Pharma-Antidepressants

Question 0

Physiological basis of depression

Answer 0

Potentiates action of norepinephrine and serotonin

Question 1

Types of depression

Answer 1

1) Refractory
2) Major depression disorder
3) Bipolar disorder

Question 2

MOA antidepressant?

Answer 2

1) MAO inhibitors
2) Tricyclic antidepressant
3) 2nd Generation (SSRI, SNRI)
4) Atypical antidepressant

Question 3

MAOA?

Answer 3

Subtype of MAO Inhibitor -> Deactivates dopamine, NE, 5-HT

Question 4

MAOB?

Answer 4

Subtype of MAO Inhibitor -> Deactivates dopamine

Causes Parkinson’s Disease

Question 5

Moclobemide

Answer 5

MAOA

Question 6

Selegiline

Answer 6

MAOB

Question 7

1) Phenelzine
2) Tranylcypromine
3) Isocarboxazide

Answer 7

MAO Inhibitor Non-Selective (Both MAOA & MAOB)

Question 8

Causes hypertensive crises when taken with Tyramine-releasing food (Catecholamines releaser)

Answer 8

MAOI

Question 9

1) Prazocin

2) Phentolamine

Answer 9

Treatment for hypertensive crises caused by MAOI + Tyramine-releasing food

Question 10

Causes serotonin syndrome (High BP, tremor, hyperthermia, metabolic acidosis, seizures) when combined with SSRI

Answer 10

MAOI

Question 11

Special characteristic of MAOI?

Answer 11

Bind irreversibly to MAO

Question 12

NE and 5-HT reuptake inhibitors

Answer 12

Tricyclic antidepressant (TCA)

Question 13

Block H1, M & A1 receptors

Answer 13

Tricyclic antidepressant (TCA)

Question 14

1) Imipramine
2) Desepramine
3) Amitriptyline
4) Nortriptyline

Answer 14

Tricyclic antidepressant (TCA)

Question 15

Special characteristic of TCA?

Answer 15

No effect on normal individual

Question 16

Helpful to treat enuresis

Answer 16

Imipramine (TCA)

Question 17

Helpful to treat migraine and neuropathic pain

Answer 17

Amitriptyline (TCA)

Question 18

Pharmacokinetics of TCA?

Answer 18

1) Taken orally

2) Metabolised in liver

Question 19

1) Antimuscarinic (Blurred vision, dry mouth, urine retention)
2) Cardiac arrhythmias (Tachycardia)
3) Alpha antagonist (Dropped BP)
4) Antihistaminic (Increased appetite, weight gain, sedation)

Answer 19

TCA

Question 20

First line of treatment for depression?

Answer 20

SSRI

Question 21

Special characteristics of SSRI?

Answer 21

No muscaranic, histaminic or alpha-adrenergic effect

Question 22

Pharmacokinetics of SSRI?

Answer 22

1) Taken orally
2) Metabolised in liver
3) Half-life of fluoxetine is the longest
4) Fluoxetine may inhibit liver enzyme
5) Excreted through kidneys

Question 23

1) Citalopram
2) Fluoxetine -> Young
3) Escitalopram, sertraline -> Adult

Answer 23

SSRI

Question 24

1) Sleep disturbance 2) Suicidal thoughts 3) Hyponatremia to elderly patients 4) Sexual dysfuntion

Answer 24

SSRI

Question 25

Discontinuation syndrome of SSRI

Answer 25

1) Headache, malaise, nervous, sleep disturbance | 2) More to short acting ones -> fluoxetine is the safest

Question 26

1) Duloxetine | 2) Venlafaxine

Answer 26

SNRI

Question 27

Side effects of SNRI?

Answer 27

1) Similar to SSRI | 2) Also may cause increased BP, urine retention, sweating

Question 28

Bupropion

Answer 28

Atypical antidepressant

Question 29

1) NE and Dopamine reuptake inhibitor 2) Used in nicotine dependence 3) Terminal illness (Cancer)

Answer 29

Bupropion

Question 30

Causes sympathomimetic effect

Answer 30

Bupropion (Atypical antidepressant)

Question 31

Bipolar disorder

Answer 31

Mixed disorder of depressive and manic phase

Question 32

Symptoms: 1) Talk rapidly and non-stop 2) Little sleep

Answer 32

Bipolar disorder

Question 33

1) Treatment for bipolar disorder 2) Requires several weeks for full effect 3) Doesn't affect mood of normal people

Answer 33

Lithium

Question 34

Precaution for lithium

Answer 34

Need drug monitoring due to narrow therapeutic index

Question 35

1) Headache, dizziness, fatigue (CNS-related) 2) Nephrogenic diabetes insipidus 3) Inhibit TSH

Answer 35

Side effect of lithium

Question 36

1) Anticonvulsants (Carbamazepine, valproic acid, lamotrigine) 2) Antipsychotics (Olanzapine, resperidone)

Answer 36

Maintenance for bipolar disorder

Question 37

Inhibit resynthesis of PIP2

Answer 37

Lithium