Pharmacology of Antidepressants Flashcards

1
Q

Describe all six drugs that Induce depression.

A
  1. Beta-Blockers (Atenolol)
  2. Calcium Channel Blockers (CCBs)
  3. Benzodiazepines (Diazepam)
  4. Dopaminergic agents (Levodopa, alpha-methyldopa)
  5. Corticosteroids (Methylprednisolone)
  6. Anabolic Steroids (Testosterone)
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2
Q

Describe the treatment of depression

A
  1. Psychotherapy
  2. Pharmacotherapy
    >tricyclic antidepressants
    >Selective Serotonin Reutake Inhbitors(SSRIs)
    >Serotonin-Norepinephrine Reuptake Inhbitors (SNRIs)
    >5HT2 antagonists
    >MOnoamine Oxidase Inhibitors
    >Atypical Antidepressants
    >Lithium
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3
Q

Describe the Agents, MOA, Indications, DI, A/E of Selective Serotonin Reuptake Inhibitors (SSRIs)

A

Agents
FAP SEC
Fluoxetine, Paroxetine, Atomoxetine, Citalopram, Escitalopram, Sertraline

MOA: Prevent the reuptake of 5-HT, leaving more 5-HT to stimulate postsynaptic 5-HT1 receptors.

Indications: MAJOR DEPRESSION, Anxiety disorders (PTSD, PD, OCD, PDD etc)

Side Effects: N, D, Anxiety, Restlessness, Insomia, Sexual Dysfunction

Drug Interactions: Do not use with MAOI (Monoamine oxidase inhibitor).

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4
Q

Describe the Indications, D/I, A/E, C/E, Dose of Fluoxetine

A

MOA: Prevent the reuptake of 5-HT, leaving more 5-HT to stimulate postsynaptic 5-HT1 receptors.

Dose: 20 to 40 mg po od, note cardiovascular and suicide risk in the elderly.

Indications: MAJOR DEPRESSION, Anxiety disorders (PTSD, PD, OCD, PDD etc)

Side Effects: N, D, Anxiety, Restlessness, Insomia, Sexual Dysfunction

Drug Interactions: Do not use with MAOI (Monoamine oxidase inhibitor).
Fluoxetine can inhbit Cyt p450 isoenzymes and this inhibit the metabolism of certain B-Blockers including propranolol and metoprolol, leading to hypokinesia and bradycardia.

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5
Q

Describe the Indications, D/I, A/E, C/E of Paroxetine

A

MOA: Prevent the reuptake of 5-HT, leaving more 5-HT to stimulate postsynaptic 5-HT1 receptors.

Indications: MAJOR DEPRESSION, Anxiety disorders (PTSD, PD, OCD, PDD etc)

Side Effects: N, D, Anxiety, Restlessness, Insomia, Sexual Dysfunction

Drug Interactions: Do not use with MAOI (Monoamine oxidase inhibitor).

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6
Q

Describe the Indications, D/I, A/E, C/E of Atomoxetine

A

MOA: Prevent the reuptake of 5-HT, leaving more 5-HT to stimulate postsynaptic 5-HT1 receptors.

Indications: MAJOR DEPRESSION, Anxiety disorders (PTSD, PD, OCD, PDD etc)

Side Effects: N, D, Anxiety, Restlessness, Insomia, Sexual Dysfunction

Drug Interactions: Do not use with MAOI (Monoamine oxidase inhibitor).

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7
Q

Describe the Indications, D/I, A/E, C/E of Citalopram

A

MOA: Prevent the reuptake of 5-HT, leaving more 5-HT to stimulate postsynaptic 5-HT1 receptors.

Indications: MAJOR DEPRESSION, Anxiety disorders (PTSD, PD, OCD, PDD etc)

Side Effects: N, D, Anxiety, Restlessness, Insomia, Sexual Dysfunction

Drug Interactions: Do not use with MAOI (Monoamine oxidase inhibitor).

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8
Q

Describe the Indications, D/I, A/E, C/E of Escitalopram

A

MOA: Prevent the reuptake of 5-HT, leaving more 5-HT to stimulate postsynaptic 5-HT1 receptors.

Indications: MAJOR DEPRESSION, Anxiety disorders (PTSD, PD, OCD, PDD etc)

Side Effects: N, D, Anxiety, Restlessness, Insomia, Sexual Dysfunction

Drug Interactions: Do not use with MAOI (Monoamine oxidase inhibitor).

