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1 Mega Step 1 Deck > Pharmacology of Mood Disorders > Flashcards

Pharmacology of Mood Disorders Flashcards

1
Q

selective serotonin reuptake inhibitors (SSRIs) - MOA

A

*inhibit serotonin transporter (SERT), decreasing 5-HT (serotonin) reuptake, leading to MORE 5-HT in the synapse

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2
Q

SSRI - meds in the class

A

*sertraline
*citalopram
*escitalopram
*fluoxetine
*paroxetine

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3
Q

sertraline - drug class

A

SSRI

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4
Q

citalopram - drug class

A

SSRI

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5
Q

escitalopram - drug class

A

SSRI

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6
Q

fluoxetine - drug class

A

SSRI

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7
Q

paroxetine - drug class

A

SSRI

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8
Q

sertraline - MOA

A

inhibit 5-HT reuptake (SERT)

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9
Q

citalopram - MOA

A

*inhibit 5-HT reuptake (SERT)
note - SSRI

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10
Q

escitalopram - MOA

A

*inhibit 5-HT reuptake (SERT)
note - SSRI

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11
Q

fluoxetine - MOA

A

inhibit 5-HT reuptake (SERT)

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12
Q

paroxetine - MOA

A

inhibit 5-HT reuptake (SERT)

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13
Q

first line SSRIs

A

*sertraline
*citalopram
*escitalopram

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14
Q

uses of SSRIs

A

*depression
*anxiety disorders
*OCD
*PTSD
*bulimia

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15
Q

ADEs of SSRIs

A

best tolerated antidepressants, but ADEs include:
*sexual dysfunction
*drowsiness or insomnia; headache
*weight gain
*GI upset
*serotonin syndrome

note - increase in suicidal ideation in those < 25 yo, but no increase in suicidal death

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16
Q

serotonin syndrome - cause

A

*too much serotonin
*usually from drug interactions or overdose (OD)

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17
Q

serotonin syndrome - symptoms

A

*CNS: delirium, agitation, restlessness, coma
*autonomic: diaphoresis, tachycardia, hyperthermia, hypertension
*neuromuscular: hyperreflexia, clonus, tremor

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18
Q

serotonin syndrome - treatment

A

*discontinue causative agents
*supportive care
*sedation with benzos, if needs

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19
Q

selective serotonin-norepinephrine reuptake inhibitors (SNRIs) - MOA

A

*inhibit SERT and NET, decreasing 5-HT and NE reuptake, leading to MORE 5-HT and NE in the synapse

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20
Q

SNRIs - meds in the class

A

*venlafaxine
*duloxetine

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21
Q

venlafaxine - drug class

A

SNRI

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22
Q

duloxetine - drug class

A

SNRI

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23
Q

venlafaxine - MOA

A

inhibit 5-HT and NE reuptake (SERT & NET)
note - SNRI

24
Q

duloxetine - MOA

A

inhibit 5-HT and NE reuptake (SERT & NET)

25
uses of SNRIs
*depression *anxiety disorders *fibromyalgia *chronic pain *neuropathy
26
ADEs of SNRIs
ADEs of SSRIs PLUS: *hypertension & tachycardia *more likely to be CNS stimulating than sedating
27
tricyclic antidepressants (TCAs) - MOA
*inhibit 5-HT and NE reuptake note - like SNRIs but hit other receptors (H1, Ach, and alpha-1), leading to more ADEs
28
important TCA med to know
amitriptyline
29
amitriptyline - drug class
tricyclic antidepressant (TCA)
30
amitriptyline - MOA
*inhibits 5-HT and NE reuptake (SERT & NET) note - TCA
31
uses of TCAs (amitriptyline)
*depression (not used for this much now) *pain disorders *migraine *prophylaxis *insomnia *neuropathy
32
ADEs of TCAs (amitriptyline)
MOA of ADEs: H1 receptor blockade, Ach receptor blockade, and alpha-1 receptor blockade *anticholinergic effects (dry mouth, urinary retention, etc) *sedation, weight gain (antihistamine effects) *cardiac conduction abnormalities (QTc prolongation, heart block) *orthostatic hypotension (alpha-blocker) *sexual dysfunction *serotonin syndrome *overdose = cardiac, coma, & convulsions
33
3 C's of TCA overdose
cardiac, coma, and convulsions
34
bupropion - MOA
*inhibits NET and DAT, leading to increased NE and DA *CNS-activating note - NO effect on 5-HT
35
uses of bupropion
*depression (common "second drug") *smoking cessation
36
ADEs of bupropion
*anxiety *insomnia/agitation *increased BP *tremor *headache *weight loss *SEIZURES (lowers sz threshold; don't use in pts with sz disorder) *NO SEXUAL DYSFUNCTION
37
unique properties of bupropion
*no effect on 5-HT *no sexual dysfunction *lowers sz threshold (do not use for pts with seizures)
38
mirtazapine - MOA
*central pre-synaptic alpha-2 antagonist, leading to increased 5-HT and NE
39
uses of mirtazapine
*insomnia *increase appetite *depression (not really used for this)
40
ADEs of mirtazapine
MOA of ADEs: H1 receptor blockade, alpha 2 receptor blockade *sedation *increased appetite and weight gain *dry mouth *serotonin syndrome *little sexual dysfunction
41
trazodone - MOA
*"serotonin modulator" - primarily a potent 5-HT2a antagonist
42
uses of trazodone
*insomnia in depressed pts
43
ADEs of trazodone
MOA of ADEs: H1 receptor blockade and alpha-1 receptor blockade *PRIAPISM *dizziness *sedation *headache *GI disturbances *orthostatic hypotension *serotonin syndrome *little sexual dysfunction
44
monoamine oxidase inhibitors (MAOIs) - MOA
*inhibit monoamine oxidase (the enzyme that breaks down neurotransmitters) *leading to increased 5-HT, NE, & DA
45
MAOIs - meds in class
*phenelzine *selegiline *tranylcypromine
46
uses of MAOIs
last resort for treatment-resistant depression
47
ADEs of MAOIs
*orthostatic hypotension *CNS stimulation or depression *dizziness *HA *hypertensive crisis *sexual dysfunction *serotonin syndrome *DRUG INTERACTIONS
48
drug interactions of MAOIs
*don't use with other 5-HT agents or sympathomimetic agents *avoid high tyramine diet
49
lithium - MOA
unknown
50
uses of lithium
bipolar disorder
51
ADEs of lithium
*tremor *GI upset *polyuria/polydipsia *dizziness *leukocytosis *seizures *confusion *coma *arrythmias
52
drug interactions of lithium
NSAIDs and thiazide diuretics decrease lithium clearance (increase the risk of toxicity)
53
LiTHIUM mnemonic for lithium
Low Thyroid Heart (Ebstein anomaly) Insipidus (nephrogenic diabetes insipidus) Unwanted Movements (tremor)
54
elimination of lithium
*RENAL elimination *important to monitor frequently if renal function impaired or changing *avoid if CrCl < 30 mL/min
55
symptoms if antidepressant is discontinued quickly (discontinuation syndrome)
flu-like syndrome, dizziness, fatigue, HA, nausea

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