Anti-Depressants

Question 1

Tricyclic Antidepressants

Answer 1

Amitriptyline, imipramine, clomipramine, trimipramine, doxepin

Question 2

Serotonin Specific Reuptake Inhibitors

Answer 2

Citalopram, escitalopram, fluoxetine, paroxetine, sertraline, fluvoxamine

Question 3

Atypical antidepressants

Answer 3

bupropion (NE and Dopamine reuptake inhibitor), atomoxetine (selective norepinephrine reuptake inhibitor), mitrazapine (a2 antagonist as serotonin and NE disinhibit), nefazodone, trazodone (serotonin antagonist/ reuptake inhibitor)

Question 4

MAO inhibitors

Answer 4

Moclobemid, tranylcypromine

Question 5

Antidepressant indications

Answer 5

depression, mood elevators, anxiety disorders, pain (not analgesics), enuresis

Question 6

Latency

Answer 6

2-3 weeks, after first week sedation plus vegetation adverse effects, increased suicidal risk, observation in hospital necessary, second week physical activity observed, third week patient elevated mood and decreased morbid preocupation

Question 7

Treatment

Answer 7

lowest possible dose, progressive increase until therapeutic dose

Question 8

Duration

Answer 8

3-6 months, should not be stopped suddenly, increased suicidal risk

Question 9

TCA

Answer 9

oldest class, most effective, second line because of orthostatic hypotension, arrhythmias, tachycardia, anticholinergic, risk of poisoning, TI is 7, dispense one week supply

Question 10

Acute intoxication

Answer 10

vital functions supported and monitored (seizures, arrhythmias), gastric lavage, activated charcoal, physostigmine, phenytoin (arrhythmia, suppression of seizure), lidocaine and beta blockers(arrhythmia), diazepam(seizures and myoclonic/dystonic),

Question 11

SSRI reuptake inhibitors

Answer 11

first line dugs, side effects like loss of appetite, nausea, vomitting, diarrhea, decreased libido, headache, insomnia, somnolence, nightmares, increased QT interval (citalopram, escitalopram),

Question 12

Atypical antidepressants

Answer 12

different mechanisms, no anticholinergic effects

Question 13

MAO inhibitors

Answer 13

third line, only administered if previous cases have failed, atypical depression, minimum 2 weeks switching classes

Question 14

Antidepressants should not be administered together with drugs causing an inhibitory effect upon CNS

Answer 14

alcohol, antihistaminic, barbiturates, benzodiazepines, hypnotics, opioids

Question 15

MAO inhibitors should not be associated

Answer 15

with food that contains tyramine (headache, tachycardia, HBP, arrhythmia, stroke), or with SSRIs (serotonin syndrome :fever, agitation, neuromuscular irritability, hypotension, coma, death