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9
Q

Describe the Indications, D/I, A/E, C/E of Sertraline

A

MOA: Prevent the reuptake of 5-HT, leaving more 5-HT to stimulate postsynaptic 5-HT1 receptors.

Indications: MAJOR DEPRESSION, Anxiety disorders (PTSD, PD, OCD, PDD etc)

Side Effects: N, D, Anxiety, Restlessness, Insomia, Sexual Dysfunction

Drug Interactions: Do not use with MAOI (Monoamine oxidase inhibitor).

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10
Q

Describe the Agents, MOA, Indications, and A/E of SELECTIVE Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs)

A

Agents(Selective SNRIs): Venlafaxine, Desvenlafaxine, Duloxetine.

MOA: Prevent the reuptake of 5-HT, NE and DA(weak), so that there’s more 5-ht and NE to stimulate postsynaptic repceptors.

Indications:MAJOR DEPRESSION, Anxiety disorders (PTSD, PD, OCD, PDD etc)
Adverse Effects: N, D, Anxiety, Restlessness, Sexual Dysfunction, Increased Blood Pressure, Agitation.

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11
Q

Repeatition

Describe the MOA, Indications and A/E of Venlafaxine

A

MOA: Prevent the reuptake of 5-HT, NE and DA(weak), so that there’s more 5-ht and NE to stimulate postsynaptic repceptors.

Indications: MAJOR DEPRESSION Anxiety disorders (PTSD, PD, OCD, PDD etc)
Adverse Effects: N, D, Anxiety, Restlessness, Sexual Dysfunction, Increased Blood Pressure, Agitation.

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12
Q

Repeatition

Describe the MOA, Indications and A/E of Desvenlafaxine

A

MOA: Prevent the reuptake of 5-HT, NE and DA(weak), so that there’s more 5-ht and NE to stimulate postsynaptic repceptors.

Indications: MAJOR DEPRESSION, Anxiety disorders (PTSD, PD, OCD, PDD etc)
Adverse Effects: N, D, Anxiety, Restlessness, Sexual Dysfunction, Increased Blood Pressure, Agitation.

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13
Q

Repeatition

Describe the MOA, Indications and A/E of Duloxetine

A

MOA: Prevent the reuptake of 5-HT, NE and DA(weak), so that there’s more 5-ht and NE to stimulate postsynaptic repceptors.

Indications: MAJOR DEPRESSION, Anxiety disorders (PTSD, PD, OCD, PDD etc)
Adverse Effects: N, D, Anxiety, Restlessness, Sexual Dysfunction, Increased Blood Pressure, Agitation.

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14
Q

Describe the Agents, MOA, Indications, and A/E of Tricyclic Antidepressants(TCAs)

A

Agents(TCAs): Imipramine, Amitriptyline, Amoxapine, Doxepin, Mirtazapine etc.

MOA(TCAs): Prevents the reuptake of 5-ht and NE by neurona; membrane. It also downregulates Beta-adrenergic and 5-ht receptors.

Indications: Major Depression AND Anxiety disorders.

Adverse effects: Antimuscarinic(fry mouth, constipation, urinary retention), Orthostatic hypotension due to peripheral alpha-1-blockade.

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15
Q

Describe the Agents, MOA, Indications, and A/E of Imipramine, Clomipramine and Trimipramine.

A

MOA(TCAs): Prevents the reuptake of 5-ht and NE by neurona; membrane. It also downregulates Beta-adrenergic and 5-ht receptors.

Indications: Major Depression AND Anxiety disorders.

Adverse effects: Antimuscarinic(fry mouth, constipation, urinary retention), Orthostatic hypotension due to peripheral alpha-1-blockade.

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16
Q

Describe the Agents, MOA, Indications, and A/E of Amitriptyline

A

MOA(TCAs): Prevents the reuptake of 5-ht and NE by neurona; membrane. It also downregulates Beta-adrenergic and 5-ht receptors.

Indications: Major Depression AND Anxiety disorders.

Adverse effects: Antimuscarinic(fry mouth, constipation, urinary retention), Orthostatic hypotension due to peripheral alpha-1-blockade.

17
Q

Describe the Agents, MOA, Indications, and A/E of Amoxipine and Mirtazapine(tetra)

A

MOA(TCAs): Prevents the reuptake of 5-ht and NE by neurona; membrane. It also downregulates Beta-adrenergic and 5-ht receptors.

