Wolters Summary - Antidepressants Flashcards

1
Q

other factors causing depression

A

beta blockers can cause depression

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2
Q

SSRI MOA

A

inhibit reuptake of serotonin

SERT rec.

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3
Q

list SSRI

A
fluoxetine/prozac 
sertraline/zoloft 
paroxetine/paxil 
escitalopram/lexapro
citalopram/celexa
fluvoxamine
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4
Q

fluoxetine

A

prozac

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5
Q

sertraline

A

zoloft

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6
Q

paroxetine

A

paxil

x

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7
Q

escitalopram

A

lexapro

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8
Q

citalopram

A

celexa

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9
Q

SSRI side effects

A
  1. GI
  2. CNS
  3. erectile dysfunciton
  4. Anticholinergic
  5. Hyponatremia
  6. QTc prolongation
    * * can help hot flashes
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10
Q

GI s.e. of SSRI

A

n/v

dry mouth

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11
Q

CNS s.e. of SSRI

A

sedation
insomnia
decreased libido
suicidal ideation

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12
Q

drug causing most s.e. of SSRI

A

paxil/paroxetine

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13
Q

SSRI with longest half life

A

Prozac

shortest- paxil so have more s.e.

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14
Q

SSRi causing QTc prolongation

A

escitalopram
citalopram

esp. citalopram

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15
Q

SSRi drug interactions

A

other serotonergic meds (esp. MAOis and linezolid)

fluoxetine

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16
Q

Fluoxetine and clopidogrel

A

Prozac is a CYP219 INHIBITOR and Clopidogrel is PRODRUG

so if taking prozac, clopidogrel will not work

same for tamoxifen

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17
Q

SNRI

list

A

Venlafaxine (Effexor)
Desvenlafaxine
Duloxetine (Cymbalta)
Levomilnacipran

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18
Q

Duloxetine

A

(Cymbalta)

19
Q

Venlafaxine

A

(Effexor)

20
Q

SSRI MOA

A

selectively inhibit reuptake of serotonin and norepinephrine

21
Q

SNRI s.e.

A

GI/CNS/Urgenital

+ Increase BP (n.e. - no biggie unless uncontrolled HTN)

22
Q

duloxetine specific s.e.

A

anticholinergic symptoms

liver toxicity

23
Q

SNRI drug interactions

A

other serotonergic meds

duolextine specific

24
Q

duloxetine SNRI

A

CYP1A2 inhibitors will increase concentration because duolextine is a 1a2 SUBSTRATE

ex. Cipro/fluvoxamine

25
Q

bupropion brand

A

Wellbutrin

26
Q

MOA bupropion

A

weak inhibitor of norepinephrine and dopamine reuptake

NO MAO or serotonin

27
Q

bupropion s.e.

A

INCREASED seizure risk !!!

also CNS (HA, appetite)

can be used to prevent smoking (Zyban)

28
Q

what antidepressant would you use for an old lady who is underweight and can’t sleep

A

mirtazapine

pre-synaptic alpha agonist (increases N.e. and serotonin)

causes sedation and weight gain

29
Q

which other antidepressant causes priapism

A

trazodone (trazoBONE)

30
Q

other antidepressant with BBW of liver toxicity

A

nefazodone

cyp3a4 inhibitor

31
Q

TCA MOA

A

selective inhibition of serotonin and norepinephrine reuptake

antihistamine and anticholinergics effects

Na Channel blocker

32
Q

TCA s.e.

A

anticholinergic **

narrow therapeutic index ** (suicidal ideation and seizures, tornadoes de pines)

cardiac problems due to Na Channel blockage

33
Q

TCA drug list

A

Amitripyline *

imipramine
despiramine
nortriptyline

(ine/amine)

34
Q

TCA overdose = which drug

A

sodium bicarbonate

given with dextrose

35
Q

MAOis (list)

A

isocarbozazid
phenelzine
selegiline (parkinsons!) **
tranylcypromine

36
Q

MAOi MOA

A

increase endogenous concentrations of dopamine, serotonin, norepinephrine thru inhibiton of monoamine oxidase (that breaks these down)

not first line

37
Q

MAOi S.E.

A

hypertensive crisis *** unable to break down tyramine foods

weight gain, thermostatic hypotension, CNS

38
Q

MAOi drug interactions

A

2 week wash out req.

other serotonin drugs

also CI with antihypertensive meds

39
Q

serotonin syndrome

A

excess serotonin

typically caused by overdose

40
Q

serotonin syndrome symptoms

A

hyperthermia (fever)
agitaiton, diaphoresis
increased bowel sounds (diarrhea)
tremor

41
Q

serotonin syndrome treatment

A

serotonin antagonist -CYPROHEPTADINE

42
Q

resistent depression

what do we use if antidepressants don’t work

A

SGAs

exercise

43
Q

beers list antidepressants

A

Anticholinergic symptoms
chronic seizures
SIADH
SSRI