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Depression Flashcards

1
Q

With what drug can you not eat cheese?

A

MAO inhibitor antidepressants

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2
Q

What antidepressant is used for tobacco withdrawl?

A

bupropion

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3
Q

Clinically characterized by low self- esteem, anxiety and sadness as predominant symptoms

A

depression

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4
Q

psychomotor retardation and some typical somatic manifestations

A

depression

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5
Q

one of the most common psychiatric illnesses

A

depression

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6
Q

depression is more common in this gender:

A

females

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7
Q

depression has an abnormality in these neurotransmitters: (2)

A
  • serotonin

- noradrenaline

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8
Q

the most serious form of cyclical depression with periods of normality is

A

primary depression

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9
Q

What causes secondary depression? (3)

A
  • strokes
  • parkinson’s disease
  • hormonal disorders
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10
Q

What causes reactive depression? whats the prognosis?

A

stressful life situations

-high intensity but good prognosis

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11
Q

Mechanism of action for antidepressants? (2)

A
  1. By inhibiting the action of MAO

2. Blocking or delaying the reuptake of NT

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12
Q

How long does depression medication need to be taken before it is known if it is effective or not

A

2-4 weeks

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13
Q

How long do we prescribe antidepressives for?

A

4-6 months

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14
Q

is withdrawl possible with antidepressants?

A

yes with possible relapse

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15
Q

MAO-A location

A

intestine

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16
Q

MAO-B location

A

brain

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17
Q

what is MAO?

A

monoaminoxidase - enzyme that metabolizes noradrenaline and serotonin

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18
Q

What are the two mechanism types of antidepressants?

A
  • reuptake inhibitors

- MAO inhibitors

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19
Q

Which antidepressant classes are the reuptake inhibitors? (3)

A
  • tricyclic antidepressants
  • selective serotonin reuptake inhibitors
  • other antidepressants
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20
Q

What are the tricyclic antidepressants? (2)

A
  • AMITRIPTYLINE

- IMIPRAMINE

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21
Q

What are the other antidepressants? (2)

A

VENLAFAXINE

DULOXETINE

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22
Q

First used to treat depression starting in the sixties

A

TRICYCLIC ANTIDEPRESSANTS

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23
Q

the reuptake inhibitor drugs act on which nuerotransmitters?

A
  • noradrenaline

- serotonin

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24
Q

tricyclic antidepressants mechanism of action? (6)

A

blocks:

  • reuptake of noradrenaline and serotonin
  • noradrenergic receptors (α1 and α2)
  • histamine H1
  • cholinergic (M)
  • dopamine (d2)
  • serotonin (5-ht2) -side effects
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25
Q

mood improvement in tricyclic antidepressants takes how long?

A

2-3 weeks

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26
Q

tricyclic antidepressants do NOT cause… (2)

A

euphoria

addiction

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27
Q

tricyclic antidepressants indications? (3)

A
  • pain at night (sedative effect - adjuvant analgesic)
  • nocturnal enuresis
  • anorexia
  • migrane prophylaxis
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28
Q

What is nocturnal enuresis?

A

involuntary urination that happens at night while sleeping

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29
Q

Which antidepressant is an adjuvant analgesic?

A

tricyclic antidepressants

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30
Q

tricyclic antidepressants route of administration?

A

oral

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31
Q

tricyclic antidepressants half life?

A

10-20 hours

-1 or 2 daily doses

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32
Q

tricyclic antidepressants metabolism?

33
Q

tricyclic antidepressants elimination?

34
Q

tricyclic antidepressants lipid solubility? cross BBB?

35
Q

tricyclic antidepressants adverse reactions? (8)

A
  • anticholinergic
  • sedation (anti-H1)
  • Arrhythmias and hypotension (blocking α1)
  • Agranulocytosis
  • Extrapyramidal reactions (parkinson-like) blocking D2 receptors
  • confusion + memory loss in elderly
  • weight gain
  • intoxication
36
Q

What drugs cause Agranulocytosis

A

tricyclic antidepressants

37
Q

What antidepressant causes psychosis?

A

tricyclic antidepressants

*suicide attempts

38
Q

tricyclic antidepressant conrtindications? (2)

A

elderly

heart disease

39
Q

tricyclic antidepressant drug interactions? (4)

A
  • Sympathomimetic drugs
  • Anticholinergics
  • antihistamines
  • antiparkinsonian drugs
  • MAOs
  • Enhance action of other CNS depressants
40
Q

Which class of anti-depressants are safer but more expensive?

