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Revision Notes - Year 1 > Depression - 123 > Flashcards

Depression - 123 Flashcards

0
Q

What do MAOIs interact with?

A

Cheese-reaction - mature cheese, beer, pickled herring, soy extracts, yeast.
Ephedrine containing products
Pethidine

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1
Q

What antidepressant requires a 2 week ‘washout’ period before the patient can start other antidepressants?

A

MAOIs

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2
Q

What is the mechanism of action of MAOIs? What are the 2 subtypes and their binding preferences?

A

Inhibit MAO.
MAO-A and MAO-B.
MAO-A prefers serotonin, MAO-B prefers dopamine

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3
Q

What is serotonin syndrome?

A

A potentially fatal drug reaction that can occur after taking drugs such as SSRIs. Excess serotonin activity produces a spectrum of symptoms such as: increased HR, shivering, sweating, high BP, agitation, confusion etc.

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4
Q

What is the mechanism of action of TCAs?

A

Inhibit the reuptake of serotonin and noradrenaline from the synaptic cleft.

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5
Q

What are some adverse effects that TCAs can cause?

A

Sedation, postural hypotension, tachycardia, arrhythmias, dry mouth etc.

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6
Q

What are TCAs contraindicated in?

A

recent MI, heart block, narrow angle glycoma.

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7
Q

What class of antidepressant is Dosulepin and when should it be prescribed?

A

TCA. It shouldn’t be!

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8
Q

What would the first line antidepressant treatment usually be?

A

Citalopram, a SSRI.

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9
Q

Does addiction occur with antidepressants? Name 2 drugs addiction occurs with.

A

No

Benzodiazepines - diazepam, temazepam.

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10
Q

What are the 2 categories of benzodiazepines?

A

Hypnotics and anxiolytics.

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11
Q

How long does tolerance take to develop with benzodiazepines?

A

Between 3-14 days of continuous use

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12
Q

Name 2 SSRIs and adverse effects they can cause.

A

Fluoxetine (prozac) and citalopram.

Nausea, anorexia, insomnia, GI problems, loss of libido, serotonin syndrome, hyponatraemia.

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13
Q

What are contraindications for SSRIs?

A

<18 years due to the increased risk of self harm.

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14
Q

What does Venlafaxine do?

A

5-HT reuptake inhibitor, used in severe depression. Has the greatest risk of death in overdose but also greatest efficacy.

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15
Q

What is the main excitatory neurotransmitter in the CNS? What does prolonged activation of these receptors cause?

A

Glutamate

Hyper-excitability - seizures etc.

16
Q

What is the main inhibitory neurotransmitter in the CNS?

A

GABA, 2 types, GABAa (fast inhibition) and GABAb

17
Q

What happens if you activate GABAa receptors and what drug does this?

A

Causes sedation - lorazepam (benzodiazepine). Alcohol also does this.

18
Q

What happens if you block GABAa receptors?

A

Hyper-excitability and seizures.

19
Q

On what principle does date rape with flunitrazepam (Rohypnol) work?

A

Benzodiazepines active GABAa receptors and cause sedation. Alcohol also causes sedation. If the 2 are mixed together the effects are additive and only small quantitates of each are needed.

20
Q

Name 4 types of glial cell and what they do

A

Astrocytes - neuronal support and damage repair
Oligodendrocytes - myelination
Microglia - macrophages of nervous system
Ependymal cells - make CSF
Glial cells take up GABA from the synapse.

21
Q

What kind of neurotransmitter is glycine? Where is it mostly active?

A

Inhibitory. Brain stem and spinal cord

22
Q

Where is most of the serotonin in the body stored?

A

Enterochromaffin cells which line the GI tract. It is involved in peristalsis there.
Enterochromaffin cells are sensitive to chemo and radiotherapy.

23
Q

What are the source of serotonin release in the brain?

A

Neurones in the raphe nuclei

24
Q

Where is acetylcholine made and what is it involved in?

A

Made by the basal forebrain, projects to the cortex and hippocampus. Also made in the brain stem tegmentum, projects into thalamus. Involved in memory, cognition. Often lost in Alzheimer’s disease.

25
Q

What neurotransmitter is Parkinson’s disease associated with? Where is this neurotransmitter made?

A

Dopamine. Made in the Substantia Nigra. Parkinson’s disease is involved in the death of neurones in the substantia nigra.

26
Q

Name some conditions in which the dopaminergic system is disorganised in

A

Schizophrenia, drug addiction, Parkinson’s, Tourettes.

27
Q

Give an example of a drug used in Parkinson’s. What does it do?

A

Ropinirole - increases dopamine adundance.

28
Q

Give an example of an antipsychotic medication that blocks dopamine receptors

A

Haloperidol

29
Q

Where are opioids made? What do they do?

A

Hypothalamus.

They function as neuromodulators (regulating the release and activity of other neurotransmitters)

30
Q

What are the 3 major types of opioid?

A

Endorphins - ‘morphine like’ (Inc morphine, tramadol, codeine, heroin)
Enkephalins
Dynorphins

31
Q

What is the name of the enzyme that transforms glutamate into glutamine in glial cells?

A

Glutamine synthetase

Revision Notes - Year 1 (41 decks)

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