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Phamacology > Depressants > Flashcards

Depressants Flashcards

1
Q 
Monoamine Oxidase Inhibitors?
Amitriptyline
Fluoxetine
Paroxetine
Phenelzine
Mirtazapine
Venlafaxine
Duloxetine
Bupropion
Clomipramine
Trazodone
Sertraline
A

Phenelzine

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2
Q 
Tricyclic Antidepressants?
Amitriptyline
Fluoxetine
Paroxetine
Phenelzine
Mirtazapine
Venlafaxine
Duloxetine
Bupropion
Clomipramine
Trazodone
Sertraline
A

Amitriptyline

Clomipramine

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3
Q 
Selective Serotonin Reuptake Inhibitors?
Amitriptyline
Fluoxetine
Paroxetine
Phenelzine
Mirtazapine
Venlafaxine
Duloxetine
Bupropion
Clomipramine
Trazodone
Sertraline
A

Fluoxetine
Sertraline
Paroxetine

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4
Q 
Serotonin/Norepinephrine Reuptake Inhibitors?
Amitriptyline
Fluoxetine
Paroxetine
Phenelzine
Mirtazapine
Venlafaxine
Duloxetine
Bupropion
Clomipramine
Trazodone
A

Venlafaxine

Duloxetine

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5
Q 
Atypical Antidepressants?
Amitriptyline
Fluoxetine
Paroxetine
Phenelzine
Mirtazapine
Venlafaxine
Duloxetine
Bupropion
Clomipramine
Trazodone
A

Bupropion
Trazodone
Mirtazapine

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6
Q 
Treats 
Depression due to hazards, 
2nd/3rd line option off label: OCD, bulimia, ADHD, anxiety
Amitriptyline
Fluoxetine
Paroxetine
Phenelzine
Mirtazapine
Venlafaxine
Duloxetine
Bupropion
Clomipramine
Trazodone
A

Monoamine Oxidase Inhibitors- Phenelzine

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7
Q 
MECHANISM OF ACTION
inhibition of monoamine oxidase (MAO) non-selective- results in (increased or decreased?) catecholamines!
Amitriptyline
Fluoxetine
Paroxetine
Phenelzine
Mirtazapine
Venlafaxine
Duloxetine
Bupropion
Clomipramine
Trazodone
A

Monoamine Oxidase Inhibitors- Phenelzine

increased

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8
Q 
Adverse Reaction- 
Increased Norepinephrine- which is (more or less)dangerous than Serotonin Syndrome
Amitriptyline
Fluoxetine
Paroxetine
Phenelzine
Mirtazapine
Venlafaxine
Duloxetine
Bupropion
Clomipramine
Trazodone
A

Monoamine Oxidase Inhibitors- Phenelzine

More

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9
Q 
Hypertensive Crisis- Drug interaction and food (low or high) in Tyramine can increase norepinephrine. 
Amitriptyline
Fluoxetine
Paroxetine
Phenelzine
Mirtazapine
Venlafaxine
Duloxetine
Bupropion
Clomipramine
Trazodone
A

Monoamine Oxidase Inhibitors- Phenelzine

High

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10
Q

Which are examples of Tyramine Food?
Cheese
Alcohol- Beer and Wine
Fresh, frozen, and canned meats (salami, pepperoni, fish, etc.)
Cured/Aged/smoked meats (salami, pepperoni, fish, etc.)
Fermented foods (sauerkraut, kimchi)
Unfermented food Fermented foods (sauerkraut, kimchi)
Fava beans
Avocado
Caffeine!!

