Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Psych 1 > Antidepressants > Flashcards

Antidepressants Flashcards

1
Q

SSRIs
SNRIs
Atypical
Tricyclic

A

Escitalopram, fluoxetinem sertraline

Duloxetine, venlafaxine

Bupropion, mirtazapine

Amittriptyline, nortrip

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Antidepressants vs mood stabilizers

A

Antidepressants for MD

Mood for BPD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Monoamine hypothesis

A

Depression causedb y monoamine deficiency

Diminished serotinin, adrenergic, dopaminerigc NT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

SSRIs
SNRIs
Atypical
TCAs

effect on monoamines and onset

A

Serotonin

Serotonin and NE

Individual effects on serotonin, NE, or dopamine

Serotonin and NE

Onset make take several weeks so MOA could be more complicated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Most to least specific

A

SSRIs
SNRIs
Atypical
TCAs

Incidence and variety of adverse effects increase as you move to TCAs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Options for resistant depression

MOno

comb

A 
Increase dose 
Switch to different class or same class

Careful use from two classes
Augmenting drug

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Augmenting drugs

A

Apriprazole is most common
Lithium

Most are known to increase synthesis/release of monoamines

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Use of SSRIs in depression

A

Usually drug of choice due to low incidence of side effects

Long delay for effects to occur (6-8 weeks)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

SSRIs MOA

A

Main receptor is SERT, presynaptic transporter which removes 5HT from synaptic cleft

Additional targets could also enhance on pre and post membrane

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

BDNF effect

A

Increase serotonin means increase in BDNF means increase neuronal growth and synapse formation means reorganzation

In hippocampus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is unique about escitalpram, sertraline and fluoxetine

A

Escitalopram is most specific

Sertraline is also weak inhibitor of dpoamine reuptake in addition to being an SSRI

FLu blocks NE reuptake and 5HT2C receptors in addition to SSRI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Discontinuation syndrome

A

GI symptoms, need to taper dose

Fluoxetine is best for this because long lived active mtabolite

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

SSRIs with CYP450 interactions

A

Fluoxetine and Sertraline

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Serotonin syndrome

A

Basically all antidepressants except for bupropion and atypicals

Early - NM probs, cog probs, temp control

Late - Tonic-clonic convulsions

Any drugs that increase sertoonin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Adverse effects of SSRIs

A

Nausea, GI, cramping
Activating/insominia
Anorgasmia
Anti-platelet effect

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

SSRIs and pregnancy and black box

A

Paroxetine is only one

Postnatal adaptation syndrome and pulmonary hypertension risk

Pediatric suicidality below 24

17
Q

Venlafaxine special

A

NE reuptake inhibition is lower so it behaves more like SSRI at low doses

18
Q

SNRIs vs SSRIs and adverse effects

A

More widely used in chronic pain disorders

Sexual adverse effects
Discontinuation symptoms
Nausea/GI cramping all from serotonergic…more with venlafaxine

Hypertension from noradrenergic effect

19
Q

Bupropion unique, interaction, contraindcation

A

NE reuptaker inhibitor and Dopamine reuptake inhibitor

NO serotonin effects so no sexual/GI

Enhanced noradrenergic and dopaminergic transmission

CYP2D6

Lowers seizrue threshold so no in epilepshy

20
Q

MIrtazapine mech

A

Blocks presynaptic alpha 2 adrenergic inhibitory receptors to increase CNS noradrenergic and seroteonergic activity

H1 histaminergic blocker for sedation and increased appetite

LIttle 5-HT uptake inhibition so decreased SSRI like adverse effects

21
Q

Sturctures of TCA s

A

Nortriptyline is active mtabolite of amitriptyline

22
Q

Antidepressant mechansim of action for antidepressant

A

serotonin reuptake and NE reuptake blocker s

23
Q

Secondayr vs teriatry amines

A

Secondary affect NE more than 5-HT

Teritary more balanced

24
Q

TCA other uses and overdosage

A

Neuropathic pain

INitial excitatory phase…subsequant depressant phase…cardiac arrythmias

Suicide prevention needs to be considers

25
Q

TCA adverse effects

A

Anti-histaminergic (sedation)
Anti-muscarinic
Anti-adrenergic (orthostatic hypotension)
Cardiac toxocity (Na blcok)

26
Q

What should you start on?

What should be used for tx resistant or refractory

A

SSRI, SNRI, bupropion, mirtazpine

TCAs and MAOIs

27
Q

What to avoid in

HTN
Cardaic
Obesity
Chronic pain

A

SNRIs, TCAs

TCAs

SSRIs/SNRIs/Buproprion usually preferred…avoid mirtazapine/TCAs

Tx with SNRIs or TCAs

Psych 1 (17 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions