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Depression Flashcards

(78 cards)

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1
Q

With what drug can you not eat cheese?

A

MAO inhibitor antidepressants

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2
Q

What antidepressant is used for tobacco withdrawl?

A

bupropion

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3
Q

Clinically characterized by low self- esteem, anxiety and sadness as predominant symptoms

A

depression

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4
Q

psychomotor retardation and some typical somatic manifestations

A

depression

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5
Q

one of the most common psychiatric illnesses

A

depression

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6
Q

depression is more common in this gender:

A

females

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7
Q

depression has an abnormality in these neurotransmitters: (2)

A
  • serotonin

- noradrenaline

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8
Q

the most serious form of cyclical depression with periods of normality is

A

primary depression

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9
Q

What causes secondary depression? (3)

A
  • strokes
  • parkinson’s disease
  • hormonal disorders
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10
Q

What causes reactive depression? whats the prognosis?

A

stressful life situations

-high intensity but good prognosis

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11
Q

Mechanism of action for antidepressants? (2)

A
  1. By inhibiting the action of MAO

2. Blocking or delaying the reuptake of NT

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12
Q

How long does depression medication need to be taken before it is known if it is effective or not

A

2-4 weeks

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13
Q

How long do we prescribe antidepressives for?

A

4-6 months

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14
Q

is withdrawl possible with antidepressants?

A

yes with possible relapse

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15
Q

MAO-A location

A

intestine

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16
Q

MAO-B location

A

brain

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17
Q

what is MAO?

A

monoaminoxidase - enzyme that metabolizes noradrenaline and serotonin

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18
Q

What are the two mechanism types of antidepressants?

A
  • reuptake inhibitors

- MAO inhibitors

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19
Q

Which antidepressant classes are the reuptake inhibitors? (3)

A
  • tricyclic antidepressants
  • selective serotonin reuptake inhibitors
  • other antidepressants
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20
Q

What are the tricyclic antidepressants? (2)

A
  • AMITRIPTYLINE

- IMIPRAMINE

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21
Q

What are the other antidepressants? (2)

A

VENLAFAXINE

DULOXETINE

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22
Q

First used to treat depression starting in the sixties

A

TRICYCLIC ANTIDEPRESSANTS

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23
Q

the reuptake inhibitor drugs act on which nuerotransmitters?

A
  • noradrenaline

- serotonin

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24
Q

tricyclic antidepressants mechanism of action? (6)

A

blocks:

