Drugs Flashcards

1
Q

Time-tested, very effective
More effective in severe depression
Blood levels

A

Tricyclic Antidepressants (TCAs)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Safe, effective

Multiple indications: GAD, social anxiety, panic, OCD, PTSD, PMDD

A

Selective Serotonin Reuptake Inhibitors (SSRIs)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Hypotension, orthostasis
Anticholinergic side effects, weight gain
Sexual side effects
Dangerous in overdose: 10 day supply can be lethal

A

Tricyclic Antidepressants (TCAs)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Some evidence more effective
Safe, better tolerated than TCAs
Multiple indications

A

Serotonin Norepinephrine Reuptake Inhibitors (SNRIs)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Can be very effective in non-responsive patients, especially *atypical depression
Time-tested

A

Monoamine Oxidase Inhibitors (MAOIs)

atypical: more sleep and food. Leadlimbs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

No sexual side effects

Weight neutral

A

Buproprion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q
Diarrhea
Nausea
Jitteriness/Anxiety
Sexual side effects
Drug interactions: P450 inhibition
A

Selective Serotonin Reuptake Inhibitors (SSRIs)

SSRI also good in bulimia

Sexual side effects are the worst

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q
Hypotension, orthostasis
Dry mouth, constipation, urinary retention
Sexual side effects
Weight gain
Hypertensive crisis--Tyramine reaction
A

Monoamine Oxidase Inhibitors (MAOIs)

lethal interactions DDI
“Libby”

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q
Sexual side effects
Sweating
Increased diastolic blood pressure
Withdrawal syndrome
Flu-like, “electric shocks”
A

Serotonin Norepinephrine Reuptake Inhibitors (SNRIs)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Increased anxiety, jitteriness, ineffective in panic
Insomnia
**Higher seizure risk: contraindicated in eating disorder patients and those with seizure disorder

A

Buproprion

NO SEX SIDE EFFECTS
Weight neutral

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Helpful with insomnia
Rapid anti-anxiety effect
Low incidence of sexual side effects

A

Mirtazapine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Summary of Antidepressants: A Treatment with Limitations

A

All are monoamine-based
All have modest efficacy
All have relatively slow onset
All have tolerability issues, especially in the long-term

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

effects on glycogen synthase kinase-3beta and protein kinase C may lead to neuroplastic changes associated with mood stabilization.

A

Lithium:

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Daytime somnolence

Weight gain

A

Mirtazapine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

principal mechanism of action believed to be the inhibition of the transamination of GABA.

A

Divalproex

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q
Best studied, best proven drug
Effective anti-manic, reasonable preventative agent, some antidepressant effect
Anti-suicidal properties
Neuro-regenerative effects
Cheap
$4 generic program
A

Lithium

17
Q
Individualized treatment (based on weight)
Rapid loading (20-30 mg/kg)
Safe and effective
A

Divalproex Sodium

18
Q

Tremor, nausea, diarrhea, taste, thirst, cognitive dulling
Narrow therapeutic window (0.6-1.2 mEq/l)
Toxic/lethal in overdose
Renal effects
Decreased urine concentration (20-30% of pts)
Diabetes insipidus
5-10% Hypothyroidism

A

Lithium

19
Q

Not proven as preventative agent
Weight gain, sedation
Not effective in bipolar depression

A

Divalproex Sodium

20
Q

All are anti-manic
Reasonably safe & effective
Different routes of administration

A

Atypical/Second Generation Antipsychotics

21
Q

Mania: multiple medications effectively treat it

Bipolar depression: very difficult to treat; quetiapine, lurasidone, lithium and possibly lamotrigine are best treatments thus far
Antidepressant use in bipolar disorder is controversial and not well proven.
Prevention:___________________

A

lithium, aripiprazole, olanzapine, lamotrigine

22
Q

Prevention of Future Episodes Bipolar

A
Lithium: best established
Lithium + divalproex: Very good, but many side effects
Aripiprazole
Olanzapine
Lamotrigine
23
Q

Mania: multiple medications effectively treat it
Bipolar depression: very difficult to treat; ___________________ are best treatments thus far
Antidepressant use in bipolar disorder is controversial and not well proven.
Prevention: lithium, aripiprazole, olanzapine, lamotrigine

A

quetiapine, lurasidone, lithium and possibly lamotrigine

24
Q

Mania: multiple medications effectively treat it
Bipolar depression: very difficult to treat; quetiapine, lurasidone, lithium and possibly lamotrigine are best treatments thus far
Antidepressant use in bipolar disorder is __________________
Prevention: lithium, aripiprazole, olanzapine, lamotrigine

A

controversial and not well proven.

25
Q

Weight gain
Risk of diabetes
Risk of increased cholesterol/lipids
Expensive

A

Atypical/Second Generation Antipsychotics