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Pharmacology Unit 3 and 4 > Antidepressants > Flashcards

Antidepressants Flashcards

1
Q

Tranylcypromine

A

Class: MAOI

Mech: Irreversibly inhibit both MAOa and MAOb

Thera: Depression, anxiety, PTSD, chronic pain, enuresis, bulimia, alcoholism

Tox: Hypertensive crisis (with tyramine-rich foods); serotonin syndrome (MAOI + SSRI); agitation (rare), delerium –> seizures
Anticholinergic, orthostatic hypotension, sexual dysfunction, weight gain, sedation

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2
Q

Phenelzine

A

Class: MAOI

Mech: Irreversibly inhibit both MAOa and MAOb

Thera: Depression, anxiety, PTSD, chronic pain, enuresis, bulimia, alcoholism

Tox: Hypertensive crisis (with tyramine-rich foods); serotonin syndrome (MAOI + SSRI); agitation (rare), delerium –> seizures
Anticholinergic, orthostatic hypotension, sexual dysfunction, weight gain, sedation

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3
Q

Desipramine

A

Class: TCA

Mech: Block reuptake of NE or 5-HT at varying potencies and selectivity; also variably block muscarinic, a-adrenergic, dopamine, and histamine receptors

Thera: Depression, anxiety, PTSD, chronic pain, enuresis, bulimia, alcoholism

Tox: Sympathomimetic (cardiac arrhythmias and conduction defects, especially at OD)
Antimuscarinic, orthostatic hypotension, sedation (additive with alcohol), seizures

Misc: Not very safe; rarely used anymore. Forms active metabolite (Desipramine).

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4
Q

Imipramine

A

Class: TCA

Mech: Block reuptake of NE or 5-HT at varying potencies and selectivity; also variably block muscarinic, a-adrenergic, dopamine, and histamine receptors

Thera: Depression, anxiety, PTSD, chronic pain, enuresis, bulimia, alcoholism

Tox: Sympathomimetic (cardiac arrhythmias and conduction defects, especially at OD)
Antimuscarinic, orthostatic hypotension, sedation (additive with alcohol), seizures

Misc: Not very safe; rarely used anymore

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5
Q

Amitriptyline

A

Class: TCA

Mech: Block reuptake of NE or 5-HT at varying potencies and selectivity; also variably block muscarinic, a-adrenergic, dopamine, and histamine receptors

Thera: Depression, anxiety, PTSD, chronic pain, enuresis, bulimia, alcoholism, prevention of cluster headaches

Tox: Sympathomimetic (cardiac arrhythmias and conduction defects, especially at OD)
Antimuscarinic, orthostatic hypotension, sedation (additive with alcohol), seizures

Misc: Not very safe; rarely used anymore. Forms active metabolite (Nortriptyline)

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6
Q

Nortriptyline

A

Class: TCA

Mech: Block reuptake of NE or 5-HT at varying potencies and selectivity; also variably block muscarinic, a-adrenergic, dopamine, and histamine receptors

Thera: Depression, anxiety, PTSD, chronic pain, enuresis, bulimia, alcoholism

Tox: Sympathomimetic (cardiac arrhythmias and conduction defects, especially at OD)
Antimuscarinic, orthostatic hypotension, sedation (additive with alcohol), seizures

Misc: Not very safe; rarely used anymore

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7
Q

Fluoxetine

A

Class: SSRI

Mech: Inhibit reuptake of 5-HT (and NE to lesser extent)

Thera: Depression, anxiety, PTSD, chronic pain, enuresis, bulimia, alcoholism; pre-menstrual dystrophic disorder

Tox: Serotonin syndrome (with MAOIs)-hyperthermia, muscle rigidity, myoclonus, rapid changes in mental status and vital signs
Fewer than tricyclics; mostly nausea, decreased sexual function

Misc: Potent P450 inhibitor; forms active metabolite (norfluoxetine)

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8
Q

Paroxetine

A

Class: SSRI

Mech: Inhibit reuptake of 5-HT (and NE to lesser extent)

Thera: Depression, anxiety, PTSD, chronic pain, enuresis, bulimia, alcoholism; pre-menstrual dystrophic disorder

Tox: Serotonin syndrome (with MAOIs)-hyperthermia, muscle rigidity, myoclonus, rapid changes in mental status and vital signs
Fewer than tricyclics; mostly nausea, decreased sexual function

Misc: Potent P450 inhibitor

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9
Q

Sertraline

A

Class: SSRI

Mech: Inhibit reuptake of 5-HT (and NE to lesser extent)

Thera: Depression, anxiety, PTSD, chronic pain, enuresis, bulimia, alcoholism; pre-menstrual dystrophic disorder

Tox: Serotonin syndrome (with MAOIs)-hyperthermia, muscle rigidity, myoclonus, rapid changes in mental status and vital signs
Fewer than tricyclics; mostly nausea, decreased sexual function

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10
Q

Escitalopram

A

Class: SSRI

Mech: Inhibit reuptake of 5-HT (and NE to lesser extent)

Thera: Depression, anxiety, PTSD, chronic pain, enuresis, bulimia, alcoholism; pre-menstrual dystrophic disorder

Tox: Serotonin syndrome (with MAOIs)-hyperthermia, muscle rigidity, myoclonus, rapid changes in mental status and vital signs
Fewer than tricyclics; mostly nausea, decreased sexual function

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11
Q

Citalopram

A

Class: SSRI

Mech: Inhibit reuptake of 5-HT (and NE to lesser extent)

Thera: Depression, anxiety, PTSD, chronic pain, enuresis, bulimia, alcoholism; pre-menstrual dystrophic disorder

Tox: Serotonin syndrome (with MAOIs)-hyperthermia, muscle rigidity, myoclonus, rapid changes in mental status and vital signs
Fewer than tricyclics; mostly nausea, decreased sexual function

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12
Q

Duloxetine

A

Class: SNRI

Mech: Inhibits reuptake of 5-HT and NE

Thera: Depression, anxiety, PTSD, chronic pain, enuresis, bulimia, alcoholism

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13
Q

Venlafaxine

A

Class: SNRI

Mech: Inhibits reuptake of 5-HT and NE

Thera: Depression, anxiety, PTSD, chronic pain, enuresis, bulimia, alcoholism

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14
Q

Bupropion

A

Class: Atypical

Mech: Blocks DA adn NE reuptake

Thera: Depression, anxiety, PTSD, chronic pain, enuresis, bulimia, alcoholism; maintain nicotine abstinence in quitting smokers

Tox: Lowers seizure threshold

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15
Q

Mirtazapine

A

Class: Atypical

Mech: 5HT2a antagonist; also inhibits 5HT reuptake

Thera: Depression, anxiety, PTSD, chronic pain, enuresis, bulimia, alcoholism; maintain nicotine abstinence in quitting smokers

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16
Q

Lithium

A

Mech: Unknown; lithium depletes secondary messengers IP3 and DAG, important in a-adrenergic and muscarinic-cholinergic transmission

Thera: Anti-manic/mood-stabilizing (bipolar); long-term cluster headache prevention

Tox: If elevated levels: neurotoxicity, cardiac toxicity, renal dysfunction
Drowsiness, weight gain, tremor, polydipsia, polyuria

Misc: Nausea and vomiting early sign of lithium OD; indomethacin and Na-depleting diuretics should be avoided (increase [Li])

Pharmacology Unit 3 and 4 (14 decks)

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