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ADELE-Noodles of Neurology > Pharmacology of antidepressants and mood stabilisers > Flashcards

Pharmacology of antidepressants and mood stabilisers Flashcards

1
Q

What are the clinical uses of antidepressant drugs?

A 
Moderate/severe depression
Dysthymia
GAD
Panic disorder
OCD
PTSD
Premenstural dysphoric disorder
Bulimia nervosa
Neuropathic pain
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2
Q

What is included in the monoamine reuptake inhibitor group of drugs?

A

Tricyclics
SNRIs
SSRIs

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3
Q

What are the three classes of antidepressant drugs?

A

MOI (monoamine oxidase inhibitors)
MRI (monoamine reuptake inhibitors)
Atypical drugs (post-synaptic receptor effects)

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4
Q

What are the two hypotheses why antidepressant medication lead to similar response?

A

1-Monoamine hypothesis

2-Neurotransmitter receptor hypothesis

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5
Q

What is noradrenaline responsible for?

A

Arosal, emotion

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6
Q

What is serotonin responsible for?

A

Mood, sleep ,feeding, behaviour and sensory perception

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7
Q

What is the typical half-life of antipsychotics?

A

Months

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8
Q

Why do you tend not to combine antidepressants?

A

Clinically actions very similar therefore you just get more SE

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9
Q

If SSRI alone for treatment of depression is not working what is added in?

A

Mirtazapine

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10
Q

TRUE/FALSE

In general the more severe the depression the more effective the antidepressant

A

TRUE

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11
Q

What drug is St Johns wort similar to?

A

MOI inhibitor

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12
Q

St Johns wort can interact with the OCP and reduce its efficacy TRUE/FALSE

A

TRUE

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13
Q

In what type of depression is MOI inhibitors considered?

A

Anergic bipolar depression

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14
Q

Name two MOI inhibitors and their mode of action

A

Phenelzine- Irreversible
Moclobemide-Reversible

…inhibitors of MAO

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15
Q

What can you not eat/drink when on MOI inhibitors?

A

Cheese
red wine/alcohol free beer
gravy, venison, game
Large amounts of caffeine

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16
Q

What biologically is the hypertensive crisis caused by?

A

Inhibition of MAO-O in gut (&liver) by irreversible inhibitors preventing breakdown of dietary tyramine

As tyramine is a potent releaser of norepinephrine –> Elevated BP

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17
Q

What is hypertensive crisis due to tyramine treated with?

A

Phentolamine infusion

18
Q

TRUE/FALSE

MOI inhibitors can potentiate other drugs by decreasing their metabolism

A

TRUE

19
Q

S/E of MOI inhibitors

A

Insomnia
Peripheral oedema
Postural hypotension

20
Q

What type of pain are tricyclics used in?

A

Neuropathic

21
Q

What is our fav tricyclic?

A

Amitriptyline

22
Q

How do tricyclics work?

A

Block the reuptake of monoamines into presynaptic terminals

23
Q

What are the SE of tricyclics?

A

Anticholinergic
Sedation (if drowsy don’t drive)
Wt gain
Cardiovascular

24
Q

Are tricyclics cardiotoxic in overdose?

A

Yes

25
Q

What is the only licences SSRI for <18?

A

Fluoxetine

26
Q

Which is the best SSRI?

A

Escitalopram

27
Q

Which SSRI is safest in cardiac problems?

A

Sertraline

28
Q

Which SSRI is safest in epilepsy?

A

Citalopram

29
Q

Which are the two classes of antidepressants that are taken at night because they are sedating?

A

TRICYCLICS (amitriptyline)

NASA ( mirtazapine)

30
Q

What are the common SE of SSRIs?

A 
Headache
Nausea
GI upset
Sweating/vivid dreams/anxiety
Confusion/dizziness
Sexual dysfunction
31
Q

What is there a risk of when on fluoxetine and drinking high amounts of caffeine?

A

Serotonin syndrome

32
Q

If prescribe someone with anxiety an SSRI transiently what will there be?

A

An increase in anxiety

33
Q

What is often a cause of admission of elderly patients as a result of being on an SSRI?

A

Hyponatraemia

34
Q

Why should SSRIs not be given to young people?

A

Risk of suicidal thoughts (however much safer in overdose)

35
Q

What are two examples of SNRIs?

A

Venlafaxine

Duloxetine

36
Q

What are three uses of Duloxetine?

A

Depression
Neuropathic pain
Bladder instability

37
Q

How do SNRIs work?

A

Block the reuptake of monoamines into presynaptic terminals

38
Q

What is the important SE of SNRIs?

A

Hypertension/cardiac arrhythmias

39
Q

In theory when would mirtazapine be used 1st line in depression?

A

If patient has insomnia and poor appetite

40
Q

Why is mirtazapine often added into other treatments?

A

Reduce the sick/headaches S/E

ADELE-Noodles of Neurology (38 decks)

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