exam 5 antidepressants

Question 1

What are the types of depression?

Answer 1

reactive, major depressive disorder, bipolar
goals of therapy: reduce signs and symptoms

Question 2

Current treatment for depression?

Answer 2

SSRIs, atypical, dual acting

Question 3

what are clinical features of depression?

Answer 3

physiological: decreased sleep, appetite changes, fatigu
pyschological: dysphoric mood, worthlessness, guilt
cognitive: decrease cognition and suicidal ideation

Question 4

what are drugs that induced depression?

Answer 4

antihypertensive and CV: BB, clonidine, prazosin
sedative hypnotics: alcohol, BZD, barbituates
anti-inflammatory and analgesics: opiates
steroids

Question 5

what is the neurotrophic hypothesis of depression?

Answer 5

BDNF is important for neuronal connections
stress and pain decreases BDNF
BDNF is antidepressant in animals
BDNF can be dendritic sprouts that promote neural connections

Question 6

How long does it take to see therapuetic response?

Answer 6

2-3 weeks for response

Question 7

what is the mechanism of MAOIs?

Answer 7

MAO acts to break down NE and 5HT
MAOi inhibits this to increase NE and 5HT in vesicles

Question 8

what are the MAOi drugs?

Answer 8

non selective: phenelzine, tranylcypromine
MOA-B selective: selegiline
MOA-A selective: moclobemide

Question 9

What are MAOI side effects?

Answer 9

HTN crisis with tyramine foods
interactions with Rx: TCAs, SSRIs, LDOP, st johns wort

Question 10

where do reuptake blockers bind to?

Answer 10

allosteric sites

Question 11

what are indications for TCAs?

Answer 11

depression, panic, enuresis, pain

Question 12

What drug class is it easy to overdose?

Answer 12

TCAs because you only need 10x the dose

Question 13

what are TCAs MOA?

Answer 13

inhibit NET, SERT, H1, antimuscarinic, antiadrenergic
sides: sedation and weight gain

Question 14

what are TCAs?

Answer 14

tertiary amine: imipramine, amitripyline, doxepin, clomimpramine
secondary: desipramine, nortripyline, maprotiline

Question 15

what are the benefits of secondary amines?

Answer 15

better at NET than SERT
less sides

Question 16

what are SSRIs?

Answer 16

fluoxetine, fluvoxamine, paroxetine, sertraline, citalopram, escitalopram

Question 17

SSRI side effects?

Answer 17

sexual dysfunction, anxiety, insomnia, tremor

Question 18

what is SSRI discontinuation syndrome?

Answer 18

brain zaps, dizzy, sweating, confusion

Question 19

what is serotonin syndrome? symptoms?

Answer 19

high levels of serotonin when given with MAOIs, TCAs, tramadole, st johns wort
symptoms: hyperthermia, muscle rigidity, restlessness

Question 20

Which drugs are SSRI and 5HT1A partial agonist?

Answer 20

Vilazodone and vortioxetine

Question 21

what is the benefit of vilazodone?

Answer 21

reduced sexual side effects compared to SSRIs

Question 22

what are tetracyclic and unicyclic antidepressants?

Answer 22

maprotiline
mirtazapine
buproprion
trazodone

Question 23

maprotiline MOA?

Answer 23

NET inhibitor

Question 24

mirtazapine MOA?

Answer 24

A2, 5HT2, 5HT3 and H1 antagonist

Question 25

buproprion MOA?

Answer 25

DAT inhibitor NET inhibitor SERT inhibitor

Question 26

trazodone MOA

Answer 26

5HT2A antagonist weak SERT inhibitor

Question 27

what are SNRI drugs?

Answer 27

venlafaxine, desvenlafaxine, duloxetine, milnacipran, lveomilnacipran, reboxetine, atomoxetine

Question 28

what are SNDRIs?

Answer 28

block all three triple blockers

Question 29

what are rapid acting antidpressants?

Answer 29

ketamine esketamine scopolamine

Question 30

what is postpartum depression?

Answer 30

occurs within 4 weeks and can last >1 year

Question 31

what are treatments for PPD?

Answer 31

SSRIs and venlafaxine CBT and counseling brexanalone

Question 32

what is the function of brexanaolone?

Answer 32

allopregnanolone levels increase during pregnancy and return to normal postpartum this causes GABA-A receptors to be desensitized brexanolone resensitizes these receptors

Question 33

what are nonpharm treatments?

Answer 33

electroconvulsive therapy, psychotherapy, hospitalization

Question 34

What is the pharmacology of filbanserin?

Answer 34

agonist at 5HT1A antagonist at 5HT2A/C hypoactive sexual desire disorder

Question 35

Etiology of bipolar disorder?

Answer 35

genetic predisposition biological 5HT and DA

Question 36

what is treatment of bipolar?

Answer 36

hospitalization psychotherapy pharmacotherapy

Question 37

What is pharmacotherapy of bipolar?

Answer 37

mood stabilizers: lithium and anticonvulsants atypical antipsychotics: olanzapine, quetia, risperidone, ziprasidone

Question 38

what is the action of lithium?

Answer 38

mechanism not understood depletion of PIP2 and associated signalling modulate GSK3

Question 39

what is valproic acid and sodium valprotate MOA?

Answer 39

increases GABAergic tone blocks NA blocks t-type ca2+ channel inhibits histone d

Question 40

what are the anticonvulsants used for bipolar and the channels they act on?

Answer 40

carbamazepine/oxcarbazepine: Na+ channel lamotrigine: Na and Ca channel topiramate: Na+ channel