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Pharmacology II > Lecture 1- Exam 3 > Flashcards

Lecture 1- Exam 3 Flashcards

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1
Q

SNRI:

A

Serotonin Norepinephrine reuptake inhibitors

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2
Q

What are the two SNRIs?

A
  1. Venlofaxine (Effexor)
  2. Duloxetine (Cymbalta)
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3
Q

What is the mechanism of action of an SNRI?

A

They block the reuptake of serotonin and norepinephrine

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4
Q

What side effects are associated with Venlofaxine and Duloxetine (SNRIs):

A
  1. nausea
  2. ELEVATED blood pressure
  3. weight gain
  4. sexual dysfunction
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5
Q

What are the two advantages she wants us to know for SNRIs?

A
  1. Safety profile with overdose
  2. Reccomend first line in all depression treatment
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6
Q

What are the oral side effects of SNRIs?

A

None

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7
Q

What are the oral side effects of SSRIs?

A
  1. increased bleeding and bruising
  2. bruxism
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8
Q

NDRI:

A

Norepineprhine Dopamine reuptake inhibitor

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9
Q

Buproprion (Wellbutrin) is classified as:

A

NDRI

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10
Q

What is the brand name of Buproprion?

A

Wellbutrin

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11
Q

We see alot of patients taking Buproprion for _______ in addition to depression, this is due to what aspect?

A

Drug/tobacco cessation; dopamine aspect

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12
Q

Why would buprorion be used as a depression medication in someone with an eating disorder?

A

it does NOT cause weight gain

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13
Q

The only antidepressant contraindicated in a patient with a seizure disorder:

A

Buproprion

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14
Q

Side effect profile of buprioprion (wellbutron):

A
  1. insomnia
  2. seizures (less common)
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15
Q

What are the two diagnostic criteria for depression?

A
  1. depressed mood
  2. Apathy/loss of interest

(For more than 2 weeks)

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16
Q

Depression is due to deficiency of monoamine neurotransmitters (NT) including: (2)

A
  1. norepinephrine
  2. serotonin
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17
Q

Depletion of _____ induces depression. Antidepressants increase levels of ____.

A

NT; NT

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18
Q

With depression drugs, once the amount of NT is increased, the receptors will be ____.

A

Downregulated (this is when we feel the drugs effects start working)

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19
Q

The nost common oral side effect associated with antidepressants:

A

xerostomia

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20
Q

The second most common oral side effect associated with antidepressants:

A

dysguesia

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21
Q

Monoamine oxidase inhibitors (MOA-I) drug-drug interactions and drug-food interactions result in:

A
  1. Hypertensive crisis
  2. Serotonin syndrome
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22
Q

What is the food interaction with monoamine oxidase inhibitors?

A

Tyramine (stinky meats and cheese)

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23
Q

What is the most common side effect of MOA-I?

A

Dry mouth

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24
Q

Hypertensive crisis with MOA-I drug interactions to avoid including:

A

Psuedophedrine (Pseudofed)

