Psych Meds Flashcards
What is the monoamine hypothesis of antidepressants?
deficit or decreased function of MOA enzymes, NE, dopamine and serotonin (5-HT)
What is the neurotrophic hypothesis of antidepressants?
neurotropic and neuroendocrine factors
what are the most widely used antidepressants?
SSRIs
Which antidepressants lack anticholinergic properties?
SSRIs, no postural HoTN, conduction defects, change in seizure threshold
What is the black box warning for SSRIs?
increased suicidal ideation
Which antidepressant increases risk of bleeding?
SSRIs
Which classes of antidepressants, combined with MAOIs can cause serotonin syndrome?
SSRIs, SNRIs, TCAs, opioids
What is Fluoxetine (SSRI) and potent inhibitor of?
P450 enzymes
Which SSRI enhances the effects of warfarin?
Paroxetine
Which SSRI causes dose dependent Qt prolongation, potentially leading to Torsades?
citalopram, escitalopram
Which antidepressant class blocks serotonin and NE reuptake?
SNRIs
Which SNRI should be avoided in patients with renal and hepatic disease?
Duloxetine
Which class of antidepressants are competitive antagonists at muscarinic cholinergic receptors, leading cholinergic effects?
TCAs
TCAs are structurally similar to what drugs?
local anesthetics and phenothiazines
If your patient is on a TCA which intra-op medication should you be conscious of giving?
Ephedrine, exaggerated response with increased circulating catecholamines
Which anticholinergic is best for patients on TCAs?
glycopyrrolate
Which antidepressants has biphasic elimination?
Bupropion (TCA)
What are consequences of TCA overdose?
inhibit cardiac Ca channels, seizures precede cardiac arrest
What is the dose of physostigmine for anticholinergic psychosis from TCA overdose?
0.5-2mg
Where are MAO-A and MAO-B exclusive to?
MAO-A platelets
MAO-B placenta
What class of antidepressants form an irreversible complex with MAO enzymes leading to prolonged effects?
MAOIs
What type of diet do people taking MAOIs follow?
tyramine free
How do you treat hyperadrenergic crisis from MAOs?
vasodilators and anti-dysrhymics
What is the treatment for MAOI overdose?
Dantrolene
