Pharmacology of antidepressants + mood stabilisers Flashcards
what type of drugs best cross the blood brain barrier?
Hydrophobic drugs
The BBB is made of fat and so is hydrophobic meaning it is easiest for hydrophobic drugs to pass through
which one of these neurotransmitters is not a monoamine:
- dopamine
- glutamate
3.noradrenaline - 5- Hydroxytryptophan (5-HT, serotonin)
- Glutamate
(the rest are monoamines)
examples of monoamines
dopamine
noradrenaline
5- Hydroxytryptophan (5-HT, serotonin)
Imipramine
Phenelzine
Fluoxetine
what is the rostral nucleus involved in?
mood
sleep
feeding
bahvaiours
sensory perception
(starts the serotonin projection pathway)
which nuclei is involved in the serotonin projection pathway
Rostral nucleus and then projects all over the cortex
what is the caudal raphe nuclei involved in?
analgesia
what is the locus coreuleus involved in?
-arousal, emotion
examples of monoamine oxidase inhibitors
Irreversible: phenelzine
Reversible: moclobemide
MOA: monoamine oxidase inhibitors
Irreversible (phenelzine) or reversible (Moclobemide) inhibitors of MAO-A and B
SE: monoamine oxidase inhibitors
- Cheese reaction” / hypertensive crisis
caused by inhibition of MAO-A in gut (& liver) by irreversible inhibitors preventing breakdown of dietary tyramine
and by multiple drug that potentiate amine transmission (e.g. pseudoephedrine, other antidepressants) - Potentiates effects of other drugs (e.g. barbiturates) by decreasing their metabolism
- Insomnia
- Postural hypotension
Peripheral oedema
Examples of triyclic antidepressants
Imipramine (most commonly)
Dosulepin
Amitriptyline
Lofepramine
MOA: triyclic antidepressants
Block the reuptake of monoamines (mainly noradrenaline and 5-HT) into presynaptic terminals
SE: triyclic antidepressants
Anticholinergic: (inhibits parasympathetic, rest and digest)
* Blurred vision
* Dry mouth
* Constipation
* Urinary retention
* Sedation
* Weight gain
* Postural hypotension
* Tachycardia
* Arrythmias
Cardiotoxic overdose
