depression

Question 1

Where is MAO found

Answer 1

nearly all tissues, including nerve terminals, intestine and liver

Question 2

MAO is food intracellularly or extracellularly?

Answer 2

intracellularly

Question 3

MAO A breaks down….

Answer 3

5HT, NA, dopamine

Question 4

MAO B breaks down

Answer 4

NA and dopamine

Question 5

Name a MAOI

Answer 5

phenelzine

Question 6

phenelzine is a (selective/nonselective)

reversible/irreversible

Answer 6

nonselective and irreversible

Question 7

adverse effects of MAOI

Answer 7

postural hypotension

restlessness and insomnia

Question 8

MAOIs should not be combined with….

Answer 8

other drugs enhancing serotoninergic function

Question 9

What is the cheese reaction

Answer 9

drug food interaction 
acute HTN (severe throbbing headache and inter cranial haemorrhage) 
less likely to occur with reversible mao-A selective vs irreversible non selective MAOIs

Question 10

what are the categories of drugs for depression treatment

Answer 10

MAOIs
tricyclic antidepressants 
SSRI
NARI 
SNRI

Question 11

what are some tricyclic antidepressants

Answer 11

non-selective:
imipramine, amitriptyline, nortriptyline
selective for NET:
desipramine

Question 12

nortriptyline is a _______ gen TCA

Answer 12

second

Question 13

what is the advantage of Nortriptyline

Answer 13

milder SE compared to amitriptyline and imipramine

improved compliance

Question 14

add of TCAs (5)

Answer 14

sedation, postural hypotension, dry mouth, blurred vision, constipation

Question 15

DDI of TCAs

Answer 15

plasma protein bound

rely on hepatic metabolism for elimination

Question 16

advantages of SSRIs vs TCAs

Answer 16

greater 5-HT reuptake selectivity than TCAs
50-1000 fold selectivity for 5-HT than NA
fewer ADR
reduced sedation
lack of CV effects (safer in od)

Question 17

what are some SSRIs (2)

Answer 17

fluoxetine

citalopram

Question 18

ADR of SSRIs

Answer 18

nausea and insomnia

sexual dysfunction

Question 19

which SSRI still has some sedation

Answer 19

citalopram

still has histamine receptor antagonism

Question 20

what is a way to prevent SSRI-induced sexual dysfunction

Answer 20

cyproheptadine or other 5HT2 blockers

Question 21

what is serotonin syndrome

Answer 21

DDI with the drugs increasing serotoninergic activity

effects: tremor, hyperthermia, CV collapse.

Question 22

what is an example of NARI

Answer 22

reboxetine

Question 23

advantage of NARIs

Answer 23

fewer ADR than TCAs and SSRIs

Question 24

ADR of reboxetine

Answer 24

not well described 
dry mouth 
constipation 
insomnia 
tachycardia

Question 25

examples of SNRIs (3)

Answer 25

venlafaxine, desvenlafaxine, duloxetine

Question 26

advantages of venlafaxine

Answer 26

fewer ADR than TCAs

claimed to work faster and better in treatment resistant patients

Question 27

ADR of SNRIs

Answer 27

nausea, insomnia, sexual dysfunction

Question 28

what are some other antidepressants

Answer 28

mirtazapinei
bupropion
agomelatine
ketamine

Question 29

what is mirtazapine

Answer 29

NE and specific serotonin antidepressant

antagonist of adrenergic alpha 2 auto receptors and 5-HT2c receptor

Question 30

what is bupropion

Answer 30

norepinephrine-dopamine reuptake inhibitor

Question 31

what is agomelatine

Answer 31

agonist of melatonin MT1 and MT2 receptors
less TCA/SSRI-associated SE
helps in sleep disorders

Question 32

what is ketamine

Answer 32

glutamate NMDA receptor antagonist