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Pharmacology > Wk 11 Antidepressant > Flashcards

Wk 11 Antidepressant Flashcards

1
Q
  1. An antidepressant should be taken for what period of time?
A

At least 4-9 months after symptoms are under control.

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2
Q
  1. An antidepressant may take how many weeks to have an effect?
A

1-3 weeks

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3
Q
  1. Explain the effects of increasing the following neurotransmitters in the brain: serotonin, norepinephrine, and dopamine.
A

Serotonin – decreased anxiety and depression
Norepinephrine – increased energy
Dopamine – decreased cravings and dependence

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4
Q
  1. Why are selective serotonin reuptake inhibitors (SSRIs) frequently given first in depression?
A

Fewer side effects and safer in overdose

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5
Q
  1. How do selective serotonin reuptake inhibitors (SSRIs) affect sexual functioning?
A

Decrease libido.

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6
Q
  1. How much weight gain can be expected with selective serotonin reuptake inhibitors (SSRIs)?
A

20 pounds

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7
Q
  1. What herb can precipitate a serotonin syndrome?
A

St. John’s Wort

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8
Q
  1. Selective serotonin reuptake inhibitors (SSRIs) should not be used with what other antidepressant category?
A

Monoamine oxidase inhibitors (MAOIs)

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9
Q
  1. What are some symptoms of the Serotonin Syndrome?
A

Agitation, anxiety, incoordination, tremors, myoclonus, fever, shivering, tachycardia, hypertension, sweating, diarrhea

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10
Q
  1. Name two neurotransmitters which may be increased in the synapses by tricyclic antidepressants.
A

Serotonin, norepinephrine

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11
Q
  1. When can the maximal effects of tricyclic antidepressants be expected after the initial dose?
A

1-2 months

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12
Q
  1. List four major categories of adverse effects expected with tricyclic antidepressants.
A

Cardiac arrhythmias, orthostatic hypotension, sedation, and anticholinergic effects such as dry mouth, decreased tears, urinary retention, and constipation.

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13
Q
  1. What high-risk group of patients should not be given tricyclic antidepressants?
A

Suicidal patients

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14
Q
  1. What is the drug that increases acetylcholine in the synapse to counteract the anticholinergic effects seen in a tricyclic overdose?
A

Physostigmine

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15
Q
  1. What would you tell a patient who is complaining of the sedative effects of a tricyclic antidepressant?
A

Sedation will diminish with time

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16
Q
  1. What drug category absolutely cannot be given with tricyclic antidepressants?
A

Monoamine oxidase inhibitors (MAOIs)

17
Q
  1. Tricyclics should be given at what time of day? Why? How is it given to the elderly to prevent cardiotoxic effects?
A

Bedtime due to sedation. BID.

18
Q
  1. Bupropion (Wellbutrin) is used to counteract what side effect of selective serotonin reuptake inhibitors (SSRIs)?
A

Sexual dysfunction

19
Q
  1. Which two neurotransmitters does buproprion (Wellbutrin) possibly increase?
A

Dopamine, norepinephrine

20
Q
  1. A history of head trauma would preclude a patient from taking buproprion (Wellbutrin) due to a risk of what?
A

Seizures

21
Q
  1. Buproprion (Wellbutrin) is used to help people stop what activity?
A

Smoking

22
Q
  1. Monoamine oxidase inhibitors (MAOIs) increase what neurotransmitters?
A

Serotonin, norepinephrine, dopamine

23
Q
  1. Monoamine oxidase inhibitors (MAOIs) are the first choice for what diagnosis?
A

Atypical depression

24
Q
  1. The coadministration of meperidine (Demerol) and monoamine oxidase inhibitors (MAOIs) can cause what?
A

Hyperthermia

25
Q
  1. The ingestion of tyramine-containing foods while taking a monoamine oxidase inhibitor (MAOI) can cause what?
A

Hypertensive crisis

26
Q
  1. Name possible symptoms of a hypertensive crisis.
A

Severe headache, dizziness, high blood pressure, chest pain, tachycardia, nausea, vomiting, sweating

27
Q
  1. How do low levels of sodium intake affect the pharmacokinetics of lithium?
A

Low sodium levels can inhibit the excretion of lithium

28
Q
  1. How does lithium affect urination?
A

Causes polyuria

29
Q
  1. How does lithium affect thyroid functioning?
A

Causes hypothyroidism by inhibiting the incorporation of iodine into the thyroid hormone.

30
Q
  1. What neuromuscular side effect is common with lithium?
A

Fine tremor

31
Q
  1. What are common side effects of divalproex sodium (Valproate)? Why is it not used in pregnancy?
A

Nausea, vomiting, diarrhea, indigestion, weight gain. Neural tube defects and delayed neurodevelopment.

32
Q
  1. How does carbamazepine (Tegretol) affect the metabolism of other drugs? How does it affect contraception?
A

Induces hepatic enzymes that increase the clearance of other drugs. Metabolizes oral contraceptives too rapidly, need back-up contraception.

33
Q
  1. Identify side effects caused by the decreased norepinephrine reuptake with SNRIs?
A

Nervousness, insomnia, anorexia and weight loss, sweating, tachycardia, hypertension, urinary retention, vertigo

Pharmacology (25 decks)

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