A 
Cheese
Alcohol- Beer and Wine
Cured/Aged/smoked meats (salami, pepperoni, fish, etc.)
Fermented foods (sauerkraut, kimchi)
Fava beans
Avocado
Caffeine
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11
Q 
Drug Interactions
Patients should not take any drugs unless it is approved by the same prescriber.
Amitriptyline
Fluoxetine
Paroxetine
Phenelzine
Mirtazapine
Venlafaxine
Duloxetine
Bupropion
Clomipramine
Trazodone
A

Monoamine Oxidase Inhibitors- Phenelzine

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12
Q 
Adverse Reactions Serotonin
Serotonin (Increased) Syndrome:
This is a dangerous build up of serotonin, however not nearly as dangerous as hypertensive crises.
Amitriptyline
Fluoxetine
Paroxetine
Phenelzine
Mirtazapine
Venlafaxine
Duloxetine
Bupropion
Clomipramine
Trazodone
A

Monoamine Oxidase Inhibitors- Phenelzine

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13
Q 
Adverse RE
S/S Shivers- Shivering, Hyperreflexia, Increased Temp, Vital Signs, Encephalopathy, Restlessness, Sweating.
Amitriptyline
Fluoxetine
Paroxetine
Phenelzine
Mirtazapine
Venlafaxine
Duloxetine
Bupropion
Clomipramine
Trazodone
A

Monoamine Oxidase Inhibitors- Phenelzine

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14
Q 
Monoamine Oxidase Inhibitors- Phenelzine -S/S Shivers
S- 
H-
I- 
V-
E-
R-
S-
A 
Shivering
Hyperreflexia
Increased Temp
Vital Signs, 
Encephalopathy, 
Restlessness, 
Sweating.
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15
Q 
Adverse RE
S/S Smart- Sweating, Myoclonus, Autonomic instability, Rigidity, Temperature Increase, Seizures. 
Amitriptyline
Fluoxetine
Paroxetine
Phenelzine
Mirtazapine
Venlafaxine
Duloxetine
Bupropion
Clomipramine
Trazodone
A

Monoamine Oxidase Inhibitors- Phenelzine

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16
Q 
Monoamine Oxidase Inhibitors- Phenelzine -S/S Smart
S--
M-
A-
R-
T-
S-
A 
Sweating
Myoclonus
Autonomic instability
Rigidity
Temperature Increase
Seizures.
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17
Q

Monoamine Oxidase Inhibitors- Phenelzine
Onset:
Fast Onset- within ? hours, Resolves by ? the exacerbating medication/s.

A

24

stopping

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18
Q 
Avoid because they increase serotonin!
Serotonin Drugs
Antidepressants
Opioid (Tramadol, Meperidine)
Other medication (dextromethorphan, linezolid), 
St. John's Wort!
Amitriptyline
Fluoxetine
Paroxetine
Phenelzine
Mirtazapine
Venlafaxine
Duloxetine
Bupropion
Clomipramine
Trazodone
A

Monoamine Oxidase Inhibitors- Phenelzine

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19
Q 
CNS Stimulation:
S/S: anxiety, insomnia, agitation, hypomania, mania
Amitriptyline
Fluoxetine
Paroxetine
Phenelzine
Mirtazapine
Venlafaxine
Duloxetine
Bupropion
Clomipramine
Trazodone
A

Monoamine Oxidase Inhibitors- Phenelzine

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20
Q

Monoamine Oxidase Inhibitors- Phenelzine

Washout period: When switching from MAO-I you must want ? week/? days to use another antidepressant.

A

2

14

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21
Q 
2nd/3rd line option off label: OCD, bulimia, ADHD, anxiety
Amitriptyline
Fluoxetine
Paroxetine
Phenelzine
Mirtazapine
Venlafaxine
Duloxetine
Bupropion
Clomipramine
Trazodone
A

Monoamine Oxidase Inhibitors- Phenelzine

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22
Q 
Treat:
Depression◦off label common : Neuropathic pain, insomnia
Amitriptyline
Fluoxetine
Paroxetine
Phenelzine
Mirtazapine
Venlafaxine
Duloxetine
Bupropion
Clomipramine
Trazodone
A

