depression

Question 1

diagnosis

Answer 1

ds5
hamiltondepression
rule out bipolar to avoid inducing mania or rapid cycling

Question 2

drugs that worsens depression

Answer 2

atomoxetine
indomethacin
efavirenze
betablocker (propranolol)
contraeptives
steroids
benzos alone
interferons
ethanol
varenicline

Question 3

natural products for depression

Answer 3

st johns wort 9SS)
valerian
5HTp (SS)
Same (SS)

Question 4

pregnancy and depression

Answer 4

psychotherpay first
SSRIs not paroxetine (cardiac effects)
potential risk of persisten pulmonary hypertension of the new born with SSRIs
SSRis and TCA are okay in breast feeding except doxapin
brexanolone is a controlled drug for post partum

Question 5

which anti depressent does not require tapering

Answer 5

fluoxetine

Question 6

boxed warning and med guides

Answer 6

for all anti depressants

Question 7

SSRIs

Answer 7

citalopram celexa
escitalopram lexapro
fluoxetine prozac
paroxetine paxil
sertraline zoloft

Question 8

SSRI warnigns

Answer 8

suicide risk
sexual dysfunction
bleeding with anticoags
QT prolongation
do not use with mao, linezolid IV methylene blue
SIADH Syndrome of inappropriate antidiuretic hormone secretio

Question 9

which SSRI is preffered in CV

Answer 9

sertraline

Question 10

which SSRI is not preff in pregnancy

Answer 10

paroxetine (sedating )

Question 11

what natural products have DDI with SSRIs

Answer 11

Ginko
Garalic
Ginger
ginseng
glucosamine
fish oils

Question 12

what are some combination SSRIs

Answer 12

vilazodone(Viibryd)- SSRI/5HT1A partial agonist
vortioxetine (trintellix)- SSRI/5HT3 receptor antagonist and 5HT1A agonist

Question 13

SNRIs

Answer 13

venlafaxine (effexor)- pain depression/anxiety
Duloxetine (cymbalta )- pain/depression/anxiety
desvenlafaxine (pristique)

Question 14

ssnri vs SSRI

Answer 14

SNRI since NE increases so does HR
drumouth constipation sweating
duloxxetine and tamoxifen interaction

Question 15

TCA

Answer 15

NE and 5HT kinda like SNRI but also blocks ach and histamine receptors

Question 16

which TCA is more effective but has more AE

Answer 16

tertiary amines

Question 17

tertiary amines

Answer 17

amitryptiline
doxepin
:pramine”

Question 18

secondary amines

Answer 18

nortyptiline (pamelor)

Question 19

AE of amines

Answer 19

QT, SS, suicidal ideation
orthostasis
dry mouth blurred vision urinary retention
weigh gain
vvid dream s

Question 20

dopa and ne inhibitor

Answer 20

bupropion (wellbutrin)
Zyban for smoking cessation
contrave for weight loss

Question 21

AE for bupropion

Answer 21

drymouth
seizure
weight loss
do not use with MAO

Question 22

MAO

Answer 22

HYPERTENSIVE CRISIS
isocarboxazid (marplan)
phenelzine (nardil )
tranylcypromine (parnate )
selegline patch emsam , zelpar for parkinsons

Question 23

what food are contra indicated with MAO

Answer 23

tyramine rich foods - cheese, pickled herring, yeast
air dried meat
saukernaut
soy
aged, fermented, smoked, pickled

Question 24

other antidepressants

Answer 24

mirtazapine (rameron) A2 blocker
trazodone 5ht reuptake blocks H and A1

Question 25

treatment resistant depression

Answer 25

after 3-8 weeks change to a new antidepressant
increast the anti depressant dose
add buspirone or low dose atypical

Question 26

adjunct therapy with antidepressants

Answer 26

aripiprazole (abilify)
quetiapine (seroquel)
esketamine (spravato

Question 27

for people with cardaic risk

Answer 27

Sertraline is preffered

Question 28

smokers can benefit from

Answer 28

bupropion

Question 29

neuropathy pts

Answer 29

duloxetine

Question 30

for seizure risk

Answer 30

do not use sertraline

Question 31

for pregnancy

Answer 31

do not use paroxetine
use SSRI

Question 32

sedation drugs

Answer 32

paroxetine mirtazapine trazodone take before bedtime

Question 33

insomnia drugs

Answer 33

bupropion, fluoxetine
take early in the day

Question 34

sexual dysfunction

Answer 34

high risk in SSRI and SNRI
lower risk with bupropion and mirtazapine

Question 35

citalopram max ddose

Answer 35

40
20 in >60 years