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Neuro > Depression > Flashcards

Depression Flashcards

1
Q

Neurotransmitters involved with depression…

A

NE, Dopamine, 5-HT(serotonin)

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2
Q

Depression drug good for noncompliant patient?

A

Long acting SSRI

Fluoxetine-PROZAC

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3
Q

Fluoxetine

A

Prozac

  • Morning dosing cause of possible Insomnia
  • Good for Weight loss
  • WEEKLY DOSING
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4
Q

If a patient cannot swallow a tablet well, what drugs can you recommend that have other dosing forms?

A

Citalopram-Solution
Paroxetine-Solution
Sertraline-Solution
Fluoxetine-Solution

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5
Q

Citalopram

A

Celexa

  • Fewest DDI, good for elderly
  • FEWEST SEX SE
  • QT & CV Problems >40mg
  • Over 60/liver probs 20mg
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6
Q

If a patient wants a drug for depression with FEWEST sexual SE, what would you give?

A

Citalopram (CELEXA)
Buprpion (WELLBUTRIN)
Mirtazapine (REMERON)

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7
Q

Escitalopram

A

Lexapro

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8
Q

Fluvoxamine

A

Luvox

  • Not approved for MDD
  • TAKE AT BEDTIME
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9
Q

Paroxetine

A

Paxil

  • Good for underweight
  • MOST SEDATION
  • NOT SAFE FOR PREGGO
  • Solution
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10
Q

Sertraline

A

ZOLOFT

  • Preferred for CV and Preggo
  • Comes in a solution form too don’t take with Disulfram and must dilute with 4oz water, OJ gingerale etc
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11
Q

SSRI Recommended for Pregnancy??

A

Sertraline (ZOLOFT)

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12
Q

SNRI MOA

A

block reuptake of NE and 5HT

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13
Q

SNRI SE

A

dry mouth, constipation, decreased appetite, insomnia, increased sweating

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14
Q

Duloxetine

A 
CYMBALTA
Morning
CI NARROW ANGLE GLAUCOMA*
Can Sprinkle on food
Monitor BP and Liver enzymes
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15
Q

Monitoring for Duloxetine

A

Cymbalta

need to monitor BP and Liver enzymes

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16
Q

Monitoring for Miratzapine

A

Remeron

need to monitor LFT/CBC

17
Q

Venlafaxine

A

Effexor
Major withdraw
Shortest half life
Not for kids

18
Q

Deslafaxine

A

Pristiq
GHOST SHELL
over 50mg not effective

19
Q

Monitoring for Deslafaxine

A

Pristiq

Cholesterol and TG

20
Q

Bupropion

A

WELLBUTRIN

  • NE&Dop
  • CI IN SEIZURE DX
  • No sex sx
  • Give for sex dysfunction, overweight, smoker, fatigued*

-May increase BP
CI: HTN & insomnia too

21
Q

Good Depression Drug choices for weight loss…

A

Prozac

Wellbutrin

22
Q

Good depression drug choices for weight gain..

A

Paxil

Remeron

23
Q

Mirtazapine

A

REMERON
A2,5HT2,5HT3,Histamine
-Higher the dose,less sedation

  • INCREASES APPETITE
  • Good for Agetation, insomnia, sex, underweight*

-Caution overwieght or hyperlipidemia

24
Q

Depression medications CI in Seizure Dx

A

Wellbutrin

Viibryd

25
Q

Nefazodone BBW

A

Hepatotoxicity

26
Q

Vilazodone

A 
VIIBRYD
SSRI+SRPA
CAUSES INSOMNIA
CI Seizure
Can increase bleeding
27
Q

Trazodone

A

OLEPTRO
Causes Sedation, so good for insomnia patients

Can SPLIT the ER tabs

28
Q

Amitriptyline

A

ELAVIL
TCA 3rd line
Use when pt has pain or HA

URINE BLUE GREEN

29
Q

Nortriptyline

A

PAMELOR
TCA 3rd line
LONG HALF LIFE

30
Q

Selegiline

A

EMSAM PATCH
MAOI-Last line

FOR RESISTANT DEPRESSION

31
Q

SE of MAOIs

A

Sedation, sexual dysfunction wt gain, HA

32
Q

Tranylcypromine

A

PARNATE

BBW HTN CRISIS WITH TYRAMINE CONSUMPTION

33
Q

If treatment is working, how long do you maintain…

A

Maintain the effective tx for 4-9 months for continuation, and 12-36 months for maintenance if necessary

34
Q

Esketamine

A

SPRAVATO

Inhaler for RESISTANT DEPRESSION

35
Q

What can we use to Augment our Depression Therapy?

A 
SGAs:
Aripriprazole (ABILIFY)
Quetiapine (SEROQUEL)
Olanzapine-Prozac (SYMBYAX)
Brexpiprazole (REXULTI)

Buspirone(BUSPAR)

36
Q

When can Lithium be used in Depression?

A

SEVERE RESISTANT DEPRESSION

37
Q

OTC Therapies for Depression

A

Omega 3 FA
St. Johns Wort
SAMe
Folate

38
Q

Non Pharm suggestions for Depression

A
  • Therapy
  • ECT, severe med resistant,not safe for preggo
  • rTMS, (magnetic stimulator) pt must not respond to 1 adequate med trial
  • Vagus nerve stimulation, 9-12 months to see results
  • Bright light therapy, seasonal dx 3-7 days for effect
  • EXERCISE

Neuro (12 decks)

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