Pharmacology Flashcards
Name all the classes of antidepressants.
SSRIs (selective serotonni reuptake inhibitors)
TCAs (tricyclic antidepressants)
irreversible MAOIs (monoamine oxidase inhibitors)
RIMAs (reversible inhibitor of monoamine oxidase A)
SARIs (serotonin antagonist and reuptake inhibitor)
NRIs (norepinephrine reuptake inhibitor)
SNRIs (serotonin-norepinephrine reuptake inhibitors)
α-2 adrenoceptor antagonists
Name 2 examples of SSRIs
Citalopram, escitalopram, fluoxetine, fluvoxetine, paroxetine, sertraline
Name 2 examples of TCAs
amitryptaline
nortryptaline
clomirmine
imipramine
trimipramine
dothiepin
doxepin
Name 2 examples of irreversible MAOIs
Tranylcypromine
Phenelzine
Name an example of a RIMA
Moclobemide
Name an example of a SARI
Nefazadone
Name an example of a NRI
Reboxetine
Name 3 examples of a SNRI
Venlafaxine
Desnevlafaxine
Duloxetine
Name 2 examples of an α-2 receptor antagonist.
Mirtazapine
Mianserin
Name 2 examples of typical antipsychotics
haloperidol
fluphenazine
droperidol
prochlorperazone
zucloperazine
chlorpromazine
thiorodazine
Name 2 examples of atypical antipsychotics
amisulpride
clozapine
olanzapine
risperidone
aripiprazole
What are the side effects of clozapine?
- GOW, DM, increase lipids
- sedation
- orthostatic hypotension
- constipation/bowel obstruction
- drooling
- urinary retention/incontinence
- lowered seizure threshold
- agranulocytosis/neutropenia
- myocarditis/cardiomyopathy
What are the side effects of olanzapine?
- GOW, DM, increased lipids
- sedation
- orthostatic hypotension
- dizzines
- peripheral oedema
- bradycardia
- antichol: urinary retention, consitpation, dry mouth
What are the side effects of chlorpromazine?
- GOW, DM, increased lipids
- sedation
- orthostatic hypotension
- anti-chol: dry mouth, constipation, urinary retention
- photosensitivity: gray-blue skin pigmentation
- hepatotoxicity
What are the side effects of amisulpride?
- increased prolactin - amenorrhoea, galactorrhoea
- prolonged QT interval
- lowered seizure threshold
What is Mirtazepine? and what does it’s side effects spare?
Mirtazepine is TCA and it spares erectile function
What are the side effects of aripiprazole?
- anxiety
- insomnia
- constipation
What is the mechanism of action of typical antipsychotics?
blocks D2 receptors
What is the mechanism of action of atypical antipsychotics?
competitive blockade of 5-HT>D2 receptors
(less likely to cause EPSE than typical antipsychotics)
What are the extrapyridamal side effects(EPSE)?
- pseudo-parkinsonism
- tardive dyskinesia
- akathisia
- acute dystonia
- neuroleptic malignant syndrome
How long does it take for antidepressants to start working?
2-4 weeks!!
With antidepressants medications, when are most of the side effects present?
During the first 1-2 weeks.
How lon gdoes it take for antidepressants to start working?
2-4 weeks
What is Serotonin toxicity?
Syndrome caused by too much serotonin due to use of SSRIs and MAOIs or TCA, ST. John’s Owrt, ecstasy, lithium.
What are the symptoms of Serotonin toxicity?
hyperthermia, myoclonus, mental state changes
What are the symptoms of muscarinic blockade?
anti-SLUD (salivation, lacrimation, urination, defecation)
What is the main symptom of alpha-1 blockade?
orthostatic hypotension
What is the pharamcology of TCAs?
non-selective reuptake inhibitor of NA and 5HT
what are the side effects of lithium?
hypothyroidism
diabetes insipidus (due to decreased response to ADH)
fine tremor
benign leukocytosis
intestinal problems
increased weight
What are the side effects of Haloperidol?
- EPSEs esp. fatal laryngeal dystonia
- lengthened QT interval
What is the main symptom of H1 blockade?
sedation
What are the side effects of SSRIs?
GI: nausea, diarrhoea/constipation
Psych: anxiety, insomnia/somnolence, headache
other: sexual dysfunction, SADH, bleeding risk, decreased BMD
What are the side effects of TCAs?
- anti-SLUD
- orthostatic hypotension
- sedation
- prolonged QT interval
- decreased seizure threshold
What is the mechanism of action of TCAs?
non-selective re-uptake inhibition of NA (alpha-1, M, H1) and 5-HT
What are the side effects of irreversible MAO inhibitors?
- orthostatic hypotension
- insomnia/sedation
- anti-SLUD
- sexual dysfunction
What are the side effects of Valproate?
“SWATH”
Sedation
Weight gain
Alopecia
Hepatotoxicity
Thrombocytopenia
Name the dopamine pathways.
- mesolimbic
- mesocortical
- nigrostriatal
- tuberohypophyseal
what are the side effects of zopiclone?
metallic taste
what are the side effects of zolpidem?
somnambulism
diarrhorea
dizziness
what are the side effects of benzodiazepines?
- sedation, disinhibition
- ataxia
- muscle weakness
- confusion
- anterograde amnesia
- dry mouth, muscle weakness
- dependence
what are BZDs used to treat?
anxiety and insomnia (short term)
skeletal muscle relaxation
What should Lithium blood levels be during an episode?
0.8 - 1.2 nmol/L
What should Lithium blood levels be during maintenance?
0.6 - 0.8 nmol/L
What mood stabilizers should be used for a rapidly cyclng bipolar?
Carbamazepine and Valproic acid
What are the signs of NMS?
“FALTER”
Fever
Autonomic instability
Leukocytosis
Tremor
Elevated CPK
Rigidity
