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PHRM 845 > exam 5 antidepressants > Flashcards

exam 5 antidepressants Flashcards

1
Q

What are the types of depression?

A

reactive, major depressive disorder, bipolar
goals of therapy: reduce signs and symptoms

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2
Q

Current treatment for depression?

A

SSRIs, atypical, dual acting

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3
Q

what are clinical features of depression?

A

physiological: decreased sleep, appetite changes, fatigu
pyschological: dysphoric mood, worthlessness, guilt
cognitive: decrease cognition and suicidal ideation

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4
Q

what are drugs that induced depression?

A

antihypertensive and CV: BB, clonidine, prazosin
sedative hypnotics: alcohol, BZD, barbituates
anti-inflammatory and analgesics: opiates
steroids

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5
Q

what is the neurotrophic hypothesis of depression?

A

BDNF is important for neuronal connections
stress and pain decreases BDNF
BDNF is antidepressant in animals
BDNF can be dendritic sprouts that promote neural connections

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6
Q

How long does it take to see therapuetic response?

A

2-3 weeks for response

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7
Q

what is the mechanism of MAOIs?

A

MAO acts to break down NE and 5HT
MAOi inhibits this to increase NE and 5HT in vesicles

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8
Q

what are the MAOi drugs?

A

non selective: phenelzine, tranylcypromine
MOA-B selective: selegiline
MOA-A selective: moclobemide

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9
Q

What are MAOI side effects?

A

HTN crisis with tyramine foods
interactions with Rx: TCAs, SSRIs, LDOP, st johns wort

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10
Q

where do reuptake blockers bind to?

A

allosteric sites

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11
Q

what are indications for TCAs?

A

depression, panic, enuresis, pain

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12
Q

What drug class is it easy to overdose?

A

TCAs because you only need 10x the dose

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13
Q

what are TCAs MOA?

A

inhibit NET, SERT, H1, antimuscarinic, antiadrenergic
sides: sedation and weight gain

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14
Q

what are TCAs?

A

tertiary amine: imipramine, amitripyline, doxepin, clomimpramine
secondary: desipramine, nortripyline, maprotiline

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15
Q

what are the benefits of secondary amines?

A

better at NET than SERT
less sides

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16
Q

what are SSRIs?

A

fluoxetine, fluvoxamine, paroxetine, sertraline, citalopram, escitalopram

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17
Q

SSRI side effects?

A

sexual dysfunction, anxiety, insomnia, tremor

18
Q

what is SSRI discontinuation syndrome?

A

brain zaps, dizzy, sweating, confusion

19
Q

what is serotonin syndrome? symptoms?

A

high levels of serotonin when given with MAOIs, TCAs, tramadole, st johns wort
symptoms: hyperthermia, muscle rigidity, restlessness

20
Q

Which drugs are SSRI and 5HT1A partial agonist?

A

Vilazodone and vortioxetine

21
Q

what is the benefit of vilazodone?

A

reduced sexual side effects compared to SSRIs

22
Q

what are tetracyclic and unicyclic antidepressants?

A

maprotiline
mirtazapine
buproprion
trazodone

23
Q

maprotiline MOA?

A

NET inhibitor

24
Q

mirtazapine MOA?

A

A2, 5HT2, 5HT3 and H1 antagonist

25
Q

buproprion MOA?

A

DAT inhibitor
NET inhibitor
SERT inhibitor

26
Q

trazodone MOA

A

5HT2A antagonist
weak SERT inhibitor

27
Q

what are SNRI drugs?

A

venlafaxine, desvenlafaxine, duloxetine, milnacipran, lveomilnacipran, reboxetine, atomoxetine

28
Q

what are SNDRIs?

A

block all three
triple blockers

29
Q

what are rapid acting antidpressants?

A

ketamine
esketamine
scopolamine

30
Q

what is postpartum depression?

A

occurs within 4 weeks and can last >1 year

31
Q

what are treatments for PPD?

A

SSRIs and venlafaxine
CBT and counseling
brexanalone

32
Q

what is the function of brexanaolone?

A

allopregnanolone levels increase during pregnancy and return to normal postpartum
this causes GABA-A receptors to be desensitized
brexanolone resensitizes these receptors

33
Q

what are nonpharm treatments?

A

electroconvulsive therapy, psychotherapy, hospitalization

34
Q

What is the pharmacology of filbanserin?

A

agonist at 5HT1A
antagonist at 5HT2A/C
hypoactive sexual desire disorder

35
Q

Etiology of bipolar disorder?

A

genetic predisposition
biological 5HT and DA

36
Q

what is treatment of bipolar?

A

hospitalization
psychotherapy
pharmacotherapy

37
Q

What is pharmacotherapy of bipolar?

A

mood stabilizers: lithium and anticonvulsants
atypical antipsychotics: olanzapine, quetia, risperidone, ziprasidone

38
Q

what is the action of lithium?

A

mechanism not understood
depletion of PIP2 and associated signalling
modulate GSK3

39
Q

what is valproic acid and sodium valprotate MOA?

A

increases GABAergic tone
blocks NA
blocks t-type ca2+ channel
inhibits histone d

40
Q

what are the anticonvulsants used for bipolar and the channels they act on?

A

carbamazepine/oxcarbazepine: Na+ channel
lamotrigine: Na and Ca channel
topiramate: Na+ channel

PHRM 845 (9 decks)

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