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pharmacology II > Pharm II, antidepressants > Flashcards

Pharm II, antidepressants Flashcards

1
Q

What are the major categories of antidepressants -6

A

monoamine oxidase inhibitors - tricyclic antidepressants - tetracyclic antidepressants - serotonin reuptake inhibitors SSRI- serotonin and NE reuptake inhibitors - NE and dopamine reuptake inhibitors

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2
Q

PARQ for MAOI

A

Diet restrictions - limit tyramine foods because they won’t be broken down - risk of serotonin syndrome

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3
Q

seratonin syndrome

A

hypertensive emergencies and fatal acelleration of HTN when tyramine is eaten while on MAOIs- also a risk with other drugs taken in conjunction

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4
Q

what does MAOI potentiat the effects of

A

sympathetimemtics like NE

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5
Q

MOA or tricyclic antidepressants

A

unknown - diminish reuptake of monoamine neurotransmitters with possible down regulation of post synaptic receptors.

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6
Q

indications for tricyclic anti-D

A

obsessive compulsive- enuresis- panic attacks and chronic pain

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7
Q

what is a side effect of tricyclic anti-D

A

severe insomnia and depression

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8
Q

what tricyclic Anti-D is also used for bed wetting

A

Amitriptyline

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9
Q

side effects of tricyclic?

A

benadryl like- dry mouth- urinary hesitancy

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10
Q

Why are tricyclic anti-Ds more risky than SSRI’s

A

because they are lethal at 10 times daily dose causing prolonged QT interval leading to arrhythmias

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11
Q

Tricyclic antidepressant

A

Amitriptyline/Elavil

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12
Q

indication for tricyclic antidepressant

A

major depression- bipolar- tension headaches- chronic pain

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13
Q

MOA tricyclic- elavil

A

CNS modulation of serotonin and NE- increasing levels of each

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14
Q

Side effects of ELAVIL

A

Dizziness -drowsey - benadryl like symptoms - dry mouth.

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15
Q

what class is Elavil/amitriptyline

A

tricyclic antidepressant

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16
Q

what is the withdrawl like symtpms of Elavil called

A

discontinuation syndrome - nausea - HA - flu like

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17
Q

name the tetracyclic anti D

A

trazodone - desyrel

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18
Q

some major side effecs of both tri and tetracyclic anti-D

A

insomnia and depression

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19
Q

MOA of tetracyclic anti D

A

serotonin reuptake inhibition (presynaptic cleft) - partal antagonist. This increases serotonin in cleft increasing SE availble at post synapse

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20
Q

indication of tetracyclic anti D

A

trazodone-desyrel - major depression - anxiety- panic - insomnia

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21
Q

what medication can be perscribed for just insomnia without depression

A

tetracyclic anti D - trazodone - desyrel

22
Q

Side effects of trazodone desyrel

A

sedation - risk of flalling in elderly- hypotension - mania in those with bipolar - increased risk of suicide

23
Q

what are the most commonly perscribed anti-Ds

A

SSRI - selective serotonin reuptake inhibitors

24
Q

MOA of SSRI

A

block serotonin reuptake presynaptically to increase serotonin available for neurotransmission at post synaptic cleft

25
Q

how effective are SSRIs

A

helpful in 50-8=70% of those with major depression - not mild or moderate

26
Q

side effects of SSRIs

A

GI upset- diarrhea- insomnia - ED - major weight gain

27
Q

what class of anti-Ds have the best benefit/rist ratio

A

SSRIs

28
Q

what happens if quit SSRI suddenly

A

profound anxiety and rebound depression that is worse than the origional

29
Q

what is the name of the SSRI

A

Fluoxetine/prozack

30
Q

indications for prozac

A

major depression- OCD- bulimia- panic disorder

31
Q

moA of SSRI

A

Prozac/fluoxetine - decreased serotonin reuptake at presynaptic cleft

32
Q

how long for SSRI to have effect

A

weeks at daily doseing

33
Q

side effects of SSRIs

A

Prozac/fluoxetine - GI upset - diarrhea- high blood pressure - ED - impotence

34
Q

what OTC drugs shoulnt’ be used with SSRIs

A

NSAID - they reduce efficacy of SSRI while increasing risk of bleeds

35
Q

what OTC drugs shouldn’t be used with Prozac/fluoxetine

A

aspirin- ibuprophen- naproxen

36
Q

name the SNRIs serotinin and NE reuptake inhibitors

A

duloxetine/cymbalta

37
Q

what depression drugs can be used for pain syndromes like peripheral neropathy/ fibromyalgia

A

cymbalta a SNRI - serotinin and NE reuptake inhibitor

38
Q

what specific neuropathy symptom can cymbalta help with

A

SNRI - pain only - not for numbness or tingling

39
Q

main use for cymbalta

A

SNRI- major depressive disorder - general anxiety and neuropathy

40
Q

side effects of cymbalta

A

SNRI - Wt gain ED and HA - sleepwalking - drymouth - insomnia

41
Q

black box warning of SNRI

A

Cymbalta/duloxetine - increase risk of suicide 18-24

42
Q

what is NDRI

A

NE and dopamine reuptake inhibitors

43
Q

what is the NDRI for us

A

bupropion/wellbutrin

44
Q

why would someone pick NDRI over SNRI

A

bupropion/wellbutrin and NDRI has less weight gain- possible weight loss and less ED

45
Q

indication for bupropion/wellbutrin

A

NDRI - major depression - bipolar - ADD

46
Q

what is the bupropion for smokeing cessation

A

NDRI - zyban

47
Q

side effects of bupropion/wellbutrin

A

anxity the opposite of pepression- insomnia- restlessness- etc

48
Q

black box warning of NDRI

A

bupropion /wellbutrin - risk of suicide

49
Q

how is Zyban worked

A

start 1 week prior to quit date- take 7 days to reach steady state.

50
Q

what is the active form of folic acid

A

levomefolic acid - 5MTHF

51
Q

what is MTHF the coenzyme for 3 monoamines

A

serotonin - dopamine - norepinephrine

52
Q

what is the neutraceutical for MTHF

A

levomefolic acid/deplin taken at high dose with prescripton

pharmacology II (31 decks)

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