Seegars - Antidepressants & Mood Stabilizers

Question 1

Sweating, hyperreflexia, akanthisia/myoclonus, shivering/tremors

Answer 1

Serotonin syndrome - SAE of SSRI

Question 2

MC drug interation with SSRI

Answer 2

Fluoxetine (CYP450 inhibitor)

Question 3

3 key TCA SEs

Answer 3

cardiovascular (alpha), anticholinergic (muscarinic), CNS (histamine)

Question 4

3 Cs of TCA toxic ingestion

Answer 4

Coma, cardiotoxicity, convulsions

Question 5

2 SARAs that block pre-synpatic 5-HT and alpha-1 post-synaptic adrenergic receptors

Answer 5

trazodone, nefazodone - used in low doses as sleep aids too

Question 6

Selectively inhibits the pre-synaptic reuptake of serotonin norepinephrin (via NET) and dopamine (via DAT)

Answer 6

NDRI’s - bupropion

Question 7

MC and “useful” SE of NRDI

Answer 7

Agitation/insomnia - stimulating effects

Question 8

MAOI that is B receptor selective

Answer 8

Selegiline

Question 9

MAOI that is available in patch form

Answer 9

Selegiline

Question 10

MAOI that can cause stimulatin/insomina effect

Answer 10

Tranylcypromine

Question 11

Biggest limiting factor of MAOIs

Answer 11

Hypertensive crisis

Question 12

TCA used for enuresis in kids

Answer 12

Imipramine

Question 13

Selectively inhibit the pre-synaptic reuptake of serotonin via SERT

Answer 13

SSRIs

Question 14

Mood stabilizer that shows a reduced risk of sucicide in bipolar agents

Answer 14

Lithium

Question 15

Drug-drug interactions MCly seen with lithium

Answer 15

Thiazide diuretics, ACEIs (esp lisinopril), NSAIDs

Question 16

Mood stabilizer that can cause nephrogenic DI in high doses

Answer 16

Lithium

Question 17

Mood stabilizer that is a major CYP450 inducer - v high likelihood of drug-drug interaction

Answer 17

Carbamazepine

Question 18

tertiary amine TCAs inhibit

Answer 18

both NE/5HT equally

Question 19

quaternary amine TCAs inhibit

Answer 19

NE more than 5HT

Question 20

SARA that selectively blocks pre-synaptic alpha2 adrenergic receptors and on serotonergic neurons

Answer 20

mirtazapine

Question 21

NDRI that can be used as an aid in smoking cessation

Answer 21

bupropion

Question 22

oral MAOIs are considered

Answer 22

irreversible

Question 23

shortest acting MAOI

Answer 23

tranylcypromine - 3-7d (amphetamine derivative)

Question 24

used to tx MDD, diabetic peripheral neuopathy, fibromyalgia, neuromuscular pain and stress incontinence

Answer 24

duloxetine

Question 25

full effects of antidepressants can be seen in

Answer 25

3-8+ wks

Question 26

anti seizure agnets used as mood stabilizers

Answer 26

carbamazepine, lamotrigine, divalproex/valproic acid

Question 27

inhibits Ca-dependent and depol provokes release of NE & DA

Answer 27

lithium

Question 28

decreases cytoplasm-to-membrane translocation of PKC and reduces PKC stimulation induces release of 5HT

Answer 28

Li and valproate

Question 29

lithium blood level is monitored at

Answer 29

trough phase

Question 30

inhibits iodination of thyroid hormone and can lead to a goiter

Answer 30

lithium