Tricyclic Antidepressants (TCA’s): Amitriptyline, Clomipramine

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23
Q 
Treat:
Depression, Bipolar Disorder, Obsessive Compulsive Disorder (OCD), bulimia nervosa, Social Anxiety.
Amitriptyline
Fluoxetine
Paroxetine
Phenelzine
Mirtazapine
Venlafaxine
Duloxetine
Sertraline
Bupropion
Clomipramine
Trazodone
A

Selective Serotonin Reuptake Inhibitors- fluoxetine, sertraline, paroxetine

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24
Q 
Treat:
	Depression, Diabetic Neuropathy, GAD, Obsessive Compulsive Disorder (OCD). 
Amitriptyline
Fluoxetine
Paroxetine
Phenelzine
Mirtazapine
Venlafaxine
Duloxetine
Bupropion
Clomipramine
Trazodone
A

D. Serotonin/Norepinephrine Reuptake Inhibitors- venlafaxine+ duloxetine

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25
Q 
Treat:
Depression, SAD (seasonal affective disorder), Smoking cessation, Weight loss,  sexual dysfunction
Amitriptyline
Fluoxetine
Paroxetine
Phenelzine
Mirtazapine
Venlafaxine
Duloxetine
Bupropion
Clomipramine
Trazodone
A

E. Atypical: Bupropion

26
Q 
Treat:
	Used for sleep and weight gain/appetite stimulant
Amitriptyline
Fluoxetine
Paroxetine
Phenelzine
Mirtazapine
Venlafaxine
Duloxetine
Bupropion
Clomipramine
Trazodone
A

ATYPICALS: Mirtazapine

27
Q 
Treat:
	Used for sleep only!
Amitriptyline
Fluoxetine
Paroxetine
Phenelzine
Mirtazapine
Venlafaxine
Duloxetine
Bupropion
Clomipramine
Trazodone
A

ATYPICALS: Trazodone

28
Q 
MIRT= Man, I’m Really Tired?
Amitriptyline
Fluoxetine
Paroxetine
Phenelzine
Mirtazapine
Venlafaxine
Duloxetine
Bupropion
Clomipramine
Trazodone
A

ATYPICALS: Mirtazapine

29
Q 
Adverse side Effect: 
	UNIQUE SIDE EFFECT: PRIAPISM
Amitriptyline
Fluoxetine
Paroxetine
Phenelzine
Mirtazapine
Venlafaxine
Duloxetine
Bupropion
Clomipramine
Trazodone
A

ATYPICALS: Trazodone

30
Q 
MECHANISM OF ACTION
Block neuronal reuptake of NE and 5-HT, therefore increasing their concentrations at synapses. Also potential to block cholinergic, histaminergic, and α1 receptors.
Amitriptyline
Fluoxetine
Paroxetine
Phenelzine
Mirtazapine
Venlafaxine
Duloxetine
Bupropion
Clomipramine
Trazodone
A

B. Tricyclic Antidepressants (TCA’s): Amitriptyline, Clomipramine

31
Q 
MECHANISM OF ACTION:
Selectively block neuronal reuptake of serotonin
Amitriptyline
Fluoxetine
Paroxetine
Phenelzine
Mirtazapine
Venlafaxine
Duloxetine
Bupropion
Clomipramine
Trazodone
A

C. Selective Serotonin Reuptake Inhibitors- fluoxetine, sertraline, paroxetine

32
Q 
MECHANISM OF ACTION:
Potent inhibitors of neuronal serotonin and norepinephrine reuptake (and weak inhibitors of dopamine reuptake*)
Amitriptyline
Fluoxetine
Paroxetine
Phenelzine
Mirtazapine
Venlafaxine
Duloxetine
Bupropion
Clomipramine
Trazodone
A

