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Pharmacology > Exam 4: Anti-Depressants > Flashcards

Exam 4: Anti-Depressants Flashcards

1
Q

Mood disorders affect ___-___% of Americans… Which sex is more affected?

A

women

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2
Q

________ depression – one or more prolonged episodes of depression measured in weeks

A

Unipolar

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3
Q

What are the 2 sub-types of unipolar depression?

A

Primary and Secondary

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4
Q

______ depression-The absence of clearly identifiable factors leading to the secondary affective state….“chemical imbalance”…Responds to antidepressant medications…Endogenous or Exogenous?

A

Primary…Endogenous

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5
Q

_______ depression-Chronologically occurs with preexisting nonaffective disorders; develops because of non affective disorders….Disease, trauma, chronic pain…Completely alleviated by treatment of non affective disorder…Endogenous or Exogenous?

A

Secondary…exogenous

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6
Q

_________ disorder… Characterized by recurrent wide SWINGS in mood from depression to mania… Usually treated with _____.

A

Manic-depressive..lithium

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7
Q

___% of adolescence and ___% of children show symptoms of depression.

A

8%…. 2%

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8
Q

What is a main concern for adolescents without treatment for depression?

A

self-medication w. drugs and alcohol

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9
Q

Women are ______ as more likely to experience depression as men.

A

2x

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10
Q

Causes of Depression-imbalance in __________..E.G.—low levels of _______.

A

neurotransmitters….SERO-TON-IN

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11
Q

Serotonin- elevates ____, helps you to fall ____ and have good quality sleep, acts on ______ center in brain to help you feel full after eating.

A

mood….asleep…saitey

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12
Q

Affective disorders are associated with ________ and ________ neurotransmission in the brain

A

noradrenergic and serotonergic

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13
Q

Biogenic Amine Hypothesis for Affective Disorders—Depression related to decreased levels of synaptically released __________ and/or ______ in the brain…_____ is a result of an EXCESS of these transmitters

A

norepinephrine and/or serotonin…mania

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14
Q

Biogenic Amine Hypothesis for Affective Disorders—A flaw…although antidepressants increase NT right away, it takes several _____ of Tx for any effect….but this might be to antidepressants improving _______ function.

A

weeks!…receptor

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15
Q

Why are women predisposed to fluctuating levels of serotonin? ______ lowers serotonin levels…._______ increases serotonin…estrogen fluctuations during puberty, pregnancy and menopause may trigger _______.

A

stress….estrogen…depression

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16
Q

comorbidity between anxiety disorders and major depression exceeds ___%

A

50%

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17
Q

How many classes of antidepressants are there? What are the ONLY 2 methods of action?

A

9…Inhibition of NT reuptake and enzymatic degradation

18
Q

Selected mechanisms of action- _______ = increase synaptic serotonin and norepinephrine

A

tri-cyc-lics

19
Q

Selected mechanisms of action- ________= increase synaptic norepinephrine

A

Tetracyclics

20
Q

Selected mechanisms of action-_______ = block the degradation of norepinephrine, dopamine and serotonin

A

MAOIs

21
Q

Selected mechanisms of action- _______ = increase synaptic serotonin

A

SSRIs

22
Q

What is our example of a weak inhibitor of reuptake of

dopamine, norepinephrine, serotonin?

A

bu-pro-pion (Wellbutrin, Zyban)

23
Q

Bu-pro-prion binds to alpha1 and alpha2 _________ receptors

A

adrenergic

24
Q

Bu-pro-prion has increased risk for _______, alcohol lowers its threshold…also, risk for emergent _________
with concurrent nicotine patch use

A

seizures….hypertension

25
Q

MAOIs: inhibit _______ which is an enzyme responsible for the metabolism of norepinephrine, serotonin and dopamine (outside of their storage vesicles) in the presynaptic nerve terminals

A

MAO

26
Q

MAOIs are used for _______ depression as well as depression associated with these 3 common diseases….

