Drugs For Emotional And Mood Disorders Flashcards
Amitriptyline (Elavil)
Tricyclic antidepressant (TCA)
For biological depression; inhibits gastric acid secretion by blocking histamine-2 receptors in the body
Amoxapine (Asendin)
Tricyclic antidepressant (TCA)
For situational and biological depression; not associated with cardiotoxicity; mild sedative
Clomipramine (Anafranil)
Tricyclic antidepressant (TCA)
For depression accompanying obsessive compulsive disorder
Desipramine (Norpramin)
Tricyclic antidepressant (TCA)
Active metabolite of imipramine
Doxepin (Sinequan)
Tricyclic antidepressant (TCA)
For depression accompanying anxiety or alcohol dependence
Imipramine (Tofranil)
Tricyclic antidepressant (TCA)
For biological depression or alcohol or cocaine dependence; may cause cardiac dysfunction and abnormal blood cell count; available IM; may control bedwetting in children
Maprotiline (Ludiomil)
Tricyclic antidepressant (TCA)
For a broad range of depression from mild to severe
Nortriptyline (Aventyl, Pamelor)
Tricyclic antidepressant (TCA)
for biological depression; interactions similar to imipramine
Protriptyline (Vivactil)
Tricyclic antidepressant (TCA)
For symptoms of depression; few sedative qualities; causes increased heart rate
Trimipramine (Surmontil)
Tricyclic antidepressant (TCA)
For depression accompanied by a sleep disorder (has strong sedative effects)
Citalopram (Celexa)
Selective serotonin reuptake inhibitor (SSRI) Antidepressant
Does not mimic the sympathetic response; has no acetylcholine blocking properties; does not inhibit MAOIs
Escitalopram oxalate (Lexapro)
Selective serotonin reuptake inhibitor (SSRI) Antidepressant
May be used for generalized anxiety disorder; does not inhibit MAOIs
Fluoxetine (Prozac)
Selective serotonin reuptake inhibitor (SSRI) Antidepressant
May be used for obsessive compulsive disorder and eating disorders.
Fluvoxamine (Luvox)
Selective serotonin reuptake inhibitor (SSRI) Antidepressant
May be used for obsessive-compulsive disorder; no severe adverse cardiovascular effects; fewer acetylcholine blocking effects
Paroxetine (Paxil)
Selective serotonin reuptake inhibitor (SSRI) Antidepressant
May be used for obsessive-compulsive disorder and panic attacks
Sertraline (Zoloft)
Selective serotonin reuptake inhibitor (SSRI) Antidepressant
Does not mimic sympathetic response; has no acetylcholine blocking properties; does not inhibit MAOIs
Desvenlafaxine (Pristiq)
Serotonin-norepinephrine reuptake inhibitor (SNRI) Antidepressant
For major depression; active metabolite of venlafaxine; available in once-daily extended release form
Dysthmic disorder
Characterized by less severe depressive symptoms that may prevent a person from feeling well or functioning normally
Major depressive disorder
Must show at least 5 of the following symptoms
- Difficulty sleeping or sleeping too much
- extreme fatigue; lack of energy
- abnormal eating patterns (eating too much or not enough)
- vague physical symptoms (GI pain, joint/muscle pain, or headaches
- inability to concentrate or make decisions
- feelings if despair, lack of self worth, guiltiness, and misery)
- obsession with death (wish to die or commit suicide)
- avoidance of psychosocial and interpersonal interactions)
- lack of interest in personal appearance or sex
- delusions or hallucinations
Mood disorder
When changes in life become severe and impair functioning with family, work and relationships. Two major categories are: depression and bipolar
Antidepressants
Medications that combat depression by enhancing mood.
Tricyclic antidepressants (TCAs)
Act by inhibiting the reuptake of both norepinephrine and serotonin into presynaptic nerve terminals. Used for major depressive disorder and milder situational depression. Adverse effect; orthostatic hypotension, sedation at the beginning but pts adjust. Long half life. Anticholinergic effects; dry mouth, constipation, urinary retention, blurred vision, tachycardia.
Duloxetine (cymbalta)
Serotonin- Norepinephrine Reuptake Inhibitor (SNRI) Antidepressant
Major depression, GAD, neuropathic pain, chronic fatigue syndrome, stress urinary incontinence, and fibromyalgia
Venlafaxine (Effexor)
Serotonin- Norepinephrine Reuptake Inhibitor (SNRI) Antidepressant
Major depression, situational depression, GAD, neuropathic pain, and migraines
Isocarboxazid (Marplan)
Monoamine Oxidase Inhibitor (MAOI) Antidepressant
May cause peripheral edema and high blood pressure; used in cases in which other approaches for treatment of depression are not successful.
