Study Guide 1

Question 1

What is often used for chronic pain when conservative tx doesn’t work?

Answer 1

Antidepressants

Question 2

SSRIs are used to regulate:

Answer 2

• mood

- depression

Question 3

SSRIs are good for these pts

Answer 3

People who have slightly decreased serotonin levels

Question 4

This SSRI is often used for chronic pain

Answer 4

Paroxetine (Paxil)

Question 5

What does SNRI stand for?

Answer 5

Serotonin-Norepinephrine Reuptake Inhibitors

Question 6

What are SNRIs used for?

Answer 6

Depression

Question 7

Off-label uses for SNRIs

Answer 7

• chronic pain
• OA
• peripheral neuropathies
• fibromyalgia

Question 8

Why are SSRIs/SNRIs used to treat pain? (How does this work physiologically?)

Answer 8

Restores serotonin influence in descending pathways that inhibit pain

Question 9

What are tricyclics used for?

Answer 9

Depression

Question 10

When are tricyclics used over SSRI/SNRI?

Answer 10

Only for pts who fail with SSRI/SNRI

Question 11

Tricyclics can also be used to treat this

Answer 11

Pain

Question 12

MAOI

Answer 12

Monoamine Oxidase Inhibitors

Question 13

What class of drugs are MAOIs?

Answer 13

Antidepressants

Question 14

Lithium is used to treat ________

Answer 14

Bipolar disorder

Question 15

This class of drug is used to treat schizophrenia

Answer 15

Antipsychotics

Question 16

How do SSRIs work?

Answer 16

block reuptake of serotonin into the presynaptic terminal

Question 17

How does increased serotonin in the presynaptic terminal create change?

Answer 17

• remains in cleft longer
• increases receptor sensitivity
• increases neuronal growth/function

Question 18

How do SNRIs act physiologically?

Answer 18

• decrease serotonin and norepinephrine reuptake

- same mechanism as SSRI

Question 19

SNRIs decrease serotonin and norepinephrine reuptake without affecting these:

Answer 19

Dopamine synapses

Question 20

What do tricyclics block?

Answer 20

Reuptake of amine neurotransmitters into the presynaptic terminal

Question 21

What is an important thing to note about the mechanism of action of tricyclics?

Answer 21

• nonselective

- block serotonin, norepinephrine, and dopamine!

Question 22

What is MAO (monoamine oxidase)?

Answer 22

• enzyme that destroys released NTs

- hits a lot of targets

Question 23

How do MAOIs work?

Answer 23

inhibit MAO to allow more NT to stay in the synaptic cleft

Question 24

MAOIs favor _______

Answer 24

Dopamine

Question 25

Mechanism of action: lithium

Answer 25

Multiple possible pathways of interaction

• may prevent neuronal degeneration and sustain function
• may be neuro protective

Question 26

Mechanism of action: antipsychotics

Answer 26

Traditional meds for this are dopamine antagonists