Anti-depressant agents Flashcards Preview

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Flashcards in Anti-depressant agents Deck (16):
1

ANtidepressive pathways involve monoamines how?

NE and 5HT acts on GPCR and brain derived neurotropic factors (BDNF) acting on TrkB to switch on genes that promote neurogenesis and protecting against apoptosis.

2

SSRI drugs

Escitalopram
fluoxetine
paroxetine

5HT reuptake inhibitors

(no sedative and no antimuscarinic action)

3

MAOIs (phenylzine)
side effect

phenylzine:
can cause hypertensive crisis with decongestants or foods high in tyramine due to acute increase in NE release

(presynaptic accumulation and release into synapse)

4

How many days does it take for onset of therapeutic effect of Lithium?

10-21 days for onset

5

How does lithium work as an antimanic drug?

Increase 5HT action or diminish NE + DA effect by interference with PIP recycling

6

DOes Lithium have a high or narrow therapeutic index?

Narrow

(BDZ have high)

- good for both manic and depressive episodes, common in combo with other agents

7

____ disorders are the most common psychiatric illnesses, followed by ___ disorders

Anxiety, mood (25%)

8

SIGECAPS is when how many symptoms have persisted for _____ weeks

Depression

5/m symptoms

2 weeks

9

DIGFAST

mania
E for at least 1 week, and present most of the day nearly every day

10

Melancholic depression

mood worse in the morning early morning awakenings, anorexia, weight loss, guilt

11

Bipolar I vs Bipolar II

I: pts with only mania

II: pts with hypomania AND major depression

12

Mood disorder diff dx

Mood disorders (bipolar + depressive disorders) can be due to :

Endocrine
- cushings, hyper/hypothyroidism, steroids
Infections

- HIV, influenza, mengitis, Creutzfeld Jakob

CNS
- Stroke, tumor, MS, epilepsy

Metabolic
- Hypercalcemia

13

Depressive disorder types

Major depressive disorder
Dysthymic disorder

14

True/False depression is a chemical imbalance as well as defect in multiple interactive pathways

false
- not chemical imbalance
- yes to neuroendocrine dysfxn

15

Neuroendocrine dysfxn in depression

Activation of HPA axis to stress →
paraventricular nucleus of hypothalamus secretes CRF →
anterior pituitary secretes (ACTH) →
adrenal cortex secretes cortisol/glucocorticoids →
affects general metabolism/behavior

16

Bipolar disorder is the ____ leading cause of death 25-34 years old

2nd

(11th leading cause of death overall)