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Flashcards in Antidepressants Deck (41)
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1

How do antidepressants work?

  • Increase the amount of neurotransmitter in the synaptic cleft
    • Inhibition of reuptake
    • Enzymatic degredation

2

Which antidepressant increases synaptic serotonin and norepinephrine?

Tricyclics

3

 

Which antidepressant increases synaptic norepinephrine?

 

Tetracyclics

4

 

Which antidepressant blocks the degredation of norepinephrine, dopamine and serotonin?

 

MAOIs

5

 

Which antidepressant increases synaptic serotonin?

 

SSRIs

6

What is an example of a dopamine-reuptake inhibitor?

bupropion (Wellbutrin, Zyban)

7

What are the characteristics of bupropion (Wellbutrin, Zyban)?

  • Increased risk for seizures
  • Risk for emergent hypertension with concurrent nicotine patch use
  • Take BP on patients using this drug

8

What does monoamine oxidase do?

It's responsible for metabolism of norepinephrine, serotonin, and dopamine - MAOI's inhibit them

9

What types of depression are MAOI's used for?

  • Atypical, non-endogenous, neurotic depression
  • Depression associated with Parkinson's
  • PTSD

10

What do you do as a dentist when your patient is on MAOIs?

  • Take blood pressure before anesthesia
  • Caution with epinephrine

11

What are the MAOIs?

  • isocarboxazid (Marplan)
  • phenelzine (Nardil)
  • selegiline (Atapryl, Eldepryl, Selpak)
  • tranylcypromine (Parnate)

12

What are the adverse events with MAOIs?

  • Causes release of endogenous catecholamines
  • Results in hyperadrenergic crisis 
    • Severe hypertension, fever, arrhythmias
  • Avoid tyramine containing foods

13

What are the popular SSRIs?

  • fluoxetine (Prozac, Sarafem)
  • proxetine (Paxil)
  • sertraline (Zoloft) 

14

Which SSRI's are the biggest market sellers?

Paxil and Zoloft

15

What is the only SSRI approved for use in children with OCD?

Zoloft

16

What has been mandated to be put on the boxes of SSRIs?

  • Antidepressants increase risk of suicidal thinking and behavior in children with depression and pyschiatric disorders

17

What antidepressant is not FDA approved for use in children?

Escitalopram 

18

What are the known side effects of SSRIs?

  • Agitation
  • Anxiety
  • Hostility
  • Aggression

19

When taking SSRI's for depression, when it the highest risk for suicidal attempt?

Within 6 weeks of initiating drug therapy

20

What are popular Serotonin/Norepinephrine Reuptake Inhibitors (SNRIs)?

  • desvenlafaxine (Pristiq)
  • duloxetine (Cymbalta)
  • milnacipran (Savella)
  • venlafaxine (Effexor XR)

21

Which SNRI is used solely to treat fibromyalgia?

milnacipran (Savella)

22

What are some oral complications or side effects of venlafaxine (Effexor XR)?

  • Xerostomia
  • Stomatitis
  • Loss of taste
  • Taste alteration
  • Tongue discoloration

23

What's an example of a tetracyclic and what's it used for?

maprotiline (Ludiomil)

Depression, anxiety with depression, dsythymic disorder

24

What's unique about Tricyclics?

Adjunctive therapy for chronic pain -- exhibits analgesic properties

25

How are tricyclic antidepressants adverse effects determined?

By their blockade on cholinergic, adrenergic and histamine transmission.

26

What are some of the side effects of TCA's?

  • Anticholinergic effects - blurred vision, xerostomia, constipation
  • Sympatholytic effects - postural hypotension, dizziness
  • Histamine antagonism - sedation

27

What are the tricylics that are blockers of both norepinephrine and serotonin?

  • amitryptyline (Elavil)
  • imipramine (Tofranil)

28

What are the tricyclics that are selective norepinephrine reuptake blockers?

  • desipramine (Norpramin)
  • nortriptyline (Pamelor)

29

What is St. John's Wort?

A weed-like plant that has been used as an antidepressant, and you cannot take with prescription antidepressants

30

What are the major active constituents in St Johns wort?

  • hyperforin and hypericin
  • flavonoids and tannis