Depression Pharmacology

Question 1

ketamine is used for what

Answer 1

treatment resistant depression

Question 2

true or false

the metabolites of ketamine have antidepressant properties

Answer 2

true

Question 3

ketamine modulates what receptors? is it competitive or noncompetitive?

Answer 3

NMDA and AMPA receptors

noncompetitive antagonist

Question 4

ketamine elevates ______ and activates _____

what do both of these things promote?

Answer 4

elevate BDNF
brain derived neurotrophic factor

activate mTOR (protein kinase)

both promote neurogenesis and synaptogenesis

Question 5

mTOR is a protein kinase that is a mechanistic target of what

Answer 5

rapamycin

Question 6

aside from for depression, what else can the tricyclics be used for

Answer 6

neuropathic pain

Question 7

MOA of tricyclics

Answer 7

inhibit NE and sertraline reuptake

more NE action than sertraline

Question 8

what is doxepin

Answer 8

a tricyclic

Question 9

what are clomipramine and trimipramine

Answer 9

tricyclic antidepressants

Question 10

other receptor activities of the tricyclics:

-muscarinic _____
-histamine _____
-alpha-1 _____
-dysregulation of _____

Answer 10

muscarinic antagonist (anticholinergic!)

histamine antagonist

alpha 1 antagonist (orthostasis!)

dysregulation of dopamine receptors (mania)

Question 11

the heterocyclic antidepressants are also known as the _____ antidepressants

Answer 11

atypical

Question 12

name 5 atypical antidepressants

Answer 12

amoxabine
mazindol
maprotiline
trazodone
buproprion

Question 13

general MOA of the atypical antidepressatns

Answer 13

inhibit NE and serotonin reuptake

Question 14

true or false

maprotiline is an atypical antidepressant and it causes sedation and may elicit seizures

Answer 14

true

Question 15

trazodone inhibits ____ reuptake and is a _____ antagonist

Answer 15

inhibits serotonin reuptake and is a 5HT2 antagonist

Question 16

true or false

trazodone has an active metabolite

Answer 16

true - m-CPP (meta-chlorophenylpiperazine)

has serotonin activity

Question 17

concern w trazodone

Answer 17

may give false positive for LSD, amphetamine, or methamphetamine (due to m-CPP metabolite)

Question 18

buproprion MOA

Answer 18

NDRI
(norepinephrine and dopamine reuptake inhibitor)

Question 19

what is fluvoxamine

Answer 19

an SSRI

Question 20

side effects of the SSRIs

Answer 20

NVD
anxiety
restless, insomnia
bleeding
sexual dysfunction
hyponatremia

Question 21

which particular SSRI has a lot of anticholinergic action

Answer 21

fluoxetine

Question 22

which SSRI causes more weight gain - fluoxetine or paroxetine

Answer 22

paroxetine

Question 23

which particular SSRI prolongs QT

Answer 23

citalopram

Question 24

____ and ____ combination is approved for treatment resistant depression

Answer 24

olanzapine + fluoxetine combination

Question 25

name 3 drugs that are approved as add on therapy to antidepressants

Answer 25

aripiprazole quetiapine brexpiprazole (rexulti)

Question 26

name 4 SNRIs

Answer 26

duloxetine venlafaxine desvenlafaxine levomilnacipran

Question 27

side effects of the SNRIs

Answer 27

NVD dizziness sweating headache sexual SE sympathomimetic - increase HR and BP insomnia, agitation, slight weight gain

Question 28

which particular SNRI is well known to cause Hypertension

Answer 28

venlafaxine

Question 29

which SNRI is a 2d6 inhibitor

Answer 29

duloxetinet

Question 30

true or false duloxetine is a CYP2D6 inducer

Answer 30

FALSE- inhibitor

Question 31

what are the NaSSA's

Answer 31

noradrenergic and specific serotonergic antidepressants ie - mirtazapine

Question 32

the NaSSA's are antagonists of what 3 things

Answer 32

alpha 2 5HT-2 5HT-3

Question 33

side effects of the NaSSA's

Answer 33

NVD dizzy sedation increased appetite weight gain headache dry mouth sedation constipation decreased sex drive

Question 34

"serotonin reuptake inhibitor and 5-HT2A antagonist"

Answer 34

trazodone

Question 35

which drug is structurally and pharmacologically related to trazodone

Answer 35

nefazodone

Question 36

"presynaptic 5HT1A partial agonist and presynaptic receptor. elevates serotonin, dopamine, and NE"

Answer 36

vilazodone

Question 37

"SSRI?? 5HT1A agonist, 5HT1B partial agonist. 5-HT3, 1D, 7 antagonist"

Answer 37

trintellix

Question 38

antidepressant for postpartum depression

Answer 38

brexanolone

Question 39

trazodone side effects

Answer 39

sedation gastric disturbance hypotention priapism prolong QT

Question 40

nefazodone has similar side effects as trazodone. however...

Answer 40

hepatic failure has occurred with nefazodone

Question 41

"partial agonist at 5HT4 receptor and thus useful for patients with IBS

Answer 41

vilazodone

Question 42

MOA brexanolone

Answer 42

GABA-A receptor modulator

Question 43

levomilnacipran

Answer 43

SNRI NE effects more than serotonin

Question 44

**DNRI

Answer 44

buproprion

Question 45

**true or false ALL antidepressants elevate all monoamines to diff degrees

Answer 45

true

Question 46

**true or false trazodone is all serotonin

Answer 46

true

Question 47

3 receptors that SSRIs bind

Answer 47

5HT-1A, 4, and 7

Question 48

**what are the 3 serotonin receptors that mediate neurogenesis

Answer 48

5HT 1A, 4, and 7

Question 49

*nefazodone MOA

Answer 49

blocks 5HT2A receptor and blocks serotonin reuptake serotonergic

Question 50

*unique about mirtazapine

Answer 50

no effect on reuptake just an agonist/antagonist

Question 51

what med will give a false (+) for amphetamine

Answer 51

trazodone

Question 52

***vortioxetine (trintellix) MOA

Answer 52

SSRI 5HT1A agonist 5HT1B partial agonist (antagonist at 5HT3, 1D, and 7 receptors)

Question 53

**affects NMDA and AMPA receptors

Answer 53

ketamine

Question 54

*what happens when an agonist binds to the GABA receptor

Answer 54

chloride entry

Question 55

**there are 2 binding sites of the GABA-A receptor: the benzodiazepine receptor and the barbiturate receptor differentiate between what each does

Answer 55

benzodiazepine - enhances GABA binding to the GABA-A receptor and amplifies GABA effects barbiturate receptor - prolongs the chloride channel opening