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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

Pharmacology Neurosciences (7 decks)

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