A

atypical…Parkinsons, Alzheimers, & PTSD

27
Q

CONTRAINDICATION FOR MAOIs in dentistry-take _____ prior to administering local anesthesia; caution with ________

A

BP….epi

28
Q

MAOI adverse events with food! When patients ingest food containing ________ amines, they are not catabolized, but enter the bloodstream, and are then taken up by sympathetic nerve terminals…Causes release of endogenous ___________…..Results in hyperadrenergic crisis….Severe hypertension, fever, arrhythmias….Avoid _______ containing foods = follow strict diet (hard cheese, red wine) = poor compliance

A

vasoactive…catecholamines…tyramine

29
Q

What are three popular SSRIs? What are the two biggest market sellers?

A

Flu-Ox-Et-Ine (Prozac, Sarafam)…..Par-ox-et-Ine (Paxil)Big market seller…..Ser-Tra-Line (Zoloft)big market seller

30
Q

_______ is the only drug approved for use in children with OCD.

A

Zoloft

31
Q

SSRIs-Highest risk time for suicidal attempt is within ____ weeks of initiation of drug therapy

A

6 weeks

32
Q

What are the TWO Serotonin/Norepi Reuptake inhibitors to know? (Tx for MAJOR depression)

A
  1. Dul-ox-et-ine (Cymbalta) 2.Ven-la-fax-ine (Effexor XR)
33
Q

Effexor XR-Generic Name: _________….Therapeutic Category: ________…Use: _____ depressive disorder, generalized anxiety disorder, social anxiety disorder, panic disorder; investigational for OCD, hot flashes, neuropathic pain, ADHD….Oral Complications: _______, stomatitis, loss of taste, taste alteration, tongue discoloration

A

ven-la-fax-ine…SSRI….MAJOR…xerostomia!!!!

34
Q

Tetra-cyclics: name-________, onhibits reuptake of _______, depression, anxiety with depression,sedative effective on anxiety, dsythymic disorder (depressive neuroses)…investigational: bulimia, enuresis, pain, panic attacks, tension headache, cocaine withdrawal

A

map-ro-til-ine….norepi

35
Q

TRI-cyclics: Block reuptake of ________ AND ________….Severe anxiety, panic attacks, phobias, OCD,
bulimia, chronic fatigue, sleep apnea…Adjunctive therapy for chronic pain, peripheral neuropathies (________)= exhibit analgesic properties…investigational for substance abuse-related disorders, ADHD…WARNING—-Take _____ on patients prior to local anesthesia; caution with _________.

A

norepinephrine and serotonin…(TRI-geminal neuralgia!!)..BP…epi

36
Q

What am I describing? Weed-like plant, Most widely studied herb with demonstrated efficacy, MANY drug interactions…CAN NOT take with prescription antidepressants

A

St. John’s Wort

37
Q

St. John’s Wort interactions-Components implicated in bleeding: hypericin…Effect: ________ some cytochrome P450 liver enzymes and Reduces anticoagulant effect of warfarin (INCREASES/DECREASES???? clotting) and lowers the INR……Decreases effects of many medications…Multiple drug interactions

A

INDUCES….INCREASES

38
Q

St. John’s Wort interactions cont.-Many drug interaction….Renders oral _________ ineffective in some…General anesthetics = patient difficult to _____ some users….Increases photosensitivity of tetracyclines…Reduces effect of glucocorticoids….Decreased efficacy of anticoagulants…Discontinue ALL herbs ____ days prior to surgery!!!

A

contraceptives…awaken (yikes!)…14 days

39
Q

Pharmokinetics of antidepressants-generally taken _____…..well absorbed from _______….reach maximal concentration in blood within __-4 hours after oral administration…half-life = more than ___ hours…._____ daily dosing, at bedtime…potency and efficacy are similar

A

orally….stomach…2..24..once

40
Q

Adverse events of anti-depressants: ________ = watch for FALLING in older adults….sedation…dizziness…light-headedness-AKA-FAINTERS AND FALLERS

A

orthostatic hypotension…

Pharmacology (23 decks)

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