antidepressants

Question 1

mechanism of antidepressants

Answer 1

potentiate action of ne and serotonin in the brain

as depression is due to deficiency of monoamines

Question 2

antidepressants

Answer 2

SSRI
SNRI
TCA 
ATYPICAL ANTIDEPRESSANTS
MAOI

Question 3

SSRI

Answer 3

CITALOPRAM 
ESCITALOPRAM
FLUOXETINE
PAROXETINE
SERTALINE
LESSER SIDE AFFECTS AS COMPARED TO OTHER ANTIDEPRESSANTS
needs 2 weeks for action in mood change,ocd,gad,PMS,bulimia
cause hepatic toxicity

Question 4

fluoxetine

Answer 4

treat bulimia
SSRI very long half life 50 hrs
potent inhibitor of cyp system with paroxetine
doesn’t cause discontinuation syndrome

Question 5

SSRI increased with food

Answer 5

sertraline

Question 6

serotonin adverse effects

Answer 6

agitation sexual dysfunction
headache sweating
insomnia 
diarrhea vomit nausea
WEIGHT CHANGE
HYPONATREMIA

Question 7

SSRI USED FOR DIFFICULT SLEEPING

Answer 7

FLUVOXAMINE PAROXETINE

Question 8

SSRI USED IN EXCESSIVE SOMNOLENCE

Answer 8

FLUOXETINE

SERTALINE

Question 9

SSRI LESS SEXUAL DYSFUNCTION

Answer 9

bupropion

mitrazapine

Question 10

fluoxetine
sertraline
fluvoxamine

Answer 10

treat OCD in children

Question 11

treat child depression

Answer 11

fluoxetine escitalopram

Question 12

citalopram

Answer 12

SSRI

causes long QT syndrome cardiac arrythmias

Question 13

serotonin syndrome

Answer 13

SSRI used with MAOI
hyperthermia, muscle rigidity, myoclonic seizures ,altered mental status
dec seizure threshold with antidepressants

Question 14

discontinuation syndrome

Answer 14

all ssri can cause after abrupt withdrawal specially with lower half lives
headache malaise flu like symptoms agitation disturbed sleep

Question 15

SNRI

Answer 15

used when depression with chronic pain usually diabetic neuropathy, fibromyalgia,low back pain
venlafaxine 
levomilnacipran
duloxetine
ppt discontinuation syndrome

Question 16

venlafaxine

Answer 16

low dose serotonin uptakeinhibitor and at moderate dose NE UPTAKE inhibited

Question 17

duloxetine

Answer 17

typical NSRI

moderate inhibitor of CYP system

Question 18

levomilnacipran

Answer 18

treat depression in Europe

cyp substrate

Question 19

atypical antidepressants

Answer 19

BUPROPION
MITRAZAPINE
NEFAZODONE
TRAZODONE
VILAZODONE
VORTIOXETINE

Question 20

BUPROPION

Answer 20

dec cravings not used with bullimic pt
attenuate nicotine withdrawal symptoms
inc risk of seizure
weak dopa and NE reuptake inhibitor

Question 21

mirtazapine

Answer 21

enhance serotonin and NE by antagonizing alpha2 adrenergic and 5HT2 +H1 antihistaminic causing sedation and antidepression
WEIGHT GAIN
help depressed people to sleep

Question 22

nefazodone and trazodone

Answer 22

weak serotonin reuptake inhibitor 
block 5HT(2alpha) receptor and h1 antihistamine 
trazodone PRIAPISM 
nefazodone HEPATIC TOXICITY
alpha 1 antagonist
sedative effects

Question 23

vilazodone

Answer 23

serotonin uptake inhibitor 5HT(1A)

PARTIAL AGONIST SSRI

Question 24

VORTIOXETINE

Answer 24

5HT1A agonism
5HT3/7 antagonism
perfect treat depression

Question 25

TCA

Answer 25

``` TERTIARY AMINES elevate mood euphoria alertness and inc muscle activity 2 weeks to work block NE n serotonin uptake sensitive to CYP system AMITRYPTALINE IMIPRAMINE CLOMIPRAMINE DOXEPIN DESIPRAMINE(ONLY NE) NORTRPTALINE MAPROTILINE(ONLY NE) AMOXAPINE ```

Question 26

AMOXAPINE

Answer 26

BLOCK 5HT2 and D2 receptor

Question 27

imipramine

Answer 27

control bed wetting in children above 6 years replaced by desmopressin least likely to cause orthostatic hypotension

Question 28

amitryptaline

Answer 28

prevent migraine headache and rate chronic pain syndromes

Question 29

doxepin

Answer 29

low dose TCA treat insomnia

Question 30

TCA SIDE EFFECTS

Answer 30

CONTRAINED IN BIPOLARS narrow therapeutic index avoid In BPH,epilepsy,preexisting arrhythmia long qt may b

Question 31

last line agents MAOI

Answer 31

MAO inhibit excess release of neurotransmitters which may leak out do MAOI accumulates NT'S in the synapse phenelzine(irreversible) trancylpromine selegiline(transdermal anti parkinsonian) isocarboazid as found in gut n liver a lot inhibition cause toxicities used in pt where none of other antidepressants work(atypical depression )

Question 32

tyramine products

Answer 32

cheese chicken liver pickled/smoked fish red wine inactivated by MAO HYPERTENSIVE CRISIS SEEN IF TYRAMINE +MAOO

Question 33

HYPERTENSIVE CRISIS

Answer 33

tyramine +maoi occipital headache, stiff neck, tachycardia,hypertension arrhythmia,seizures stroke treat with PHENTOLAMINE AND PRAZOSIN

Question 34

TREAT MANIA AND BIPOLAR

Answer 34

lithium very toxic at high dose renal best with liver failure patients

Question 35

lithium adverse effects

Answer 35

``` headache dry mouth polydipsia polyruria polyphasic gi distress hand tremor dizziness dermat Rxn THYROID FUNCTION REDUCED ```