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Neuro drug > Depression therapeutic Drugs > Flashcards

Depression therapeutic Drugs Flashcards

1
Q

Amitriptyline

Class and indication

A

TCA
depression
Neuropathic pain
Migraine prophylaxis

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2
Q

Clomipramine

Class and indication

A

TCS

Depression
OCD

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3
Q

Dothiepin

Class and indication

A

TCA

Depression

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4
Q

Imipramine

Class and indication

A

TCA
depression

Nocturnal in children

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5
Q

Nortriptyline

Class and indication

A

TCA

Depression
Neuropathic pain

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6
Q

Fluoxetine (half life)

Class and indication

metabolite (half life)

A

SSRI

half life = 4-6days

Depression
OCD
bulimia nervosa

norfluoxetine (half life = 4-16days)

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7
Q

Excitalopram

Class and indication

A

SSRI

Depression
Anxiety disorder

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8
Q

Citalopram

Class and indication

A

SSRI

Depression
Panic disorder

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9
Q

Paroxetine

class and indication

A

SSRI

Depression
Anxiety disorder

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10
Q

Sertraline

class and indication

counseling point

A

SSRI

Depression
OCD
Panic disorder

F = 36%
Sertraline should be taken with food to increase absorption (+30-40%)

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11
Q

Vortioxetine

class and indication

A

SSRI

Depression

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12
Q

Venlafaxine

Class and indication

A

SNRI

Depression,
GAD

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13
Q

Desvenlafaxine

Class and indication

A

SNRI

Depression

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14
Q

Duloxetine

CLass and indication

A

SNRI

Depression, 
GAD
Diabetic neuropathy 
fibromyalgia
chronic musculoskeletal pain
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15
Q

Mirtazapine

Class and indication

A

NaSSA

Depression

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16
Q

Moclobemide

Class and indication

A

RIMA (Reversible Monoamine Oxidase Inhibitor)

Depression
social anxiety disorder

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17
Q

Bupropion indication

Dont use in _____ patients

A

Depression and smoking cessation

Dont use in patient with

  • Seizure
  • psychosis
  • eating / electrolyte disorder
  • alcohol / BZD withdrawal

causes insomnia

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18
Q

Trazodone indication

A

depression and insomnia

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19
Q

tianeptine indication

A

depression

20
Q

agomelatine indication

A

depression

21
Q

Drug for OCD

A

Clomipramine
Fluoxetine
Fluvoxamine
Sertraline

22
Q

Fluvoxamine

class and indication

A

SSRI

Depression
OCD

23
Q

Drug for anxiety disorder

A

Escitalopram

Paroxetine

24
Q

Drug for GAD

A

Venlafaxine

Duloxetine

25
Q

Drug for panic disorder

A

citalopram

sertraline

26
Q

TCA metabolite

parent –> metabolite

A

Amitriptyline –> Nortriptyline

Imipramine –> Desipramine

27
Q

TCA MOA and SE

A

Blocks reuptake of NE & 5HT.
Anticholinergic
H1 and alpha-adrenergic antagonism

ADR

  • GE and sexual dysfunction
  • Anticholinergic,
  • Sedation,
  • weight gain,
  • Orthostatic hypotension
  • Arrhythmias,
  • Seizure,
  • Fatal on overdoses

secondary amine (nortyiptyline, despiramine) have lower anticholinergic, sedation and cardiotoxic side effects.

28
Q

SSRI MOA and SE

A

Blocks reuptake of 5HT selectively

HYPONATREMIA (SIADH)
GI & SEXUAL dysfunction.
Fluoxetine –> insomnia

Headache,
transient nervousness during initiation
Bleeding risk
EPSE

-Paroxetine = most anticholinergic, sedating, increase weight, T ½ short.(withdrawal)

Escitalopram/ Citalopram: QTc prolongation if high dose in elderly/starvation/female

-Vilazodone: low risk in sexual dysfunction

29
Q

SNRI MOA and SE

A

Blocks reuptake of NE & 5HT

HYPONATREMIA (SIADH) 
GI & SEXUAL dysfunction. 
Headache, 
transient nervousness during initiation 
Bleeding risk 
EPSE 
increase BP (Venlafaxine) 
Urinary hesitation (Duloxetine)
30
Q

