depression Flashcards
SE: HTN crises (with tyramine-rich foods, ie. fermented foods), serotonin sd (MAOI+SSRI), agitation (rare), delerium –> seizures
MAOIs: tranylcypromine and phenelzine
what are the 4 MAOI’s? where are they used and what do they inhibit?
Tranylcypromine and phenelzine are both MAOI’s that IRREVERSIBLY inhibit both MAOa (oxidizes NE, 5HT, tyramine) and MAOb (DA, phenyethylamine), used for depression.
selegilin and rasagiline are both MAOb selective, used in Parkinson’s
SE: anticholinergic, orthostatic hypoTN, sexual dysfnc, weight gain, sedation
MAOIs; tranylcpromine and phenelzine
tx: depression, anxiety, PTSD, chronic pain, enuresis, bulimia, alcoholism
and in addition to these, __a_ also prevents tension HAs and migraines, while __b_also tx premenstrual dystrophic disorder, and _c__ also used to maintain nicotine abstinence in quitting smokers
- all the antidepressants (MAOIs, tricyclics, SSRIs, SNRIs, atypicals).
a. amitrptyline
b. fluoxetine
c. bupropion
what are the 4 tricylics?
- desipramine
- imipramine
- amitriptyline
- nortriptyline
block reuptake of NE or 5HT at varying potencies and selectivity, but bc they are dirty, they also block muscarinic, a-adrenergic, DA, and 5HT recepters
tricyclics: desipramine, imipramine, amitriptyline, nortriptyline
SE: sympathomimetic (tremor, insomnia) (cardiac arrhythmias and conduction defects, esp at OD); antimuscarinic (blurred vision, constipation, confusion), orthostatic hypoTN (a-antagonist), sedation (additive with etOH) (histamine antagonist), seizures;;;;not very safe, rarely used anymore
tricyclics
which two tricyclics for active metabolites?
imipramine and amitriptyline
all antidepressants inhibit what?
either/both: REUPTAKE transporters for NE and/or 5HT
name 5 SSRIs
- fluoxetine
- paroxetine
- sertraline
- escitalopram
- citralopram
SSRIs that inhibit reuptake of 5HT»_space; NE
5
- fluoxetine
- paroxetine
- sertraline
- escitalopram
- citalopram
ines (SPFines), and 2prams
which group is different from tricyclics in the following ways: ___ have longer duration of action., some ____ inhibit P450 enzymes and is much safer in OD than tricyclics (no seizures or cardiac arrhythmia, less side effects), but have more NAUSEA, and complaints of sexual dysfnc
SSRIs
which SSRIs form active metabolites?
fluoxetine (forms norfluoxetine)
which SSRIs are particularly potent p450 inhibitors?
fluoxetine and paroxetine
whats the major SE of SSRIs (with another drug ___)? also what are the SEs?
SSRI + MAOI –> dramatic inc in 5HT in synapses –> serotonin sd: hyperthermia, muscle rigidity, myoclonus, AMS, vital signs change–> potentially lethal.
