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SBM psychiatry > PHARM - anxiety, depression, and mania drugs > Flashcards

PHARM - anxiety, depression, and mania drugs Flashcards

1
Q

leading SSRI and others

A
  • CITALOPRAM
  • escitalopram
  • fluoxetine
  • paroxetine
  • fluvoxamine
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2
Q

leading serotonin acting TCA

A

chlomipramine

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3
Q

leading SNRI and others

A
  • VENLAFAXINE
  • desvenlafaxine
  • duloxetine
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4
Q

leading NDRI

A

bupropion

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5
Q

leading NE acting TCA and others

A
  • NORTRYPTILINE
  • imipramine
  • amitriptyline
  • desipramine
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6
Q

leading MAO-Is

A
  • phenelzine

- tranylcipramine

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7
Q

most of the cells that use serotonin as a primary signaling messenger are in the

A

Raphe nucleus

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8
Q

citalopram SEs and interactions

A
  • SSRI
  • increased suicidal ideation up to age 25
  • GI, sexual, sleep, sweating, hyponatremia, mania
  • QTc elongation - risk of Torsade’s at high doses
  • R enantiomer has weak 2D6 inhibition, can increase levels of TCAs and MAOIs
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9
Q

NE predominant nerve cells are mostly found in the…

A

Locus Coeruleus

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10
Q

venlafaxine SEs and interactions

A
  • SNRI
  • increased suicidal ideation up to age 25
  • GI, sex, sleep, sweating, hyponatremia, mania
  • diastolic BP increase
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11
Q

secondary vs tertiary amines (TCAs “SNRIs”), drugs and benefits

A

tertiary - imipramine, amitriptyline, chlomipramine
secondary - nortriptyline, desipramine
secondary are better because they have less side effects and are focused more toward NE than serotonin

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12
Q

nortriptyline SE and interactions

A
  • TCA
  • weight gain, sedation, ACh, hypotension, arrhythmia, sexual, sweating
  • 2D6 inhibition
  • interacts with MAO-I, TCA, tramadol
  • lethal in overdose
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13
Q

bupropion SE and interactions

A
  • NDRI
  • SEs - insomia, tremors, tinnitus, seizures
  • no sexual side effects because it doesn’t affect serotonin
  • interactions - 2D6, MAO-I, TCA, tramadol, levodopa
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14
Q

how do MAO-Is work? switching from AD to MAO-I?

A
  • shut down monoamine oxidase, increasing amount of all three monoamines, NE, serotonin, and dopamine
  • need a two week wash out period when switching from AD
  • MAO-Is are third line ADs because of side effects but may be more effective overall because of the triple action
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15
Q

major MAO-I side effects

A
  • serotonin syndrome - when drugs that increase serotonin are added (mereprine, Libby Zion)
  • dietary tyramine - precursor to monoamines
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16
Q

mirtazapine mechanism

A
  • NaSSA, dual reuptake

- blocks A2 (NE), 5HT receptors, and H1 histamine receptors

17
Q

mirtazapine SE and interactions

A
  • sedating, weight gain, histamine block

- do not combine with MAO-I

18
Q

bupropion least likely to cause….

A

mania

19
Q

bupropion may reduce….

A

sexual side effects of ADs

20
Q

what are the two major MAO-Is and what are their main SEs?

A

phenelzine - sedating

tranylcypromine - stimulating

21
Q

what are SARIs and what is their mechanism?

A
  • serotonin 2A antagonists

- block 5HT2A, 5HT2C, A1

22
Q

5 therapeutic uses of BZDs

A
  • sedative
  • anxiolytic
  • seizure
  • muscle relaxant
  • anterograde amnesia/anesthesia
23
Q

what is the basic BZD mechanism?

A
  • positive allosteric modulator
  • binds and increases receptor affinity for GABA
  • Cl- rushes into cell
  • hyperpolarization, now greater energy needed to stimulate cell
24
Q

diazepam mechanism

A
  • non-selective BZD
  • binds any receptor with alpha 1-3, 5
  • anywhere in brain
25
Q

% alpha receptors on GABA receptors and what they are responsible for

A 
alpha 1 (60%) - addiction, sedation, amnesia
alpha 2 (20%) - anxiolytic
alpha 3 (10%) - muscle relaxation
alpha 5 (<5%) - inverse agonist can enhance learning
26
Q

diazepam SEs

A

depression, sedation, amnesia, ataxia, dependence and withdrawal

27
Q

diazepam interactions

A
  • CNS depressants and cimetidine
28
Q

what are z-compounds?

A
  • alpha 1 selective BZD agonists
29
Q

name the three major z-compounds

A
  • zolpidem
  • zalaplon
  • eszopiclone
30
Q

what is buspirone mechanism?

A

5HT-1A partial agonist

31
Q

what is buspirone used for?

A

general anxiety disorder (GAD) or major depressive disorder (MDD)

SBM psychiatry (20 decks)

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