Depression Flashcards

1
Q

monamine theory of depression

A

result of functionally deficient monoaminergic transmission in the brain i.e. NA and 5HT neurotransmitters
Increase of these would increase mood

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2
Q

3 drugs types that inhibit monoamine uptake

A

non-selective NA/5HT uptake inhbitors
Selective Serotonin Reuptake inhibitors
Selective NA uptake inhibitors

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3
Q

MOA of tricyclic antidepressants

A
  1. Block NA and 5HT transporter proteins

2. Block M, H and 5HT receptors

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4
Q

Side effects of tricyclic antidepressants

A
Constipation
urine retention
blurred vision 
dry mouth 
postural hypotension 
due to interaction with muscarinic receptors on smooth m, cardiac muscle and secretory glands
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5
Q

tricyclic antidepressants Toxicity

A

excitement, delirium, coma and respiratory depression + cardiac dysrhythmias

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6
Q

What drug interactions of TCADs should be considered

A
  1. promote effect of alcohol and anti-hypertensives

2. do not give TCADs with MAOinhibitors

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7
Q

1st line tx for anxiety

eg

A

SSRIs

citalopram, fluoxetine/prozac

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8
Q

MOA of SSRIs

A

inhibit 5HT uptake

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9
Q

Reason for reduced compliancy with SSRIs

A

initial period of hyperactivity / agitation
takes time to reach anti-depressant effects
-> contraindicated for someone with suicidal idealisation

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10
Q

SE of SSRIs

A

nausea
insomnia
anorexia
loss of libido

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11
Q

tremor, hyperthermia, CV collapse

A

Serotonin Syndrome

rest of SSRI combined with MAOIs

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12
Q

MAOIs are selective for what enzyme

moa?

A

MAOa which is the enzymes that primarily degrades 5HT
=> MAOIs reduces the degradation of 5HT
some impact on stopping NA and DA degradation but less so

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13
Q

Iproniazid is a

A

irreversible MAOI

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14
Q

Meclobamide is

A

reversible MAOI

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15
Q

Side effects of MAOIs

A
hypotension 
atropine-like effects
wight gain
CNS stimulation 
hepatotoxicity!!
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16
Q

Advice given to patient starting MAOIs

A

avoid chest + yeast products containing tyramine

17
Q

patient on MAOI presents with very high temp

A

hyperpyerxia causes by combining MAOI with pethidine

18
Q

When are MAOIs used

A

severe depression not responding to SSRIs or TCAs

19
Q

What are MAO-B inhibitors used for

A

Parkinsons

- prevent DA degradation