Pharmacology

Question 0

Tricyclic Antidepressant mechanism

Answer 0

Inhibit uptake of NA and 5-HT
Used less now due to cardiotoxicity
Can be lethal in overdose

Question 1

SSRI mechanism

Answer 1

Serotonin selective reuptake inhibitors

Enhance serotoninergic neurotransmission

Question 2

Monoamine oxidase inhibitors - mechanism

Answer 2

Inhibit monoamines metabolism, so increase synaptic levels
Rarely used now due to risk of hypertensive crisis
Due to NA build up when eat tyramine
Do not combine with other antidepressants

Question 3

SSRI examples

Answer 3

Sertraline
Fluoxetine
Paroxetine
Citalopram

Question 4

SSRI side effects

Answer 4

Nausea, vomiting, appetite change, blurred vision, anxiety, insomnia

Question 5

Serotonin and NA reuptake inhibitor examples

Answer 5

Venlafaxine

Duloxetine

Question 6

SNRI side effects

Answer 6

As SSRIs plus

Constipation, hypertension, raised cholesterol

Question 7

Tricyclic antidepressant examples

Answer 7

Amitrptyline
Clomipramine
Imipramine

Question 8

TCA side effects

Answer 8

Tachycardia, arrythmias
Dry mouth
Blurred vision
Constipation, urinary retention
Postural hypotension, sedation

Question 9

Noradrenergic and specific serotonin antidepressant (NASSA)

Answer 9

Mirtazapine

Question 10

Mirtazapine side effects

Answer 10

Sedation, increased appetite, oedema

NA and specific 5-HT antidepressant

Question 11

NA reuptake inhibitor antidepressant

Answer 11

Reboxetine

Question 12

Reboxetine

Answer 12

NARI

Dry mouth, constipation, sweating, urinary problems, tachycardia

Question 13

MAOIs

Answer 13

Phenelzine

Tranylcypromine

Question 14

MAOI side effects

Answer 14

Hypertensive crisis - cheese reaction
Postural hypotension, dizziness
Drowsiness, insomnia
Headache, blurred vision

Question 15

Mocobemide

Answer 15

Reversible inhibitor if monoamines oxidase A

Side effects inc agitation/anxiety, sleep disorder, nausea, hypertension

Question 16

Antidepressants generally…

Answer 16

Increase monoamines at synapse
By decreasing reuptake or breakdown
5-HT and central b-adnergic receptors become downregulated
Accounts for 4-6 delay in effects

Question 17

Antidepressant indicated in…

Answer 17

Moderate - severe depression
Ideally with psychotherapy
Plus antipsychotic if psychotic symptoms

Question 18

First choice antidepressants usually…

Answer 18

SSRIs
Relatively mild side effects
And safety in overdose

Question 19

Antidepressant therapy continues how long?

Answer 19

Till no longer depressed, then plus 6 months

To prevent relapse

Question 20

Recurrent depression - treat for how long?

Answer 20

Treat longer, about 2 years

Question 21

Antidepressant maintenance dose…

Answer 21

Same as for acute treatment

As lower doses rarely effective

Question 22

Common antidepressant sideffects

Answer 22

All can cause hyponatraemia, sexual dysfunction

Most lower seizure threshold (epilepsy!)

Question 23

Avoid antidepressants in patients with…

Answer 23

Mania / hypo mania

Question 24

Advice to patients on antidepressants

Answer 24

Not to drink alcohol die to increased sedation
Not to drive if feeling drowsy
Explain onset of action is delayed

Question 26

Treatment if childhood depression

Answer 26

Try to treat psychologically

Antidepressants only for most severe

Question 27

Donepezil

Answer 27

Used to treat cognitive impairment in AD

Question 28

Riluzule

Answer 28

Has some efficacy in delaying progression of MND

Question 29

Baclofen

Answer 29

Can be used to treat spasticity

Question 30

Propronolol

Answer 30

Can be used to treat essential tremor