  • reuptake of noradrenaline and serotonin
  • noradrenergic receptors (α1 and α2)
  • histamine H1
  • cholinergic (M)
  • dopamine (d2)
  • serotonin (5-ht2) -side effects
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25
mood improvement in tricyclic antidepressants takes how long?
2-3 weeks
26
tricyclic antidepressants do NOT cause... (2)
euphoria | addiction
27
tricyclic antidepressants indications? (3)
- pain at night (sedative effect - adjuvant analgesic) - nocturnal enuresis - anorexia - migrane prophylaxis
28
What is nocturnal enuresis?
involuntary urination that happens at night while sleeping
29
Which antidepressant is an adjuvant analgesic?
tricyclic antidepressants
30
tricyclic antidepressants route of administration?
oral
31
tricyclic antidepressants half life?
10-20 hours | -1 or 2 daily doses
32
tricyclic antidepressants metabolism?
hepatic
33
tricyclic antidepressants elimination?
renal
34
tricyclic antidepressants lipid solubility? cross BBB?
high | yes
35
tricyclic antidepressants adverse reactions? (8)
- anticholinergic - sedation (anti-H1) - Arrhythmias and hypotension (blocking α1) - Agranulocytosis - Extrapyramidal reactions (parkinson-like) blocking D2 receptors - confusion + memory loss in elderly - weight gain - intoxication
36
What drugs cause Agranulocytosis
tricyclic antidepressants
37
What antidepressant causes psychosis?
tricyclic antidepressants | *suicide attempts
38
tricyclic antidepressant conrtindications? (2)
elderly | heart disease
39
tricyclic antidepressant drug interactions? (4)
- Sympathomimetic drugs - Anticholinergics - antihistamines - antiparkinsonian drugs - MAOs - Enhance action of other CNS depressants
40
Which class of anti-depressants are safer but more expensive?
SSRIs
41
What drug do we use for buliemia? why?
SSRI - anxiolytic and anorectic effects Venlafaxine
42
SSRI mechanism of action
serotonin reuptake inhibitor
43
SSRI start to change mood after how long?
1-2 weeks
44
SSRI indications (2)
depression | bulimia
45
SSRI route of administration?
oral
46
SSRI metabolism?
active metabolites
47
SSRI protein binding?
high (80-95%)
48
SSRI adverse reactions? (2)
- GI intolerance: nausea and vomit | - anorexia
49
which antidepressants have fewer cardiovascular, anticholinergic, and neurological side effects?
SSRIs have less than tricyclic antidepressants
50
SSRI interactions? (3)
- enhance other CNS depressants - MAO - ASA
51
How does aspirin interact with SSRIs (2)
- displaces proteins binding to SSRI | - increases the free fraction
52
mechanism of action for venlafaxine?
-other antidepressant -inhibits norepinephrine and serotonin reuptake
53
What drug is a more potent inhibitor of serotonin?
venlafaxine
54
Venlafaxine has NO ___ & _____ effects
no anticholinergic effects & no hypotension
55
What adverse effects does venlafaxine have?
No significant adverse effects (mainly headache, hypertension, ...)
56
Which antidepressant doesnt have any significant adverse effects?
venlafaxine
57
Mechanism of action for MAO inhibitors?
inhibit the oxidative deamination of monoamines
58
What are the two MAO isoenzymes?
- MAO -A | - MAO-B
59
MAO-A acts with which neurotransmitters? (2)
unfolds: - serotonin (5-HT) - noradrenaline (NA)
60
MAO-A acts with which neurotransmitter?
metabolism of dopamine
61
Selective MAO inhibitors?
- inhibit MAO-A (CLORGILINE, MOCLOBEMIDE) | - or inhibit MAO-B (SELEGILINE)-> Treatment of parkinson
62
nonselective MAO inhibitors?
TRANYLCYPROMINE
63
How long to see theraputic effects of MAO inhibitors?
2 weeks
64
MAO inhibitor route of administration?
oral
65
MAO inhibitor metabolism?
liver
66
What drug is used when tricyclic or other antidepressants fail?
nonselective or MAO-A inhibitors
67
drug of choice in the atypical depressions and in mental disorders with an important anxiety component
MAO inhibitors
68
Drug used for agoraphobia and other phobias, panic attacks, obsessive-compulsive disorder
MAO inhibitors
69
What antidepressant can cause hepatitis?
MAO inhibitor
70
What antidepressant can cause leukopenia?
MAO inhibitor
71
MAO inhibitor adverse reactions? (5)
- Orthostatic hypotension - Sympathetic stimulation - Hepatitis - Leukopenia - Decrease of salivary secretion
72
MAO inhibitor interactions?
- FOOD:hypertensive crisis (tyramine reaction) - Antidepressants -hypertensive crisis - Sympathomimetic drugs: avoid adrenaline in local anaesthesia - Opioid analgesics (potentiation of these drugs)
73
What drugs can cause hypertensive crisis when taken with MAO inhibitors?
- food (tyramine reaction) | - antidepressants
74
With which antidepressant do we need to avoid adrenaline in local anaesthesia
MAO inhibitors
75
Which drug has an interaction with tyramine? what happens?
- MAO inhibitors | - hypertensive crisis
76
What foods have tyramine present in them?
- cheese - liver - sausages - chocolate - wine - beer
77
Why does MAO interact with tyramine?
- indirect sympathomimetic - tyramine is metabolized by MAO action - inhibition causes increased release of catecholamines and increase of BP
78
What other indications are antidepressants used for?
- Psychiatric pathology: Anorexia, bulimia - Tobacco withdrawal (Bupropion) - Adjuvant analgesics - migrane prophylaxis - nocturnal enuresis

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