Flood Chapter 43 Flashcards
Elderly patients taking antidepressant therapy are at particular risk for?
toxicity
Drugs used for psychopharmacologic therapy include? (5)
antidepressants, anxiolytics, lithium, antipsychotics, and anticonvulsants.
______and ________are the drugs most likely to be prescribed by primary care physicians for the treatment of depression in adults.
Antidepressants and anxiolytics
What drugs are useful for treatment of bipolar disorders and psychotic disorders including schizophrenia?
Lithium, anticonvulsants, and antipsychotic
Antidepressant therapy side effects may be less well tolerated among the elderly population due to age. True/False
False: They are less tolerated due to coexisting disease
It is estimated that up to 50% of the population is treated for a depressive illness at some time in life. True or False?
False: Its 10% of the population not 50% of the population.
It is well accepted that anesthesia can be safely administered to patients being treated with drugs used to treat mental illness. True/False
True
Clinical uses of antidepressant drugs include?
Childhood ADHD Bulimia PTSD Unipolar and Bipolar depression OCD Migraine prophylaxis Neuropathic pain Social Phobia Panic disorder
Neurobiologically, reuptake blockade or monoamine oxidase (MAO) inhibition occurs promptly after initiation of antidepressant therapy, but clinical improvement typically does not occur for 2 to 4 weeks. This could be explained by?
Perhaps adaptive changes including downregulation of neurotransmitter receptors are necessary before evidence of clinical improvement appears.
Antidepressants are logically classified based on their?
chemical structures and their acute neuropharmacologic effects.
The precise mechanism by which antidepressants work is
unknown
Antidepressants appear to act by
altering noradrenergic neurotransmission and/or serotoninergic neurotransmission thereby increasing the amount of norepinephrine and serotonin in synapses.
What is the black box warning on Newer SSRIs
Increased suicidal tendencies in children and adolescents.
Nevertheless, the risk is small and many patients benefit from treatment with SSRIs emphasizing the need to individualize therapy.
What are the drugs of choice for the treatment of mild to moderate depression
selective serotonin reuptake inhibitors (SSRIs)
First-line pharmacotherapy for panic disorder and obsessive-compulsive syndrome are?
SSRIs
SSRIs are also effective in treatment of social phobia and posttraumatic stress disorder. T/F
True
A prominent cause of noncompliance with SSRI therapy in both men and women is?
drug-induced sexual dysfunction in both men and women (delayed ejaculation, anorgasmia, decreased libido).
Newer SSRIs are believed to act on ________ and _________ pathways in the brain.
serotonin and norepinephrine
MOA of newer SSRIs include
Dual serotonin and norepinephrine reuptake blockade (venlafaxine) and α2-receptor blockade (mirtazapine).
SSRIs that share the ability to block the reuptake of serotonin include (6 Older SSRIs)
fluoxetine paroxetine sertraline fluvoxamine citalopram escitalopram.
This newer SSRI may cause hypertension it some individuals
Venlafaxine.
It has dual serotonin and norepinephrine reuptake blockade.
Standard practice dictates trying several SSRIs before moving to another class of medication because?
Different SSRIs have different side effect profiles.
Patients who do not respond to one drug or who fail to tolerate the drug may do well on a different SSRI.
There is abundant evidence that _______ receptors are involved in the etiology of anxiety.
serotonin
Potent inhibition of serotonin reuptake appears to be necessary for effectiveness in the treatment of ___________.
obsessive-compulsive disorders