Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

NAPLEX Review > Depression > Flashcards

Depression Flashcards

1
Q

What neurotransmitters are believed to be involved in depression?

A 
Serotonin (5-HT)
Glutamate
Acetylcholine
Dopamine
Norepinephrine
Epinephrine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the most widely used depression assessment scale?

A

Ham-D (HDRS)

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

What are the DSM-5 criteria for being diagnosed with depression

A 
At least 5 of the following during the same 2 week period (M SIG E CAPS)
Mood - depressed
Sleep - increased/decreased
Interest - diminished
Guilt or feeling of worthlessness
Energy - decreased
Concentration - decreased
Appetite - increased/decreased
Psychomotor agitation or retardation 
Suicidal ideation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Why should benzos not be used alone to manage depression and anxiety?

A

They can mask depression

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

What drugs can cause or worsen depression

A 
Atomoxetine
Indomethacin
Efavirenz
Rilpivirine
Beta blockers (esp propranolol)
Hormonal contraceptives
Anabolic steroids
Benzos
Systemic steroids
Interferons
Varenicline
Ethanol
Antidepressants in first few weeks
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Natural products used for treating depression

A

St. John’s wort

SAM (S-adenosyl-L-methionine)

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

What should initial choice of antidepressant medication be based on? What is usually first line?

A

Side effect profile, safety concerns, and patient specific-symptoms
SSRI/SNRI

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

What medications are MAOi?

A

Phenelzine
Tranylcypromine
Isocarboxazid
Selegiline (MAO-B)

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

S/sx serotonin syndrome

A

Nausea, dizziness, HA, diarrhea, agitation, tachycardia, or hallucinations

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

Antidepressant withdrawal s/sx

A

Anxiety, agitation, insomnia, dizziness, flu-like symptoms

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

What antidepressant doesn’t need to be tapered? Why?

A

Fluoxetine

Long half-life

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

How long do guidelines recommend treating a patient before determining their antidepressant is not working

A

4-8 weeks at therapeutic dose

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

What to do if a patient is not improving on current dose of antidepressant

A

Change therapies
Increase dose
Use combo with different MOA
Augment with buspirone or low dose atypical

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

What medications can be used to augment if a patient is not improving on current dose of antidepressant

A 
Buspirone
Aripiprazole (Abilify)
Olanzapine + fluoxetine
Quetiapine ER
Lithium
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Initial drug treatment for depression in pregnancy

A

SSRI (not paroxetine d/t cardiac effects) – preferred but warning d/t risk of persistent pulmonary HTN in newborn

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

Treatment for post-partum depression

A

Breastfeeding is beneficial

SSRI or TCA preferred (except doxepin)

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

What IV medication is approved for post-partum depression

A

Brexanolone (Zulresso)

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

BBW for all antidepressants

A

Increase in suicidal thoughts or actions in children, teens, or young adults in first few months

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

How long does it take for physical/psychological symptoms to improve when taking antidepressants?

A

Physical: 1-2 weeks
Psychological: 4 weeks or longer

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

What medications are SSRIs

A 
Citalopram (Celexa)
Escitalopram (Lexapro)
Fluoxetine (Prozac)
Paroxetine (Paxil)
Sertraline (Zoloft)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Citalopram and escitalopram max daily dose

A 
Citalopram 40mg (>60 years max is 20)
Escitalopram 20mg (>60 years max is 10)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

SSRI MOA

A

Increase 5-HT by inhibiting its reuptake in neuronal synapse

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

SSRI CI, warnings, SE

A

CI: do not use with MAOi, linezolid
Warnings: QT prolongation, SIADH/hyponatremia, fall risk, bleeding risk
SE: Sexual side effects (decreased libido)

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

What is sarafem indicated for?

A

Premenstrual dysphoric disorder (PMDD)