D. Serotonin/Norepinephrine Reuptake Inhibitors- venlafaxine+ duloxetine

33
Q 
Adverse RE
Which has Serotonin syndrome
Amitriptyline
Fluoxetine
Paroxetine
Phenelzine
Mirtazapine
Venlafaxine
Duloxetine
Bupropion
Clomipramine
Trazodone
A

Monoamine Oxidase Inhibitors- Phenelzine

Tricyclic Antidepressants (TCA’s): Amitriptyline, Clomipramine

Selective Serotonin Reuptake Inhibitors- fluoxetine, sertraline, paroxetine

Serotonin/Norepinephrine Reuptake Inhibitors- venlafaxine+ duloxetine

34
Q 
AD E
Cardiac Toxicity: EKG Before treatment!
fatal if a patient were to overdose and take their whole Rx bottle
Amitriptyline
Fluoxetine
Paroxetine
Phenelzine
Mirtazapine
Venlafaxine
Duloxetine
Bupropion
Clomipramine
Trazodone
A

Tricyclic Antidepressants (TCA’s): Amitriptyline, Clomipramine

35
Q 
lower seizure threshold, Anticholinergic properties, paradoxical sweating.
Amitriptyline
Fluoxetine
Paroxetine
Phenelzine
Mirtazapine
Venlafaxine
Duloxetine
Bupropion
Clomipramine
Trazodone
A

Tricyclic Antidepressants (TCA’s): Amitriptyline, Clomipramine

36
Q 
hyperhidrosis”, Histamine blocking- sedation (use it for sleep!), weight gain.
Amitriptyline
Fluoxetine
Paroxetine
Phenelzine
Mirtazapine
Venlafaxine
Duloxetine
Bupropion
Clomipramine
Trazodone
A

Tricyclic Antidepressants (TCA’s): Amitriptyline, Clomipramine

37
Q 
Prevents the uptake on platelets results in More Bleeding!
Amitriptyline
Fluoxetine
Paroxetine
Phenelzine
Mirtazapine
Venlafaxine
Duloxetine
Bupropion
Clomipramine
Trazodone
A

Selective Serotonin Reuptake Inhibitors- fluoxetine, sertraline, paroxetine

38
Q 
Adverse Side Effects
Serotonin Syndrome (2-72 hours after treatment)
Amitriptyline
Fluoxetine
Paroxetine
Phenelzine
Mirtazapine
Venlafaxine
Duloxetine
Bupropion
Clomipramine
Trazodone
A

Selective Serotonin Reuptake Inhibitors- fluoxetine, sertraline, paroxetine

Serotonin/Norepinephrine Reuptake Inhibitors- venlafaxine+ duloxetine

39
Q 
INCREASED NOREPINEPHRINE
Weight Gain, Increased anxiety, Insomnia, Hypertension- 
Amitriptyline
Fluoxetine
Paroxetine
Phenelzine
Mirtazapine
Venlafaxine
Duloxetine
Bupropion
Clomipramine
Trazodone
A

Serotonin/Norepinephrine Reuptake Inhibitors- venlafaxine+ duloxetine

40
Q 
Which deal with weight gain?
Amitriptyline
Fluoxetine
Paroxetine
Phenelzine
Mirtazapine
Venlafaxine
Duloxetine
Bupropion
Clomipramine
Trazodone
A

Tricyclic Antidepressants (TCA’s): Amitriptyline, Clomipramine

Selective Serotonin Reuptake Inhibitors- fluoxetine, sertraline, paroxetine

Serotonin/Norepinephrine Reuptake Inhibitors- venlafaxine+ duloxetine

41
Q 
Which deals with weight lost?
Amitriptyline
Fluoxetine
Paroxetine
Phenelzine
Mirtazapine
Venlafaxine
Duloxetine
Bupropion
Clomipramine
Trazodone
A

