Study Guide 1 Flashcards
What is often used for chronic pain when conservative tx doesn’t work?
Antidepressants
SSRIs are used to regulate:
- mood
- depression
SSRIs are good for these pts
People who have slightly decreased serotonin levels
This SSRI is often used for chronic pain
Paroxetine (Paxil)
What does SNRI stand for?
Serotonin-Norepinephrine Reuptake Inhibitors
What are SNRIs used for?
Depression
Off-label uses for SNRIs
- chronic pain
- OA
- peripheral neuropathies
- fibromyalgia
Why are SSRIs/SNRIs used to treat pain? (How does this work physiologically?)
Restores serotonin influence in descending pathways that inhibit pain
What are tricyclics used for?
Depression
When are tricyclics used over SSRI/SNRI?
Only for pts who fail with SSRI/SNRI
Tricyclics can also be used to treat this
Pain
MAOI
Monoamine Oxidase Inhibitors
What class of drugs are MAOIs?
Antidepressants
Lithium is used to treat ________
Bipolar disorder
This class of drug is used to treat schizophrenia
Antipsychotics
How do SSRIs work?
block reuptake of serotonin into the presynaptic terminal
How does increased serotonin in the presynaptic terminal create change?
- remains in cleft longer
- increases receptor sensitivity
- increases neuronal growth/function
How do SNRIs act physiologically?
- decrease serotonin and norepinephrine reuptake
- same mechanism as SSRI
SNRIs decrease serotonin and norepinephrine reuptake without affecting these:
Dopamine synapses
What do tricyclics block?
Reuptake of amine neurotransmitters into the presynaptic terminal
What is an important thing to note about the mechanism of action of tricyclics?
- nonselective
- block serotonin, norepinephrine, and dopamine!
What is MAO (monoamine oxidase)?
- enzyme that destroys released NTs
- hits a lot of targets
How do MAOIs work?
inhibit MAO to allow more NT to stay in the synaptic cleft
MAOIs favor _______
Dopamine
Mechanism of action: lithium
Multiple possible pathways of interaction
- may prevent neuronal degeneration and sustain function
- may be neuro protective
Mechanism of action: antipsychotics
Traditional meds for this are dopamine antagonists
