SECTION II DRUGS Flashcards
1
Q
CNS
- First line for major depressive disorder
- Inhibits 5-HT (serotonin) transporter reuptake
- Black box warning: You may have suicidal thoughts
A
SSRI
2
Q
CNS
- Most active SSRI with a long half-life
- Strong CYP2D6 inhibitor
- Pregnancy category C
- Most unlikely to cause discontinuation syndrome
- 5-6 week washout period; stays in the system for a
long time
A
Fluoxetine (SSRI)
3
Q
CNS
- Sedating SSRI that is a strong CYP1A2 inhibitor
- Pregnancy category C
- Use to treat OCD
A
Fluvoxamine (SSRI)
4
Q
CNS
- Causes weight gain, strong CYP2D6 inhibitor
- Pregnancy category D
- Can cause sexual dysfunction
- Treats a lot of symptoms due to high affinity
A
Paroxetine (SSRI)
5
Q
CNS
- Causes more GI upset compared to other SSRIs
- Pregnancy category C
- Could cause discontinuation syndrome
A
Sertraline (SSRI)
6
Q
CNS
- Enantiomer of citalopram with QT prolongation
- No clinical advantage over citalopram
A
Escitalopram (SSRI)
7
Q
CNS
- Inhibits serotonin and NE transporter for reuptake
A
SNRI
8
Q
CNS
- Has multiple pain indications and therefore very broad coverage for treatment
- Any dose can cause serotonin and NE transporters to be inhibited
- Can cause liver toxicity
A
Duloxetine (SNRI)
9
Q
CNS
- Causes serotonin reuptake to be inhibited at low
doses - Causes NE reuptake to be inhibited at high doses
- Has hypertensive effects at higher doses, and can
result in cardiotoxicity
A
Venlafaxine (SNRI)
10
Q
CNS
- Only used for fibromyalgia
- Levomilnacipran has higher activity at NE receptor reuptake inhibition
A
Milnacipran (SNRI)
11
Q
CNS
- Tranylcypromine, isocarboxazid, phenelzine,
selegiline - Binds to MAO-A and MAO-B irreversibly, which
increase concentrations of 5-HT, NE, DA - Treats atypical depression
- MAO-A breaks down serotonin, tyramine, NE, DA in
brain and GI - MAO-B break down DA and tyramine in brain
- May cause serotonin syndrome
- Discontinue 10 days before surgery
- Average 14 day washout period
- Could cause orthostatic hypotension
- Patient with ADHD should NOT take MAO-I
A
MAO-inhibitors
12
Q
CNS
-Selectively taken at low doses to reduce depression
- Useful for treatment of Parkinson’s disease, delays
motor complications
- Selective MAO-B inhibitor; for brain
- Use within 10 days prior to Sx is contraindication
- Interacts with SSRI, SNRI, TCA
A
Selegiline
Rasagiline
Safinamide (MAO-B
inhibitor)
13
Q
CNS
- First line for major depressive disorder and social anxiety disorders
- Does not cause sexual dysfunction
- Physical stimulus first and then cognitive
- Most widespread effects, related to weight loss,
smoking cessation
A
Bupropion (Misc. antidepressant)
14
Q
CNS
- Central alpha-2 receptor antagonist, increases
release of NE and 5HT - Appetite and weight gain
- Little to no sexual effects
A
Mirtazapine (Misc.
antidepressant)
15
Q
CNS
- inhibits serotonin transport reuptake and
antagonizes 5HT2A - Orthostatic hypotension (α1 antagonist)
- Sedative at low doses (H1 antagonist))
A
Trazodone (Misc.
Antidepressant)