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Clinical Pharmacology > Depression/Anxiety > Flashcards

Depression/Anxiety Flashcards

1
Q

If you have a patient that struggles with depression and anorexia, what drug should be considered?

A

Mirtazapine (increased appetite)

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2
Q

Which SSRI has strict dosing?

A

Citalopram (should no exceed 40mg/d for anyone, should not exceed 20mg/d for most pts >60yo or those on CYP2C19 inhibitors)

Higher doses = increased risk of QT

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3
Q

CI of Bupropion

A

Pts with seizure history

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4
Q

T/F: orthostasis is common with tertiary and secondary amine TCAs

A

True

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5
Q

What is FINISH syndrome? What drug is it worse with?

A 
Flu-like symptoms
Insomnia
Imbalance
Sensory disturbances
Hyperarousal

Paroxetine

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6
Q

Which SNRI should you not use for pts with liver disease due to hepatotoxicity risk?

A

Duloxetine

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7
Q

If a pt presents with atypical MDD with hyperphagia or hypersomnia, what class of meds should be considered?

A

Monoamine Oxidase A Inhibitors

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8
Q

Which SNRI is most associated with dose dependent HR/BP increase?

A

Venlafaxine

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9
Q

Which TCA should be considered for migraine prophylaxis?

A

Amitriptyline

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10
Q

Which SSRI has a long half life?

A

Fluoxetine

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11
Q

Which BZD is good for seizure disorders?

A

Clonazepam

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12
Q

Priapism = what AD?

A

Trazadone

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13
Q

What meds are short term/intermittent use for anxiety?

A

Benzo’s

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14
Q

What are the SNRIs? (4)

A

Venlafaxine
Desvenlafaxine
Duloxetine
Milnacipran/Levomilnacipran

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15
Q

Which 3 benzo’s come in IV formulation?

A

Lorazepam
Diazepam
Midazolam

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16
Q

What medication is usually the drug of choice for anxiety?

A

SSRI/SNRI (venlafaxine)

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17
Q

If your patient is trying to quit smoking and has depression, what should you use?

A

Bupropion

18
Q

What is the monoamine oxidase B inhibitor? Pts with what neurologic condition may benefit due to the patch formulation?

A

Selegiline

Parkinson’s pts who cannot swallow

19
Q

What are the 2 secondary amine TCAs?

A

Desipramine

Nortriptyline

20
Q

Which SSRI has a very short half life and concerns for withdrawal?

A

Paroxetine

21
Q

Which SNRI is best for pain from diabetic peripheral neuropathy/fibromyalgia/chronic MSK pain?

A

Duloxetine

22
Q

When should a TCA be considered?

A

Intolerant or refractory to SSRI/SNRI, or for pain syndromes

23
Q

Which SSRI is best for kids?

A

Fluoxetine

24
Q

Which amines have more sedation, wt gain, and anticholinergic effects?

A

Tertiary > secondary

25
Q

What AD is safe for pregnancy?

A

Sertraline

26
Q

What BZD is used for status epilepticus?

A

Lorazepam

27
Q

What are the 5 BZD’s?

A 
Alprazolam
Clonazepam
Lorazepam
Diazepam
Midazolam
28
Q

What are the 4 tertiary amine TCAs?

A

Imipramine, Clomipramine, Doxepin, and Amitriptyline

29
Q

What are the 3 Monoamine Oxidase A Inhibitors?

A

Isocarboxazid
Tranylcypromine
Phenelzine

30
Q

Which two drugs are SSRIs and partial 5-HT receptor agonists?

A

Vilazodone

Vortioxetine

31
Q

T/F: Benzo’s are safe during pregnancy

A

False

32
Q

What screening must be completed when putting pts on TCAs?

A

Screen for cardiac conduction abnormalities, monitor regularly

33
Q

What are the SSRIs? (5)

A 
Fluoxetine
Paroxetine
Sertraline
Citalopram
Escitalopram
34
Q

If you have a patient that struggles with depression and insomnia, what drug should be considered?

A

Trazadone

35
Q

What class of meds is consistently linked to dementia?

A

BZDs

36
Q

Classic signs for TCA overdose

A

The Three C’s:
Convulsions
Cardiac arrhythmias/cardiac arrest
Coma

37
Q

If your patient is having sexual function concerns with their current AD, what should you consider next?

A

Bupropion

38
Q

Which AD should you avoid if anxiety is present?

A

Bupropion

39
Q

Which SNRI is most associated with discontinuation/FINISH syndrome?

A

Venlafaxine

40
Q

Red flags for dependency on BZDs

A

Long term use (>1 month)
Rebound anxiety and insomnia on withdrawal
Strong desire to use them
Driving under influence of BZDs
Use of BZDs despite falls
Use of them in addition to other hypnotics (ETOH, opioids)
Continuing to use despite recommendation to stop

41
Q

Other than minimal sexual dysfunction, what are two other benefits of bupriopion?

A

Minimal sedation

Minimal weight gain

42
Q

Which 2 BZDs are used for conscious sedation?

A

Diazepam

Midazolam

Clinical Pharmacology (54 decks)

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