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pharm antiepileptics > antidepressants > Flashcards

antidepressants Flashcards

1
Q

mechanism of antidepressants

A

potentiate action of ne and serotonin in the brain

as depression is due to deficiency of monoamines

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2
Q

antidepressants

A 
SSRI
SNRI
TCA 
ATYPICAL ANTIDEPRESSANTS
MAOI
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3
Q

SSRI

A 
CITALOPRAM 
ESCITALOPRAM
FLUOXETINE
PAROXETINE
SERTALINE
LESSER SIDE AFFECTS AS COMPARED TO OTHER ANTIDEPRESSANTS
needs 2 weeks for action in mood change,ocd,gad,PMS,bulimia
cause hepatic toxicity
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4
Q

fluoxetine

A

treat bulimia
SSRI very long half life 50 hrs
potent inhibitor of cyp system with paroxetine
doesn’t cause discontinuation syndrome

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5
Q

SSRI increased with food

A

sertraline

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6
Q

serotonin adverse effects

A 
agitation sexual dysfunction
headache sweating
insomnia 
diarrhea vomit nausea
WEIGHT CHANGE
HYPONATREMIA
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7
Q

SSRI USED FOR DIFFICULT SLEEPING

A

FLUVOXAMINE PAROXETINE

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8
Q

SSRI USED IN EXCESSIVE SOMNOLENCE

A

FLUOXETINE

SERTALINE

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9
Q

SSRI LESS SEXUAL DYSFUNCTION

A

bupropion

mitrazapine

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10
Q

fluoxetine
sertraline
fluvoxamine

A

treat OCD in children

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11
Q

treat child depression

A

fluoxetine escitalopram

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12
Q

citalopram

A

SSRI

causes long QT syndrome cardiac arrythmias

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13
Q

serotonin syndrome

A

SSRI used with MAOI
hyperthermia, muscle rigidity, myoclonic seizures ,altered mental status
dec seizure threshold with antidepressants

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14
Q

discontinuation syndrome

A

all ssri can cause after abrupt withdrawal specially with lower half lives
headache malaise flu like symptoms agitation disturbed sleep

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15
Q

SNRI

A 
used when depression with chronic pain usually diabetic neuropathy, fibromyalgia,low back pain
venlafaxine 
levomilnacipran
duloxetine
ppt discontinuation syndrome
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16
Q

venlafaxine

A

low dose serotonin uptakeinhibitor and at moderate dose NE UPTAKE inhibited

17
Q

duloxetine

A

typical NSRI

moderate inhibitor of CYP system

18
Q

levomilnacipran

A

treat depression in Europe

cyp substrate

19
Q

atypical antidepressants

A 
BUPROPION
MITRAZAPINE
NEFAZODONE
TRAZODONE
VILAZODONE
VORTIOXETINE
20
Q

BUPROPION

A

dec cravings not used with bullimic pt
attenuate nicotine withdrawal symptoms
inc risk of seizure
weak dopa and NE reuptake inhibitor

21
Q

mirtazapine

A

enhance serotonin and NE by antagonizing alpha2 adrenergic and 5HT2 +H1 antihistaminic causing sedation and antidepression
WEIGHT GAIN
help depressed people to sleep

22
Q

nefazodone and trazodone

A 
weak serotonin reuptake inhibitor 
block 5HT(2alpha) receptor and h1 antihistamine 
trazodone PRIAPISM 
nefazodone HEPATIC TOXICITY
alpha 1 antagonist
sedative effects
23
Q

vilazodone

A

serotonin uptake inhibitor 5HT(1A)

PARTIAL AGONIST SSRI

24
Q

VORTIOXETINE

A

5HT1A agonism
5HT3/7 antagonism
perfect treat depression

25
Q

TCA

A 
TERTIARY AMINES elevate mood euphoria alertness and inc muscle activity 2 weeks to work
block NE n serotonin uptake 
sensitive to CYP system
AMITRYPTALINE 
IMIPRAMINE
CLOMIPRAMINE
DOXEPIN
DESIPRAMINE(ONLY NE)
NORTRPTALINE
MAPROTILINE(ONLY NE)
AMOXAPINE
26
Q

AMOXAPINE

A

BLOCK 5HT2 and D2 receptor

27
Q

imipramine

A

control bed wetting in children above 6 years replaced by desmopressin
least likely to cause orthostatic hypotension

28
Q

amitryptaline

A

prevent migraine headache and rate chronic pain syndromes

29
Q

doxepin

A

low dose TCA treat insomnia

30
Q

TCA SIDE EFFECTS

A

CONTRAINED IN BIPOLARS
narrow therapeutic index
avoid In BPH,epilepsy,preexisting arrhythmia
long qt may b

31
Q

last line agents MAOI

A

MAO inhibit excess release of neurotransmitters which may leak out do MAOI accumulates NT’S in the synapse
phenelzine(irreversible)
trancylpromine
selegiline(transdermal anti parkinsonian)
isocarboazid
as found in gut n liver a lot inhibition cause toxicities
used in pt where none of other antidepressants work(atypical depression )

32
Q

tyramine products

A

cheese chicken liver pickled/smoked fish red wine inactivated by MAO
HYPERTENSIVE CRISIS SEEN IF TYRAMINE
+MAOO

33
Q

HYPERTENSIVE CRISIS

A

tyramine +maoi
occipital headache, stiff neck, tachycardia,hypertension arrhythmia,seizures stroke
treat with PHENTOLAMINE AND PRAZOSIN

34
Q

TREAT MANIA AND BIPOLAR

A

lithium
very toxic at high dose renal
best with liver failure patients

35
Q

lithium adverse effects

A 
headache 
dry mouth
polydipsia
polyruria polyphasic
gi distress
hand tremor 
dizziness
dermat Rxn
THYROID FUNCTION REDUCED

pharm antiepileptics (5 decks)

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