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Psychology > Depression Pharmacology > Flashcards

Depression Pharmacology Flashcards

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1
Q

SSRI’s

A

First line tx of depressive disorders.

No difference in efficacy, but difference in SE

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2
Q

SSRI MOA

A

Block presynaptic serotonin uptake pump.

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3
Q

When do SSRI’s reach peak plasma level?

A

1-8 hrs

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4
Q

Where are SSRI’s cleared?

A

Well absorbed in GI tract and

Cleared in the Liver

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5
Q

Which SSRI’s inhibit the CyP450 less than others?

A

Citalopram (celexa)

Escitalopram

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6
Q

SSRI SE

A 
Sexual Dysfxn
Drowsiness
Weight gain
DIzziness
Insomnia
Anxiety
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7
Q

SSRI withdrawl symptoms

A 
Dysphoria
Dizziness
GI distress
Fatigue
Chills
Myalgias
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8
Q

Response time for SSRI’s

A

From 2 wks to 6 wks

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9
Q

Citalopram brand name

A

Celexa

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10
Q

Citalopram dose, indications

A

20-40 mg

Good to use when concerned about drug interactions

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11
Q

Citalopram SE

A

QT prolongation in doses over 40mg.
Hepatic impairment
Age> 60 yrs

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12
Q

Escitalopram brand name

A

Lexapro

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13
Q

Escitalopram indications, dose

A

10-20mg
Similar to citalopram
Fewer drug interactions

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14
Q

Fluoxetine brand name

A

Prozac

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15
Q

Fluoxetine dose

A

20-40 daily
or
90mg slow release weekly

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16
Q

Fluoxetine advantage

A

Least problems with weight gain.

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17
Q

Fluvoxamine brand name

A

Luvox

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18
Q

Fluvoxamine dose, SE

A

50-200mg daily

Weight gain, nausea, sedation more common

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19
Q

Paroxetine brand name

A

Paxil

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20
Q

Paroxetine dose, indications

A

20-40 mg daily
Nausea, sedation likely.
Weight gain
Significant withdrawl sx

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21
Q

Which SSRI causes the most weight gain?

A

Paroxetine (paxil)

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22
Q

Sertraline brand name, dose

A

Zoloft

50-200mg

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23
Q

Which med is more likely to cause diarrhea than others?

A

Sertraline (Zoloft)

24
Q

SNRI’s (three)

A

Venlafaxine (effexor)
Duloxetine (cymbalta)
Desvelafaxine (Pristiq)

25
Q

SNRI MOA

A

Inhibit reuptake of both norepi and serotonin

26
Q

Which SNRI has more drug interactions?

A

Duloxetine (cymbalta)

27
Q

Venlafaxine brand name

A

Effexor

SNRI

28
Q

Duloxetine brand name

A

Cymbalta

SNRI

29
Q

Desvenlafaxine brand name

A

Pristiq

SNRI

30
Q

SNRI SE

A

Nausea
DIzziness
DIaphoresis
Sexual dysfxn

31
Q

Which SNRI most commonly causes nausea?

A

Desvelafaxine (pristiq)

32
Q

Monitor patients on pristiq for?

A

Elevation in BP

33
Q

Duloxetine (cymbalta) SE

A
  • CI in acute angle closure glaucoma.
  • Liver, renal impairment
  • Weight gain (high doses)
34
Q

Which SNRI is indicated for diabetic peripheral neuropathy?

A

Cymbalta (duloxetine)

35
Q

Which SNRI causes weight gain?

A

Duloxetine (cymbalta)

36
Q

Why are TCA’s generally avoided in practice?

A

Anticholinergic SE

Highly sedating

37
Q

TCA MOA

A

Inhibit uptake or serotonin and norepi

38
Q

TCA SE

A
  1. Heart block, arrhythmias, sudden death

2. Lower seizure threshold

39
Q

Patients over 40 starting TCA must be screened for?

A

Conduction system disorder

40
Q

TCA’s are not well tolerated in which age group?

A

elderly

41
Q

TCA names

A

Amitriptyline
Doxepin
Desipramine
Nortryptaline

42
Q

MAOi names

A

Phenelzine (Nardil)

Tranylcypromine (Parnate)

43
Q

MAOi’s

A

Multiple interactions
Poorly tolerated
Leave prescribing to psychiatrist

44
Q

Which food must be avoided with MAOi’s?

A 
Tyramine containing foods such as:
Aged cheese
Cured meet
Soy sauce
others
45
Q

Trazodone brand name

A

Desyrel

46
Q

Trazodone (desyrel)

A

Serotonin antagonist and reuptake inhibitors.
Good for sleep at low doses.
Antidepressant at high doses.

47
Q

Trazodone (desyrel) SE

A

Sedation
Orthostasis
Priapism

48
Q

Bupropion brand name

A

Wellbutrin

49
Q

Bupropion MOA

A

Inhibits reuptake of dopamine

50
Q

Bupropion SE

A

Anxiety
Lowers seizure threshold
Avoid in bulemia
No withdrawl symptoms

51
Q

Bupropion uses

A

Adjunct to SSRi for sexual dysfxn.
No weight gain
Mildly stimulating

52
Q

Mirtazepine (Remeron)

A

Increases release of norepi and serotonin
Sedation (insomnia)
Weight gain
Good for pts with nausea

53
Q

Serotonin syndrome S/S

A 
Hyperthermia
Agitation
Ocular clonus
Tremor, hyperreflexia
Muscle rigidity
DIlated pupils, dry mucous mems
Diaphoresis
54
Q

HARM

A 
for serotonin syndrome
Hyperthermia
Autonomic instability (delerium)
Rigidity
Myoclonus
55
Q

Serotonin syndrome tx

A

DC agents
Sedate using benzos (loraz)
O2, fluids
Avoid APAP

56
Q

Antidote for setotonin syndrome if benzos fail?

A

Cyproheptadine

57
Q

How long does it take for serotonin syndrome to resolve?

A

About 24 hrs

MAOi’s have worse outcome and longer recovery

Psychology (12 decks)

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