Pharmacology Or Antidepressants And Mood Stabilisers Flashcards
What are clinical uses of antidepressants?
Moderate to severe depression Dysthymia GAD Panic disorder, OCD, PTSD Premenstrual dysphoric disorder Bulimia nervous Neuropathic pain
Antidepressant drug classes
Monoamine oxidase inhibitors
Tricyclic antidepressants
Selective serotonin inhibitors (SSRIs)
Atypical antidepressants
Mode of action of mono amine oxidase inhibitors
Irreversible (phenelzine) or reversible (moclobemide) inhibitors of MAO - A and B
Side effects of mono amine oxidase inhibitors
Hypertensive crisis (cheese reaction) Insomnia Postural hypotension Peripheral oedema May reduce metabolism of other drugs (barbiturates)
Examples of tricyclics
Imipramine
Dosulepin
Amitriptyline
Iofepramine
Action of tricyclics
Block reputable of mono amines (5-HT & noradrenaline) into presynaptic terminals
Side effects of tricyclics
Anticholinergic - blurred vision, dry mouth, constipation, urinary retention
Sedation
Weight gain
Cardiovascular - postural hypotension, tachycardia, arrhythmia so
Cardiotoxic in overdose
What does SSRI stand for?
Selective serotonin reuptake inhibitor
Examples of SSRIs
Fluoxetine
Citalopram
Sertraline
Paroxetine
Action of SSRIs?
Selectively inhibit the reuptake of serotonin (5-HT) from synaptic cleft
Side effects of SSRIs?
Nausea Headache Sweating Worsened anxiety Sexual dysfunction Hyponatraemia Increased risk self harm/suicidal in young
Examples of atypical antidepressants
Mirrazapine (mixed receptor effects - blocks alpha 2, 5-HT2 and 5-HT3)
Bupropion (dopamine uptake inhibitor)
Do you have to monitor when giving lithium?
Yes
12hr post dose blood levels monitored due to narrow therapeutic index
What is lithium given as?
Lithium carbonate
Action of lithium?
May block phosphatidylinositol pathway or inhibit glycogen synthesis kinase 3B