Chapter 21 - Antidepressant Agents Flashcards Preview

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Flashcards in Chapter 21 - Antidepressant Agents Deck (11):
1

Imipramine (I) (A)

Tricyclic Antidepressant

I: Relief of Symptoms of Depression; enuresis in children over 6 years, offlabel: control of chronic pain

A: Inhibits presynaptic reuptake of NE and serotonin; anticholinergic at CNS and peripheral receptors; sedating.

2

Imipramine (AE)

Sedation
Anticholinergic effects
Ortho HOTN
Bone Marrow depression

3

Imipramine (CI-DD)

CI: Recent MI
myelography within the next 48 or previous 24 hours
MAOI
Manic depressive PT
BLACK BOX: increased suicide in adolescents and children

DD: Oral anticoags (^ effect and bleeding)
sympathomimetics
MAOIs and TCAs

4

Phenelzine (I)

Monoamine Oxidase Inhibitors

Treatment of patients with depression who are unresponsive to other antidepressive therapy or in whom other antidepressive therapy is CI

5

Phenelzine (A)

Irreversibly inhibits Monoamine Oxidase allowing NE, 5HT, and dopamine to accumulate in the synaptic cleft

6

Phenelzine (AE)

Overactivity
Hyperreflexia
potential for hypertensive crisis
tremors

7

Phenelzine (CI-DD)

CI:Pheochromocytoma
CV disease, CAD, CHF
Abnormal CNS vessels, headaches
Psychiatric PT
BLACKBOX: suicide in adolescents and children

DD: MOAI and other Antidepressants lead to HTN crisis, coma, convulsions with TCAs
SSRIs: serotonin syndrome
wait 6 weeks to start them
Insulin (hypoglyc effects)

8

Fluoxetine (I)

SSRI
Treatment of...
Depression
OCD
Bulimia
Premenstrual dysphoric disorder
Panic disorders
OFFLABEL: chronic pain, alcoholism, neuropathies, obesity

9

Fluoxetine (A)

Inhibits CNS neuronal reuptake of 5HT, with little effect on NE and little affinity for cholinergic, histaminic, or alpha adrenergic sites.

10

Fluoxetine (AE)

Nervousness
Insomnia
Upper resp infections
Sexual dysfunction

11

Fluoxetine (CI-DD)

CI: Diabetes
Severely depressed or suicidal PT (increased risk)

DD: MAOIs (allow 2-4 weeks)
TCAs increased therapeutic and toxic effects