Antidepressants

Question 1

First Gen drugs

Answer 1

tricyclics and MAO inhibitors

Question 2

2nd and 3rd Gen drugs

Answer 2

tetracyclics and unicyclics; 5-HT2 antagonists; SSRI; SNRI

Question 3

drugs that inhibit 5-HT reuptake w/ greater potency but not technically SSRIs

Answer 3

trazodone and venlafaxine

Question 4

drug that inhibits NE reuptake w/ greater potency

Answer 4

maprotiline

Question 5

drugs that have little effect on re-uptake of either 5-HT or NE

Answer 5

bupropion and mirtazapine

Question 6

tricyclic dibenzazepine tertiary amine

Answer 6

imipramine

Question 7

tricyclic dibenzazepine secondary amine

Answer 7

desipramine

Question 8

tricyclic dibenzocycloheptadiene tertiary amine

Answer 8

amitriptyline

Question 9

tricyclic dibenzocycloheptadiene secondary amine

Answer 9

protriptyline

Question 10

tricyclic dibenzoxepine tertiary amine

Answer 10

doxepine

Question 11

probably primary action of alleviation of depression of TCAs

Answer 11

blockage of NE reuptake

Question 12

sedative effects of TCAs are enhanced by …

Answer 12

CNS depressants

Question 13

co-administration of TCAs with … can lead to sever hyperpyrexia, hypertension, tremors, convulsions, coma or death

Answer 13

MAOIs

Question 14

inhibitors of cytochrome P450 … will increase concentration of TCAs

Answer 14

erythromycin, clarithromycin, fluoxetine

Question 15

inducer of cyp-450

Answer 15

carbamazepine

Question 16

MAOIs of both MAO A and B

Answer 16

phenelzine and trancylcypromine

Question 17

located in gut and peripheral tissues; preferentially oxidizes 5-HT, but not NE or dopamine

Answer 17

MAO-A

Question 18

located in platelets; preferentially metabolizes dopamine

Answer 18

MAO-B

Question 19

MAOIs block metabolism of … and other amines found in aged cheese, beer and chianti, may escalate levels of monoamines

Answer 19

L-dopa

Question 20

if MAOIs are given with other anti depressants (esp. SSRIs) may cause …

Answer 20

malignant serotonin syndrome

Question 21

1st clinically available atypical; tetracyclic; used to treat psychoses and mood disorders; blocks NE greater than 5-HT; sedation and may cause seizures

Answer 21

maprotiline

Question 22

N-demethylated metabolite of antipsychotic drug loxapine; action resembles secondary amine TCAs but also blocks dopamine and 5-HT2a; anticholinergic and parkinsons like side effects

Answer 22

amoxapine

Question 23

triazole derivatives; inhibition of 5-HT2a; weak re uptake inhibition of serotonin and NE; short plasma half life; treatment of depression, insomnia of SSRIs, panic attacks; sedation, CV side effects, priapism of males

Answer 23

trazodone and nefodazone

Question 24

aminoketone; weak inhibitor of NE, 5-HT and DA re-uptake; depression; smoking cessation; seasonal affective disorder; agitation; insomnia, anorexia and weight loss, seizures

Answer 24

bupropion

Question 25

blocks presynaptic A2 receptors; increases amine release by removing feed back inhibition; no effect on serotonin re uptake; CV effects (serious), sedation, dry mouth, blurred vision, weight gain

Answer 25

mirtazapine

Question 26

SSRIs

Answer 26

fluoxetine, sertraline, paroxetine, citalopram, escitalopram

Question 27

half life and daily dose of fluoxetine

Answer 27

70 and 20-80

Question 28

half life and daily dose of sertraline

Answer 28

25 and 50-200

Question 29

half life and daily dose of paroxetine

Answer 29

20 and 10-50

Question 30

half life and daily dose of citalopram/escitalopram

Answer 30

35 and 20-40

Question 31

fluoxetine taken with lithium, TCAs, warfarin

Answer 31

increased action of 2nd drug

Question 32

fluvoxamine taken with alprazolam, theophylline, TCAs and warfarin

Answer 32

increased blood levels of 2nd drug

Question 33

MAOIs taken with SSRIs, food containing tyramine

Answer 33

hypertensive crisis, serotonin syndrome

Question 34

nefazodone taken with alprazolam, triazolam

Answer 34

increased blood levels of 2nd drug

Question 35

paroxetine, sertraline taken with warfarin, TCAs

Answer 35

increased blood levels of 2nd drug

Question 36

TCAs taken with sedative/hypnotics, ethanol

Answer 36

increased CNS depression

Question 37

highly sedating

Answer 37

amitriptyline, doxepin, trazadone, mirtazapine

Question 38

anti muscarinic effects

Answer 38

amitriptyline and doxepin

Question 39

SSRIs generally lack ... and are safe in overdose

Answer 39

sedating activities

Question 40

main line drug of bipolar disorder

Answer 40

lithium salts

Question 41

diabetes insipidus

Answer 41

chronic toxicity of lithium salts

Question 42

plasma levels of lithium are elevated by

Answer 42

thiazide diuretics (chlorothiazide) and ACE inhibitors (catopril)

Question 43

NSAIDs decrease ...

Answer 43

renal excretion

Question 44

alcohol and caffeine promote ...

Answer 44

lithium excretion