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PHRM 845 > Watts Antidepressants > Flashcards

Watts Antidepressants Flashcards

1
Q

what was the first antidepressant and what class?

A

imipramine

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2
Q

types of depression with percentages

A

reactive - 60%
major depressive disorder - 25%
bipolar affective - 15%

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3
Q

drug induced depression classes

A

antihypertensive
sedative hypnotics
anti-inflammatory/analgesics
steroids

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4
Q

biogenic amine hypothesis

A

reserpine depletes NE and 5HT

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5
Q

neuroendocrine hypothesis

A

overactive HPA and CRF
stress causes hypothalamus to release cortisol

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6
Q

antidepressants do what to CRF

A

reduce levels

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7
Q

CRF1 does what

A

arousal
anxiety
sexual dysfunction
sleep problems
activation of HPA axis

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8
Q

CRF2 does what

A

appetite suppression

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9
Q

neurotrophic hypothesis

A

depressed ppl have reduced BDNF and volume of hippocampus

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10
Q

antidepressants to what to BDNF

A

increase

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11
Q

increase in BDNF does what to dendritic sprouts

A

increase

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12
Q

MAO inhibitors mechanism of action

A

prevents degradation of NE and 5HT by mao
- increased amount of NE and 5HT packaged in vescicles

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13
Q

non selective MAO inhibitors

A

phenelzine
tranylcypromine

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14
Q

non selective MAO inhibitors are _________

A

irreversible

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15
Q

MAO B selective inhibitor

A

selegiline (reversible)

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16
Q

MAO A selective inhibitor

A

moclobemide

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17
Q

MAO side effects

A

headache
drowsiness
dry mouth
weight gain
orthostatic hypotension
sexual dysfunction

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18
Q

avoid what kind of foods with MAO

A

tyramine containing

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19
Q

orthosteric site is where what binds?

A

serotonin

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20
Q

indications for TCAs

A

depression, pain, panic, enuresis

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21
Q

patients more likely suicidal with what class

A

TCAs (2 weeks into treatment)

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22
Q

tertiary amines inhibit what

A

NE and 5HT via NET and SERT

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23
Q

tertiary amines also are antagonists at what

A

antihistamine
antimuscarinic
antiadrenergic

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24
Q

side effects of tertiary amines

A

weight gain
sedation
autonomic
(very strong)
also conduction of heart

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25
Q

tertiary amine drugs

A

imipramine
amitriptyline
clomipramine
doxepin

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26
Q

imipramine metabolized to what

A

desipramine (secondary amine)

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27
Q

amitriptyline metabolized to what

A

nortriptyline (secondary amine)

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28
Q

imipramine uses

A

ADHD
enuresis

29
Q

clomipramine use

A

OCD (orgasm while yawning)

30
Q

secondary amine drugs

A

desipramine
nortriptyline
maprotiline

31
Q

secondary amines inhibit what mainly

A

NET

32
Q

secondary amines side effects

A

less sedation
less weight gain
less CV
less anticholinergic

33
Q

SSRI moa

A

serotonin transporters blocked
increased 5HT in synapse

34
Q

side effects of SSRIs

A

N/V
headache
sexual dysfunction
anxiety
insomnia

35
Q

SSRI discontinuation syndrome symptoms

A

brain zaps
dizzy
sweating

36
Q

what can occur if SSRIs are given with MAOis or TCAs

A

serotonin syndrome:
restless, shiver, hyperthermia

37
Q

treatment of serotonin syndrome

A

administration of serotonin antagonists (cyptoheptadine)
benzos to control movements

38
Q

vilazodone MOA

A

SSRI + 5HT1A partial agonist

39
Q

vartioxetine MOA

A

SSRI + 5HT1A partial agonist

40
Q

vilazodone side effect profile

A

reduced sexual dysfunction compared to SSRIs

41
Q

tetracyclic antidepressants

A

maprotiline
mirtazapine

42
Q

maprotiline is a ____ inhibitor

A

NET

43
Q

D2 antagonists will have what side effects

A

motor side effects

44
Q

mirtazapine targets whwat

A

alpha 2 receptor antagonist
5HT antagonist
H1 antagonist

45
Q

bupropiron is a _____

A

unicyclic antidepressant

46
Q

bupropion inhibits what

A

DAT
NET
SERT

47
Q

trazodone MOA

A

5HT2 antagonist
SERT inhibitor
(off label alpha 1, H1, 5HT2)

48
Q

venlafxine use

A

GAD and panic disordewr

49
Q

SNRIs

A

desvenlafaxine
venlafaxine
duloxetine
milnacipran
levomilnacipran

50
Q

duloxetine treats what

A

peripheral neuropathy

51
Q

milnacipran treats what

A

fibromyalgia

52
Q

NSRI meds

A

reboxetine
atomoxetine

53
Q

triple blockers block what

A

serotonin
norepinephrine
dopamine
SDNRIs

54
Q

what is a triple blocker example

A

cocaine

55
Q

NMDA antagonist drug

A

ketamine
esketamine

56
Q

ketamine useful at what doses

A

subanesthetic

57
Q

esketamine approved with what

A

oral antidepressant

58
Q

post partum depression treatment

A

SSRI: fluoxetine/paroxetine
brexanolone

59
Q

brexanolone MOA

A

resensitizes GABA-A receptors

60
Q

what happens during pregnancy

A

increase in allopregnanolone
GABA-A receptors desensitize

61
Q

non pharm options for depression

A

electroconvulsive
psychotherapy
hospitalization

62
Q

fibanserin use

A

female sexual desire stimulate
originally developed as antidepressant

63
Q

filbanserin targets

A

5HT1A agonist
5HT2A/C antagonist
(polypharmacology)

64
Q

mania features

A

euphoria
high risk behavior
decrease sleep and appetite
aggressive

65
Q

lithium mechanism

A

depletes PIP2 and IP3 so less Gq activation and recycling of PIP2

66
Q

effectiveness of lithium

A

lag time- takes awhile bc we need to burn out the PIP2

67
Q

valproic acid and valproate mechanism

A

increase GABA
block Na channels
block Ca channels
inhibit histone deacetylase

68
Q

drugs that block Na inactive state

A

carbamazepine/oxcarbazepine
lamotrigine
topiramate

PHRM 845 (38 decks)

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