25
Which SSRI is preferred in patients with cardiac risk?
Sertraline
26
How long of a break should you have after stopping an SSRI before starting an MAOi? Why?
Two weeks | 5 weeks with fluoxetine d/t long half life
27
What 2 SSRIs have highest risk for QT prolongation?
Citalopram and escitalopram
28
Which SSRIs are CYP2D6 inhibitors
Fluoxetine Paroxetine Fluvoxamine
29
Viibryd generic, MOA, administration notes
Generic: vilazodone MOA: SSRI and 5-HT1A partial agonist Take with food
30
Trintellix generic, MOA
Generic: Vortioxetine MOA: SSRI, 5-HT5 RA and 5-HT1A agonist
31
What medications are SNRIs?
Venlafaxine (Effexor) Duloxetine (Cymbalta0 Desvenlafaxine (Pristiq)
32
SNRI CI, warnings, SE
CI: SNRIs and MAOi can be lethal drug interaction and can cause HTN crisis Warnings: SIADH/hyponatremia, fall risk, bleeding SE: similar to SSRI PLUS increased HR, dilated pupils, dry mouth, excessive sweating and constipation
33
What medications are secondary and tertiary TCAs?
Secondary: Nortriptyline (Pamelor), amoxapine, desipramine, maprotiline, protriptyline Tertiary: Amitriptyline, Doxepin, clomipramine, imipramine, trimipramine
34
TCA MOA
Inhibit NE and 5-HT reuptake and block ACh and histamine receptors
35
Difference between secondary and tertiary amine TCA
Secondary: relatively selective for NE Tertiary: slightly more effective, but have a worse side effects
36
TCA CI, SE, and notes
CI: Do not use with MAOi, linezolid, or methylene blue SE: QT prolongation with overdose, orthostasis, dry mouth, blurred vision, urinary retention, constipation, weight gain Notes: tertiary amines have greater anticholinergic properties and are more likely to cause sedation and weight gain
37
What antidepressants are dopamine and norepinephrine reuptake inhibitors?
Bupropion (Welbutrin)
38
Bupropion CI and SE
CI: seizure disorder, history of anorexia/bulimia, do not use with MAOi, linezolid, IV methylene blue or other forms of bupropion SE: Dry mouth, CNS stimulation, tremors/seizures, weight loss
39
MAOi warnings
Not commonly used but watch for drug-drug and drug-food interactions – if missed could be fatal; HTN crisis or serotonin syndrome when taken with TCAs, SSRIs, SNRIs, many other drugs and tyramine-rick foods
40
What is the washout period when switching from fluoxetine to MAOi?
5 weeks d/t long half-life
41
What drugs can MAOi NOT be used with d/t serotonin syndrome?
Linezolid, lithium, tramadol, methadone, St. John’s wort
42
What foods should be avoided in someone on an MAOi?
Tyramine-rick foods (aged cheese, pickled herring, yeast extract, air-dried meats, sauerkraut, soy sauce)
43
What medication is a tetracycline antidepressant? MOA, SE
Mirtazapine (Remeron) MOA: central presynaptic alpha-2 adrenergic antagonist effects increasing release of NE and 5-HT SE: Sedation, increased appetite, weight gain
44
Trazodone MOA, indication, CI, SE
MOA: inhibits 5-HT reuptake, blocks H1 and alpha-1 adrenergic receptors Indication: rarely used as antidepressant – used primarily for sleep CI: do not use with MAOi, linezolid, or IV methylene blue SE: Sedation, priapism
45
Nefazodone BBW
Hepatotoxicity – rarely used d/t this
46
Which antidepressant preferred in cardiac/QT risk?
Sertraline
47
What antidepressant is preferred in smokers
Bupropion
48
What antidepressant is preferred in patients with peripheral neuropathy or pain?
Duloxetine
49
What antidepressant is preferred in patients who have seizure disorder
NOT bupropion
50
What antidepressant is preferred in patients who are pregnant?
NOT paroxetine Psychotherapy in mild/moderate depression Citalopram, escitalopram, fluoxetine, sertraline preferred
51
What antidepressant is preferred in patients who have daytime sedation?
Fluoxetine, bupropion
52
What antidepressant is preferred in patients with insomnia
Paroxetine, mirtazapine, trazodone | Take at night
53
What antidepressant is preferred in patients with sexual dysfunction
Bupropion or mirtazapine
54
Depression that does not fully respond to ___ full treatment trials is considered treatment resistant
2
55
What antipsychotics are used to augment depression therapy in treatment resistant depression?
Aripiprazole (Abilify) Olanzapine/fluoxetine (Symbyax) Quetiapine (Seroquel) Brexpiprazole (Rexulti)
56
Antipsychotics BBW, CI
BBW: elderly patients with dementia-related psychosis are at increased risk of death CI: Olanzapine/fluoxetine (Symbyax) – do not use with pimozide, thioridazine and caution with other QT prolongation drugs
57
Abilify SE
Anxiety, insomnia, akathisia
58
Olanzapine SE
Sedation, weight gain, increased lipids and glucose
59
Quetiapine SE
Sedation, orthostasis, weight gain, increased lipids and glucose

NAPLEX Review (79 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions