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AU14 Pharmacology > Exam 2; Anti-Depressants and Lithium > Flashcards

Exam 2; Anti-Depressants and Lithium Flashcards

1
Q

This is 60% of all depressions; normal response to a loss or problem; usually limited in time

A

reactive depression

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2
Q

This is 40% of all depressions; no clear correlation with life events

A

endogenous depression

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3
Q

What are the two types of endogenous depression

A

uni-polar

bi-polar

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4
Q

What are some symptoms of depression

A 
depressed mood
decrease interest in life in general
sleep disturbances
appetite changes
loss of energy
feeling of worthlessness/denial of past accomplishments
guilt
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5
Q

What are two symptoms of severe depression

A

psychological pain
suicidal tendencies; recurrent thoughts of death
loss of cognitive function

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6
Q

What are two factors that can cause depression

A

heredity and environmental factors

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7
Q

What is the biochemical basis of depression

A

depletion of neurotransmitters in the CNS (NE and SHT)

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8
Q

This treatment of depression is used primarily when the patient is not responsive to drug treatments

A

electroconvulsive treatment; shock therapy

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9
Q

What are five conditions that anti-depressants can be used to treat

A 
depression
bulimia
OCD
panic attacks
ADD
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10
Q

What are the two mechanisms behind anti-depressants

A

prevent NE or SHT re-uptake

prevent neurotransmitter breakdown

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11
Q

What are two first generation NE re-uptake inhibitors; tricyclic anti-depressants

A

imipramine

amitriptyline

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12
Q

What are the second generation SSRIs (selective serotonin re-uptake inhibitors); inhibiting SHT re-uptake in the CNS

A 
fluoxetine
sertraline
paroxetine
fluvoxamine
citalopram
escitalopram
vilazodone
vortioxetine
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13
Q

What are the third generation SNRIs; inhibiting the re-uptake of SHT and NE

A

Venlafaxine
duloxetine
milnacipram
desvenlafaxine

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14
Q

What are three other anti-depressants

A

buproprion
nefazodone
mirtazapine

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15
Q

Which class of anti-depressants is more likely to have side effects

A

the first generation; acts on multiple receptors

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16
Q

What are four symptoms of first generation anti-depressants

A

sedation
weight gain
anticholinergic effects; arrthymias, hypotension, α1 blockade

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17
Q

What are four side effects of second generation anti-depressants

A

GI upset
insomnia
headache
decreased libido

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18
Q

What are some side effects of third generation anti-depressants

A

just like second generation plus cardiovascular stimulation

19
Q

What is the therapeutic index of anti-depressants

A

fairly low; 5-6 (5-6 times the recommended dose to be toxic

first generation more toxic than second generation

20
Q

What happens to someone who takes a massive overdose of anti-depressants

A

seizures
respiratory depression
cardiac arrthymias
renal failure

21
Q

The difference between first, second, and third generation, is mainly what

A

pharmacokinetic

22
Q

What is the half like of anti-depressants like

A

very long; stays in the body a long time after you take them

23
Q

What are anti-depressants metabolized by

A

P450

24
Q

The effects of anti-depressants are synergistic with what

A

ethanol; will see unwanted effects

25
Q

These three anti-depressants inhibit the metabolism of NE and SHT

A

tranylcyrpromine
phenelzine
isocarboxazid

26
Q

What is the metabolism of MAO inhibitors

A

irreversibly inhibit the metabolism of SHT and NE; slow onset

27
Q

What are the CNS effects of MAO inhibitors

A

insomnia
agitation
hallucinations
seizures

28
Q

What are three non-CNS effects of MAO inhibitors

A

liver toxicity
weight gain
hypotension

29
Q

This interacts poorly with MAO inhibitors

A

indirect acting amines like amphetamines

30
Q

What is the mechanism behind the poor interaction of indirect acting amines and MAO inhibitors

A

amphetamines cause an increase in NE, the MAO inhibitor will inhibit the metabolism on NE, resulting in a huge excess of NE and the inability to break it down = hypertensive crisis

31
Q

Certain foods that contain this will lead to hypertensive crisis similar to that of taking MAO and ampthetamines

A

food containing the indirect acting amine; tyramine

aged cheeses, wines, smoked food

32
Q

What is it that the FDA warns about involving anti-depressants

A

all anti-depressants will increase the risk of suicide in children and adolescents; depression with a manic phase will be much worse

33
Q

This is probably hereditary condition type of depression

A

bipolar (manic) depression

34
Q

What are some symptoms of manic depression

A 
euphoria
increased motor and sexual activity
flight of ideas
decreased sleep
poor judgment
social intrusiveness
tantrums
35
Q

What is the percentage of those with manic depression that attempt suicide

A

25-50%

mostly in conjunction with drug/alcohol abuse

36
Q

What are three treatments for those with manic depression

A

electroconvulsive therapy
anti-psychotic drugs
lithium

37
Q

What are two anti-psychotic drugs used to treat manic depression

A

phenothiazine

haloperidol

38
Q

This is the most effective at treating manic depression; used prophylactically

A

lithium; 70% success in patients

39
Q

What is the mechanism of action of lithium

A

alters glutamate metabolism
decreases NE release
alters SHT

40
Q

What is the therapeutic index of lithium

A

very low; <2

41
Q

What are six side effects of taking lithium short term

A 
tremors
increased thirst
increased urine production
edema
weight gain
nystagmus
42
Q

What are two side effects of taking lithium long term

A

rengal damage

hypothyroid

43
Q

What are three symptoms of taking lithium at a toxic level

A

nausea
delirium
coma

44
Q

These are five mood stabilizers to treat bipolar; all are anti-seizure

A 
valproic acid
carbamazepine
lamotripene
acetazolamide
aripriprazole

AU14 Pharmacology (29 decks)

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