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PHM 701 > Depression > Flashcards

Depression Flashcards

1
Q

What are the SSRI agents?

A
  • Citalopram
  • Escitalopram
  • Fluoxetine
  • Fluvoxame
  • Paroxetine
  • Sertraline
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2
Q

What are the SNRI agents?

A
  • Duloxetine
  • Desvenlafaxine
  • Levomilnacipram
  • Venlafaxine
  • Milnacipram
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3
Q

What are the TCA agents?

A
  • Amtriptylline
  • Amoxapine
  • Clomipramine
  • Desipramine
  • Doxepin
  • Imipramine
  • Maprotiline
  • Trimipramine
  • Nortryptylline
  • Protriptyline
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4
Q

What are the MAOIs?

A
  • Phenelzine
  • Selegeline
  • Rasagiline
  • Tranylcypromine
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5
Q

What are the miscellaneous agents for depression?

A
  • Bupropion
  • Brexanolone
  • Esketamine
  • Mirtazapine
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6
Q

What SSRIs are FDA-recommended for MDD

A
  • Citalopram
  • Escitalopram
  • Fluoxetine
  • Paroxetine
  • Sertraline
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7
Q

What are your first line medications for depression?

A
  • SSRI
  • SNRI
  • Bupropion
  • Mirtazapine
  • Vortioxetine
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8
Q

What should you do if symptoms persist after 4 - 8 weeks?

A

Switch to alternate AD
Augment with alternative MOA, 2nd gen APS or Psychotherapy

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9
Q

What are the two main MDD Rating Scales?

A

HAM - D
MADRS

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10
Q

What should you do if you see a an extreme response less than 2 weeks?

A

Watch. D/C, taper due to manic switch

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11
Q

Counseling symptoms for Serotonin Syndrome

A

Mental Status Changes
Autonomic instability
Neuromuscular abnormality
GI symptoms

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12
Q

Issues/Adverse Effects of SSRIs

A

QTc prolongation w/ concomitant meds
Increased risk of bleeding (NSAIDs/plates/anticoags)
Hyponatremia
Sexual side effects
Withdrawal Syndrome
Hepatic Impairment

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13
Q

True or False. With SSRIs, dose modifications are common and are required for renal impairment

A

False. With SSRIs, there’s caution/dose modification with hepatic impairment

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14
Q

True or false. SSRIs are more sedating than energy boosting.

A

False. The other way around

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15
Q

Which SSRI is available as ODT?

A

Citalopram

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16
Q

What is the dosing of Citalopram in older adults?

A

20 mg

17
Q

What is one of the most sedating SSRIs and also can be anticholinergic and is cautioned in the elderly?

A

Fluvoxamine

18
Q

What is the only SSRI approved for once weekly admin?

A

Fluoxetine

19
Q

What is the Drug Interaction for Fluvoxamine?

A

CYP1A2

20
Q

What SSRI is available as a liquid?

A

Fluoxetine

21
Q

For which population is Citalopram 20 mg required?

A
  • 60 years old plus
  • CYP2C19 Poor Metabolizers
  • Hepatic impairment
22
Q

What dose is required for Escitalopram in the hepatically impaired?

A

10 mg

23
Q

What population should be cautious or avoid paroxetine?

A

Avoid in the elderly
Avoid in pregnancy

*Reports of bone fracture

24
Q

What is the most common drug-drug interaction with SSRIs?

A

CYP2D6

25
Q

Side effects of SNRIs

A

Abnormal bleeding (5HT reuptake on platelets)
Elevated blood pressure
Hyponatremia
5HT Syndrome
Discontinuation Syndrome

26
Q

True or False. SNRIs are more energy boosting than other antidepressants.

A

True

27
Q

What SNRIs are indicated for Depression (MDD)?

A

Duloxetine
Desvenalfaxine
Venlafaxine
Levomilnacipram

28
Q

Should you give Venlafaxine with food?

A

Yes

29
Q

What is the dual diagnosis with Duloxetine?

A

Depression
Pain

30
Q

In what populations should you avoid use of Duloxetine?

A

Hepatic Dysfunction
ESRD

31
Q

What TCAs are used in Depression?

A

All but Clomipramine

32
Q

What is the dual diagnosis with Doxepin?

A

Depression
Insomnia

33
Q

MAOIs Precaution with Washout

A

Must wait 4 - 5 half lives of drug/active metabolite (usually 2 weeks)

34
Q

Washout period for Fluoxetine

A

5 weeks

35
Q

Washout period fro Vortioxetine

A

3 weeks

36
Q

Dietary restrictions with MAOIs

A

Tyramine containing foods and can lead to hypertensive crisis

37
Q

What formulation does Selegline come in?

A

Patch

***9 -12 mg - implement diet restrictions

38
Q

What are your antidepressant Serotonin Modulators?

A

Nefadozone
Trazodone
Vilazodone
VortioxetineAISIG

PHM 701 (8 decks)

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