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Test 6 > Pharm 5 Anti-Depressants > Flashcards

Pharm 5 Anti-Depressants Flashcards

1
Q

Reserpine

A

Deplete NE, 5-HT, DA

Causes depression

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2
Q

Amine hypothesis

A

Depression due to lower 5-HT & NE

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3
Q

NTs affected:
MAOIs
Tricyclics
SSRIs

A

DA, NE, S

NE, S

S

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4
Q

Mirtazapine MOA

A

A2a inhibitor

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5
Q

Tricyclic SE (3)

A

Antihistamine - sedation
Antimuscarinic - dry mouth, constipation
Alpha-1 blockade - orthostatic hypotension

Reflex tachycardia (NE) can be FATAL

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6
Q

2 prototypical tricyclics

Metabolites

A

Imipramine. ->. Desipramine

Amitriptyline. ->. Nortriptyline

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7
Q

Desipramine SE

A

Sudden death in children

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8
Q

Tricyclic compliance problem

A

Impotence

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9
Q

Tricyclic drug interaction

A

Increased cardiotoxicity with MAOI

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10
Q

Next gen tricyclic AD

A

Less toxic, same efficacy

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11
Q

Bupropion (Wellbutrin)

A

2nd gen TCA
Indication: nicotine withdrawal
MOA: Mostly DA stimulator (psychomotor activation)
SE: Seizure risk
Less cardiotoxicity & less impotence

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12
Q

Venlafaxine

A

3rd gen TCA

MOA: NE & 5-HT
SE: Increase in diastolic BP
No cardiotoxicity

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13
Q

Trazodone

Nefazodone

A 
Sleep aid (sedation)
Bad antidepressant

SE: Priapism

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14
Q

SSRI side effects

A

NO cardiotoxicity

NO sedation

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15
Q

Fluoxetine (prozac)

A

SSRI

SE: Increased risk for suicide
       Sexual dysfunction
       Initial weight loss
       Inhibit CYP450
       200 hour t1/2
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16
Q

Sertraline

A

SSRI

Like fluoxetine but
No CYP450 inhibition
Shorter half life

17
Q

Paroxetine, Fluvoxamine

A

SSRI

Similar to sertraline, but some CYP450 inhibition

18
Q

Citalopram

A

SSRI

Similar to sertraline

Most selective

19
Q

Serotonin syndrome

A

After switching from SSRI -> MAOI or triptans (headache), excessive 5-HT in synapse

Lethal (hyperthermia, myoclonus, HTN)

20
Q

MAOI interaction

A

Tyramine from food

21
Q

2 long acting MAOIs

A

Phenelzine, Tranylcypromine

Nonselective (MAOI A & B)

22
Q

2 newer MAOI

A

Moclobemide
-Reversible inhibitor of MAOI A (no DA)

Selegiline
-MAOI B - used for Parkinson’s Disease

23
Q

MAOI advantage

A

Much quicker than SSRIs

Mood elevation in depressed AND normal

24
Q

MAOI SE

A

Hypomania
Hypotension (DA)
Sexual dysfunction

25
Q

MAOI interaction

A

Tyramine from food promotes release of NE stores

Dangerous HTN

26
Q

OCD tx

A

SSRIs (fluoxetine)

TCA (clomipramine)

27
Q

Anxiety disorder Tx

A

TCA - imipramine

28
Q

St Johns Wort problem

A

Induces liver enzymes, interferes with AD & warfarin metabolism

29
Q

Mifepristone

A

Morning after pill
Glucocorticoid-R antagonist
Mild AD effect

Test 6 (18 decks)

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