Phenelzine (Nardil)
Monoamine Oxidase Inhibitor (MAOI) Antidepressant
May cause a hypertensive crisis or respiratory depression; use cautiously in pts with epilepsy or diabetes, or who are likely to abuse drugs or alcohol
Tranylcypromine (Parnate)
Monoamine Oxidase Inhibitor (MAOI) Antidepressant
Severe depression in cases which pts have not responded to other medications
Bupropion (Wellbutrin)
Atypical Antidepressants
For changing moods, schizoaffective disorders, and to quit smoking; increased risk for seizures; weaker blocker of serotonin and norepinephrine uptake
Mirtazapine (Remeron)
Atypical Antidepressants
Potent blocker of 5-hT2 and 5-hT3 receptor subtypes; blocks presynaptic alpha2 receptors, enhancing norepinephrine release; use caution in which pts have kidney or liver dysfunction.
Nefazodone
Atypical Antidepressants
Minimal cardiovascular effects; fewer effects in blocking acetylcholine; less sedation; less sexual dysfunction compared to other antidepressants
Trazodone (Desyrel)
Atypical Antidepressants
Increases total sleep time; reduces night awakenings; has anxiolytic effects
Selective Serotonin Reuptake Inhibitors (SSRIs)
Drugs that slow the reuptake of serotonin into presynaptic nerve terminals. Major advantage is greater safety.
Serotonin syndrome (SES)
Adverse event that may occur when a pt is taking an SSRI and an additional rx that affects the metabolism, synthesis, or reuptake of serotonin
Serotonin-Norepinephrine Reuptake Inhibitors
Inhibit both the reuptake of serotonin and norepinephrine with minimal effects on other neurotransmitters or their receptor subtypes.
Monoamine Oxidase Inhibitors (MAOIs)
Limit the breakdown of norepinephrine, dopamine, and serotonin in the CNS. Adverse effects; orthostatic hypotension, headache, insomnia, and diarrhea.
Bipolar disorder
Characterized by extreme and opposite moods. Pts. May display signs of euphoria and depression or feelings of excitement and calm.
Mania
Symptoms:
- insomnia
- activity for days without rest and without appearing tired
- easy agitation and aggression
- feelings of exaggerated confidence
- making choices w/o regard for a long-term plan or consequences of action
- attention seeking
- unusual interest in sex
- drug abuse, incl. alcohol, cocaine, or sleeping medications
- denial that behavior is a problem
Pts with bipolar often display these signs. Symptoms are opposite of depressive symptoms
Mood stabilizers
Ability to moderate extreme emotions between mania and depression. Lithium, antiseizure and atypical antipsychotic drugs are used for mood stabilization for bipolar pts
Attention deficit-hyperactivity disorder (ADHD)
Characterized by developmentally inappropriate behaviors involving difficulty in paying attention or focusing on tasks.
D- and I- amphetamine racemic mixture (adderall)
Drugs for attention deficit-hyperactivity disorder (ADHD) CNS stimulants
May be used for daytime sleep disorder (narcolepsy); high potential for abuse; also called amphetamine sulfate
Dextroamphetamine mixture (Adderall XR)
Drugs for attention deficit-hyperactivity disorder (ADHD) CNS stimulants
Potent appetite suppressant; short term treatment of ADHD; safety in children less than 3 yrs old has not been established
Methamphetamine (Desoxyn)
Drugs for attention deficit-hyperactivity disorder (ADHD) CNS stimulants
Abuse potential high in adults
Methylphenidate (Ritalin)
Drugs for attention deficit-hyperactivity disorder (ADHD) CNS stimulants
Most widely used drug for pts with ADHD; more dramatic effect on attention deficit than for hyperactivity
Benzphetamine (Didrex)
Drugs for attention deficit-hyperactivity disorder (ADHD) CNS stimulants
Drug for pts with ADHD
Dexmethylphenidate (Focalin XR)
Drugs for attention deficit-hyperactivity disorder (ADHD) CNS stimulants
Drug for pts with ADHD
Lisdexamfetamine (Vyvanse)
Drugs for attention deficit-hyperactivity disorder (ADHD) CNS stimulants
Drugs for pts with ADHD
Atomoxetine (Strattera)
Drugs for attention deficit-hyperactivity disorder (ADHD)
Nonstimulants
Inhibits reuptake of norepinephrine; safety and efficacy in children less than 6 yes old has not been established
Clonidine (Catapres)
Drugs for attention deficit-hyperactivity disorder (ADHD)
Nonstimulants
Sometimes prescribed when pts are extremely aggressive; active, or have difficulty sleeping; stimulates alpha2 receptors in the brain; available in transdermal patch
