Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pharmacotherapy 3 Exam 1 > Depression > Flashcards

Depression Flashcards

1
Q

Symptoms of depression: “SIGECAPS”

A 
Sleep changes
Interest loss
Guilt
Energy loss
Concentration loss
Appetite changes
Psychomotor agitation
Suicidal
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Diagnosis of depression requires:

A

5 symptoms of SIGECAPS in a 2 week period. One symptom must be either depressed mood or loss of interest/pleasure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Medications that can worsen depression

A

Hormones and heart medications

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Treatment phases and goals

A

Acute phase: 6-12 weeks; goal of remission
Continuation phase: 4-9 months; goal to eliminate symptoms and prevent relapse
Maintenance phase: 12-36 months; goal to prevent recurrence

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

How to discontinue antidepressants

A

Taper, do not stop abruptly; this may cause recurring symptoms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Highest risk of relapse is within ___ months of discontinuation

A

2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Time to effects of antidepressants

A

Week 1: energy, sleep, appetite
Week 2: sadness, libido, self-care, concentration, suicide risk
Week 4: depressed mood, hopelessness, interest
Takes 4-6 weeks to see a response from the medication

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Nonresponse: ___% decrease in baseline symptoms
Partial response: ___% decrease in baseline symptoms
Partial remission: ___% decrease in baseline symptoms

A

<25%
25-49%
>50%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

First line treatment options

A

SSRI, SNRI, bupropion, mirtazapine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Second line treatment options

A

Switch to a different first line option or augment with an antidepressant with a different MOA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Third line treatment options

A

Consider TCA or MAO-I

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

6 different SSRIs

A 
Citalopram (Celexa)
Escitalopram (Lexapro)
Fluoxetine (Prozac)
Fluvoxamine (Luvox)
Paroxetine (Paxil)
Sertraline (Zoloft)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

The maximum recommended dose for citalopram is ___mg or ___mg for people age 60+

A

40mg

20mg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

___ is the SSRI which is the most activation and has the least sexual dysfunction

A

Fluoxetine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

___ is the SSRI with the longest half-life and is best for non-adherent patients

A

Fluoxetine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

The washout period for all SSRIs is ___ weeks besides fluoxetine, which has a washout period of ___ weeks

A

2

5

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

___ is the SSRI which is pregnancy category D and has a high rate of sexual side effects

A

Paroxetine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

___ is the SSRI which causes GI side effects and has a high rate of sexual side effects

A

Sertraline

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

4 different SNRIs

A

Duloxetine (Cymbalta)
Desvenlafaxine (Pristiq)
Venlafaxine (Effexor)
Levomilnacipran (Fetzima)

20
Q

The initial dose of venlafaxine is ___mg/day and the usual dose is ___mg/day

A

37.5-75mg/day

75-225mg/day

21
Q

This SSRI can cause QT prolongation

A

Citalopram

22
Q

This SNRI is associated with CV adverse effects

A

Venlafaxine

23
Q

This SNRI is associated with an increased risk of hyperlipidemia

A

Dexvenlafaxine

24
Q

This SNRI is contraindicated with hepatic impairment

A

Duloxetine

25
Q

True or False: SNRIs cause greater sexual dysfunction than SSRIs

A

False. SNRIs cause little sexual dysfunction

26
Q

The primary symptom of serotonin syndrome is ___

A

Myoclonus (muscle rigidity)

27
Q

How to treat serotonin syndrome

A
  1. Discontinue med
  2. Hydration and antipyretics (Tylenol, ibuprofen)
  3. Serotonin antagonist in more severe cases (cyproheptadine)
28
Q

Symptoms of discontinuation syndrome (abrupt stopping of SSRI or SNRI)

A

Flu-like symptoms

29
Q

This SSRI is least likely to cause discontinuation syndrome

A

Fluoxetine due to its long half-life

30
Q

This antidepressant is useful for co-management of depression and smoking cessation/patients with ADHD with the added benefit of causing no sexual dysfunction

A

Bupropion

31
Q

Avoid this antidepressant in patients with eating disorders, alcohol use, and seizures

A

Bupropion

32
Q

Bupropion IR dosing

A

100mg BID. Max of 450mg daily (divided TID)

Max of 150mg/dose

33
Q

Bupropion XR dosing

A

150-450mg QD

34
Q

Adverse effects of bupropion include:

A

Weight gain, increased lipids, and drowsiness

35
Q

A rare (usually during first month of treatment) adverse effect of this antidepressant is priapism

A

Trazodone

36
Q

True or False: The antidepressant effect of trazodone is only seen at higher doses

A

True. Also, its side-effects limit its use as an antidepressant

37
Q

TCAs commonly have ___ side effects

A

Anticholinergic (dry)

38
Q

___ can lower seizure threshold and have a risk of overdose in suicide

A

TCAs

39
Q

Examples of TCAs

A 
Tertiary amines
- Greater inhibition of serotonin reuptake > NE
Amitriptyline
Clomipramine
Doxepin 
Imipramine

Secondary amines
- Greater inhibition of NE > serotonin; less anticholinergic side effects
Desipramine
Nortriptyline

40
Q

Examples of MAO-Is

A

Phenelzine
Tranylcypromine
Selegiline

41
Q

This MAO-I comes as a patch

A

Selegiline

42
Q

Avoid taking MAO-Is with food that contain ___

A

Tyramine (beer, cheese, dry meat, fava beans)

Can cause hypertensive crisis (increase BP, diaphoresis, NV, HA)

43
Q

First line therapy should be tried for at least ___ weeks before switching to an alternative therapy

A

4

44
Q

Antidepressants should be continued for at least ___ year

A

1

45
Q

All antidepressants have a BBW for ___ in people aged ___

A

Suicidal thoughts

18-24

46
Q

In elderly patients, initiate antidepressants at ___ the normal dose and titrate more ___

A

1/2

Slowly

Pharmacotherapy 3 Exam 1 (6 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions