TCA Flashcards

1
Q

Amitriptyline can be used for

A
  1. Depression
  2. Neuropathic pain
  3. Migraine prophylaxis
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2
Q

Common side effect of TCA:

A
  1. GI and sexual dysfunction
  2. Anticholinergic
  3. Sedation
  4. Wt gain
  5. Arrhythmia
  6. Sz
  7. Fetal on overdose
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3
Q

SSRI, E.g.

A
  1. Fluxetine
  2. Fluvoxamine
  3. Escitalopram
  4. Citalopram
  5. Paroxetine
  6. Sertraline
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4
Q

Fluoxetine, can be used for

A
  1. Depression
  2. OCD
  3. BULIMIA nervosa
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5
Q

S/e of escitolopram and citalopram

A
  1. Prolonged QTc if high dose in elderly
  2. GI and sexual dysfunction
  3. Hyponatremia
  4. EPSE
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6
Q

Mirtazapine, is

A
  1. NaSSA (NorA and specific Serotonergic antidepressant)
  2. Used for depression
  3. Help to reverse GI and sexual dysfunction from SSRI OR SNRI
  4. S.e. sedation, increase appetite and wt gain
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7
Q

3 med, FDA approved for treatment of general anxiety

A
  1. Alprazolam
  2. Diazepam
  3. Lorazepam
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8
Q

Serotonergic agent + serotonergic agent or + high dose tramadol, would lead to

A

Serotonin syndrome

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9
Q

S/s of serotonin syndrome:

A

Mild: insomnia, anxiety, nausea, diarrhoea, high BP, tachycardia, hyperreflexia

Mod: agitation, myoclonus, tremors, mydriasis, flushing, diaphoresis, low fevee

Servere: severe hyperthermia, confusion, rigidity, coma, resp failure, death

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10
Q

Which Antidepressant is CYP450 inhibitor and with marked increase AUC

A
  1. Fluvoxamine
  2. Paroxetine
  3. Bupropion
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11
Q

Pt who suddenly discontinue antidepressant treatment(e.g. venlafacine, paroxetine), would develop:

A
  1. Antidepressant discontinuation syndrome “FINISH”
    F: FLU LIKE syndrome
    I: INSOMNIA
    N: NAUSEA /VOMITING
    I: IMBALANCE
    S: SENSORY DISTURBANCE ( burning, tingling electric like sensation)
    H: hyperarousal (anxiety, irritability, agitation, mania, jerkiness)
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12
Q

S/e of venlafaxine

A

HYPERTENSION

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13
Q

Bupropion

A

1.No serotonergic effects (no sexual dysfunction)
2. Not suitable for h/o sz, eating d/o
3. Used for smoking cessation

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14
Q

When start antidepressant for young pt <24yr old, need to watch out for:

A
  1. Suicidality risk
  2. Need to counsel pt and carers
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15
Q

Antidepressant with low risk for CYP interactions:

A
  1. Mirtazapine
  2. Escitalopram
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16
Q

Which drug is most likely to develop discontinuation syndrome:

A
  1. Paroxetine
  2. Venlafaxine
    (Due to short t1/2)

Less likely for fluoxetine (due to long half life)