S15C172 - Atypical antidpressants, serotonin syndrome

Question 1

Serotinergic drugs

Answer 1

• MAOI
• SSRI
• SNRI
• TCA
• trazodone
• bupropion (low)

-others: amphetamines, buspirone, cocaine, dextromethorphan, fentanyl, levodopa, linezolid, lithium, st john’s wart, mescaline, tramadol

Question 2

buproprion OD

Answer 2

• risk of seizure, usually w/in first 1-4h but up to 8h, tx with benzos
• dopaminergic activity can cause: catatonia, psychosis, hallucinations, paranoia
• toxicity can occur at 450mg

Question 3

SSRI OD

Answer 3

• Sz: sedation, n/v, tremor, sinus tachy most common

- tx: charcoal

Question 4

Serotonin Syndrome

Answer 4

=exposure to medication + alteration in cognition/behaviour + autonomic nervous system function abnormality + abnormal neuromuscular activity

• -5-HT2a receptor is responsible
• signs: AMS, hyperthermia, increased tone (lower>upper), hyperreflexia, tremor, diaphoresis
• *myoclonus helps differentiate SS from mimickers

Question 5

SNRI OD

Answer 5

• sympathetic nervous syste mstimulation
• tachy, HTN, diaphoresis, tremor, mydriasis
• venlafaxine, duloxetine
• seizures
• wide QRS, long QT