Indications: Major Depression AND Anxiety disorders.

Adverse effects: Antimuscarinic(fry mouth, constipation, urinary retention), Orthostatic hypotension due to peripheral alpha-1-blockade.

18
Q

Describe the Agents, MOA, Indications, and A/E of Doxepine

A

MOA(TCAs): Prevents the reuptake of 5-ht and NE by neurona; membrane. It also downregulates Beta-adrenergic and 5-ht receptors.

Indications: Major Depression AND Anxiety disorders.

Adverse effects: Antimuscarinic(fry mouth, constipation, urinary retention), Orthostatic hypotension due to peripheral alpha-1-blockade.

19
Q

Describe the Agents, MOA, Indications, and A/E of *Mianterin(tetra)

A

MOA(TCAs): Prevents the reuptake of 5-ht and NE by neurona; membrane. It also downregulates Beta-adrenergic and 5-ht receptors.

Indications: Major Depression AND Anxiety disorders.

Adverse effects: Antimuscarinic(fry mouth, constipation, urinary retention), Orthostatic hypotension due to peripheral alpha-1-blockade.

20
Q

Describe the AGENTS, MOA, Indications, A/E and D/I of Monoamine Oxidase Inhibitors.

A

Agents: Tranylcypromine, Moclobemide, Phenelzine.

MOA Results in the oxidative deamination of NA, DA and 5-HT, thus increasing cytosolic stores of the neurotransmitters.

Indications: Refractory or Atypical depression when SSRIs, TCAs and sometimes even electroconvulsive therapy in ineffective.

Adverse Effects: Sedation, Postural hypertension, insomnia, restlessness and confusion.

Drug Interactions: *DO NOT USE WITH OTHER CLASSES OF ANTIDEPRESSANTS.
Monoamine Oxidase Inhibitors prolongs the effects of CNS depressants such as Alcohol, anaesthetics, sedative hypnotics.

Withdrawal causes delirium, psychosis and confusion

21
Q

Describe the MOA, Indications, A/E, and D/I of Tranylcypromine

A

MOA: Inhbits both forms of MOA (MOA-A and MOA-B). It is irreversible and non-selective.
Results in the oxidative deamination of NA, DA and 5-HT, thus increasing cytosolic stores of the neurotransmitters.

Indications: Refractory or Atypical depression when SSRIs, TCAs and sometimes even electroconvulsive therapy in ineffective.

Adverse Effects: Sedation, Postural hypertension, insomnia, restlessness and confusion.

Drug Interactions: *DO NOT USE WITH OTHER CLASSES OF ANTIDEPRESSANTS.
Monoamine Oxidase Inhibitors prolongs the effects of CNS depressants such as Alcohol, anaesthetics, sedative hypnotics.

Withdrawal causes delirium, psychosis and confusion

22
Q

Describe the AGENTS, MOA, Indications, A/E and D/I of *Moclobemide

A

*MOA Inhibits one or both forms of MOA(MOA-A and MOA-B).
Results in the oxidative deamination of NA, DA and 5-HT, thus increasing cytosolic stores of the neurotransmitters.

Indications: Refractory or Atypical depression when SSRIs, TCAs and sometimes even electroconvulsive therapy in ineffective.

Adverse Effects: Sedation, Postural hypertension, insomnia, restlessness and confusion.

Drug Interactions: *DO NOT USE WITH OTHER CLASSES OF ANTIDEPRESSANTS.
Monoamine Oxidase Inhibitors prolongs the effects of CNS depressants suck as Alcohol, anaesthetics, sedative hypnotics.

Withdrawal causes delirium, psychosis and confusion

23
Q

Describe the AGENTS, MOA, Indications, A/E and D/I of *Phenelzine

A

MOA Inhibits one or both forms of MOA(MOA-A and MOA-B).
Results in the oxidative deamination of NA, DA and 5-HT, thus increasing cytosolic stores of the neurotransmitters.

Indications: Refractory or Atypical depression when SSRIs, TCAs and sometimes even electroconvulsive therapy in ineffective.

Adverse Effects: Sedation, Postural hypertension, insomnia, restlessness and confusion.

Drug Interactions: *DO NOT USE WITH OTHER CLASSES OF ANTIDEPRESSANTS.
Monoamine Oxidase Inhibitors prolongs the effects of CNS depressants such as Alcohol, anaesthetics, sedative hypnotics.

Withdrawal causes delirium, psychosis and confusion