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Flashcards in depression 2 Deck (18)
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1

It a patient has depression and anxiety, what first line MDD me should not be used

anxiety

2

bupropion inhibits what enzyme, interacting with what drugs

CYP 2D6 inhibitor; tamoxifen ritonavir

3

what is the MOA of trazodon

5-HT reuptake antagonist; 5HT2A antagonist; enhances 5HT1A neurotransmission

4

what are some side effects of trazodone

congestion
priapism
orthostatic hypotension
weight gain

5

what are the therapeutic uses of trazodone? how long are their onsets?

major depression = up to 6 week onset
hypnotic = 1-3 hours for onset

6

what drug works well with trazodone, increasing its concentration

fluoxetine

7

trazodone lacks blocking properties of what?

cholinergic receptors and norepinephrine reuptake

8

why is nefazodone rarely used

hepatotoxicity

9

If a patient can't tolerate an SSRI because of nausea, what is another good option?

mirtazapine

10

what component of mirtazapines MOA leads to weight gain

5HT2C antagonism

11

mirtazapines antagonism of what site decreases nausea

5HT3

12

what is the unlabeled use for mirtazipine

PTSD

13

True/ False:
the higher the dose of mirtazapine the more sedating

false; less sedating at high doses, more sedating at low doses

14

what are the adverse effects of tricyclic antidepressants

1. dry mouth
2. blurred vision
3. constipation
4. urinary retention
5. confusion

15

what is antagonized by tricyclics and what adverse effects do these cause

1. H1 histamine antagonism - sedation and weight gain
2. a1-adrenergic antagonism - orthostatic HTN and diaphoresis

16

Why should suicidal ideation patients not get a 30 day supply of TCA's

low therapeutic index; can be lethal in overdoses

17

what are the 4 contraindications with TCAs

1. QTc greater than 450
2. concomitant use of MAOI in the past 14 days
3. patients who are pregnant or lactating
4. patients with narrow angle glaucoma

18

what are the advantages of TCAs for depression

therapeutic levels can be drawn for adherence or toxicity