41
Q

What drug do we use for buliemia? why?

A

SSRI
- anxiolytic and anorectic effects

Venlafaxine

42
Q

SSRI mechanism of action

A

serotonin reuptake inhibitor

43
Q

SSRI start to change mood after how long?

44
Q

SSRI indications (2)

A

depression

bulimia

45
Q

SSRI route of administration?

46
Q

SSRI metabolism?

A

active metabolites

47
Q

SSRI protein binding?

A

high (80-95%)

48
Q

SSRI adverse reactions? (2)

A
  • GI intolerance: nausea and vomit

- anorexia

49
Q

which antidepressants have fewer cardiovascular, anticholinergic, and neurological side effects?

A

SSRIs have less than tricyclic antidepressants

50
Q

SSRI interactions? (3)

A
  • enhance other CNS depressants
  • MAO
  • ASA
51
Q

How does aspirin interact with SSRIs (2)

A
  • displaces proteins binding to SSRI

- increases the free fraction

52
Q

mechanism of action for venlafaxine?

A

-other antidepressant
-inhibits norepinephrine and
serotonin reuptake

53
Q

What drug is a more potent inhibitor of serotonin?

A

venlafaxine

54
Q

Venlafaxine has NO ___ & _____ effects

A

no anticholinergic effects & no hypotension

55
Q

What adverse effects does venlafaxine have?

A

No significant adverse effects (mainly headache, hypertension, …)

56
Q

Which antidepressant doesnt have any significant adverse effects?

A

venlafaxine

57
Q

Mechanism of action for MAO inhibitors?

A

inhibit the oxidative deamination of monoamines

58
Q

What are the two MAO isoenzymes?

A
  • MAO -A

- MAO-B

59
Q

MAO-A acts with which neurotransmitters? (2)

A

unfolds:

  • serotonin (5-HT)
  • noradrenaline (NA)
60
Q

MAO-A acts with which neurotransmitter?

A

metabolism of dopamine

61
Q

Selective MAO inhibitors?

A
  • inhibit MAO-A (CLORGILINE, MOCLOBEMIDE)

- or inhibit MAO-B (SELEGILINE)-> Treatment of parkinson

62
Q

nonselective MAO inhibitors?

A

TRANYLCYPROMINE

63
Q

How long to see theraputic effects of MAO inhibitors?

64
Q

MAO inhibitor route of administration?

65
Q

MAO inhibitor metabolism?

66
Q

What drug is used when tricyclic or other antidepressants fail?

A

nonselective or MAO-A inhibitors

67
Q

drug of choice in the atypical depressions and in mental disorders with an important anxiety component

A

MAO inhibitors

68
Q

Drug used for agoraphobia and other phobias, panic attacks, obsessive-compulsive disorder

A

MAO inhibitors

69
Q

What antidepressant can cause hepatitis?

A

MAO inhibitor

70
Q

What antidepressant can cause leukopenia?

A

MAO inhibitor

71
Q

MAO inhibitor adverse reactions? (5)

A
  • Orthostatic hypotension
  • Sympathetic stimulation
  • Hepatitis
  • Leukopenia
  • Decrease of salivary secretion
72
Q

MAO inhibitor interactions?

A
  • FOOD:hypertensive crisis (tyramine reaction)
  • Antidepressants -hypertensive crisis
  • Sympathomimetic drugs: avoid adrenaline in local anaesthesia
  • Opioid analgesics (potentiation of these drugs)
73
Q

What drugs can cause hypertensive crisis when taken with MAO inhibitors?

A
  • food (tyramine reaction)

- antidepressants

74
Q

With which antidepressant do we need to avoid adrenaline in local anaesthesia

A

MAO inhibitors

75
Q

Which drug has an interaction with tyramine? what happens?

A
  • MAO inhibitors

- hypertensive crisis

76
Q

What foods have tyramine present in them?

A
  • cheese
  • liver
  • sausages
  • chocolate
  • wine
  • beer
77
Q

Why does MAO interact with tyramine?

A
  • indirect sympathomimetic
  • tyramine is metabolized by MAO action
  • inhibition causes increased release of catecholamines and increase of BP
78
Q

What other indications are antidepressants used for?

A
  • Psychiatric pathology: Anorexia, bulimia
  • Tobacco withdrawal (Bupropion)
  • Adjuvant analgesics
  • migrane prophylaxis
  • nocturnal enuresis

Pharm (14 decks)

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