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25
Serotonin syndrome with MOA-I drug interactions to avoid:
1. cough suppressants (dexomethophan) 2. Tramadol
26
From a dental persepctive, what drug might we prescribe that could result in serotonin syndrome if a patient is taking a monamine oxidase inhibitor?
Tramadol
27
The drug interaction with monamine oxidase inhibitor that will cause serotonin syndrome:
Tramadol
28
Tricyclic antidepressants (TCAs) may be used off label for:
Neuropathic pain & insomnia
29
Tertiary TCA most commonly prescribed:
Amitriptyline (Elavil)
30
Secondary TCA most commonly prescribed:
Nortriptyline (Pamelor)
31
What neurotransmitters do TCAs work on?
Norepinephrine & serotonine (blocks the NE and serotonin reuptake pumps)
32
TCAs also block the uptake of ____ which can lead to weight gain, drowsiness and dry mouth
histamine
33
TCAs also block the _____ receptor leading to constipation, dry mouth, blurred vision, memory problems, and drowsiness
Muscarinic receptor
34
TCAs also block the ____ receptor leading to dizziness and decreased blood pressure
alpha-1
35
What are the SERIOUS side effects of TCAs?
1. cardiac conduction disturbances (QT prolongation) 2. significant risk of morbidity and mortality associated with overdose ^ 7 day supply is enough to OD
36
Drug interactions with TCA: TCA + CNS depressants (ex: opioid pain medication) =
additive CNS depressant effects
37
SSRI:
Selective serotonin reuptake inhibitor
38
List the SSRIs: (5)
1. Fluoxetine (Prozac) 2. Partoxetine (Paxil, Pexeva) 3. Seratline (Zoloft) 4. Citalopram (Celexa) 5. Escitalopram (Lexapro)
39
The following drugs are classified as: 1. Fluoxetine (Prozac) 2. Partoxetine (Paxil, Pexeva) 3. Seratline (Zoloft) 4. Citalopram (Celexa) 5. Escitalopram (Lexapro)
SSRIs
40
Brand name for Floxetine:
Prozac
41
Brand name for Paroxetine:
Paxil, Pexeva
42
Brand name for Sertaline:
Zoloft
43
Brand name for Citalopram:
Celexa
44
Brand name for Escitalopram:
Lexapro
45
How does an SSRI work?
blocks the seratonin reuptake pump (this way more serotonin stays in the synapse available to be used)
46
What is the effect of an SSRI on norepinephrine?
No effect
47
What side effects come with an SSRI?
1. GI upset 2. Headaches 3. Insomnia 4. Restlessness 5. Anxiety 6. Weight gain 7. Sexual dysfunction
48
Most SSRI side effects are transient (meaning go away after the body adjusts) excluding:
1. weight gain 2. sexual dysfunction
49
Side effects of SSRIs related to dentistry:
1. bruxism 2. increased bleeding and bruising
50
Paroxetine and Fluoxetine are both:
CYP450 2D6 inhibitors
51
why is it important that paroxetine and fluoxetine (both SSRIs) are CYP450 and 2D6 inhibitors?
because they prevent metabolism of codeine, hydrocodone and oxycodone to an active medication meaning pain relief is reduced
52
What two SSRIs have a drug interaction with opioid medications (codeine, hydrocodone, and oxycodone?
1. Paroxetine (Paxil) 2. Fluoxetine (Prozac)
53
The three drugs we need to know that can inhibit CYP450 2D6?
1. Paroxetine (Paxil) 2. Fluoexetine (Prozac) 3. Buproprion (Wellbutrin)
54
Why is it significant if a drug is an inhibitor of CYP4502D6?
Because they prevent the metabolism of codeine, hydrocone and oxycodone
55
What is the brand name for Mirtazapine?
Remeron
56
Mirtazapine (Remeron) is classified as:
Presynaptic alpha-2 antagonist
57
What receptor is blocked by Mirtazapine (Remeron)?
Alpha-2
58
Mirtazapine (Remeron) is a pretty clean drug excepting for:
It blocks the histamine (H1) receptor
59
What are the side effects of Mirtazapine (Remeron)?
1. sedation 2. dry mouth 3. weight gain
60
Only antidepressant that is an orally dissolvable tablet:
Mirtazapine (Remeron)
61
What is our goal of treating depression?
1. Remission-resolution of depression symptoms 2. improve functioning 3. reduce risk of relapse
62
T/F: There is no antidepressant that shows superior efficacy
True- they are all equally effective
63
Selection of antidepressant therapy is based on:
1. past history of antidepressant therapy 2. family history of antidepressant response 3. current disease states/drug therapy 4. adverse effect profile 5. cost
64
mild to moderate depression can be treated with:
psychotherapy alone
65
All antidepressants demonstrate equivalent efficacy of about:
70%
66
A therapeutic trial for an antidepressant is:
6-8 weeks
67
What is the first steps of improvement if an antidepressant is working:
1. anxiety 2. sleep 3. appetite
68
After starting an antidepressant, when can we see resolution of the depressed mood/suicidal thoughts itself?
2-4 weeks
69
Maintenance therapy for first episode of depression should be continued for:
9-12 months post resolution
70
Maintenance therapy for second episode of depression should be continued for:
5 years
71
If someone has more than two depressive episodes, maintenance therapy should continue for:
lifelong
72

Pharmacology II (15 decks)

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