Pharm Final: Depression

Question 1

What are three neurotransmitters involved in depression?

Answer 1

serotonin (5-HT)
dopamine
norepinepherine

Question 2

What are the three main classes for depression tx?

Answer 2

MAOI, SSRI, TCA

Question 3

What is mechanism of action for MAOI?

Answer 3

inhibits mao enzymes which keep neurotransmitters elevated

Question 4

What are examples of MAOI?

Answer 4

phenelizine, tranlcypromine

start low and titrate need 4 weeks to see if effective

Question 5

What are SE of MAOI?

Answer 5

OTN, sedation, liver toxicity, confusion, sexual dysfunction, weight gain, HTN crisis

Question 6

What foods should totally be avoided with MAOI use?

Answer 6

cheese, smoked fish, liver, aged meat, beer and ale, wine

Question 7

What are tricyclic antidepressants MOA?

Answer 7

increase NE and serotonin at the synapse

dosing: start low titrate up, once a day at bedtime

Question 8

What are SE of TCA?

Answer 8

sedation, cognitive impairment, tremor, anticholinergic affects, OTN, weight gain, sex dysfunction

Question 9

What drug class can inhibit metabolism of TCA?

Answer 9

SSRI, thus it will increase levels of TCA

Question 10

What are examples of TCA?

Answer 10

Amitriptyline, doxepin, nortriptyline

Question 11

What is the moa of SSRI?

Answer 11

first line tx for moderate to mild depression,

inhibits uptake of serotonin at synapse

4 week trial needed

Question 12

What are SE of SSRI?

Answer 12

GI, HA, insomnia, fatigue, anxiety, sexual dysfunction

No CVD SE and safe in overdose

Question 13

What is SSRI discontinuation syndrome?

Answer 13

appears 1-4 post dis use and continues up to 25 days

sx: flu like, N/V, muscle aches, pains, HA

TX: taper drug slowly

Question 14

What are examples of SSRI?

Answer 14

fluoxetine(longest half life but beware with elderly), paroxetine, citalopram

Question 15

What CAM can help with depression?

Answer 15

St John’s Wort, only in mild to moderate depression