptake and cause release of catecholamines

uses: ADHD, increase alertness, reduce fatigue, improve task performance, reduce negative behavior

Amphetamines (4)

amphetamine (adderall)
methylphenidate (ritalin)
dexmethylphenidate (focalin)
daytrana- transdermal methylhenidate patch

Amphetamines AE

insomnia
anorexia
cardiac stimulant- increase HR, BP
tolerance
physical dependence/ addiction potential

lisdexamfetmaine (vyvanse)

additional stimulant
FDA approved

Non-stimulants for ADHD (3)

atomoxetine (strattera)
guanfacine (intuniv)
clonidine

Conventional (FGA’s) antipsychotics

MOA: block DA receptors

more effect on positive than negatice S/S

Atypical (SGA’s) antipsychotics

MOA: moderate blockade of DA receptors with potent blockade of 5HT receptors

effective for positive and negative S/S

Antipsychotic effects

dysphoria
impair cognitive performance

Phenothiazines (4)

MOA: block dopamine receptors thiothixene (navane) chlorpromazine (thorazine) prochloperazine (compazine) promethazine (pherergan)

Non-phenothiazines

MOA: block dopamine receptors haldoperidol (haldol) droperidol (inapsine)

Conventional (FGA) antipsychotics AE

pseudoparkinsonism dystonia akathisia tardive dyskinesia sedation orthostatic hypotension sexual dysfunction antimuscarinic effects

Atypical (SGA) antipsychotics AE

weight gain increase glucose hyperlipidemia sedation antimuscarinic effects extrapyramidal effects

Clozapine (clozaril)

MOA: blocks DA4 but also 5HT2, alpha and H1 uses: most effective agent fro schizophrenia -reduces suicide

Other SGA's (5)

risperidone olanzapine quetiapine aripiprazole (abilify) cariprazine (vraylar)

Ariprprazole (abilify)

MOA: partial agonist at 5HT and D2 receptors, DA system atabilizer Uses: psychosis, bipolar mania, ASD, major depressive disorder, aggresion in AD BBW: increase mmortality and suicidal thoughts in depression causes compulsive behaviors (gambling, eating, shopping, sex)

Ariprprazole (abilify) AE

BBW: increase mmortality and suicidal thoughts in depression causes compulsive behaviors (gambling, eating, shopping, sex)

Cariprazine (vraylar)

has D2/5HT2 effect + D3 uses: schizophrenia, bipolar mania BBW: increase mortality in elderly dementia patients

Cocaine

MOA: reuptake of DA, NE, 5HT, also local anesthetic action, vasoconstriction

Amphetamines

MOA: block catecholamine uptake and cause release t1/2: 10 hrs methamphetamine moa: halogenated amphetamine which increase entry into brain and central effects, t1/2: 5hrs

MDMA (ecstasy)

mehthylenedioxy- derivatives of methamphetamine MOA: binds to 5HT transporter and causes profound release of 5HT

Ecstasy AE

relaxed mood enhanced empathy introspection and communication sweating tachycardia fatigue muscle spasms

Ketamine

MOA: NMDA antagonist, dissociative anesthetic, unpleasant dreams, hallucinations uses: useful for pediatric procedures outside, depression, pain

LSD

MOA: acts at multiple sites in brain and spinal cord, probably through 5HT2 receptors

Other drugs for drug abuse

canniboids psilocybin (magic mushrooms) dextromethorphan (DXM)