E. Atypical: Bupropion

42
Q 
ADVERSE EFFECTS
Hallucinations, delusions, vivid dreams- especially for smoking cessation, increased seizure risk, anticholinergic like- constipation, dry mouth, weight loss
Amitriptyline
Fluoxetine
Paroxetine
Phenelzine
Mirtazapine
Venlafaxine
Duloxetine
Bupropion
Clomipramine
Trazodone
A

Atypical: Bupropion

43
Q 
Withdrawal Syndrome
Dizziness, headache, anxiety, tremor, etc 
?  is believed to have least due to long half-life
Amitriptyline
Fluoxetine
Paroxetine
Phenelzine
Mirtazapine
Venlafaxine
Duloxetine
Bupropion
Clomipramine
Trazodone
A

Selective Serotonin Reuptake Inhibitors- fluoxetine, sertraline, paroxetine
fluoxetine

44
Q 
MNEMONIC	SSRI/SNRI
S-
S-
R-
I-
A 
MNEMONIC
SSRI/SNRI
Sexual Dysfunction/Sodium loss
Serotonin Syndrome/Sick Stomach/ Size Increase(CHRONIC T(Therapy))
Restlessness
Insomnia
45
Q 
Don’t forget the Sodium Loss/Hyponatremia, this can be seen in geriatrics for?
Amitriptyline
Fluoxetine
Paroxetine
Phenelzine
Mirtazapine
Venlafaxine
Duloxetine
Bupropion
Clomipramine
Trazodone
A

Selective Serotonin Reuptake Inhibitors- fluoxetine, sertraline, paroxetine

Serotonin/Norepinephrine Reuptake Inhibitors- venlafaxine+ duloxetine

46
Q 
Which drug have a 14 day washout period and vis versa?
Amitriptyline
Fluoxetine
Paroxetine
Phenelzine
Mirtazapine
Venlafaxine
Duloxetine
Bupropion
Clomipramine
Trazodone
A

Selective Serotonin Reuptake Inhibitors- fluoxetine, sertraline, paroxetine

Serotonin/Norepinephrine Reuptake Inhibitors- venlafaxine+ duloxetine

Phenelzine

47
Q 
St. John’s Wort (Inducer)
Amitriptyline
Fluoxetine
Paroxetine
Phenelzine
Mirtazapine
Venlafaxine
Duloxetine
Bupropion
Clomipramine
Trazodone
A

Selective Serotonin Reuptake Inhibitors- fluoxetine, sertraline, paroxetine

48
Q 
DRUG-DRUG INTERACTIONS
Other drugs that increase serotonin levels
GI Bleed risk- NSAIDS, anticoagulants
Amitriptyline
Fluoxetine
Paroxetine
Phenelzine
Mirtazapine
Venlafaxine
Duloxetine
Bupropion
Clomipramine
Trazodone
A

Selective Serotonin Reuptake Inhibitors- fluoxetine, sertraline, paroxetine

Serotonin/Norepinephrine Reuptake Inhibitors- venlafaxine+ duloxetine

49
Q 
Tri Depresents
Mnemonic- TCA
T-
C- 
A-
A

T-think
Think how the drug works- Increase serotonin and Norepinephrine
C- Cardiac◦
Watch out for the heart, also alpha-1 blockade- orthostatic hypotension/dizziness
A- Anti- A lot◦
Antidepressant (suicidal Ideation)◦Anticholinergic (delirium, seizures)◦Antihistamine (sleepiness, weight gain)

50
Q 
Monitor for weight gain
Monitor for history of GI Bleeds◦Watch out with NSAIDS + Anticoagulants
Patients should be educated to report any sexual functions problems to their provider
Amitriptyline
Fluoxetine
Paroxetine
Phenelzine
Mirtazapine
Venlafaxine
Duloxetine
Bupropion
Clomipramine
Trazodone
A

Selective Serotonin Reuptake Inhibitors- fluoxetine, sertraline, paroxetine

Serotonin/Norepinephrine Reuptake Inhibitors- venlafaxine+ duloxetine

51
Q 
Patients should be monitored for hypertension
Amitriptyline
Fluoxetine
Paroxetine
Phenelzine
Mirtazapine
Venlafaxine
Duloxetine
Bupropion
Clomipramine
Trazodone
A

