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Pharmacology > Psych: Antidepressants > Flashcards

Psych: Antidepressants Flashcards

1
Q

Which antidepressant is also used for nicotine withdrawal and smoking cessation?

A

Bupropion

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2
Q

Which antidepressant is also used for enuresis?

A

Imipramine

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3
Q

Which antidepressant is also used for neuropathic pain (diabetic, fibromyalgia, and chronic MSK pain)

A

Duloxetine

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4
Q

Which antidepressant is also used for stress incontinence?

A

Duloxetine

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5
Q

What are the 5 R’s?

A 
Response (50% reduction in sx)
Remission
Recovery (6-12 months)
Relapse (return of sx before recovery)
Recurrance (return of sx after recovery)
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6
Q

What is the withdrawl symptoms of ALL antidepressants?

FINISH

A 
Flu-like
Insomnia
Nausea
Imbalance
Sensory disturbances
Hyperarousal
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7
Q

MOA of citalopram and escitalopram?

A

SSRIs

-block SERT reuptake of seritonin

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8
Q

MOA of fluoxetine, paroxetine, and sertraline?

A

SSRIs

-block SERT reuptake of seritonin

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9
Q

MOA of vilazodone? (2)

A

SSRI (blocks SERT)

Partial agonist of 5HT1A

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10
Q

MOA of vortioxetine? (4)

A

SSRI (blocks SERT)
Partial agonist of 5HT1B
Full agonist at 5HT1A
Full antagonist of 5HT1D

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11
Q

MOA of isocarboxazid, phenelzine, and tranylcypromine?

A

MAO Inhibitors

-increase NE, DA, and 5HT

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12
Q

MOA and ROI of selegiline?

A

MOA-B inhibitor only
-increases DA for parkinson’s

Worn asa patch

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13
Q

MOA of Venlafaxine, Desvenlafaxine, and duloxetine?

A

SNRI’s

-increases NE and 5HT

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14
Q

MOA of levomilnacipran?

A

SNRI

-increases NE and 5HT

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15
Q

Which drugs are secondary amines TCA drugs? (AND)

A

Amoxapine
Nortripyline
Desipramine

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16
Q

MOA of Amitriptlyine, clomipramine, doxepin, and imipramine?

A

SNRI’s (TCAs)

  • 5HT=NE
  • also block H1, muscarinincs, and a1

Tertiary amines

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17
Q

MOA of nortriptyline and desipramine?

A

SNRI’s (TCAs)

  • NE>5HT
  • also block H1, muscarinics, and a1

Secondary amines

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18
Q

What older drug class has the most histamine, anticholinergic, and adrenergic side effects

A

TCAs

CNS sedation, sexual dysfunction, weight gain, and withdrawal symptoms

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19
Q

What are the two significant side effects of SSRI’s?

A

Serotonin syndrome

Suicidality

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20
Q

MOA of bupropion?

A

Selectively inhibits pre-synaptic uptake of NE and DA
-blocks NET and DAT

Also some evidence of causing some more release

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21
Q

MOA of mirtazapine?

A

Blocks presynaptic a2 and 5ht and post-synaptic 5HT2 blocker
-also H1 blockade (sedation)

22
Q

MOA of Nefazodone?

A

Post synaptic a1 and 5HT2 blocker

-also H1 blockade (sedation)

23
Q

MOA of trazodone?

A

Postsynaptic a1 and 5HT2 blocker

-also H1 blockade (sedation)

24
Q

MOA, ROI, and clinical use of esketamine?

A

NMDA receptor antagonist used for treatment-resistant depression

Administered intranasally

25
Q

MOA and clinical use of brexanolone?

A

IV infused GABAa receptor agonist for treatment-resistant post partum depression

26
Q

Which SSRI has least effects on CYP450? (2)

A

Vortioxetine and escitalopram

27
Q

What are the three key systems are affected by TCAs?

A

Cardiovascular (a1 agonism)
-tachycardia, orthostatics, dysrhythmias

Anticholinergic (muscarininc)
-dry mouth, uriniary retention. blurred vision

CNS
-depression, sedation

28
Q

What are the three C’s of TCAs?

A

Coma
Cardiotoxicity (conduction abnormalities)
Convulsion

29
Q

What are the three C’s of TCAs?

A

Coma
Cardiotoxicity (conduction abnormalities)
Convulsion

30
Q

Does mirtazapine have SERT/NET activity?

A

nope

31
Q

Adverse effects of mirtazapine?

A

Sedation and weight gain

32
Q

Adverse effects of trazodone?

A

Sedation and orthostatics

33
Q

Adverse effects of trazodone?

A

Sedation and orthostatics

34
Q

Serious adverse effect of bupropion?

A

Seizure

-especially in bulemics or anorexia; other volunerable pts

35
Q

How long should you wait after stopping MAOs before starting most SSRIs?

A

2 weeks minimum

36
Q

How long should you wait after stopping fluoxetine before starting other meds?

A

5 weeks

37
Q

What is the major concern with MAO inhibitors?

A

Hypertensive crisis

-especially after eating tyramine containing foods (cheese, wine, peas)

38
Q

What antiseizure meds can be used as mood stabilizers?

A

Cabamazepine
Valproate
Lamotrigine

39
Q

What ion was first established for mood disorders (bipolar disorder)

A

Lithium

40
Q

How does lithium work in mood disorders?

A

Inhibits dopamine release, downregulates NMDA recepotrs, and promotes GABAergic neurotransmission

41
Q

What intracellular changes does lithium cause?

A

Lithium inhibits IP3, PKC, MARCKS, and GSK-3

42
Q

What neuroprotective changes does lithium cause?

A

Increases CERB, which produces BDNF and Bcl-2

43
Q

What is the renal side effect of lithium?

A

nephrogenic diabetes insipidus

-polyuria and polydipsia that doesnt change with ADH

44
Q

Is lithiums therapeutic index large or small?

A

Small

-monitor closely

45
Q

What meds increase lithium toxicity?

A

Diuretics (especially thiazides)
ACEi (especially lisinopril)
NSAIDs

46
Q

Does lithium cause suicidal ideations?

A

Nope, actually can reduce the risk

47
Q

Clinical use for valproate in bipolar disorder?

A

Acute bipolar disorder ONLY

-not maintainence

48
Q

Clinical use for lamotrigine in bipolar disorder?

A

Maintenance of bipolar disorder ONLY

-not acute

49
Q

Clinical use for carbamazepine in bipolar disorder?

A

Acute and maintenance of bipolar disorder

50
Q

Carbamazepine is a CYP450 _______ (inducer or inhibitor)?

A

Inducer

51
Q

MOA of amoxapine?

A

SNRI’s (TCAs) and increases DA

  • NE>5HT
  • also block H1, muscarinics, and a1
52
Q

What two antidepressant drugs increase dopamine?

A

Buproprion and Amoxapine

Pharmacology (50 decks)

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