Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Exam 6 > Depression > Flashcards

Depression Flashcards

(44 cards)

Start Studying
1
Q

What the 5 most popular SSRIs

A 
Citalopram (celesta)
Escitalopram (lexapro)
Fluoxetine (Prozac)
Sertraline (Zoloft)
Paroxetine (Paxil)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Which is the worse SSRI?

A

Paroxetine

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

What is the mechanism of SSRIs? How much activity inhibited at clinical doses? Why isn’t effect immediate?

A

Allosteric 5-HT inhibition.
80% inhibited
Clinical effect probably from overtime desensitization and down regulation of 5HT R’s

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

SSRIs have little affinity for ___, ____, or ____ receptors. Except for _____

A

histamine, α, or muscarinic

paroxetine (hits hist and muscarinic)

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

Fluoxetine is FDA approved for _____

A

bulimia

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

_______ is an SSRI that is safe to use in patients with CV disease

A

sertraline

SAD-HART trial

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

How long do Adverse effects from SSRIs last

A

1-2 weeks

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

What are some adverse effects from SSRIs

A

Nausea, GI upset, diarrhea (increase 5ht stimulation everywhere)
Headaches, insomnia
Sexual dysfunction

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

Paroxetine inhibits ________ which leads to even more sexual dysfunction than other SSRIs might cause

A

nitric oxide synthase

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

An AE of SSRIs that’s a concern for geriatric patients is ____________ due to __________

A

syndrome of inappropriate antidiuretic hormone secretion/hyponatremia
stimulation of arginine vasopressin from posterior pituitary

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

Paroxetine specifically has adverse effects of

A

increased weight gain, sexual dysfunction, sedation, anticholinergic adverse effects

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

Citalopram has the specific adverse effect _______.
What is the max dose that can be used in adults vs geriatrics?
What drug drug interaction does someone NEED to look for?

A 
QTc prolongation
40mg adults, 20mg geriatrics
CYP2C19 inhibitors (omeprazole PPI-> max 20mg)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Are SSRIs fatal in overdose?

A

no

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

What can happen if someone suddenly discontinues their SSRI?

A

dreams, paresthesias, flu like symptoms,

paroxetine specific-> cholinergic rebound

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

Which SSRI has a lower risk of withdrawal symptoms and why?

A

fluoxetine bc long half life and active metabolite

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

Which SSRIs are potent inhibitors of CYP2D6?

A

fluoxetine and paroxetine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What’s the deal with NSAIDs and SSRIs?

A

SSRIs prevent 5ht from being taken up into platelets and released for aggregation-> increase GI bleed risk

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Some groups of things that might cause serotonin syndrome?

Study These Flashcards
A

MAOIs, linezolid, triptans, tramadol

19
Q

What are 4 commonly used SNRIs?

Study These Flashcards
A

Venlafaxine (Effexor)
Duloxetine (Cymbalta)
Desvenlafaxine (Pristiq) (metabolite of venlafaxine)
levomilnacipran (fetzima)

20
Q

What is the MOA for SNRIs?

Study These Flashcards
A

inhibit 5ht and NE reuptake transporters

21
Q

What is special about the MOA of Venlafaxine? (what dose do you need)

Study These Flashcards
A

weak inhibitor of NE reuptake due to low affinity

Need dose greater than 150mg for SNRI. otherwise its just an SSRI

22
Q

What is special about duloxetine MOA?

Study These Flashcards
A

inhibits 5ht and NE at low doses

23
Q

Do SNRIs have affinity for histamine, α, or muscarinic receptors?

24
Q

SNRIs are useful in depression with _____ because ______

Study These Flashcards
A

lethargy

increase in NE

25
SNRIs can also be used in _______
anxiety, peripheral neuropathy, fibromyalgia
26
What are NE related AEs from SNRIs?
increased BP, HR, sweating | caution in patients with CV disease
27
What is the MOA of bupropion?
Inhibition of NE and DA. no effect at 5HT, muscarinic, α, or histamine
28
Bupropion can be used with another antidepressant for __________ and _______
anhedonia, low mood | decreased sexual dysfunction compared to other antidepressants
29
________ is the antidepressant of choice for depression with lethargy, lack of energy, sexual dysfunction and low mood
Bupropion | also helpful in smoking cessation, ADHD, and weight loss
30
Bupropion is not good when depression is comorbid with ____, _____, or _____
anxiety, irritability, insomnia
31
Bupropion _______ at really high doses. Where should you exhibit caution?
lower seizure threshold. Eds, epilepsy, alcoholism, CNS tumor
32
What are some adverse effects of bupropion?
nausea, agitation, tremor, insomnia, decreased appetite
33
What is the mechanism of action for MIrtazapine (remeron)
Antagonist at presynaptic auto and hetero α 2 and 5ht receptors -> increase release NE and 5HT NOT an reuptake inhibitor
34
What is Mirtazapine an antagonist at?
5ht2a, 5ht2c, 5ht3 Histamine 1 (good for insomnia) no activity at α 1 or muscarinic
35
Miratazapine will have an _____ in sexual dysfunction vs other antidepressants, useful in depression with __________
decrease | insomnia, weight loss, anxiety, N/V, failure to thrive
36
Do not use Mirtazapine in depression with __________
sedation, hypersonic, weight gain
37
What is the mechanism of tricyclic antidepressants?
Inhibit 5ht and NE reuptake transporters | high affinity for histamine, α 1, or muscarinic
38
When would you whip out the tricyclic antidepressants?
later stage. its as effective but less tolerated becasue more AEs and DDIs
39
Are tricyclic antidepressants lethal in overdose? if so, how?
Yes Inhibit Na channels->longer ventricular depolarization->QRS widen->arrhythmia Treat with sodium bicarb (displaces TCA)
40
What are TCA specific AEs and what population should they be avoided using in
anticholinergic (dry mouth, blurry vision, urinary retention, constipation) avoid in geriatric patients
41
What is the dietary restriction for MAO-Is?
don't eat tyramine rich foods -> increase in peripheral NE -> hypertensive crisis.
42
Are MAO I's fatal in OD?
yes
43
What is esketamine used for?
treatment resistant depression, rapid antisuicidal properties
44
What is brexanolone used for?
treatment for post partum depression

Exam 6 (14 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions