Drugs for Central Noradrenergic and Serotonergic Systems Flashcards

1
Q

reserpine

A

Monoamine theory of depression: Catecholamine theory

  • dec NE
  • induce depression-like syndrome (but good antihypertensive drug)
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2
Q

amphetamine

A

Monoamine theory of depression: Catecholamine theory

  • inc NE
  • reduces depression
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3
Q

iproniazid

A

Monoamine theory of depression: Catecholamine theory

  • inc NE
  • reduces depression
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4
Q

fluoxetine

A

Monoamine theory of depression: Monoamine theory

  • inc 5HT
  • reduces depression
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5
Q

imipramine

A

Tricyclic non selective reuptake inhibitors NSRIs: tricyclic antidepressants TCAs

  • have 3-C rings
  • dec NE and 5HT reuptake into axon terminals in CNS –> inc both concentration and effect in synaptic gap in CNS
  • use: unipolar depression, bipolar disorder (depresive phases/episodes), enuresis (nighttime bedwetting), eating disorders, chronic pain, phobias & panic attacks, obsessive compulsive disorders
  • side effect: parasympathetic nervous system (dry mouth, constipation), symp ns (vasodilation, tachycaria), CNS-based(weight gain [sexual dysfunction, sedation])
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6
Q

desimipramine

A

Tricyclic non selective reuptake inhibitors NSRIs: tricyclic antidepressants TCAs

  • have 3-C rings
  • dec NE and 5HT reuptake into axon terminals in CNS –> inc both concentration and effect in synaptic gap in CNS
  • use: unipolar depression, bipolar disorder (depresive phases/episodes), enuresis (nighttime bedwetting), eating disorders, chronic pain, phobias & panic attacks, obsessive compulsive disorders
  • side effect: parasympathetic nervous system (dry mouth, constipation), symp ns (vasodilation, tachycaria), CNS-based(weight gain [sexual dysfunction, sedation])
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7
Q

amytriptyline

A

Tricyclic non selective reuptake inhibitors NSRIs: tricyclic antidepressants TCAs

  • have 3-C rings
  • dec NE and 5HT reuptake into axon terminals in CNS –> inc both concentration and effect in synaptic gap in CNS
  • use: unipolar depression, bipolar disorder (depresive phases/episodes), enuresis (nighttime bedwetting), eating disorders, chronic pain, phobias & panic attacks, obsessive compulsive disorders
  • side effect: parasympathetic nervous system (dry mouth, constipation), symp ns (vasodilation, tachycaria), CNS-based(weight gain [sexual dysfunction, sedation])
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8
Q

aortryptyline

A

Tricyclic non selective reuptake inhibitors NSRIs: tricyclic antidepressants TCAs

  • have 3-C rings
  • dec NE and 5HT reuptake into axon terminals in CNS –> inc both concentration and effect in synaptic gap in CNS
  • use: unipolar depression, bipolar disorder (depresive phases/episodes), enuresis (nighttime bedwetting), eating disorders, chronic pain, phobias & panic attacks, obsessive compulsive disorders
  • side effect: parasympathetic nervous system (dry mouth, constipation), symp ns (vasodilation, tachycaria), CNS-based(weight gain [sexual dysfunction, sedation])
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9
Q

clomipramine

A

Tricyclic non selective reuptake inhibitors NSRIs: tricyclic antidepressants TCAs

  • have 3-C rings
  • dec NE and 5HT reuptake into axon terminals in CNS –> inc both concentration and effect in synaptic gap in CNS
  • use: unipolar depression, bipolar disorder (depresive phases/episodes), enuresis (nighttime bedwetting), eating disorders, chronic pain, phobias & panic attacks, obsessive compulsive disorders
  • side effect: parasympathetic nervous system (dry mouth, constipation), symp ns (vasodilation, tachycaria), CNS-based(weight gain [sexual dysfunction, sedation])
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10
Q

duloxetine

A

Non tricyclic non selective reuptake inhibitors

-same as TCA (side effects less intense), but not chemically

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11
Q

venlaxafine

A

Non tricyclic non selective reuptake inhibitors

-same as TCA (side effects less intense), but not chemically

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12
Q

isocarboxazid

A

MAO inhibitor

  • dec NE and 2HT degradation in axon terminals in CNS –> inc both vesicular storage –> inc both release and receptor activation and effect
  • use: only as antidepressant (when patient is refractory to other drugs)
  • side effect from food and drug interactions: inc NE release (dietary amines are indirect sympathomimetics), cardiac effect lethal (combination of dietary amine induced NE release and MAOI induced ind of stored/released NE causes massive release of NE into synaptic gap)
  • food: cheese, wine, chocolate
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13
Q

phenelzine

A

MAO inhibitor

  • dec NE and 2HT degradation in axon terminals in CNS –> inc both vesicular storage –> inc both release and receptor activation and effect
  • use: only as antidepressant (when patient is refractory to other drugs)
  • side effect from food and drug interactions: inc NE release (dietary amines are indirect sympathomimetics), cardiac effect lethal (combination of dietary amine induced NE release and MAOI induced ind of stored/released NE causes massive release of NE into synaptic gap)
  • food: cheese, wine, chocolate
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14
Q

tranylcypromine

A

MAO inhibitor

  • dec NE and 2HT degradation in axon terminals in CNS –> inc both vesicular storage –> inc both release and receptor activation and effect
  • use: only as antidepressant (when patient is refractory to other drugs)
  • side effect from food and drug interactions: inc NE release (dietary amines are indirect sympathomimetics), cardiac effect lethal (combination of dietary amine induced NE release and MAOI induced ind of stored/released NE causes massive release of NE into synaptic gap)
  • food: cheese, wine, chocolate
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15
Q

fluoxetine

A

Serotonin specific reuptake inhibitors SSRIs

  • inhibition of 5HT reuptake
  • uses: unipolar depression, bipolar disorder (depressive phase), chronic pain, eating disorders, anxiety disorders, obsessive compulsive disorders
  • side effect: CHRONIC not overdose: major decrease of sexual libido & satisfaction, ACUTE/CHRONIC overdose: “serotonin syndrome”, confusion, hallucinations, tachycardia, palpitations, hyperreflexia
  • use: PROZAC for depression, SARAFEM for premenstrual dysphoria
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16
Q

sertraline

A

Serotonin specific reuptake inhibitors SSRIs

  • inhibition of 5HT reuptake
  • uses: unipolar depression, bipolar disorder (depressive phase), chronic pain, eating disorders, anxiety disorders, obsessive compulsive disorders
  • side effect: CHRONIC not overdose: major decrease of sexual libido & satisfaction, ACUTE/CHRONIC overdose: “serotonin syndrome”, confusion, hallucinations, tachycardia, palpitations, hyperreflexia
  • use: PROZAC for depression, SARAFEM for premenstrual dysphoria
17
Q

paroxetine

A

Serotonin specific reuptake inhibitors SSRIs

  • inhibition of 5HT reuptake
  • uses: unipolar depression, bipolar disorder (depressive phase), chronic pain, eating disorders, anxiety disorders, obsessive compulsive disorders
  • side effect: CHRONIC not overdose: major decrease of sexual libido & satisfaction, ACUTE/CHRONIC overdose: “serotonin syndrome”, confusion, hallucinations, tachycardia, palpitations, hyperreflexia
  • use: PROZAC for depression, SARAFEM for premenstrual dysphoria
18
Q

aripiprazole

A

Partial agonist @ dopamine receptors

  • adjunct to TCA or SSRI as antidepressant (not used alone)
  • partial agonist at DA receptors
  • functionally DA antagonist
  • side effect: hyperglycemia & development of diabetes
19
Q

buproprion

A

NE and dopamine reuptake inhibitor

  • inhibitor of DA reuptake by NE transporter in brain areas where DA transporter may be absent
  • use: unipolar depression, bipolar disorder (depressive phases), WELLBUTRIN for depression, ZYBAN for aid to quit tobacco use
20
Q

lithium

A

Therapeutic anti mania drugs: lithium

  • mechanism of action unknown
  • use: bipolar disorder & mania (not useful in unipolar depression, may cause depression, may be used with antidepressant to create “balance”)
  • side effect: CHRONIC: renal damage (inc chance of acute intoxication), ACUTE: tremors & muscular rigidity, apathy & coma
21
Q

valproate

A

Therapeutic anti mania drugs: antiepileptic

-use: manic phases of bipolar disorder

22
Q

carbamazepine

A

Therapeutic anti mania drugs: antiepileptic

-use: manic phases of bipolar disorder

23
Q

lamotrigine

A

Therapeutic anti mania drugs: antiepileptic

-use: prevent depressive cycling in bipolar disorder

24
Q

aripiprazole

A

Therapeutic anti mania drugs: DA receptor partial agonist

  • adjunct to TCA or SSRI as antidepressant (not used alone)
  • partial agonist at DA receptors
  • functionally DA antagonist
  • side effect: hyperglycemia & diabetes development