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therapeutics 2 > Depression Pharmacotherapy > Flashcards

Depression Pharmacotherapy Flashcards

1
Q

pattern of recurrence with episodes

A

more episodes = higher recurrence rate

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2
Q

what is the acronym for diagnosing depression

A

SIGECAPS

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3
Q

what is SIGECAPS

A

Sleep
Interest decreased
Guilt/Worthlessness
Energy Loss/Fatigue
Concentration trouble
Appetite changes
Psychomotor agitation
Suicidal ideation

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4
Q

what must one symptom be for diagnosing depression

A

at least one symptom must be depressed mood or loss of interest or pleasure in doing things

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5
Q

what are the self rating scales for depression

A

PHQ-9
MDQ

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6
Q

what are the goals of treatment for depression

A
  1. decrease signs and symptoms of depression
  2. restore functioning to baseline
  3. decrease risk of relapse and recurrence
  4. decrease risk of suicide ideation
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7
Q

what is the boxed warning for all antidepressants

A

suicidality risk for all antidepressants for patients under 24 years old

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8
Q

Citalopram class

A

SSRI

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9
Q

citalopram side effect

A

dose dependent QTc prolongation

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10
Q

citalopram CYPs

A

CYP2C19 substrate
CYP3A4 substrate

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11
Q

fluoxetine class

A

SSRI

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12
Q

fluoxetine half-life

A

long half life

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13
Q

fluoxetine cyps

A

2D6 inhibitor, 3A4 inhibitor

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14
Q

tapering fluoxetine

A

do not need to taper

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15
Q

fluvoxamine cyps

A

inhibits cyp 1A2 and 2C19

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16
Q

paroxetine class

A

SSRI

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17
Q

paroxetine side effects

A

weight gain and sedation
septal wall defect risk to fetus

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18
Q

paroxetine tapering

A

must taper due to anticholinergic effects

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19
Q

paroxetine cyps

A

inhibits 2D6 and 2B6

20
Q

sertraline class

A

SSRI

21
Q

sertraline major SE

A

more GI upset

22
Q

adverse effects of all SSRIs

A

weight gain/loss
increased bleeding risk
hyponatremia
sexual dysfunction

23
Q

Desvenlafaxine class

A

SNRI

24
Q

desvenlafaxine side effects

A

dose limiting side effect of nausea

25
Q

Duloxetine class

A

SNRI

26
Q

duloxetine side effects

A

nausea (slow titration)
hepatotoxicity

27
Q

duloxetine cyps

A

2D6

28
Q

levomilnacipran class

A

SNRI

29
Q

when to make levomilnacipran adjustments

A

renal impairments or strong 3A4

30
Q

venlafaxine class

A

SNRI

31
Q

venlafaxine cyp

A

2D6 inhibitor

32
Q

amitriptyline class

A

TCA

33
Q

adverse effects for SNRIs

A

increase in BP
nausea

34
Q

what labs to get for duloxetine

A

LFTs

35
Q

what is amitriptyline mostly used for

A

pain syndromes

36
Q

adverse effects of amitriptyline

A

only at higher doses
decreased seizure threshold
anticholinergic
CV
weight gain
sexual dysfunction

37
Q

MAOI washout period

A

2 week washout before switching or 5 weeks for fluoxetine

38
Q

diet requirements for MAOIs

A

tyramine diet
except selegiline patch

39
Q

when to caution use of MAOIs

A

HTN crisis
serotonin syndrome

40
Q

Buproprion MOA

A

dopamine and NE reuptake inhibitor
stimulates insomnia and appetite suppression

41
Q

Buproprion dosing in depression

A

XL only

42
Q

buproprion pearls

A

2D6 inhibitor
CI in active seizure disorder and eating disorder
can be used in combo with SSRI/SNRI

43
Q

mirtazapine side effects

A

sedation and increased appetite w/ dosed under 15mg

44
Q

mirtazapine warning

A

agranulocytosis and increased cholesterol

45
Q

vilazodone MOA

A

SSRI may have some 5HT1a agonism and prove anxiolytic effects

46
Q

vilazodone combination therapy

A

DO NOT combine with SSRI/SNRI

47
Q

vilazodone pearls

A

take w/ food
substrate 3A4

therapeutics 2 (24 decks)

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