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Psychiatry (2) > Pharmacology of Antidepressants > Flashcards

Pharmacology of Antidepressants Flashcards

1
Q

What NT is depleted primarily in depression?

A

Serotonin

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2
Q

What type of drug is Phenelzine?

A

MAOi

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3
Q

What type of drug is Selegeline?

A

MAOi

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4
Q

Outline the MOA of Phenelzine

A

MAOi

• Inhibit MAO enzymes ≈ reduce breakdown of NE/serotonin and dopamine ≈ increase levels of serotonin/dopamine/NE

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5
Q

What is are the common SEs with Phenelzine?

A

MAOi

  • Weakness
  • Headache
  • Weight gain
  • Dizziness
  • Fatigue
  • Impotence
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6
Q

What is are the common SEs with Selegeline? ?

A

MAOi

  • Weakness
  • Headache
  • Weight gain
  • Dizziness
  • Fatigue
  • Impotence
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7
Q

What class of drugs should you avoid when prescribing MAOis?

A

• Not used with SSRI/TCA + Opioids (morphine/tramadol) –> increase serotonin to high levels = Confusion, hypertension, tremor, coma and death i.e. neuroleptic malignant syndrome

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8
Q

What types of food should you avoid if you are on MAOis?

A

• High-tyramine foods (cheese/venison/meats/alcohol/green vegetables)

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9
Q

What class of drugs is Moclobemide?

A

• Moclobemide is a RIMA

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10
Q

Give the SEs of Moclobemide.

A
  • Weakness
  • Headaches
  • Dizziness
  • Fatigue
  • Weight gain
  • Impotence
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11
Q

Why may moclobemide be better than selegeline or risegeline?

A
  • Reduced effect of tyramine (alcohol/meat – venison/green vegetables/cheese)
  • Short acting thus 7 days prior to change to another antidepressant
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12
Q

What class of drugs is Amitriptyline?

A

• Amitriptyline

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13
Q

What class of MOA is Imipramine?

A

• Inhibit re-uptake of NE and Serotonin via blocking transporters (5-HT re-uptake transporter/ NE re-uptake transporter/ mAChR) responsible for re-uptake and block action of ACh (anti-cholinergic) ≈ increase [NA] + [Serotonin] in synapses

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14
Q

What class of MOA is Nortriptyline?

A

• Inhibit re-uptake of NE and Serotonin via blocking transporters (5-HT re-uptake transporter/ NE re-uptake transporter/ mAChR) responsible for re-uptake and block action of ACh (anti-cholinergic) ≈ increase [NA] + [Serotonin] in synapses

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15
Q

What class of drugs is Nortriptyline?

A

TCA

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16
Q

What class of drugs is Amitriptyline?

A

TCA

17
Q

Give the SEs of Amitriptyline.

A
  • Blurred vision
  • Dry mouth
  • Constipation
  • Bronchodilation
  • Reduced bronchial secretions
  • Urinary retention
  • Weight gain/loss
  • Hypotension
  • Rash
  • Hives
  • Tachycardia
18
Q

Give the SEs of Nortriptyline.

A
  • Blurred vision
  • Dry mouth
  • Constipation
  • Bronchodilation
  • Reduced bronchial secretions
  • Urinary retention
  • Weight gain/loss
  • Hypotension
  • Rash
  • Hives
  • Tachycardia
19
Q

What class of drugs is Citalopram?

A

SSRIs

20
Q

What class of drugs is Escitalopram?

A

SSRIs

21
Q

What class of drugs is Sertraline?

A

SSRIs

22
Q

What class of drugs is Paroxetine?

A

SSRIs

23
Q

What class of drugs is Fluoxetine?

A

SSRIs

24
Q

What is the MOA of Escitalopram?

A

• Bind to Serotonin re-uptake transporter ≈ reduce reuptake ≈ increase [Serotonin]

25
Q

What is the MOA of Fluoxetine?

A

• Bind to Serotonin re-uptake transporter ≈ reduce reuptake ≈ increase [Serotonin]

26
Q

What is the MOA of Paroxetine?

A

• Bind to Serotonin re-uptake transporter ≈ reduce reuptake ≈ increase [Serotonin]

27
Q

Give the potential SEs of SSRIs

A 
•	Nausea 
•	Rash
•	Muscle aches
•	Insomnia*** -> Sleep difficulties (Fluoxetine)
•	Aggression
•	Anxiety
•	Cognition
•	Learning memory
•	Mood
•	Sleep 
•	Sweating 
•	Epilepsy
-> No driving for 12 months (be weary)
  • Reduced libido
  • Sexual dysfunction

• LQTS (Citalopram)

28
Q

Why may Citalopram be CI in a patient under Cardiovascular monitoring?

A

LQTS

29
Q

What is the MOA of Duloxetine?

A

• Serotonin Norepinephrine Reuptake Inhibitor (SNRI) -> Bind Serotonin and Norepinephrine Re-Uptake Transporters -> increase [Serotonin] + [Norepinephrine]

30
Q

What other comorbidities may Duloxetine be used for?

A

Stress Urinary Incontinence

Neuropathic pain

31
Q

Give the potential SEs of Duloxetine.

A
  • Nausea
  • Headaches
  • Insomnia
  • Hypersomnia/Drowsiness
  • Dizziness
Low % of Anticholinergic effects
•	Dry mouth
•	Sweating
•	Blurred vision
•	Constipation
32
Q

What class of drug is Mirtazipine?

A

Tetracycline Antidepressants

33
Q

Give the MOA of Tetracyclic Antidepressants

A

• Presynaptic alpha-2 adrenoceptor antagonist ≈ increase [NE] + [5-HT]

34
Q

What dosage difference can taking Mirtazipine have?

A

Higher doses (30/50mg) = stimulant

Low doses (15mg) = drowsiness

Psychiatry (2) (13 decks)

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