Serotonin/Norepinephrine Reuptake Inhibitors- venlafaxine+ duloxetine

52
Q 
Monitor for weight loss
Amitriptyline
Fluoxetine
Paroxetine
Phenelzine
Mirtazapine
Venlafaxine
Duloxetine
Bupropion
Clomipramine
Trazodone
A

E. Atypical: Bupropion

53
Q 
take in the morning to avoid insomnia issues
Amitriptyline
Fluoxetine
Paroxetine
Phenelzine
Mirtazapine
Venlafaxine
Duloxetine
Bupropion
Clomipramine
Trazodone
A

E. Atypical: Bupropion

Selective Serotonin Reuptake Inhibitors- fluoxetine, sertraline, paroxetine

Serotonin/Norepinephrine Reuptake Inhibitors- venlafaxine+ duloxetine

54
Q 
Take with food to avoid sick stomach. 
Amitriptyline
Fluoxetine
Paroxetine
Phenelzine
Mirtazapine
Venlafaxine
Duloxetine
Bupropion
Clomipramine
Trazodone
A

E. Atypical: Bupropion

Selective Serotonin Reuptake Inhibitors- fluoxetine, sertraline, paroxetine

Serotonin/Norepinephrine Reuptake Inhibitors- venlafaxine+ duloxetine

55
Q 
Understand Hypertensive Crisis Symptoms ( High Tyramine- Drug interaction- St. John's Wort.
Amitriptyline
Fluoxetine
Paroxetine
Phenelzine
Mirtazapine
Venlafaxine
Duloxetine
Bupropion
Clomipramine
Trazodone
A

Monoamine Oxidase Inhibitors- Phenelzine

56
Q 
CNS stimulation
Amitriptyline
Fluoxetine
Paroxetine
Phenelzine
Mirtazapine
Venlafaxine
Duloxetine
Bupropion
Clomipramine
Trazodone
A

Monoamine Oxidase Inhibitors- Phenelzine

57
Q 
Suicidal Ideation   
Orthostatic hypotension 
SLOW to work!- Several weeks
Amitriptyline
Fluoxetine
Paroxetine
Phenelzine
Mirtazapine
Venlafaxine
Duloxetine
Bupropion
Clomipramine
Trazodone
A

Monoamine Oxidase Inhibitors- Phenelzine

Tricyclic Antidepressants (TCA’s): Amitriptyline, Clomipramine

Selective Serotonin Reuptake Inhibitors- fluoxetine, sertraline, paroxetine

Serotonin/Norepinephrine Reuptake Inhibitors- venlafaxine+ duloxetine

E. Atypical: Bupropion

58
Q 
Monitor baseline EKG for patients 
Amitriptyline
Fluoxetine
Paroxetine
Phenelzine
Mirtazapine
Venlafaxine
Duloxetine
Bupropion
Clomipramine
Trazodone
A

Tricyclic Antidepressants (TCA’s): Amitriptyline, Clomipramine

59
Q 
TAKE AT BEDTIME! THEY CAUSE DROWSINESS
Amitriptyline
Fluoxetine
Paroxetine
Phenelzine
Mirtazapine
Venlafaxine
Duloxetine
Bupropion
Clomipramine
Trazodone
A

Tricyclic Antidepressants (TCA’s): Amitriptyline, Clomipramine

60
Q 
inistration: 
Takes minimum 1 month to maximum of 3 months to see benefit (if no response after 1 month, try alternative agent) 
Amitriptyline
Fluoxetine
Paroxetine
Phenelzine
Mirtazapine
Venlafaxine
Duloxetine
Bupropion
Clomipramine
Trazodone
A

Alll

Phamacology (13 decks)

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