ic12 depression medication moa and side effects Flashcards
list of TCAs and their classification
differences in classification
3rd degree amines
- amitriptyline
- clomiPRAMINE
2nd degree amine
- nortriptyline
- desiPRAMINE
2nd degree amine TCAs have less anticholinergic, sedation, and cardiotoxic side effects
MOA and side effects of TCA
GI
sexual dysfunction
weight gain, sedation, orthostatic hypotension, arrhythmia (QTC conduction abnormalities), seizure risk
what TCA used for OCD
clomipramine
list of SSRIs
fluoxetine
fluvoxamine
sertraline
escitalopram/citalopram
paroxetine
which SSRI has the longest half life and how long
fluoxetine (t1/2 4-6 days)
extended if norfluoxetine (4-16 days)
MOA of SSRI
selectively inhibits serotonin reuptake autoreceptors in the presynapse
SE of SSRIs
GI and sexual dysfunction
headache, transient nervousness during initiation
hyponatremia (SIADH)
bleeding risk, EPSE
which SSRI has the most sedating and weight gain effects (+ additional properties)
paroxetine
- most anticholinergic and sedating
it also has short half life = withdrawal risk.
which SSRI has risk of QTC prolongation if high doses in elderly
escitalopram
citalopram
which SSRI has risk of insomnia
fluoxetine
other indication of fluoxetine
eating disorders
list of SNRI and their MOA
venlafaxine (and desvenlafexine)
duloxetine
selective inhibitor of NE and 5HT
additional indication of SNRI
use in chornic pain MSK, diabetic peripheral neuropathy, fibromyalgia..
SE of SNRI
similar to SSRI
which SNRI has BP increase
venlafaxine
which SNRI might cause urinary hesitation
duloxetine
MOA of mirtazapine (name the drug class)
NaSSA
Noradrenaline and specific serotonin antagonist
alpha2, 5ht2,3, histamine antagonisms
also increase NE
SE of mirtazapine (and special counselling)
somnolence (useful for insomnia)
weight gain
increased appetite
can reverse the GI and sexual side effects of SSRI/SNRI
what is bupropion and its mOA
NDRI
NE and Dopamine reuptake inhibitor
less sexual side effect compared to SSRI/SNRI
SE of bupropion and special counselling
insomnia
seizrue
psychosis
NOT SUITABLE FOR EATING DISORDERS
another indication for bupropion
smoking cessation aid
what is moclobemide
MAOI
safest among MAOis
trazodone MOA, SE, indications
BLOCKS 5HT reuptake
antagonises 5HT2, H1 and alpha1
SE
same as SSRI + sedation + orthostatic hypotension
- rare: priapism
used for insomnia instead of depression
agomelatine MOA, SE, contraindications
melatonin MT1, 2 agonist
5ht2c antagonist
increase DA and NE
causes GI SE and increases LFTs
c/I: fluvoxamine, ciprofloxacin.
