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STEP1 > Depression > Flashcards

Depression Flashcards

1
Q

What are the Kubler Ross stages of grief?

A 
DABDA
Denial
Anger
Bargaining
Depression
Acceptance
**can happen with loss or imminent loss or any major life event
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2
Q

What are the risk factors for suicide?

A

DIT:
Psych disorder
Feelings of hopelessness or worthlessness
Impulsivity
increased age (younger-attempt more, older-successful more)
Male sex (women attempt more, men succeed more)
Access to weapons (firearms)
Hx of suicide attempt

SADPERSONS:
Sex (male)
Age (young & old)
Depression
Previous Attempt
EtoH or drug use
Rational thinking gone
Sickness
Organized Plan
No spouse
Social support lacking
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3
Q

What is required for diagnosis of Major Depressive Disorder?

A

5/9 SIGECAPS for >2 wks, must include anhedonia or depressed mood

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4
Q

What is persistent depressive disorder (dysthymia)?

A

depression (sometimes milder)>2 years

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5
Q

What is atypical depression?

A 
mood reactivity (happier when good things happen)
interpersonal rejection sensitivity
leaden paralysis
hypersomnia
hyperphagia
1. CBT & SSRIs
2. MAO inhibitors
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6
Q

What are the features of sleep in MDD?

A 
Increased REM
decreased REM latency
Increased REM early in sleep cycle
less slow wave sleep
**repeated nighttime awakenings and early morning awakening
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7
Q

What are the SSRIs?

A 
Flashbacks paralyze senior citizens
fluoxetine
paroxetine
sertraline
citalopram
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8
Q

What are the SE of SSRIs?

A

sexual dysfunction
risk for serotonin syndrome
SIADH, GI distress

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9
Q

What are the SNRIs? What is their MOA?

A 
Venlafaxine
duloxetine
desvenlafaxine
minacipran
inhibit 5-HT and NE reuptake
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10
Q

What else is venlafaxine used for?

A

generalized anxiety disorder
panic disorder
PTSD

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11
Q

What else is duloxetine used for?

A

diabetic peripheral neuropathy, chronic pain

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12
Q

What is minacipran used for?

A

not depression

fibromyalgia

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13
Q

What are the TCAs? What is their MOA?

A 
**inhibit 5-HT and NE reuptake
amitriptyline
nortriptyline
imipramine
desipramine
clomipramine
doxepin
amoxapine
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14
Q

What is a special function of imipramine ?

A

helps w/ bed wetting

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15
Q

What else is clomipramine used for?

A

OCD, like trichotillomania

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16
Q

What are the SE of TCAs?

A

Tri-Cs
anti-Cholinergic: tachycardia, urinary retention, dry mouth, confusion, hallucination
Cardiotoxicity: prolong QT interval, arrhythmias
CNS toxicity: seizures, coma

17
Q

What is the treatment for OD on TCAs?

A

NaHCO3

18
Q

What are some MAOIS?

A 
MAO Takes Pride In Shanghai
Tranylcypromine
Phenelzine
Isocarboxazid
Selegiline
Rasagiline
19
Q

What else are selegiline and rasagiline used for? MOA?

A

specifically inhibit MAO-B which break down dopamine

used to treat Parkinson’s

20
Q

What is the SE of MAOIs?

A

HTN crisis w/ ingestion of tyramine (in old cheese etc)

Serotonin Syndrome

21
Q

What does tyramine do exactly at nerve terminals?

A

stimulates release of NE along with amphetamines and ephedrine

22
Q

What are some drugs that when taken together could cause serotonin syndrome?

A 
SSRIs
SNRIs
TCAs
MAOIs
Triptans (migraines)
St. John's Wart
Kava-kava
amphetamines
23
Q

What is the MOA of bupropion?

A

we don’t know, but increases NE and dopamine

24
Q

What are the side effects of bupropion?

A

stimulation-insomnia
seizures, esp if anorexic or bulimic
NO SEXUAL SIDE EFFECTS

25
Q

What is another indication for bupropion?

A

smoking cessation

26
Q

What is the MOA of mirtazapine?

A

alpha 2 antagonist

weirdly 5-HT2 and 5-HT3 antagonist

27
Q

What are the side effects of mirtazapine?

A

sedation and dry mouth
increase in appetite and weight gain
great for skinny insomniacs who are elderly

28
Q

What is the MOA for trazadone and nefazadone?

A

inhibits 5-HT2 and alpha 1

29
Q

What is the main indication for trazadone and main SE?

A

used for insomnia (not really for depression)

main side effect is priapism.

30
Q

What are the symptoms of serotonin syndrome?

A

muscle rigidity
cardiovascular collapse (autonomic instability)
hyperpyrexia

STEP1 (54 decks)

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