PHARMA antidepressants Flashcards by aura a

Q

Main classes of antidepressants

A

A Selective Serotonin Reuptake Inhibitor (SSRIs); B Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs); C Tricyclics (TCAs) (pramines & -tryptylines); D 5-HT2 Antagonists (-zodones); E Tetracyclics/Unicyclics; F Monoamine Inhibitors (MAOIs)

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Q

1 Citalopram

A

A SELECTIVE Serotonin Reuptake inhibitors (SSRIs)

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Q

2 Escitalopram

A

A SELECTIVE Serotonin Reuptake inhibitors (SSRIs)

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Q

3 Fluoxentine*

A

A SELECTIVE Serotonin Reuptake inhibitors (SSRIs)

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Q

4 Fluvoxamine

A

A SELECTIVE Serotonin Reuptake inhibitors (SSRIs)

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Q

5 Paroxentine

A

A SELECTIVE Serotonin Reuptake inhibitors (SSRIs)

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Q

6 Sertraline

A

A SELECTIVE Serotonin Reuptake inhibitors (SSRIs)

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Q

7 Vilazodone

A

A SELECTIVE Serotonin Reuptake inhibitors (SSRIs)

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Q

MOA of SSRIs

A

Selective blockage of SERT, little effect in NET and beta adrenergic receptors

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Q

SSRI with longest half life

A

Fluoxentine

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Q

SSRI with highest bioavailability

A

FluVoxamine (bioaVailability)

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Q

SSRI with highest volume of distribution

A

Paroxentine

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Q

SSRI na potent inhibitor of CYP206, with higest drug interactions

A

FluvoXamine & ParoXentine (with X = enzyme inhibitor)

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Q

SSRI that causes weight GAIN and cardial septal defect

A

Paroxentine

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Q

SSRI that causes dizziness and paresthesias

A

Sertraline and Paroxentine

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Q

SSRI adverse effect related to reproduction

A

sexual dysfunction

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Q

SSRI that significantly improves anxiety symptoms

A

Citalopram

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Q

Most potent SSRI

A

Escitalopram

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Q

SSRI that causes weight LOSS

A

Fluoxentine

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Q

Clinical use of Fluvoxamine (SSRI)

A

used in OCD and panic disoders

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Q

Clinical use of Paroxentine (SSRI)

A

anticholinergic function; sedating

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Q

SSRI na taken with food to increase absorption, causes nausea

A

Sertraline

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Q

1 Duloxetine* class

A

B Serotonin-Norepinephrine Reuptake inhibitors (SnRIs)

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Q

2 Milnacipran class

A

B Serotonin-Norepinephrine Reuptake inhibitors (SnRIs)

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3 Venlafaxine class

B Serotonin-Norepinephrine Reuptake inhibitors (SnRIs)

4 Desvenlafaxine class

B Serotonin-Norepinephrine Reuptake inhibitors (SnRIs)

MOA of SNRIs

moderate selective blockade of SERT and NET

Half life of Venlaxagine and Desvenlaxagine (SNRIs)

11-12 hours, short half life but dosing is still OD

SNRI shortest t1/2 & highest bioavailability

Milnacipran

SNRI na highest volume of distribution & most protein-bound; once daily dosing

Duloxetine

SNRI na lowest protein binding

Venlafaxine and Desvenlafaxine

SNRI na conugated

Desvenlafaxine

Most common adverse effects of SNRI

Anticholinergic like dry mouth, constipation, urinary retention, blurred vision, confusion

SNRI that causes cardiac toxicity

Venlafaxine

SNRI that causes hepato toxicity

Duloxentine

Contraindication of SNRI

MAOIs

SNRI that elevates TCA levels

Duloxentine

Clinical use of Duloxentine (SNRI)

Urinary stress incontinence

Clinical use of Venlafaxine and Desvenlafaxine

Vasomotor symptoms of menopause

1 Imipramine*

C Tricyclic

2 Clomipramine*

C Tricyclic

3 Desipramine

C Tricyclic

4 Trimipramine

C Tricyclic

5 Amitryptyline

C Tricyclic

6 Nortriptyline

C Tricyclic

7 Protryptyline

C Tricyclic

8 Doxepin

C Tricyclic

MOA of tricyclics

same with SNRI but less adverse effects

Tricyclics have long half lives Pero sino yung shortest half life sakanila?

Imipramine (imi mini miney moe Shortie hahaha)

TCA with shortest t1/2 but highest volume of distribution

Imipramine

TCA with no active metabolites but with wide therapeutic window

Desipramine and Nortryptyline

alpha blocking effect of anti depressants causes what

Orthostatic hypotension

h1 antagonism effect of anti depressants causes what

Weight gain and sedation

TCA with sexual effects

Clomipramine

TCA that causes weight gain and sedation

Doxepine

1 Nefazodone

D 5 HT 2 Antagonists

2 Trazodone

D 5 HT 2 Antagonists

Nefazodone and Trazodone MOA

Inhibition of 5-HT2A receptor

5HT2 antagonist that causes sedation

Trazodone

5HT2 antagonist that causes hepatotoxicity

Nefazodone

5HT2 antagonist that causes PRIAPISM

Trazodone

1 Bupropion

E Tetracyclics / Unicyclics

2 Amoxapine

E Tetracyclics / Unicyclics

3 Maprotiline

E Tetracyclics / Unicyclics

4 Mirtazapine

E Tetracyclics / Unicyclics

Tetracyclic with biphasic elimination

Bupropion

Tetracyclic with shortest half life

Amoxapine

Amoxapine adverse effect (tetracyclic)

Parkinsonian syndrome

Mirtazapine adverse effect (tetracyclic)

Sedation

TCA-like tetracyclics

Maprotiline and Amoxapine

1 Isocarboxazid

F MAO inhibitor

2 Phenelzine

F MAO inhibitor

3 Tranylcypromine

F MAO inhibitor

4 Selegiline

F MAO inhibitor

5 Moclobemide

F MAO inhibitor

MAOIs most common adverse effect

hypotension & weight gain

MAOIs drug interaction

Serotonergic agents - causing SEROTONIN SYNDROME

Indication for use of Antidepresants

Major depression

What to use for post traumatic stress disorder

SSRIs

What to use for OC DISORDER

SSRIs

What to use for SOCIAL ANXIETY DISORDER

SSRIs, Venlafaxine

What to use for PAIN DISORDER

TCAs, Duloxetine, Milnacipran

What to use for PRE MENSTRUAL DYSPHORIC DISORDER

Fluoxetine, Sertraline

What to use for SMOKING CESSATION

Bupropion

What to use for BULIMIA

Fluoxetine, Bupropion (weight loss)

What to use for URINARY STRESS INCONTINENCE

Duloxetine

What to use for PERIMENOPAUSAL EFFECTS

Desvenlafaxine, Venlafaxine, Nefazodone

What to use for PREMATURE EJACULATION

SSRIs

Order of choice of antidepressants

SSRIs then SNRIs then Bupropion then Mirtazapine

Order of choice of antidepressants with least association with side effects

Bupropion then Mirtazapine then Nefazodone