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MS 2 - Unit 3 > Pharmacology - Antidepressants - Oliver Brown > Flashcards

Pharmacology - Antidepressants - Oliver Brown Flashcards

1
Q

T/F: Most antidepressant drugs block the reuptake of both NE and 5HT to varying degrees.

A

True

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2
Q

Give the class: Tranylcypromine

A

MAOI

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3
Q

Give the class: Fluoxetine

A

SSRI

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4
Q

Give the class: Citalopram

A

SSRI

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5
Q

Give the class: Duloxetine

A

SNRI

serotonin-norepi reuptake inhibitor

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6
Q

Give the class: Venlafaxine

A

SNRI

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7
Q

Give the mechanism:
Tranylcypromine
Phenelzine

A

Irreversibly inhibit both MAO-A and MAO-B

MAOI

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8
Q

Give the side effects: Tranylcypromine

A

Hypertensive crisis (with tyramine-rich foods); serotonin syndrome (MAOI + SSRI)

Anticholinergic, orthostatic hypotension, sexual dysfunction, weight gain, sedation, insomnia, dizziness

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9
Q

What is Tranylcypromine used for:

A

Depression, anxiety, PTSD, chronic pain, enuresis, bulimia, alcoholism

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10
Q 
Give the mechanism: 
Fluoxetine
Sertraline
Citalopram
Escitalopram
Paroxetine
A

Inhibit reuptake of 5-HT (and NE to lesser extent)

SSRI

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11
Q 
Give the indication: 
Fluoxetine
Sertraline
Citalopram
Escitalopram
Paroxetine
A

Depression, anxiety, PTSD, chronic pain, enuresis, bulimia, alcoholism; pre-menstrual dystrophic disorder

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12
Q 
Give the side effects: 
Fluoxetine
Sertraline
Citalopram
Escitalopram
Paroxetine
A

Serotonin syndrom (with MAOIs)

Fewer than tricyclics; mostly nausea, decreased sexual function

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13
Q

What is unique about Fluoxetine and Paroxetine as SSRIs?

A

They are Potent P450 inhibitors; form active metabolite (norfluoxetine)
Specifically CYP2D, CYP2C, CYP2A

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14
Q

Give the class: Venlafaxine (Effexor)

A

SNRI

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15
Q

Give the mechanism:
Duloxetine (Cymbalta)
Venlafaxine (Effexor)

A

Inhibits reuptake of 5-HT and NE

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16
Q

Give the indication:
Duloxetine (Cymbalta)
Venlafaxine (Effexor)

A

Depression, anxiety, PTSD, chronic pain, enuresis, bulimia, alcoholism

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17
Q

Give the class: Buproprion

A

Atypical antidepressant

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18
Q

Give the class: Mirtazapine

A

Atypical antidepressant

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19
Q

Give the mechanism: Mirtazapine

A

5HT2a antagonist; also inhibits 5HT reuptake

20
Q

Give the indication: Buprioprion

A

Depression, weight loss, smoking cessation (my answer)

Depression, anxiety, PTSD, chronic pain, enuresis, bulimia, alcoholism; maintain nicotine abstinence in quitting smokers (their answer)

21
Q

Give the indication: Mirtazapine

A

Depression, anxiety, PTSD, chronic pain, enuresis, bulimia, alcoholism

22
Q

Give the important side effect of Buproprion

A

It lowers the seizure threshold

23
Q

Give the class:
Trazodone
Nefazodone

A

5HT2A antagonist
also inhibits serotonin reuptake
use for depression esp when coupled with insomnia
Side effects include drowsiness (major)

24
Q

What are some miscellaneous antidepressant treatments?

A 
Lithium salts
St. John's Wort
ECT
TMS (transcranial magnetic stimulation) - like ECT but w/o the siezure
NRIs
Ketamine
25
Q

Give the class: Phenelzine

A

MAOI

26
Q

MAO-A oxidizes mainly:

A

NE, 5HT, tyramine

27
Q

MAO-B oxidizes mainly:

A

DA, phenylethylamine

28
Q

What is serotonin syndrome?

A

When a pt is on MAOI and SSRI (or other drugs)
potentially lethal
Hyperthermia, Muscle rigidity, Myoclonus, Rapid changes in mental status and vital signs

29
Q 
Give the class: 
Desipramine
Imipramine
Amitriptyline
Nortriptyline
A

Tricyclics

30
Q 
Give the mechanism:
Desipramine
Imipramine
Amitriptyline
Nortriptyline
A

Block reuptake of NE or 5-HT at varying potencies and selectivity; also variably block muscarinic, a-adrenergic, dopamine, and histamine receptors

31
Q 
Give the indication:
Desipramine
Imipramine
Amitriptyline
Nortriptyline
A

Depression, anxiety, PTSD, chronic pain, enuresis, bulimia, alcoholism

32
Q

What is the added unique indication of Amitriptyline?

A

prevention of tension headaches, migraines

Depression, anxiety, PTSD, chronic pain, enuresis, bulimia, alcoholism;

33
Q 
Give the side effects:
Desipramine
Imipramine
Amitriptyline
Nortriptyline
A

Sympathomimetic (cardiac arrhythmias and conduction defects, especially at OD)

Antimuscarinic, orthostatic hypotension, sedation (additive with alcohol), seizures

34
Q

Are the tricyclics used often to treat depression?

A

No

Not very safe; rarely used anymore

35
Q

Overdose of tricylcics may cause what serious adverse effect?

A

cardiac arrhythmias

conduction defects

36
Q

Main complaints patients give when taking SSRIs are:

A

Nausea

Sexual dysfunction

37
Q

What is the only atypical antidepressant that is selective for dopamine uptake transporter?

A

Buproprion

38
Q

Give the mechanism: Ketamine

A

NMDA receptor antagonist

produces rapid antidepressant response - rapidly increases synaptogenesis in mice

39
Q

What is enuresis?

A

Institutionalized elderly patients who have incontinence

An indication for antidepressant use

40
Q

T/F: SSRIs are more effective antidepressants than tricyclics.

A

False

They have the same efficacy but are better tolerated.

41
Q

What anticonvulsants are used to treat bipolar depression?

A

Carbamazepine

Valproate

42
Q

What class of drugs are indicated for severe bipolar disorder?

A

The antipsychotics:
Olanzapine (Zyprexa)
Risperidone (Risperdal)
Aripiprazole (Abilify)

43
Q

Give the side effects: Lithium

A

Drowsiness, weight gain, tremor, polydipsia, polyuria

Neurotoxicity, Cardiac toxicity, renal dysfunction with elevated levels

44
Q

Give the mechanism: Lithium

A

Lithium causes depletion of inositol phosphate second messengers (IP3 and DAG depleted)

45
Q

What is the bioamine hypothesis of depression?

A

Too little CNS NE and or 5HT (amount or activity)

MS 2 - Unit 3 (45 decks)

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