pharmacology Flashcards
what is the monoamine hypothesis for depression
depression results from a functional deficit of monoamine transmitters - particularly serotonin (5-HT) and noradrenaline
explain the 2 main dopamine pathways in terms of schizophrenia
mesolimbic pathway is overactive due to too much dopamine - causes positive symptoms
mesocortical pathway is underactive due to too little dopamine - causes negative symptoms
what is the best drug for management of physical symptoms of anxiety
b-blockers : propranolol
what is the main fear regulation centre in the brain
amygdala
what is released in response to stress and from where
cortisol released from adrenal glands
hypothalamus secretes CRH, triggers ant pit to release ACTH
what is the main inhibitory neurotransmitter and what is it’s role
GABA - reduces activity of neurones in the amygdala and the CSTC circuit - involved in worry
what is the target of benzodiazepines in managing anxiety
enhances the action of GABA-A
what is the key neurotransmitter that innervates the amygdala
serotonin
mechanism of action of MAO inhibitors and what they are used for
inhibit the metabolism of serotonin and noradrenaline in the presynaptic cell - used to be used to treat depression
name some MOA-I’s
moclobemide
phenelzine
what is the cheese reaction and which drugs cause it
hypersensitivity crisis caused by MAO-Is in the gut preventing the breakdown of dietary tyramine
what is the most common tricyclic antidepressant
amitriptyline
what is the mechanism of action of amitriptylline
blocks the reuptake of serotonin and noradrenaline
what is the most common side effect of amitriptylline
constipation
+ urinary retention, dry mouth
name some common SSRIs
fluoxetine, sertraline, citalopram
what is the MOA of SSRIs
selectively inhibit the reuptake of serotonin from the synaptic cleft
what is the only SSRI licenced for under 18’s
fluoxetine
common side effects of SSRIs
GI upset, sexual dysfunction, hyponatraemia
what is a complication seen in patients within the first few months of starting an SSRI
serotonin syndrome
what is the triad classically associated with serotonin syndrome
altered mental status - agitation, anxiety, delirium
autonomic hyperactivity - hyperthermia, tachycardia, hypertension, flushing N+V
neuromuscular abnormalities - tremor, clonus, rigidity, hyperreflexia
name some SNRIs
venlafaxine
duloxetine
what is the mechanism of action in SNRIs
blocks the reuptake of noradrenaline and serotonin into the presynaptic terminals
what kind of drug is mirtazapine
antidepressant
give 2 examples of typical antipsychotics
haloperidol
chlorpromazine
