Flashcards in Antidepressants Deck (11):
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)
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
treatment of OCD
SSRIs, clomipramine (TCA)
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.
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)
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
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.
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
used for smoking cessation too. incr. NE and DA via unknown mechanism. toxicity: stimulant effects, headache, seizure in bulimic pts. no sexual side effects.
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.