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Flashcards in Pharm 13 Deck (28)
2

MAOI should not be administered with SSRI's or potent TCA's due to development of this condition

Serotonin syndrome

(Tach, sweating, dilated pupils, myoclonus, hyperreflexia, hyperthermia)

3

Sedation is a common side effect of these drugs.
Lower seizure threshold.
Uses = BAD, acute panic attacks, phobias, enuresis, and chronic pain
Overdose = lethal

Tricyclic antidepressants (TCA)

4

Three C's associated with TCA toxicity

Coma, Convulsions, Cardiac problems (arrhythmias and wide QRS)

5

Agents having higher sedation and antimuscarinic effects than other TCA's

Tertiary amines

6

A hypnotic & TCA used in chronic pain, that has marked antimuscarinic effects

Amitriptyline

7

TCA with greatest sedation of this group, and marked antimuscarinic effects, used for sleep

Doxepin

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TCA used in OCD.
Most significant of TCA's for risk of seizure, weight gain, and neuropsychiatric signs and symptoms

Clomipramine

9

Secondary amines that have less sedation and more excitation effect

Nortriptyline, Desipramine

10

Antidepressant associated with neuroleptic malignant syndrome

Amoxapine

11

Antidepressant associated with seizures and cardiotoxicity

Maprotiline

12

Antidepressant having stimulant effects similar to SSRI's and can increase blood pressure

Venlafaxine

13

Antidepressant inhibiting norepinephrine, serotonin, and dopamine reuptake

Venlafaxine

14

Antidepressant used for sleep that causes priapism

Trazodone

15

Antidepressant which is an inhibitor of CYP450 and may be associated with hepatic failure

Nefazodone

16

Antidepressant with MOA as alpha 2 antagonist, has effects on both 5-HT and NE, blocks histamine receptors, and is sedating

Mirtazapine

17

SE of mirtazapine

Liver toxicity, increased serum cholesterol

18

Except for these agents all SSRI have significant inhibition of CYP450 enzymes

Citalopram and its metabolite escitalopram

19

SSRI with long T1/2 and can be administered once weekly for maintenance, not acute tx

Fluoxetine

20

SSRI indicated for premenstrual dysphoric disorder

Fluoxetine (Sarafem)

21

Some of SSRIs' therapeutic effects beside depression

Panic attacks, social phobias, bulimia nervosa, and PMDD premenstrual dysphoric disorder), OCD

22

SSRI less likely to cause a withdrawal syndrome

Fluoxetine

23

Activation of these receptors open K+ ion channels to cause membrane hyperpolarization

Postsynaptic Mu receptors

24

All opioids except this agent (which has a muscarinic blocking action) cause pupillary constriction

Meperidine

25

SE of these drugs include dependence, withdrawal syndrome, sedation, euphoria, respiratory depression nausea and vomiting, constipation, biliary spasm, increased ureteral and bladder tone, and reduction in uterine tone

Opioid Analgesics

26

Strong opioid agonists

Morphine, methadone, meperidine, and fentanyl

27

Opioids used in anesthesia

Morphine and fentanyl

28

Use of this opioid + MAOI --> hyperpyrexic coma
Use of this opioid + SSRIs --> serotonin syndrome

Meperidine

29

Weak opioid agonist, poor analgesic
Overdose --> severe toxicity including respiratory depression, circulatory collapse, pulmonary edema, and seizures

Propoxyphene