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depression Flashcards

(74 cards)

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1
Q

what are the nerve cells of the brain

A

neurons and glial cells

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2
Q

dienacephalon

A

made up of thalmus and hypothalmus

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3
Q

medulla oblongata

A

regulates cardiovasculature, digestive tract, and respiratory tract

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4
Q

cerebellum

A

coordinates motor stimulations and controls posture

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5
Q

limbic system

A

pre frontal cortex,thalmus, hypothalmus, temporal lobe, and these structures: amygdala, hypocampus, nucleus acumbens: regulates emotional responses

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6
Q

amygdala

A

emotions (example, hipocampus decides what emotions will go with what situations)

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7
Q

hipocampus

A

learning and memory consolidations (feeds into the amygdala what is remembered from past experiences with situations)

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8
Q

nucleus accumbens

A

reinforcement of behaviors

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9
Q

what occurs in the post synaptic membrane

A

receptor binding

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10
Q

what neurotransmitters are monoamines

A

DA,NE, epinephrine, seritonin (from trytophan) , histamine

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11
Q

what neurotransmitters are catacholamines

A

DA and NE from tryosine

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12
Q

what kind of receptor is 5-HT, D, and adrenergic

A

G coupled, increase cAMP or Ca (excitatory)

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13
Q

un-coupling

A

kinase on the G receptor is phosphorylated so that G proteins can’t be activated

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14
Q

receptor down regulation

A

receptor is endocytosed and degraded

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15
Q

monoamine theory

A

a decrease in available monoamines causes synaptic connections to be rerouted or lost, this is supported because drugs that increase the amount of monoamines in the cleft help reverse depression

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16
Q

HPA theory

A

increased cortisol and CRH. increased cortisol damages hipocampus so it can’t inhibit CRH so more CRH and more cortisol is made.CRH can inhibit an emotional response in the amygdala and nucleus accumbans. This plus repeated stress causes depression

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17
Q

effect of long term reuptake inhibition

A

autoreceptor signaling is decreased, biosynthesis of monoamines is increased, and post synaptic receptor are down regulated

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18
Q

whats the biggest sign of depression in kids

A

anhedonia, loss of interest

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19
Q

what are the diagnostic symptoms of depression

A

Depression, Interest, Guilt, Energy, Sleep, Concentration, Appetite, Suicidal ideation (5+ symptoms with at least one being depression or loss of interest)

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20
Q

goals of acute phase

A

remession, 3 weeks without depression and no more than 3 symptoms

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21
Q

goals of continuation phase

A

prevent relapse

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22
Q

goals of maintenence phase

A

prevent new episode or reoccurence

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23
Q

vortioxetine

A

SSRI

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24
Q

tranylcypromine

A

MAOI

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25
levomilnacipran
SNRI
26
Imapramine
TCA
27
Which of the following has the most severe side effects: | Paroxitine, vortoxitine, levomilnacipran, desimapramine
desimapramine
28
which can't be taken with hard cheese: selgeline, levomilnacipran, imapramine, vortioxetine, vilazadone
selgeline
29
what's the Pgp do?
pumps things, like drugs, back out of the brain
30
what are the secondary ways that reuptake inhibitors may help depression
increase cAMP thus increasing growth of neurons, increase BDNF, down regulating post synaptic receptors
31
what is known about antidepresents mechanisms
they increase amount of monoanimes in the post synaptic cleft and they cause secondary effects that help
32
what causes a greater chance of withdrawl in antipsychotic drugs
shorter half lives
33
anxiety, crying spells, insomina, nausea, vomitting, parasethias, and flu like symptoms (FINISH)are what
seratonin withdrawl symptoms
34
this SSRI is an enatmerically pure form of another SSRI
ecitalopram
35
at low doses this SNRI is an SSRI
venlefaxine
36
which class of drugs can increase BP
SNRI
37
BK has narrow-angle glaucoma, which drug can he not take
levomilacipran
38
which TCA's have a higher affinity for serotonin
amytriptylan and imapramine
39
which TCA's have a higher affinity for NE
nortryptylan and desimapramine
40
which drugs should not be taken if patient has cardiovascular problem
TCA's, MAOI's, mirtazapine and duloxetine
41
if BK is having suicidal thoughts what main drug type should he stay away from and why
TCA, has a smaller therapeutic window then others
42
what is mertazapines mechanism of action
5-HT and adrenergic antagonist, potent H1 inhibitor, low muscarinic effect
43
weight gain is probably from antagonizing which receptor
H1
44
which antipsychotic can be used for nicotine cessation
buproprion
45
what is buproprions mechanism
unknown but appears to block reuptake
46
which medication should be avoided with seizures
buproprion
47
which med should be avoided in alcohol withdrawl, or eating disorders
buproprion
48
what are the phenylpipridines
nefazadone, vilaxadone
49
what is the triazlopropridine
trazdone
50
what is the mechanism of trazadone and nefazadone
they block 5 ht
51
what is the mechanism of vilaxadone
it is an agonist at 5 ht
52
MAOI's ______ inhibit MAO
irreversibly
53
when switching from selgeline to amytriptaline how long should you wait
2 weeks
54
when switching from paroxitine to tranycloprimine you should wait
2 weeks
55
when switching from fluoxetine to phenelizine you should wait
5 weeks
56
which SNRI is metabolized by the kidney
levomilnacipran
57
which drugs go through glucoronidation
SNRI's, TCA's, and mirtazapine
58
what does 2B6 metabolize
buproprion and MAOI's
59
which drugs would need to be decreased or avoided if a patient is a poor metabolizer?
SNRI, TCA, and mirtazapine
60
who are the major 2D6 inhibitors
Vortioxetine, fluoxetine, paraxetine, duloxetine, buproprion
61
who are the major 2C ihibitors
Sertraline
62
why can't MAOI's be taken with tryamine foods (hard cheese, pickled foods, wines)
tryamine is a precourser to catalcholamines so it would cause serotonin syndrome, worst with MAO-A
63
best meds for insomnia and depresssion
TCA and mirtazapine
64
what med is best for migraines
amtriptalyn
65
what med is best for pain
duloxitine
66
which med is use adjuctively for insomnia
trazadone
67
what meds can be used as add on
alpipramine, olonzapine, quatrapine, buprorion, mirtazapine
68
when should patients fill out the rating scale
beginning, 6-8 weeks, then periodacly
69
what are symptoms of serotonin syndrome
tremor, myoclunus, hyperreflexia, hyperpyrezxia, tachycardia, tachypina, diaphorisis, mydridis, agitation, anxiety, confusion
70
weight gain
TCA's, MAOIs mirtazapine
71
best for not getting sexual dysfunction
buproprion, mirtazapine
72
considerations for elderly
starting does cut in half, SSRI's can mess with antiplatelet drugs, can take up to 12-16 weeks to work
73
pregnancy
fluoxetine, citalpram, TCA
74
how does vortioxetine work
inhibits reuptake of serotonin and is also an agonist, partial agonist, and antagonist at different 5-ht receptors

depression (3 decks)

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