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Pharmacology > Pharmacology of Depression > Flashcards

Pharmacology of Depression Flashcards

1
Q

what is the target for sertraline?

A

serotonin transporter
mild dopamine transporter

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2
Q

what is the MOA of sertraline?

A

inhibition of serotonin reuptake = serotonin accumulates

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3
Q

what are the main side effects of sertraline?

A

GI effects - nausea, diarrhoea
sexual dysfunction
anxiety
insomnia

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4
Q

what other receptor does sertraline act on?

A

inhibits dopamine transporter mildly

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5
Q

what is the MOA of citalopram?

A

inhibition of serotonin reuptake = serotonin accumulation

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6
Q

what is the target for citalopram?

A

serotonin transporter

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7
Q

what are the common side effects for citalopram?

A

GI effects - diarrhoea, nausea
insomnia
anxiety

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8
Q

what other receptors does citalopram work on?

A

antagonist of muscarinic and H1 receptors

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9
Q

what is the MOA for fluoxetine?

A

inhibition of serotonin reuptake = accumulation of serotonin

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10
Q

what is the role of serotonin in the CNS?

A

regulation of mood, personality and wakefulness

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11
Q

what are the common side effects of fluoxetine?

A

GI effects - nausea, diarrhoea
sexual dysfunction
anxiety
insomnia

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12
Q

what cautions must be taken with fluoxetine?

A

warfarin
complete inhibition of CYP2D6 and partial inhibition of CYP2C19

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13
Q

what is the MOA of venlafaxine?

A

inhibition of serotonin reuptake, and a bit of noradrenaline

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14
Q

what is the role of noradrenaline in the CNS?

A

regulation of emotions and cognition

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15
Q

what is the target for venlafaxine?

A

noradrenaline and serotonin transporter

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16
Q

what are the common side effects of venlafaxine?

A

GI effects - nausea, diarrhoea
sexual dysfunction
anxiety
insomnia
hypertension at high doses

17
Q

what is the MOA of mirtazapine?

A

antagonises central presynaptic alpha-2-adrenergic receptor – increased release of serotonin and noradrenaline
antagonises central 5HT2 receptor leaving 5HT1 open to serotonin and anti-depressant effects

18
Q

what is the target for mitrazapine?

A

alpha-2 receptor

5-HT2 receptor

19
Q

what are the common side effects of mirtazapine?

A

weight gain, sedation

20
Q

what disorder should be taken into account for mirtazapine?

A

may exacerbate REM sleep behaviour disorder - helps REM sleep and consistency of sleep

21
Q

why must sertraline and venlafaxine be weaned off slowly?

A

potential for rebound depression, serotonin syndrome

22
Q

what receptor does mirtazapine have the highest affinity for?

A

H1 receptor - causing sedation at low doses

23
Q

how are the effects of mirtazapine binding to H1 offset at higher doses?

A

sedation effects are overcome by increased noradrenergic transmission

24
Q

first line treatment for depression

A

SSRI

25
Q

what do you have to do before switching from SSRI to any other

A

trial at least 2 SSRIs

26
Q

what to try if SSRI failure or bad SEs (2nd line)

A

SNRI

mitrazapine

Pharmacology (9 decks)

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