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Flashcards in Antidepressants Deck (11):
1

Side effects of SSRIs

fluoxetine, paroxetine, sertraline, citalopram
cause fewer side effects/toxcities than TCAs, but can cause GI distress and sexual dysfunction. serotonin syndrome may be seen with any drug that increases 5-HT (MAO inhibitors, SNRIs, TCAs). casues hyperthermia, confusion, myoclonus, cardiovascular collapse, flushing, diarrhea, seizures.
treatment: cyproheptadine (5-HT2 receptor antagonist)

2

SNRIs: drugs, uses, side effects

venlafaxine, duloxetine. inhibit 5-HT and NE reputake. both good for depression; venlafaxine also used in GAD and panic disorders; duloxetine also good for diabetic peripheral neuropathy.
most common side is high BP

3

treatment of OCD

SSRIs, clomipramine (TCA)

4

TCAs: uses, names

most end in -iptyline (amitriptyline, nortriptyline) or -ipramine (imipramine)
used for major depression; clomipramine used for OCD, fibromyalgia.
block reuptatke of NE and 5-HT.

5

TCAs: toxicity

Tri-Cs: convulsions, coma, cardiotoxicities (arrhythmia). respiratory depression, hyperpyrexia. confusion and hallucinations in elderly d/t anticholinergic effects. Use NaHCO3 for CV toxicity (incr. binding of TCA to plasma proteins, decr. free TCA).
they also have alpha1-blocking effects (hypotension), and atropine like effects (tachycardia, urinary retention, dry mouth)

6

MAO inhibitors

tranylcypromine, phenelzine, isocarboxazid, selegiline
mechanism: nonselective MAO inhibition to increase the levels of amine neurotransmitters (NE, 5-HT, DA).
used for atypical depression, anxiety, hypochondriasis

7

MAO-inhibitors: side effects and contraindications

can cause a hypertensive crisis (esp. with ingestion of tyramine), CNS stim. contraindicated with SSRIs, TCA, St. John's Wart, meperidine, and dextromethrophan (synthetic codein analog for cough) to prevent seratonin syndrome.
phentolamine is a reversible alpha blocker given to pts on MAO-Is who take tyramine containing foods.

8

trazodone

primarily blocks 5-HT and alpha-1 adrenergic receptors. mostly used for insomnia; high doses needed for antidepressent effects. toxicity: sedation, nausea, priapism (trazo"BONE"), hypotension

9

buproprion

used for smoking cessation too. incr. NE and DA via unknown mechanism. toxicity: stimulant effects, headache, seizure in bulimic pts. no sexual side effects.

10

mirtazapine

alpha-2 antagonist (incr. release of NE and 5-HT) and potent 5-HT2 and HT3 receptor antagonist.
toxicity; sedation, incr. appetite, weight gain, dry mouth.

11

How do you treat narcolepsy? What causes narcolepsy?

decreased orexin production in the lateral hypothalamus causes narcolepsy
teat with daytime stimulants (modafinil, amphetamines), and nighttime sodium oxybate (GHB)