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Pharmacology > Mood Stabilizers > Flashcards

Mood Stabilizers Flashcards

1
Q

Biogenic Amine Hypothesis

A

Depression is due to deficiency of monoamines, such as NE, Serotonin at key sites in the brain

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2
Q

MOA of Antidepressants

A

Inhibits reuptake of NE by blocking NET
Inhibits reuptake of 5-HT by blocking SERT

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3
Q

Tertiary Amine TCAs

A

Amitriptyline (Elavil®)
Clomipramine (Anafranil®)
Imipramine (Tofranil®)
Doxepine (Aponal®)
Trimipramine (Surmontil®)
Dosulepine/ Dothiepin (Prothiaden®)

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4
Q

Secondary Amine TCAs

A

Desipramine (Norpramin®)
Protriptyline (Vivactil®)
Nortryptyline (Pamelor®)

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5
Q

A/Es of TCAs

A

Orthostatic Hypotension
Autonomic Side Effects
Cardiac Conduction Delays & Heart Block
Sexual Dysfunction
Sedation
Seizures
Weight Gain
Cardiac dysrhythmia

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6
Q

Process involved in the biotransformation of Amitriptyline to Nortriptyline

A

N-demethylation

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7
Q

Useful in the treatment of Nocturnal Enuresis (Bed Wetting) due to its Anticholinergic Effects

A

Imipramine

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8
Q

Treatment of TCAs Toxicity

A

NaHCO3

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9
Q

MOA of Selective serotonin reuptake inhibitors (SSRIs)

A

Inhibits reuptake of 5-HT!

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10
Q

Most widely used drugs for treatment of depression and anxiety disorders

A

SSRIs

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11
Q

TF: SSRIs are much safer than TCAs, as it seldom cause cardiac arrhythmia and seizures

A

True

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12
Q

Selective Serotonin Reuptake Inhibitor
(SSRIs)

A
  • Fluoxetine
  • Paroxetine
  • Fluvoxamine
  • Sertraline
  • Citalopram
  • Escitalopram
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13
Q

Fluoxetine

A

Depression
Panic
Bulimia
Anorexia nervosa
OCD

Converted to Norfluoxetine
Half-life: 2.5 Days

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14
Q

Fluvoxatine

A

OCD, panic attack

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15
Q

Can be used for elderly

A

Sertraline
SE: Sedation

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16
Q

Paroxetine

A

For hot flushes and perimenopause (Low dose)

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17
Q

A/Es of SSRIs

A

Increase alertness
Nervousness
Dizziness
Insomnia

18
Q

Serotonin Norepinephrine Reuptake
Inhibitor (SNRI)

A

Duloxetine - For neuropathic pain & GAD
Venlafaxine - Less affinity to NE reuptake
Milnacipran - For fibriomyalgia
Levomilnacipran (S-isomer)

19
Q

Noradrenaline Reuptake Inhibitor (NaRI)

A

Raboxetine

20
Q

Selective Serotonin Reuptake Enhancer (SSRE)

A

Tianeptine (Stablon®)

21
Q

Non-Selective Monoamine oxidase inhibitors (MAOIs)

A

Phenelzine (Nardil®)
Isocarboxacid
Tranylcypromine (Parnate®)

22
Q

Selective MAOI-A

A

Moclobemide (Aurorix®)

23
Q

Selective MAOI-B

A

Selegeline (Eldepryl®)

24
Q

MAOIs + SSRIs

A

Serotonin Syndrome

25
Q

MAOIs + Tyramine

A

Hypertension Crisis

26
Q

Weak inhibitor of the neuronal reuptake of dopamine, norepinephrine, and serotonin

A

Bupropion

27
Q

Bupropion MOA

A

Noncompetitive antagonist at nicotinic cholinergic receptors

28
Q

Bupropion clinical uses

A

Smoking deterrent
Treatment of obesity (Bupropion + Naltrexone)

29
Q

5-HT2 antagonists

A

Nefazodone (Serzone®) - Hepatotoxic
Trazodone (Desyrel®) - Cause Priapism (prolonged, painful erection)

  • ZODONE
30
Q

Tetracyclic antidepressant, alpha 2 receptor blocker

A

Mirtazapine - cause agranulocytosis

31
Q

Extracts of St. John’s Wort

A

Hypericin - fewer SE, less effective

32
Q

Mania

A

Delusion
Increased libido
Elevated mood
Talkativeness

33
Q

Lithium carbonate MOA

A

Reduces formation of Inositol triphosphate (IP3)

34
Q

1st line treatment & prevention of bipolar disorder

A

Lithium

35
Q

Diuretics + Lithium carbonate

A

Increase Li toxicity

36
Q

Adverse Effects of Lithium carbonate

A

Low Therapeutic Index
Tremor, N/V
Neurotoxic
Cardiotoxic
Polyuria
Hypothyroidism
Teratogenic (Eibstein anomaly)

37
Q

Idiosyncratic Reactions of Lithium Carbonate

A

Nephrogenic DI
Thyroid abnormalities
Ebstein Anomaly
Alteration Levels of:
a. Acetazolamide
b. “xanthine” drugs
c. Sodium competes with Li excretion
*Increased levels of ACEi, NSAIDs, Thiazide Diuretics

38
Q

Alternative drugs for Bipolar disorder

A

Carbamazepine
Lamotrigine
Valproic acid
Benzodiazepine - relieve manic symptoms

39
Q

For rapid cycling bipolar disorder and has better safety profile than Lithium

A

Valproic Acid

40
Q

For acute mania and prophylaxis for depressive phase of bipolar disorder

A

Carbamazepine (Tegretol)

41
Q

Atypical Psychotics can be used for Bipolar Disorder

A

Risperidone
Olanzapine
Aripiprazole
Arsenapine

Pharmacology (26 decks)

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