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Flashcards in Depression Deck (78):
0

NMDA antagonist that has recent interest in use in depression

Ketamine

1

3 important roles of NE

1. sleep and arousal
2. attention
3. learning and memory

2

2 ways in which catecholamines are metabolized

1. Monoamine oxidases (MAO)
2. catechol-O-methyltransferase (COMT)

3

Types of NE receptors

alpha and beta adrenergic metabolotropic receptors

4

NE pre-synaptic autoreceptor that is important in feedback inhibition

alpha2 receptor

5

Where the majority of neurons that synthesize serotonin are located

raphe nuclei

6

Serotonin receptor that is a ligand-gated ion channel

5HT3

7

Serotonin receptor that is a pre-synaptic auto-receptor that is important in feedback inhibition

5HT1D

8

Enzyme that metabolizes serotonin within the neuron

MAO

9

Main precursor of serotonin

tryptophan

10

Enzyme involved in the synthesis of both serotonin and NE

aromatic L-AA decarboxylase

11

3 MAO-Is that are exhibit non-selective MAO-A and B irreversible inhibition and increase synaptic 5HT, NE and DA

1. Pheneizine
2. Transylcypromine
3. Isocarbazid

12

MAOI that exhibits selective MAO-A irreversible inhibition and increases synaptic DA

Selegiline TS

13

Cut off below which selegilline does not have dietary restrictions

6 mg

14

Toxicity that can occur if MAOIs are taken with tyramine-containing foods

hypertensive crisis

15

Drug that is used in the case of hypertensive crisis associated with MAOIs

Phentolamine

16

Drug is a non-selective serotonin antagonist that can be used to help reverse serotonin syndrome

cyproheptadine

17

5 tertiary amine TCAs that have NE > 5HT reuptake

1. amitryptyline
2. imipramine
3. trimipramine
4. clomipramine
5. doxepin

18

Only TCA that has sig. 5HT reuptake inhibition

Clomiptamine

19

SSRI that has been shown to be safely used post-MI

Sertraline

21

3 secondary amine TCAs that have selective NE reuptake inhibition, less antimuscarinic action, less sedation, and less postural hypotension

1. Desipramine
2. Nortriptyline
3. Protriptyline

22

5 patient populations to use caution with TCAs

1. underlying CV disease
2. seizure disorder
3. angle-closure glaucoma
4. urinary retention
5. elderly

23

3 main adverse effects of TCAs

1. atropine-like effects (dry mouth, blurred vision, constipation, urinary retention)
2. orthostatic hypotension
3. sedation

25

5 SSRIs

1. Fluoxitine
2. Paroxetine
3. Sertraline
4. Citalopram
5. Escitalopram

26

Initial adult dose of citalopram

20 mg QD

27

Max adult dose/day of citalopram

40 mg

28

Initial adult dose of escitalopram

10 mg QD

29

Highest rate of sexual dysfunction and weight gain of the SSRIs

Paroxitine

30

SSRI that is pregnancy category D

Paroxitine

33

SSRI that has the highest rate of diarrhea

Sertraline

34

Initial adult dose of fluoxitine

10 mg QD

37

Max adult dose/day of escitalopram

20 mg

38

Initial adult dose of paroxitine CR

25 mg QD

39

Max adult dose/day of fluoxitine

80 mg

40

Max adult dose/day of paroxitine CR

62.5 mg

41

SSRI that has the longest half-life

Fluoxitine

42

5 SNRIs

1. Duloxetine
2. Venlafaxine
3. Desvenlafaxine
4. Milnacipran
5. Levomilnacipran

43

SNRI that is only FDA approved for fibromyalgina, not depression

Milnacipran

44

Initial adult dose of duloxetine

20-30 mg BID

45

Max adult dose/day of duloxetine

60 mg

46

Initial adult dose of venlafaxine

25 mg TID or 37.5 mg BID

47

Max adult dose/day for venlafaxine

375 mg

48

Initial adult dose of venlafaxine ER

75 mg QD

49

Max adult dose/day of venlafaxine ER

225 mg

50

2 drugs that are selective serotonin reuptake inhibitors and are partial 5HT1A receptor agonist

1. Vilazodone
2. Vortioxtine

51

2 drugs that are weak serotonin reuptake inhibitors and 5HT2A and 5HT2C receptor antagonist

1. Trazodone
2. Nefazodone

52

Black box warning for nefazodone

Rare hepatic failure

53

Drug that inhibits dopamine and NE uptake

Buproprion

54

Initial adult dose of buproprion IR

100 mg BID

55

Max adult dose/day of buproprion IR

450 mg

56

Initial adult dose of buproprion SR

150 mg QD

57

Max adult dose/day of buproprion SR

400 mg

58

Initial adult dose of buproprion XL

150 mg QD

59

Max adult dose/day of buproprion XL

450 mg

60

Drug that is an alpha-2, 5HT2, 5HT3 and H1 antagonist

Mirtazapine

61

Initial adult dose of mirtazapine

15 mg QHS

62

Max adult dose of mirtazapine

45 mg

63

SEs of mirtazapine

sedation and weight gain

64

Neuronal growth factor that antidepressants may cause the upregulation of

BDNF (brain derived neurpotropic factor)

65

Transcription factor that regulates BDNF

CREB (cyclic AMP responsive element binding protein)

66

Typical duration of an untreated MDE

at least 6 months

67

Typical duration of a treated MDE

4-5 months

68

QIDS score that indicates no depression

0-5

69

QIDS score that indicates mild depression

6-10

70

QIDS score that indicates moderate depression

11-15

71

QIDS score that indicates severe depression

16-20

72

QIDS score that indicates very severe depression

>20

73

QIDS score that indicates a response (regardless of starting score)

6-8

74

QIDS score that indicates remission

<6

75

The return of symptoms meeting full criteria within 6-12 months following remission of the index episode

Relapse

76

Occurrence of a new episode following 6-12 months of full and sustained remission from the index episode

Recurrence

77

5 most common residual symptoms

1. Insomnia
2. Fatigue
3. Pain
4. Difficulty concentrating
5. Lack of interest

78

Max adult dose/day of sertraline

200 mg

79

Max adult dose/day of paroxitine

50 mg

81

Initial adult dose of sertraline

50 mg QD

86

Initial adult dose of paroxitine

20 mg QD

97

Main precursor of NE

Tyrosine

99

Where neurons that synthesize NE primarily originate from

locus ceruleus