module 3 SNRI, atypical antiD, serotonin receptor agonist Flashcards
SNRI drugs
venlafaxine
duloxetine
SNRI MOA
block NE and 5HT reuptake
- venlafaxine: concentration dependent
SNRI use
depression
- duloxetine: also neuropathic pain
SNRI contraindication
HTN
duloxetine interactions
CYP2D6, 1A2
venlafaxine prodrug
desvenlafaxine active form
bupropion MOA
atypical antidepressant
inhibit dopamine and NE reuptake
bupropion AE
insomnia
least sexual side effects
bupropion contraindications
seizure disorder
eating disorder
bupropion administration
IR:TID
SR: BID
XL: daily
mirtazapine MOA
atypical antidepressant
antagonizes 5HT2/3 and a2 adrenergic receptors
antagonizes histamine
mirtazapine AE
inc. appetite
sedation
less sexual dysfunction
mirtazapine interactions
CYP3A4
Nefazodone MOA
atypical antidepressant inhibits 5HT transporter antagonize: -5HT2 - Histamine - A1
nefazodone use
depression
anti-anxiety
- 2nd or 3rd line drug
nefazodone AE
sedation orthostasis hepatotoxicity fulminant liver failure less sexual dysfunction
nefazodone contra
liver dysfunction
nefazodone interaction
CYP3A4
trazodone MOA
atypical antidepressant inhibit 5HT transporter antagonize: - 5HT2 - histamine - A1
trazodone AE
priapism
trazodone use
high dose: antidepressant
low dose: sleep agent
trazodone interactions
CYP3A4
buspirone MOA
serotonin receptor agonist
- 5HT1A
nonsedating
nonaddictive
buspirone use
anxiety
buspirone AE
dizzy
nausea
drugs that inc. neurotransmission without known MOA
ampthetamine
methamphetamine
methylphenidate
modafinil
armodafinil
- may interfere with synaptic vesicle storage
- may displace 5HT, NE, DA from vesicles and reuptake
2nd line
unknown MOA drugs AE
induction os psychosis and alertness
- use: narcolepsy
lithium MOA
interfere with cAMP and IP3 formation
lithium use
bipolar
- mania and depression control
lithium AE
nausea thirst polyuria hypothyroidism tremor weakness confusion teratogenesis
lithium contra
narrow TI
preg
renal insufficiency
- secreted and reabsorbed in renal tubules
lithium interactions
diuretics
probenecide
lithium monitoring
therapeutic levels: 07-1.2.
lithium administration
long half life: 12-27hrs
Mood stabilizers for bipolar disorder
carbamazepine
valproic acid