Brainscape's Knowledge GenomeTM

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


See full index

Pharm Exam 1 > Depression > Flashcards

Depression Flashcards

1
Q

5 SSRI’s

A 
fluoxetine
sertraline
paroxetine
citalopram
escitalopram
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

ADR of SSRI’s

A 
Sexual
Wt gain
long QT
SIADH
Serotonin Syndrome
FINISH syndrome
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what is finish syndrome?

A 
flue like sxs
insomnia
imbalance
sensory disturbances
hyperarousal
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what drug specifically causes FINISH syndrome

A

paroxetine

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

what SSRI can be used in pregnancy

A

sertraline

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

SSRI with shortest 1/2 life

A

paroxetine

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

SSRI with highest risk of QT prolongation with high dose

A

citalopram

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

SSRI’s that inhibit 2D6

A

Fluoxetine

Paroxetine

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

what CYP does citalopram inhibit

A

2C19

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

what drugs shouldn’t be combined with citalopram

A

omeprazole/esomeprazol

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

3 SNRI’s to know

A

venlafaxine
desvenalfaxine
duloxetine

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

MOA of SNRI

A

inhibit serotonin and NE reuptake

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what SNRI’s have ghost tablets

A

venlafaxine

desvenlafaxine

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

ADR of SNRI’s

A 
increase BP/HR
Nausea
Constipation
Insomnia
Serotonin syndrome
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

specific ADR of duloextine

A

hepatotoxicity

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

what is discontinuation syndrome?

A

after 1 missed dose–anxiety, dizziness, flu-like symptoms

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

what SNRI causes discontinuation syndrome

A

venlafaxine

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

what SNRI inhibits 2D6

A

duloxetine

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

Theory behind SSRI and 5HT agonist drugs MOA

A

Provide direct stimulation of postsynaptic cleft in addition to blocking reuptake of serotonin -> QUICKER than SSRI (reuptake only)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What the 3 things to know about SSRI and partial 5HT agonists?

A
  1. Names (vilazodone, vortioxetine)
  2. NOT quicker
  3. NOT more efficacious
  4. May have less side effects (esp. sexual dysfunction)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Bupropion should be avoided in what pts

A 
anxious pts (it is amphetamine-like) 
seizure pts
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

what CYP does bupropion inhibit?

A

2D6

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Trazadone MOA

A

SSRI
agonist @ 5HT
antagonist of histamine
alpha-1 antagonist

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

what is trazadone really good at treating w/ depression

A

insomnia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

ADR’s of trazadone

A

QT prolongation
hypotension
**Priapism
sedation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

what does trazadone induce?

A

P-gp

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

MOA of mirtazapine

A

antagonist of Alpha-2 receptors and serotonin receptors-increase NE and serotonin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Mirtazapine is good in patients with depression + ?

A

anorexia–helps old ppl eat

insomnia

29
Q

Tertiary Amine TCAs

A

imipramine
Clomipramine
Amitriptyline
Doxepin

30
Q

Secondary Amine TCAs

A

Desipramine

Nortiptyline

31
Q

3* TCA ADR

A

orthostasis
sedation
wt gain
anti-cholinergic

32
Q

use of imipramine not in depression

A

nocturnal enuresis in kids

33
Q

TCA used with insomnia

A

doxepin

34
Q

TCA used with OCD

A

clomipramine

35
Q

unlabeled use of TCA’s

A

neuropath pain

36
Q

TCA used in migrane prophylaxis

A

amytripyline

37
Q

monitoring for TCA’s

A

ECG if >40 y/o

38
Q

signs of TCA OD

A

cardiac arrhythmia d/t QT prolongation

39
Q

why do ppl die of TCA od?

A

d/t hypotension and ventricular arrhythmia b/c fast Na+ channels get blocked

40
Q

which TCA’s are better tolerated

A

secondary

41
Q

extra ADR’s of 2* TCA’s

A

gynecomastia
sexual function
SIADH

42
Q

3 MAOI-A

A

isocarboxazid
tranylcypromine
phenelzine

43
Q

MOA of MAOI

A

increase NE, dopamine, serotonin

44
Q

clinical indications for MAOI-A use

A

MDD w/ hyperphagia or hypersomnia

45
Q

ADR’s of MAOI-A

A

dizziness
xerostomia
nausea
HA

46
Q

what foods need to be avoided while on MAOI-A’s?

A

tyramine rich foods

47
Q

what drugs can you not combine MAOI-A’s with?

A

serotonin drugs, CNS depressants, sympathomemetics

48
Q

MAOI-B drug

A

Selegilne

49
Q

what pts is selegine best for? why?

A

parkinson pt’s who cannot swallow pills b/c this is a PATCH

50
Q

what foods need to be avoided when selegiline is taken at high doses?

A

tyramine rich foods

51
Q

Step 1 of depression Tx

A

lifestyle changes

52
Q

step 2:

A 
SSRI; 
adults= citalopram or sertraline
kids; fluoxetine 
OR 
SNRI; bupropion/mirtazapine
53
Q

mild-mod depression tx

A

antidepressant

54
Q

severe depression tx

A

antidepressant + psychotherapy

55
Q

depression + psychotic symptom tx

A

antidepressant + psychotherapy + atypical antipsychotic

56
Q

how long should pts be on depression meds

A

minimum 6-9months for 1st episode

57
Q

best drug for depression + anxiety

A

SSRI

58
Q

drugs with lowest wt gain

A

fluoxetine

bupropion

59
Q

drugs with lowest sexual dysfunction

A

bupropion> mirtazapine

60
Q

drugs that increase energy w/ depression

A

bupropion or SNRI

61
Q

what can anti-depressant induce..

A

mania

62
Q

how do we avoid inducing mania

A

screen for bipolar before starting antidepressants

63
Q

drugs for postpartum depression

A

Sertraline or escitalopram

64
Q

when do we screen kids for depression

A

12 years old

65
Q

after 4-8wks of optimization that isn’t working how do we handle tx

A

can switch to other SSRI or SNRI

66
Q

when do we have to cross-taper?

A

SSRI or SNRI–> bupropion, mirtazapine, or TCA

67
Q

when do we refer?

A

when we start to use more than 1 agent
switching to TCA or MAO-I
atpical antipsych use

68
Q

what drug can you not taper fluoxetine to?

A

MAOI

69
Q

how long do you need to give fluoxetine to be 100% gonezo?

A

7 days

Pharm Exam 1 (9 decks)

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