pharm Flashcards
TCAs mainly uptake
NA
TCAs eg
Desipramine
Amitriptyline
Imipramine
TCAs SEs
- m blockade: dry mouth, blurred vision, urinary retention, constipation
- H1 blockade: mild sedation
- a1 blockade: orthostatic hypotension
TCAs alarming effect
the combo of antimuscarinic + NA reuptake blockade can over excite heart -> arrhythmias, systoles
what are the firstline drugs for depression
SSRIs
what do SSRIs do
block uptake of 5HT only
SSRIs eg
Fluoxetine
Citalopram
Paroxetine
SSRI adverse efx
often acute anxiety due to acute elevation in 5HT before downreg happens
serotonin syndrome
occurs during excess increase in 5HT
MAOI moa
non selectively binds and destroys MAO-A
MAOI eg
Tranylcypromine
MAOI adverse efxMA
- insomnia / drowsiness
- postural hypotension
- atropine like effects
- loss libido
cheese reaction happens with?
MAOIs
bc they block MAO enzymes in the liver and gut
this reduces digestion of dietary MAs including tyramine
tyramine causes massive exocytosis of NA + 5HT from nerves which can case hypertensive crisis
RIMA moa
reversibly inhibs action of MAO enzymes in nerve terminals - more so MAO-A
RIMA eg
Moclobemide
RIMA adverse efx
- nausea and vomiting
NO cheese reaction, post hypo or atropine like effects
SARI moa
selective 5HT reuptake inhib with less potency
(5HT2 antag)
why SARI good?
prevents effects like anxiety in SSRI
SARI adverse efx
- sleepiness
- dizziness
- dry mouth
- liver damages (Nefazodone)
SARI eg
Nefzodone
bipolar disorder med
lithium
lithium moa
permeates through voltage gated sodium channels - not pumped out by sodium-potassium-ATPase pump so accumulates in tissues
less eff in rapid cyclic bipol disorders
lithium adverse efx
buildup - toxicity
tremor
hyperactivity
decreases kidney concentration ability
typical schizophrenia meds
Chlorpromazine
Haloperidol