Anti-depressants Flashcards Preview

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Flashcards in Anti-depressants Deck (27)
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1
Q

For mild to moderate depression, what is the clinical indication

A

Drugs do not show clinical improvement in studies, yet some patients will report improvement within a day or two, others they take weeks and weeks

2
Q

What event do all antidepressants increase the likelihood of

A

all antidepressants lower the seizure threshold, especially when combined with alcohol; increase in suicidal thinking and/or behavior

3
Q

when would a tricyclic antidepressant be indicated

A

When the patient also has a hard time falling and/or staying asleep (insomnia)

4
Q

Which antidepressant class has the most severe side effects

A

MAOI monoamine oxidase inhibitor

5
Q

What dietary restrictions come with MAOI drugs

A

No high tyramine foods: raisins, aged cheeses and meats, red wine, many soy products

6
Q

What happens if a person on an MAOI eats tyramine containing foods

A

potentially toxic elevation of catecholamine levels, resulting in severe headaches, nausea and hypertension.
Hypertensive emergencies and fatal accelerated hypertension have been reported

7
Q

What is the MOA of tricyclic antidepressants (TCA)

A

Diminishing the reuptake of monoamine neurotransmitters is clearly one of the chief effects. Subsequent down regulation of postsynaptic receptors may be the true mechanism of action

8
Q

What are the indications for TCA

A

obsessive compulsive disorders, enuresis, panic attacks, chronic pain and migraine headaches as well as depression

9
Q

What are side effects of TCA

A

anti-cholinergic signs and symptoms such as dry mouth, constipation, urinary hesitancy, orthostatic hypotension and sedation

10
Q

What side effect of TCA is of note for men

A

it causes constriction of the bladder neck, important if the man has BPH

11
Q

What drug class is amitriptyline (Elavil)

A

tricyclic antidepressant (TCA

12
Q

What are the indications of amitriptyline

A

major depression, bipolar disorder, migraine and tension headaches, chronic pain

13
Q

What is the MOA of SSRIs

A

blockade of serotonin reuptake at the pre-synaptic terminal which results in the subsequent increased level of serotonin available for further neurotransmission

14
Q

What are common side effects of SSRIs

A

increased number of bowel movements, dizziness, HA, fatigue, anxiety, insomnia, impotence, weight gain, nausea

15
Q

What drug class is fluoxetine (prozac)

A

SSRI

16
Q

What are the indications for fluoxetine (prozac)

A

Major depressive disorder, obsessive compulsive disorder, bulimia and panic disorder

17
Q

What are symptoms of serotonin syndrome

A

fever, agitation, diarrhea, elevated BP

18
Q

What drug class is Duloxetine (cymbalta)

A

serotonine and norepinephrine reuptake inhibitor (SNRI)

19
Q

What are the indications for duloxetine (cymbalta)

A

neurogenic pain, fibromyalgia, GAD, painful peripheral neuropathy

20
Q

What comorbidity indicates prescription of a tri- or tetra-cyclic antidepressant

A

insomnia

21
Q

what drug class is trazodone (Desyrel)

A

tetracyclic antidepressant

22
Q

What are the indications for trazodone (desyrel)

A

Panic disorder, anxiety, insomnia, MDD

23
Q

What are the side effects of trazodone (desyrel)

A

sedation, orthostatic hypotension, fatigue, cardiac dysrhythmia, mania in a bipolar patient

24
Q

What drug class is bupropion (wellbutrin)

A

norepinephrine and dopamine reuptake inhibitor (NDRI) and nicotine receptor agonist

25
Q

What are the indications for bupropion (wellbutrin)

A

major depression, smoking cessation, bipolar, ADD

26
Q

What are some side effects of bupropion

A

weight loss, Headache, insomnia, dry mouth, tremors, restlessness, agitation, anxiety, sweating and dizziness

27
Q

What nutrient deficiency is correlated with depression

A

folate (folic acid) because it is essential for neurotransmitter production