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drugs Flashcards

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1
Q

first line therapy for depression and anxiety disorder

A

SSRI- prefered over the other classes in children

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2
Q

advantages of SSRIs

A

easy dosing, less S/E, low toxicity in cases of overdose (because they don’t affect NE, acetylcholine, histamine, or dopamine)

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3
Q

side effects of SSRIs

A

common: GI upset, sexual dysfunction, headache, changes in energy level (fatigue, restlessness)
others: anxiety, nervousness, , insomnia, weight changes

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4
Q

who should you avoid prescibing citalopram to?

A

patients with long QT syndrome

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5
Q

what increases your risk of serotonin syndrome?

A

using an SSRI with MAOI

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6
Q

what is serotonin syndrome (symptoms)?

A

neuro (acute AMS seizures occasionally coma and death)

ANS: restlessness, diaphoresis, tremor, hyperthermia, N/V, abdominal cramps, mydriasis, sinus tachycardia

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7
Q

MOA of SNRIs

A

inhibit neuronal serotonin, NE, and dopamine

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8
Q

indications for using SNRIs

A

may be used as first line agents PARTICULARLY IN PATIENTS WITH SIGNIFICANT FATIGUE OR PAIN SYNDROMES IN ASSOCIATION WITH DEPRESSION

used as 2nd line agents in patients with no response to SSRIs

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9
Q

side effects of SNRIs

A

similar to SSRIs including hyponatremia and noradrenergic S/E: HTN** and dizziness

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10
Q

contraindications for SNRIs

A

MAOI use, renal/hepatic impairment, seizures, avoid abrupt discontinuation. Use in caution with HTN

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11
Q

increased risk of what if you use SNRIs with St. John’s Wort?

A

serotonin syndrome

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12
Q

MOA of TCAs

A

inhibits neuronal reuptake of serotonin and NE

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13
Q

indications for TCAs

A

depression, insomnia, diabetic neuropathic pain, post-herpatic neuralgia, migraine, incontinence

used less often because of their side effect profile and severe toxicity in overdose

nondepressed pts experience sleepiness, depressed patients experience elevated mood

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14
Q

side effects of TCAs

A

anticholinergic effects (dry mouth, blurred vision, constipation,drowsiness, sedation, hallucinations, memory impairment, difficulty urinating), sedation, weight gain, prolonged QT interval.

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15
Q

wide complex tachycardia indicates overdose of what?

A

TCAs (as well as sinus tach, neuro sx, ARDS)

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16
Q

contraindications for TCAs

A

use of MAO inhibitors, recent MI, seizure hx

17
Q

tetracyclic compounds MOA

A

enhances central noradrenergic and serotonergic activity

18
Q

indications for tetracyclic compounds

A

depression. less sexual dysfunction s/e compared to other classes

c/i if patient uses with MAOIs

19
Q

s/e of tetracyclic compounds

A

sedation, dry mouth, constipation, weight gain, agranulocytosis

20
Q

MOA of buproprion hydrochloride

A

inhibits the neuronal uptake of dopamine and norepinephrine

21
Q

indications for buproprion hydrochloride

A

depression (zyban used for smoking cessation)

22
Q

side effects of buproprion hydrochloride

A

seizures, agitation, anxiety, restlessness, weight loss,HTN, headache

23
Q

major difference in S/E of buproprion hydrochloride and SSRIs

A

less GI distress and sexual dysfunction with buproprion hydrochloride

24
Q

contraindications/ cautions with buproprion hydrochloride

A

seizure d/o***

avoid abrupt withdrawal, bulimia, anorexua, MAOI use, patients undergoing drug/ETOH detox

25
Q

MOA of MAOIs

A

blocks breakdown of neurotransmitters (dopamine, serotonin, epinephrine, norepinephrine) by inhibiting monoamine oxidase

26
Q

indications for MAOIs

A

refractory depression. effective in many types of affective and anxiety sisorders

27
Q

S/E of MAOIs

A

**HYPERTENSIVE CRISIS-

28
Q

what must all people taking MAOIs avoid?

A

MUST AVOID TYRAMINE-CONTAINING FOOD** (tyramine is an AA that helps regulate BP, and MAO breaks down excess tyramine in the body. tyramine can reach dangerous levels and cause a serious spike in BP- aka MAOI prevents breakdown of tyramine leading to HTN), insomnia, anxiety, orthostasis, weight gain, sexual dysfunction

aged or fermented cheese, wine, beer, aged foods, smoked meats, chocolates, coffee, tea.

29
Q

contraindications for MAOIs

A

MAOI + SSRI = serotonin syndrome: acute AMS, agitation, diaphoresis, tremor, hyperthermia, seizures occasionally coma and death

MAOI + TCA = delirium and HTN

30
Q

how long should antidepressants be continued at minimum to determine efficacy?

A

3-6 weeks

psych EOR exam (6 decks)

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