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Psych Exam 1 > Antidepressants - Linger > Flashcards

Antidepressants - Linger Flashcards

(86 cards)

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1
Q

citalopram

A

SSRI

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2
Q

escitalopram

A

SSRI

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3
Q

fluoxetine

A

SSRI

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4
Q

fluvoxamine

A

SSRI

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5
Q

paroxetine

A

SSRI

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6
Q

sertraline

A

SSRI

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7
Q

duloxetine

A

SNRI

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8
Q

venlafaxine

A

SNRI

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9
Q

amitriptyline

A

TCA

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10
Q

desipramine

A

TCA

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11
Q

imipramine

A

TCA

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12
Q

nortriptyline

A

TCA

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13
Q

trazodone

A

5-HT2 antagonist

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14
Q

bupropion

A

tetracyclinc/unicyclic

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15
Q

mertazapine

A

tetracyclic/unicyclic

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16
Q

selegiline

A

MAOI

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17
Q

antidepressants

A

affect serotonin, NE, or both

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18
Q

reserpine

A

decreases biogenic amines

blocks vesicular uptake of monoamines

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19
Q

neurotrophic factor

A

BDNF
-growth factor -neurogenesis

involved mood and depression disorders

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20
Q

fluoxetine

A

long t-1/2

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21
Q

selegiline

A

transdermal and sublingual forms

-decrease food interactions

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22
Q

SSRI MOA

A

inhibit serotonin transporter - SERT

increased serotonin at synaptic cleft

80% blocked - therapeutic dosage

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23
Q

possible chronic adapatation to SSRIs

A

downregulation of postsynaptic 5-HT2 receptor density

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24
Q

SNRI MOA

A

inhibit SERT and NET

higher affinity of SERT than NET

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25
TCA MOA
inhibit SERT and NET different TCAs - different affinities for SERT and NET
26
TCA
also have high affinity - adrenergic, cholinergic, histmaine receptors -more side effects
27
trazodone
5-HT2 antagonist
28
nefazodone
5-HT2 antagonist counterintuitive why they work
29
suicide patients
more 5-HT2 receptors - overdensity may be involved in path of depression
30
bupropion MOA
selective inhibitor of DAT - dopamine transporter stimulate presynaptic release of NE and DA no effect on serotonin
31
MAOI MOA
mitochondrial enzyme - MAO - metabolize monoamines to inactive metabolites MAO-A - NE and 5-HT cause accumulation of NE, 5-HT, DA in vesicles of nerve endings
32
tyramineselegiline MOA
metabolized by MAO-A and MAO-B with MAOI - can get accumulation - not goodselective irreversible MAO-B inhibitor (low dose and nonselective MAO-A/B inhibitor - high dose (refractory depression)
33
1-2 months
until max benefit of antidepressants adequate response achieved - recommend minimum 6-12 months of tx
34
85% patients with major depressive disorder
have at least one recurrence in lifetime
35
>2 MDD episodes in 5 years, or >3 episodes lifetime
long-term maintenance anti-depressant therapy
36
tx of anxiety disorders
many SSRI and SNRIs approved
37
antidepressants vs. benzos for anxiety
antidepressants - slower acting, but no risk of dependence
38
OCD tx
respond to serotonergic agents fluoxetine, fluvoxamine, paroxetine, clomipramine
39
premenstrual dysphoric disorder tx
SSRIs - fluoxetine and sertraline
40
smoking cessation tx
bupropion reduce urge to smoke
41
eating disorder tx
antidepressants | -tx of bulimia, not nervosa
42
insomnia tx
amitriptyline and trazodone depression related insomia
43
HA tx
SSRIs less effective than TCA in chronic tension HAs
44
tx pruritis
TCA - antihistamine
45
finding right antidepressant for patient
empiric - trial and error
46
first line tx MDD and anxiety
SSRI less cardiotoxic with OD fewer antimuscarinic properties
47
pt cannot tolerate sexual dysfunction
bupropion
48
bupropion and mirtazapine
common combined with other antidepressants - augment therapeutic response
49
TCA and MAOI
lethal in OD
50
patient under age 25
increased suicidality with all antidepressants but untreated depression - even more risk of suicide
51
adverse SSRIs
minor sedation and antimuscarinic GI - N/V, upset stomach, constipation diminished sexual function - loss libido, delayed organism HA, insomnia, hypersomnia, weight gain
52
discontinuation syndrome
of SSRIs dizzy and paresthesia withdraw agents with short half lives - paroxetine and sertraline
53
short half life SSRI
paroxetine and sertraline withdraw - discontinuation syndrome
54
CI of SSRI
active manic episode paroxetine CI in pregnant
55
CI in pregnant
SSRI paroxetine
56
SNRI ADRs
insomnia, anxiety, agitation elevated BP and HR
57
increased risk of bleeding
venlafaxine antiplatelet aggregation effect more cardiac toxicity in OD as well
58
TCA ADRs
anticholinergic - drowsy, dry mouth, constipation, urinary retention, blurry vision, confusion orthostatic hypotension (a-adrenergic block) weight gain - H1 histamine antagonist cardiotoxicity, arrhythmia, convulsion, hepatic dysfxn, hyponatremia sexual dysfunction
59
imipramine and amitriptyline
significant antimuscarinic and cardiac side effects
60
CI for TCA
arrhythmia, recent MI, liver disease, glaucoma, mania
61
5-HT2 antagonist ADRs
sedation and GI issues sexual dysfxn - uncommon orthostatic hypotension
62
black box warning for hepatotoxicity
nefazodone 5-HT2 antagonist
63
agitation, anorexia, insomnia
wuth bupropion
64
no sexual side effects
mirtazapine and bupropion
65
tyramine food
avoid if taking MAOIs
66
overdose
TCA - most toxic - arrhythmia, altered mental status, seizure also - MAOIs - potentially lethal - autonomic instability, hyperadrenergic symptoms, psychotic symptoms, confusion, delirium, fever, seizures
67
st johns wort
herbal tx of depression inducer of CYP450
68
serotonin syndrome
interaction of MAOI with SSRI, SNRI, TCA, and some analgesics overstiumation of 5-HT receptors
69
delirium, agitation, coma, HTN, tachy, hyperthermia, diaphoreses, myoclonus, hyperreflexia, tremor
serotonin syndrome
70
pt switched from SSRI to MAOI
therapy discontinued for at least 2 weeks - prior to initiation of new therapy - risk of serotonin syndrome
71
tx of serotonin syndrome
withdrawal offending drug - sedate -benzos intubate, ventilate 5-HT2 block - with cyproheptadine or chlorpromazine
72
tyramine foods
chocolate, meat, pickled, aged, cheeses, alcoholi metabolized by MAO if take MAOI - reduce metabolism - get catecholamine release - rise in HR and BP
73
attention, motivation, pleasure, reward
dopamine
74
alertness, energy
NE
75
obsession/compulsion
serotonin
76
bupropion
DA selective - low potency
77
more effective antidepressant therapy
combined with psychotherapy
78
inhibit neuronal 5-HT reuptake - little effect on DA and NE
SSRIs
79
bad interaction with alcohol
SSRI
80
cardiotoxicity
venlafaxine
81
tx smoking cessation
bupropion
82
ADR with therapeutic TCA
antimuscarinic effect arrhythmia and seizure - if OD
83
three Cs of TCA overdose
coma, cardiotoxicity, convulsions
84
tx enuresis
TCAs
85
tx premature ejaculation
SSRIs
86
tx bulimia nervosa
fluoxetine - and other SSRIs

Psych Exam 1 (16 decks)

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