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psych final > drugs for mood disorders > Flashcards

drugs for mood disorders Flashcards

1
Q

clinical triad of serotonin syndrome

A

cognitive/behavioral changes
autonomic instability
neuromuscular abnormalities

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2
Q

key feature of serotonin syndrome that differentiates it from NMS

A

clonus

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3
Q

TCA MOA

A

increase 5HT and NE

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4
Q

TCAs are more effective than SSRIs for-

A

melancholic depression (anhedonia and lack of mood reactivity)

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5
Q

TCA overdose

A

coma, convulsion, cardiotoxicity

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6
Q

treatment of TCA overdose

A

sodium bicarbonate

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7
Q

m/c cause of death from TCA overdose

A

cardiac arrhthymia

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8
Q

TCA class ADRs (6)

A 
anticholinergic
anti-alpha1
antihistamine- sedation, weight gain 
sexual dysfunction
decreased seizure threshold
cardiac arrhythmias
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9
Q

type of TCA with more SE

A

tertiary (vs. secondary)

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10
Q

tertiary TCAs (5)

A 
amitriptyline
clomipramine
doxepin
imiprimine
trimiprimine
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11
Q

secondary TCAs (3)

A

amoxapine
desimiprimine
nortriptyline

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12
Q

TCA used for OCD

A

clomiprimine

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13
Q

TCA used for enuresis

A

imiprimine

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14
Q

TCA with least anticholinergic effects

A

desimiprimine

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15
Q

TCA with leads a1 antagonism

A

nortriptyline

safest in elderly *

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16
Q

SSRI MOA

A

increase 5HT

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17
Q

most significant ADR of SSRIs

A

sexual dysfunction

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18
Q

effect of SSRIs on CYP

A

most are inhibitors

exceptions- citalopram and escitalopram

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19
Q

teratogenic effects of SSRIs

A

1st trimester- heart defects

after 20 weeks- PPHN, neonatal behavioral syndrome

20
Q

SSRI that can cause QT polongation

A

citalopram

21
Q

SNRI MOA

A

increase 5HT and NE

similar to TCA but less ADRs

22
Q

unique ADR of SNRI

A

hypertension

23
Q

uses of SNRIs

A

serious depression, fibromyalgia, neuropathic pain

24
Q

Atomoxetine (MOA, Use)

A

inhibits NE reuptake, used for ADHD

25
Q

bupropion MOA

A

increases DA and NE

26
Q

avoid bupropion in (2)

A

patients with seizure d/o, eating d/o due to increased seizure risk

27
Q

benefit of bupropion over SSRI

A

less sexual SE

28
Q

mirtazapine MOA

A

a2 antagonist (increases NE release)

29
Q

ADRs of mirtazapine (2)

A

sedation and weight gain

30
Q

mirtazapine is preferred in patients with depression +

A

anorexia

31
Q

ADR of nefazodone

A

hepatotoxicity

32
Q

ADRs of trazodone (2)

A

priapism, QTc prolongation

33
Q

MOA of MAO-Is

A

inhibit MAO to increase 5HT, NE, DA

34
Q

MAO-Is may be superior to SSRIs for treatment of

A

atypical depression (leaden paralysis, hyperphagia, weight gain, maintain mood reactivity)

35
Q

2 interactions of MAO-Is

A

tyramine= hypertensive crisis

other drugs that increase 5HT= serotonin syndrome

36
Q

MAO-iS

A

phenelazine
tranylcypromine
selegiline (MAO-B)

37
Q

when stopping MAO-I

A

wait 2 weeks before starting another class, allows for synthesis of new MAO

38
Q

MOA of lithium

A

alteration of Na transport in neurons = mood stabilization

39
Q

elimination of lithium

A

100% by kidneys

40
Q

ADRs of lithium

A 
neurologic (tremor, ataxia, drowsiness)
metallic taste
hypothyroid
nephrogenic DI
weight gain
leukocytosis
41
Q

teratogenicity of lithium

A

cat D- ebstein’s anomaly (tricuspid)

42
Q

things that can precipitate lithium toxicity (3)

A

dehydration
drugs (ACE-I, NSAIDs, thiazides)
overdose

43
Q

mood stabilizer that is auto-inducer

A

carbamazepine

44
Q

mood stabilizer with worst teratogenic effects

A

valproic acid- neural tube defects, decreased IQ, behavioral problems, autism

45
Q

only mood stabilizer that is category C

A

lamotrigene

psych final (7 decks)

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