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Psychiatry 2 > Somatic Therapies > Flashcards

Somatic Therapies Flashcards

1
Q

What is the MOA of SSRI’s?

A

Selective Serotonin Reuptake inhibitors in the presynaptic neuron

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2
Q

Where are SSRI’s metabolized?

A

In the liver

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3
Q

What is the normal dosing regimen for SSRIs?

A

Once per day except fluvoxamine (2x)

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4
Q

Which SSRIs have active metabolites?

A

Fluvoxetine and Sertraline

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5
Q

What are the early signs of serotonin syndrome?

A

Lethargy, restlessness, confusion, flushing, diaphoresis, tremor

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6
Q

What are later effects of serotonin synd?

A

Hyperthermia, hypertonicity, rhabdomyolysis, renal failure, death

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7
Q

What is the effect of SSRIs on Cyt P450?

A

Inhibits enzymes: Decreases mets of other drugs

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8
Q

What are the indications of SNRIs?

A

Depression, Anxiety, Chronic Pain

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9
Q

What are the dosing traits of venlafaxine?

A

SSRI at low dose

SNRI at higher doses

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10
Q

What are the traits of Desvenlafaxine?

A

Metabolite of Venlafaxine
Better tolerated
Equal RI of S and N

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11
Q

What are indications for Buproprion?

A

MDD, SAD, ADHD, Smoking Cessation (NOT ANXIETY)

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12
Q

What are the traits of Buproprion?

A

Inhibits Reuptake of Dopamine and NE

Structure of Stimulant

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13
Q

What are the SA of Buproprion?

A

HA, Nausea, Anx, Tremor, insomnia, Seizure at high dose

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14
Q

What is the MOA of Vilazodone?

A

SSRI and 5HT1A rec part agonist

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15
Q

What are the SA of Vilazodone?

A

Min sexual dysfunction

N/V Insomnia

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16
Q

What is the MOA of Trazadone?

A

Weak Inhib of SE and 5HT2

17
Q

What are indications for Trazodone?

A

MDD but significant sedation better for insomnia

18
Q

What is the MOA of Mirtazapine? Indications?

A

5HT2 and 3 and a1 antagonist

Sleep aid

19
Q

What are the SA of Mirtazepine?

A

Sedation, Weight gain

20
Q

What are the SA of TCAs?

A

Sedation, Wt gain (Antihist)

Constipation, urinary hesit, retention, dry mouth, vision blurring (Antichol)

21
Q

What are the Cardio effects of TCAs?

A

Orthostatic Hypotension, Reflex Tachcardia. Don’t use in a Heart block. Fatal arrhythmia in OD

22
Q

What are the Monoamines degraded by MAO?

A

Tyramine, SE, DO, NE (Not degraded in presence of MAO-I) MAO-A:: SE and NE

23
Q

What drugs are best at achieving remission from depression?

A

SNRIs however not as well tolerated

24
Q

What are considerations when switching Antidepressants?

A 
Taper off original drug
Use drug with diff MOA
COnsider pre-existing Medical Conditions
Med that fits Sx
Min drug interactions
25
Q

What are traits of the best medication?

A

Cost, Tolerability, Sx types

Prescriber experience and comfort

26
Q

Which MDD meds have danger during pregnancy, nursing?

A

Paroxetine: Cardiac Abn
Sertraline Safest
PPHN (Persistent pulm Htn)

Psychiatry 2 (13 decks)

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