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Flashcards in Antidepressants Deck (39):
1

What drugs are first line for depression?

SSRIs

2

What is the mechanism of action of SSRIs?

selectively inhibits reuptake of 5HT from postsynaptic cleft

3

What does SSRI stand for?

selective serotonin reuptake inhibitors

4

What are some examples of SSRIs?

sertraline
citalopram
fluoxetine

5

What SSRI is licensed in children?

fluoxetine

6

What SSRIs are safe in pregnancy?

sertraline and fluoxetine

7

What SSRI is good for use in patients with epilepsy?

citalopram

8

What SSRI can prolong the QTc interval?

citalopram

9

What SSRI is good for use in patients with cardiac problems?

sertraline

10

What are some discontinuation side effects of SSRIs? How can these be avoided?

diarrhoea
sweating
postural hypotension

gradually decrease dose over 4 weeks instead of coming off all at once

11

What are the side effects of SSRIs?

sexual dysfunction
vivid dreams
headache
nausea
sweating

12

SSRIs are safe in overdose - true or false.

True

13

When should you take SSRIs?

in the morning

14

How long should an antidepressant be trialled before trying something else?

4-6 weeks

15

Which antidepressant can cause an increase in suicidal idealisation in under 25s?

SSRIs

16

What antidepressant class should you try if SSRIs aren't working?

SNRIs

17

What does SNRI stand for?

serotonin and noradrenaline reuptake inhibitors

18

What is the mechanism of action of SNRIs?

block reuptake of NA and 5HT into presynaptic cleft

19

What are some examples of SNRIs?

duloxetine
venlafloxine

20

When should you take SNRIs?

IN the morning

21

What are some examples of tricyclic antidepressants?

amitryptilline
lifepramine
imipramine

22

Are tricyclics toxic in overdose?

Yes - cardiotoxic
don't give to people with a history of suicide attempt by overdose

23

What is the mechanism of action of tricyclic antidepressants?

block reuptake of NA and 5HT

24

When do you take tricyclic antidepressants? Why?

At night - sedation

25

What are the side effects of tricyclic antidepressants?

weight gain
anticholinergic effects - dry mouth, constipation, urinary retention
arrhythmias
postural hypotension

26

What is the mechanism of action of monoamine oxidase inhibitors?

inhibit MAO A and B enzymes

27

What are some examples of MAO inhibitors?

phenylzine
mobeclomide

28

When are MAO inhibitors used? Why?

IN resistant depression - due to side effects and diet restriction

29

Why is diet restricted with MAO inhibitors?

Can cause hypertensive crisis
Build up of tyramine (usually broken down by MAO enzymes) - in certain foods e.g. cheese, chocolate
Potent releasor of NA --> hypertension

30

What are some symptoms of hypertensive crisis?

nose bleeds
anxiety
SOB
headache

31

How is a hypertensive crisis treated?

phentolamine infusion

32

What are some side effects of MAO inhibitors?

insomnia
postural hypotension
jaundice
oedema
rare - liver damage

33

What does NaSSA stand for?

noradrenergic and specific serotonergic antidepressant

34

What is an example of NaSSA?

mirtazapine

35

When is mirtazapine used?

If SSRI/SNRIs haven't worked

36

What is the mechanism of action of mirtazapine?

blocks alpha 2 and 5-HT 2 and 3

37

What can you give with mirtazapine to stop the seratonergic side effects?

SSRI

38

What are side effects of mirtazapine?

weight gain
sedation - good in insomnia

39

What happens if you take mirtazapine with alcohol?

GI upset