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Psychiatry > Pharmacology of antidepressants and mood stabilisers > Flashcards

Pharmacology of antidepressants and mood stabilisers Flashcards

1
Q

What are antidepressants used for?

A

mod-severe depression; dysthymia; generalised anxiety disorder; premenstrual dysphoric disorder; bulimia nervosa; neuropathic pain

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2
Q

What are the broad types of antidepressant drugs?

A

monoamine oxidase inhibitors; monoamine reuptake inhibitors; atypical drugs

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3
Q

What ar ethe types of monoamine reuptake inhibitors?

A

tricyclics; selective serotonin reuptake inhibitors and noradrenaline reuptake inhibitors

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4
Q

What is the monoamine hypothesis?

A

depression results from a functional deficit of monoamine transmitters- serotonin and noradrenaline

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5
Q

What facts support the monoamine hypothesis?

A

drugs that deplete stores of monoamines can induce low mood; CSF from depressed patients have decreased monoamines or metabolites

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6
Q

What is serotonin synthesised from?

A

tryptophan

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7
Q

What is serotonin involved in?

A

mood; sleep; feeding behaviours and sensory perception; analgesia

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8
Q

What is noradrenaline involved in?

A

arousal and emotion

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9
Q

What is noradrenaline synthesised from?

A

tyrosine

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10
Q

What happens to monoamines once synthesised in the post synaptic knob?

A

transfers into vesicles or is oxidised in the mitochondria and then leaves the zxon

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11
Q

What drugs affect the oxidation in the synaptic knob of neurotransmitter?

A

monoamine oxidase inhibitors

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12
Q

What are the main MAO inhibitors?

A

phenelzine; moclobemide

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13
Q

What is the difference between phenelzine and moclobemide in terms of MOA?

A

phenelzine irreversibly inhibits MAO-A and B whereas moclobemide hibits them reversibly

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14
Q

What are the SE of monoamine oxidase inhibitors?

A

cheese reaction/hypertensive crisis; potentiates effects of other drugs by decreasing their metabolism; insomnia; postural hypotension; peripheral oedema

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15
Q

What is the cheese reaction with monoamine oxidase inhibitors

A

Because gastro-intestinal MAO prevents dietary tyraminefrom entering the tissues, a marked hypertensive response can occur ingest foods or beverages rich in such amines which increase noradrenaline which causes vasconstriction- MAO-A would normally breakdown excess NA

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16
Q

What is the MOA of tricyclics?

A

prevent reuptake of monoamine neurotransmitters presynaptic terminal

17
Q

Give an example of a tricyclic?

A

imipramine; amitriptlyine

18
Q

What are the common SE of tricyclics?

A

anti-cholinergic; sedation; weight gain; postural hypotension; tachycardia; arrhythmias

19
Q

What is an example of a selective serotonin reuptake inhibitor?

A

fluoxetine; citalopram; paroxetine

20
Q

What are the SE of SSRIs?

A

nausea; HA; sweating; vivid dreams; worsened anxiety; sexual dysfunction; hyponatramiea; transient inc. in self harm/suicidal ideation in <25

21
Q

What receptors does mirtazapine work at?

A

a2; 5-HT2 and 5-HT3

22
Q

What are the SE of mirtazapine?

A

weight gain adn sedation

23
Q

WHat is useful about mirtazapine?

A

can block serotenergic SE if given with SSRIs

24
Q

What is the MOA of lithium?

A

block phosphatidylinositol pathway or inihibitt glycogen synthase kinase 3b

25
Q

What must be measured 12 hours post-dose of lithium?

A

blood evels must be monitored-narrow therapeutic index

26
Q

What are the common SE of lithium?

A

dry mouth; pllydipsia and polyuria; tremor; hypothyroidism; reduced renal function; nephrogenic diabetes insipidus; weight gain

27
Q

What are the toxic effects of lithium?

A

vomiting; diarrhoea; ataxia/coarse tremor; drowsiness; convulsions and coma

28
Q

What is the possible MOA of anticonvulsants as mood stabilisers?

A

block overactive pathways

29
Q

What are the SE of carbamazepine?

A

drowsiness; ataxia; CVS effects; induces liver enzymes

30
Q

What is the MOA of antipsychotics as mood stabilisers?

A

dopamine antagonism and 5-HT antagonism

31
Q

What ar ethe SE of antipsychotics?

A

sedation; weight gain ; metabolic syndrome; extrapyramidal SE-aripiprazole

Psychiatry (20 decks)

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