NaSSA MOA and SE

A

Mirtazapine

A2-adrenoceptor antagonist
INCREASE 5HT & NE
5HT2&3, H1 antagonism

  • Somnolence, INCREASE appetite, weight gain
  • REVERSE GI and SEXUAL SE of SNRI/SSRI
31
Q

NDRI MOA and SE

A

Bupropion

Blocks reuptake of NE & DA

Seizure,
Insomnia,
Psychosis

DECREASE sexual SE of SSRI/SNRI

32
Q

Trazodone MOA and SE

A

Blocks reuptake of 5-HT;
Antagonizes 5-HT2A, H1 and A1 adrenoceptor

HYPONATREMIA (SIADH)
GI & SEXUAL dysfunction.

Headache,
transient nervousness during initiation
Bleeding risk
EPSE

Sedation
orthostatic hypotension
RARE SE: priapism

33
Q

Agomelatine MOA and SE and DDI

A

MT-1, MT-2 agonist

GI, increase LFTs Interactions:

DDI : Fluvoxamine, Ciprofloxacin
(Cyp1A2 inhibitor)

34
Q

Adjunct used as hypnotics

A

BZD
z-hypnotics
antihistamine
melatonin receptor agonist

35
Q

Adjunct used as mood stabilizer

A

Second gen antipsychotics (atypical antipsychotics)

36
Q

BZD

indication
MOA
SE
Doses and half life

A

hypnotics

potentiates GABA

SE: 
sedation
drowsiness
confusion
amnesia

Lorazepam
Half life: 12 (8-25hr)
adult dose: PO 0.5-2mg HS PRN (bedtime)

Diazepam
Half life: 20-54hr
adult dose: PO 2-15mg HS PRN (Bedtime)

Minimise risk for dependency by limiting to 2 weeks PRN short course therapy

37
Q

Z-hypnotics

MOA
SE
Doses and half life

A

Preferentially binds to benzodiazepine binding sites with gamma and A1 subunits (causes sedation).

SE:
Taste disturbance (zopiclone)
complex sleep behaviour (sleep walking)
- perform hx on childhood sleep walk

Zolpidem:
Halflife: 1.5-4hr 
Adult dose: 
>18yo PO 10mg HS PRN
CR 6.25-12.5mg HS PRN
women: Half dose

Elder/debilitated
PO 5mg HS PRN (increase if necessary)

Zolpiclone
Half life: 6hr
Adult dose:
>18yo PO 7.5mg HS PRN

Elder
PO 3.75mg HS PRN (increase if necessary)

38
Q

Lorazepam

halflife dose indication

A

hypnotics
Half life: 12 (8-25hr)
adult dose: PO 0.5-2mg HS PRN (bedtime)

39
Q

Diazepam

halflife dose indication

A

hypnotics
Half life: 20-54hr
adult dose: PO 2-15mg HS PRN (Bedtime)

40
Q

Zolpidem

halflife dose indication

A 
hypnotics :
Halflife: 1.5-4hr 
Adult dose: 
>18yo PO 10mg HS PRN
CR 6.25-12.5mg HS PRN
women: Half dose

Elder/debilitated
PO 5mg HS PRN (increase if necessary)

41
Q

Zolpiclone

halflife dose indication

A

hypnotics
Half life: 6hr
Adult dose:
>18yo PO 7.5mg HS PRN

Elder
PO 3.75mg HS PRN (increase if necessary)

42
Q

Antihistamine MOA ADR DOSE

A

H1 antagonism

Sedation, anticholinergic effects (dry mouth, constipation)

Promethazine or Hydroxyzine
p.o. 25-50mg ON PRN

43
Q

Fluoxetine dose

start
range
max

A

start
20mg om

range
20-60mg

max
80mg

44
Q

amitriptyline dose
start
range
max

A

start
50-100mg/day

range
30-300mg

max
300mg

45
Q

Mirtazapine dose
start
range
max

A

start
15mg

range
15-45mg

max
45mg

46
Q

Bupropion dose

A

150mg BD (8hr apart)

Neuro drug (21 decks)

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