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Pharmacology II > Depression and Mania > Flashcards

Depression and Mania Flashcards

1
Q

Pathophysiology of Depression

A

decreased brain levels of NE, 5-HT, and DA

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2
Q

Treatment Phases of Depression

A

acute- 6-12 weeks- remission
continuation- 4-9 months after remission, prevent relapse, eliminate residual symptoms
maintenance- 12-36 months to prevent recurrence

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3
Q

Tx for Depressive Disorders

A

SSRIs- first line
SNRIs
Bupropion

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4
Q

Examples of SSRIs for Depression

A

paroxetine

citalopram

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5
Q

MOA of SSRIs

A

blocks SERT and inhibits reuptake of serotonin

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6
Q

Advantages of SSRIs

A

higher TI- safer

no cardiovascular SE from M or a block

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7
Q

SE of SSRIs

A

sexual dysfunction- 5-HT2

GI- 5-HT3

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8
Q

Examples of SNRIs for Depression

A

Venlafaxine

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9
Q

MOA of SNRIs

A

blocks SERT and NET to inhibit reuptake of serotonin and NE

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10
Q

Bupropion MOA

A

blocks reuptake of DA and NE

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11
Q

Bupropion is also used for…..

A

smoking cessation

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12
Q

SE of SNRIs

A

sexual dysfunction

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13
Q

SE of Bupropion

A

higher risk of seizures with high doses

no sexual side effect

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14
Q

Examples of TCAs

A

amitriptyline

imipramine

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15
Q

MOA of TCAs

A

blocks SERT and NET to inhibit reuptake of serotonin and NE

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16
Q

SE of TCAs

A

ANS side effects
low TI- dangerous
block H1- sedation

17
Q

MAOI Examples

A

phenelzine

tranylcypromine

18
Q

MOA of MAOI

A

irreversibly inhibits MAOa- metabolizes and increases lvls of NE and 5-HT
inhibits MAOb- metabolizes and increases lvls of DA

19
Q

SE of MAOIs

A

ANS effects from M and a1 block
many drug interactions
serotonin syndrome with drugs that increase 5-HT

20
Q

Examples of Mood Stabilizers- Bipolar

A

Lithium
Valproic Acid
Carbamazepine

21
Q

MOA of Lithium

A

inhibits inositol monophosphatase and inositol diphosphatase

inhibits glycogen synthase kinase-3B (GSK-3B) that increases hippocampal levels of B-catenin

22
Q

Pharmacokinetics of Lithium

A

low TI
onset of 5-7 days
eliminated by kidney- t1/2 of 24 hrs
competes with Na for renal reabsorption- diuretics increase toxicity

23
Q

SE of Lithium

A

hand tremor, edema
nephrogenic diabetes insipidus
hypothyroidism

24
Q

Lithium and Pregnancy

A

Ebstein’s anomaly of the new born- disformed tricuspid valve

25
Q

MOA of Valproic Acid

A

blocks NA and Ca channels

facilitates GABA

26
Q

Pharmacokinetics of Valproic Acid

A

onset of 3-5 days; faster than lithium

27
Q

SE of Valproic Acid

A

life threatening pancreatitis

28
Q

Valproic Acid and Pregnancy

A

spina bifida- neural tube defects

29
Q

SE of Carbamazepine

A

Stevens- Johnson Syndrome

Pharmacology II (16 decks)

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