Exam 2; Anti-Depressants and Lithium Flashcards Preview

AU14 Pharmacology > Exam 2; Anti-Depressants and Lithium > Flashcards

Flashcards in Exam 2; Anti-Depressants and Lithium Deck (44):
1

This is 60% of all depressions; normal response to a loss or problem; usually limited in time

reactive depression

2

This is 40% of all depressions; no clear correlation with life events

endogenous depression

3

What are the two types of endogenous depression

uni-polar
bi-polar

4

What are some symptoms of depression

depressed mood
decrease interest in life in general
sleep disturbances
appetite changes
loss of energy
feeling of worthlessness/denial of past accomplishments
guilt

5

What are two symptoms of severe depression

psychological pain
suicidal tendencies; recurrent thoughts of death
loss of cognitive function

6

What are two factors that can cause depression

heredity and environmental factors

7

What is the biochemical basis of depression

depletion of neurotransmitters in the CNS (NE and SHT)

8

This treatment of depression is used primarily when the patient is not responsive to drug treatments

electroconvulsive treatment; shock therapy

9

What are five conditions that anti-depressants can be used to treat

depression
bulimia
OCD
panic attacks
ADD

10

What are the two mechanisms behind anti-depressants

prevent NE or SHT re-uptake
prevent neurotransmitter breakdown

11

What are two first generation NE re-uptake inhibitors; tricyclic anti-depressants

imipramine
amitriptyline

12

What are the second generation SSRIs (selective serotonin re-uptake inhibitors); inhibiting SHT re-uptake in the CNS

fluoxetine
sertraline
paroxetine
fluvoxamine
citalopram
escitalopram
vilazodone
vortioxetine

13

What are the third generation SNRIs; inhibiting the re-uptake of SHT and NE

Venlafaxine
duloxetine
milnacipram
desvenlafaxine

14

What are three other anti-depressants

buproprion
nefazodone
mirtazapine

15

Which class of anti-depressants is more likely to have side effects

the first generation; acts on multiple receptors

16

What are four symptoms of first generation anti-depressants

sedation
weight gain
anticholinergic effects; arrthymias, hypotension, α1 blockade

17

What are four side effects of second generation anti-depressants

GI upset
insomnia
headache
decreased libido

18

What are some side effects of third generation anti-depressants

just like second generation plus cardiovascular stimulation

19

What is the therapeutic index of anti-depressants

fairly low; 5-6 (5-6 times the recommended dose to be toxic
first generation more toxic than second generation

20

What happens to someone who takes a massive overdose of anti-depressants

seizures
respiratory depression
cardiac arrthymias
renal failure

21

The difference between first, second, and third generation, is mainly what

pharmacokinetic

22

What is the half like of anti-depressants like

very long; stays in the body a long time after you take them

23

What are anti-depressants metabolized by

P450

24

The effects of anti-depressants are synergistic with what

ethanol; will see unwanted effects

25

These three anti-depressants inhibit the metabolism of NE and SHT

tranylcyrpromine
phenelzine
isocarboxazid

26

What is the metabolism of MAO inhibitors

irreversibly inhibit the metabolism of SHT and NE; slow onset

27

What are the CNS effects of MAO inhibitors

insomnia
agitation
hallucinations
seizures

28

What are three non-CNS effects of MAO inhibitors

liver toxicity
weight gain
hypotension

29

This interacts poorly with MAO inhibitors

indirect acting amines like amphetamines

30

What is the mechanism behind the poor interaction of indirect acting amines and MAO inhibitors

amphetamines cause an increase in NE, the MAO inhibitor will inhibit the metabolism on NE, resulting in a huge excess of NE and the inability to break it down = hypertensive crisis

31

Certain foods that contain this will lead to hypertensive crisis similar to that of taking MAO and ampthetamines

food containing the indirect acting amine; tyramine
aged cheeses, wines, smoked food

32

What is it that the FDA warns about involving anti-depressants

all anti-depressants will increase the risk of suicide in children and adolescents; depression with a manic phase will be much worse

33

This is probably hereditary condition type of depression

bipolar (manic) depression

34

What are some symptoms of manic depression

euphoria
increased motor and sexual activity
flight of ideas
decreased sleep
poor judgment
social intrusiveness
tantrums

35

What is the percentage of those with manic depression that attempt suicide

25-50%
mostly in conjunction with drug/alcohol abuse

36

What are three treatments for those with manic depression

electroconvulsive therapy
anti-psychotic drugs
lithium

37

What are two anti-psychotic drugs used to treat manic depression

phenothiazine
haloperidol

38

This is the most effective at treating manic depression; used prophylactically

lithium; 70% success in patients

39

What is the mechanism of action of lithium

alters glutamate metabolism
decreases NE release
alters SHT

40

What is the therapeutic index of lithium

very low; <2

41

What are six side effects of taking lithium short term

tremors
increased thirst
increased urine production
edema
weight gain
nystagmus

42

What are two side effects of taking lithium long term

rengal damage
hypothyroid

43

What are three symptoms of taking lithium at a toxic level

nausea
delirium
coma

44

These are five mood stabilizers to treat bipolar; all are anti-seizure

valproic acid
carbamazepine
lamotripene
acetazolamide
aripriprazole