Primer 6 - Antidepressant Flashcards
What are syndromes of Serotonin Syndrome?
- Mental status changes
- Autonomic instability
- Neuromuscular abnormalities
What is the treatment for Serotonin syndrome?
- Cooling and Benzodiazepines
2. Cyproheptadine but it is not first line.
What are side effects of SNRIs?
- Elevated blood pressure
- Sedation
- Nausea
How do tricylic antidepressants work?
They inhibit the reuptake of norepinephrine and seratonin. They are like SNRI but a lot older.
What are side effects of tricyclic antidepressants?
- Sedation
- Alpha-blocking effects- hypotension, sedation, dizzyness.
- Low antipsychotic effect
- Anticholinergic effects
What TCA is the least sedating of all the TCAs?
Desipramine.
What are the tri-C’s that TCA can cause in overdose?
- Convulsion
- Coma
- Cardiotoxicity
Can also cause Respiratory depression, hyperpyrexia, confusion and hallucination.
What is the treatment for TCA overdose?
Sodium bicarbonate if there is cardiovascular toxicity from TCA overdose to alkalinize the urine (TCAs are weak acids).
What is MAOIs washout period?
A 2 week period of time that you are to abstain from any MAOIs before taking other drugs.
What are 3 atypical antidepressants?
- Bupropion
- Mirtazapine
- Trazodone
How does Bupropion work?
Inhibits the reuptake of dopamine and norepinephrine. It has a stimulant effect. Lowers seizure threshold. Does not cause sexual side effects.
How does Mirtazapine work?
An alpha 2 antagonist: the receptors are located on the pre-synaptic nerve terminal on adrenergic neurons: Stimulating alpha 2 inhibits further norepinephrine release (blocking these increases norepinephrine.
Also a potent serotonin2 and serotonin3 receptor antagonist.
What are side effects of Mirtazapine?
- Anti-histamine.
How does Trazodone work?
Inhibits serotonin antagonist and reuptake inhibitor.
What are 2 medications that can be safely added to SSRI?
Bupropion and Trazodone.
What are 2 side effects of Trazodone?
- Sedation
2. Priapism
