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Pharmacology > Psych: Antidepressants > Flashcards

Psych: Antidepressants Flashcards

(52 cards)

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1
Q

Which antidepressant is also used for nicotine withdrawal and smoking cessation?

A

Bupropion

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2
Q

Which antidepressant is also used for enuresis?

A

Imipramine

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3
Q

Which antidepressant is also used for neuropathic pain (diabetic, fibromyalgia, and chronic MSK pain)

A

Duloxetine

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4
Q

Which antidepressant is also used for stress incontinence?

A

Duloxetine

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5
Q

What are the 5 R’s?

A 
Response (50% reduction in sx)
Remission
Recovery (6-12 months)
Relapse (return of sx before recovery)
Recurrance (return of sx after recovery)
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6
Q

What is the withdrawl symptoms of ALL antidepressants?

FINISH

A 
Flu-like
Insomnia
Nausea
Imbalance
Sensory disturbances
Hyperarousal
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7
Q

MOA of citalopram and escitalopram?

A

SSRIs

-block SERT reuptake of seritonin

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8
Q

MOA of fluoxetine, paroxetine, and sertraline?

A

SSRIs

-block SERT reuptake of seritonin

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9
Q

MOA of vilazodone? (2)

A

SSRI (blocks SERT)

Partial agonist of 5HT1A

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10
Q

MOA of vortioxetine? (4)

A

SSRI (blocks SERT)
Partial agonist of 5HT1B
Full agonist at 5HT1A
Full antagonist of 5HT1D

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11
Q

MOA of isocarboxazid, phenelzine, and tranylcypromine?

A

MAO Inhibitors

-increase NE, DA, and 5HT

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12
Q

MOA and ROI of selegiline?

A

MOA-B inhibitor only
-increases DA for parkinson’s

Worn asa patch

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13
Q

MOA of Venlafaxine, Desvenlafaxine, and duloxetine?

A

SNRI’s

-increases NE and 5HT

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14
Q

MOA of levomilnacipran?

A

SNRI

-increases NE and 5HT

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15
Q

Which drugs are secondary amines TCA drugs? (AND)

A

Amoxapine
Nortripyline
Desipramine

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16
Q

MOA of Amitriptlyine, clomipramine, doxepin, and imipramine?

A

SNRI’s (TCAs)

  • 5HT=NE
  • also block H1, muscarinincs, and a1

Tertiary amines

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17
Q

MOA of nortriptyline and desipramine?

A

SNRI’s (TCAs)

  • NE>5HT
  • also block H1, muscarinics, and a1

Secondary amines

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18
Q

What older drug class has the most histamine, anticholinergic, and adrenergic side effects

A

TCAs

CNS sedation, sexual dysfunction, weight gain, and withdrawal symptoms

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19
Q

What are the two significant side effects of SSRI’s?

A

Serotonin syndrome

Suicidality

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20
Q

MOA of bupropion?

A

Selectively inhibits pre-synaptic uptake of NE and DA
-blocks NET and DAT

Also some evidence of causing some more release

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21
Q

MOA of mirtazapine?

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A

Blocks presynaptic a2 and 5ht and post-synaptic 5HT2 blocker
-also H1 blockade (sedation)

22
Q

MOA of Nefazodone?

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A

Post synaptic a1 and 5HT2 blocker

-also H1 blockade (sedation)

23
Q

MOA of trazodone?

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A

Postsynaptic a1 and 5HT2 blocker

-also H1 blockade (sedation)

24
Q

MOA, ROI, and clinical use of esketamine?

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A

NMDA receptor antagonist used for treatment-resistant depression

Administered intranasally

25
MOA and clinical use of brexanolone?
IV infused GABAa receptor agonist for treatment-resistant post partum depression
26
Which SSRI has least effects on CYP450? (2)
Vortioxetine and escitalopram
27
What are the three key systems are affected by TCAs?
Cardiovascular (a1 agonism) -tachycardia, orthostatics, dysrhythmias Anticholinergic (muscarininc) -dry mouth, uriniary retention. blurred vision CNS -depression, sedation
28
What are the three C's of TCAs?
Coma Cardiotoxicity (conduction abnormalities) Convulsion
29
What are the three C's of TCAs?
Coma Cardiotoxicity (conduction abnormalities) Convulsion
30
Does mirtazapine have SERT/NET activity?
nope
31
Adverse effects of mirtazapine?
Sedation and weight gain
32
Adverse effects of trazodone?
Sedation and orthostatics
33
Adverse effects of trazodone?
Sedation and orthostatics
34
Serious adverse effect of bupropion?
Seizure | -especially in bulemics or anorexia; other volunerable pts
35
How long should you wait after stopping MAOs before starting most SSRIs?
2 weeks minimum
36
How long should you wait after stopping fluoxetine before starting other meds?
5 weeks
37
What is the major concern with MAO inhibitors?
Hypertensive crisis | -especially after eating tyramine containing foods (cheese, wine, peas)
38
What antiseizure meds can be used as mood stabilizers?
Cabamazepine Valproate Lamotrigine
39
What ion was first established for mood disorders (bipolar disorder)
Lithium
40
How does lithium work in mood disorders?
Inhibits dopamine release, downregulates NMDA recepotrs, and promotes GABAergic neurotransmission
41
What intracellular changes does lithium cause?
Lithium inhibits IP3, PKC, MARCKS, and GSK-3
42
What neuroprotective changes does lithium cause?
Increases CERB, which produces BDNF and Bcl-2
43
What is the renal side effect of lithium?
nephrogenic diabetes insipidus | -polyuria and polydipsia that doesnt change with ADH
44
Is lithiums therapeutic index large or small?
Small | -monitor closely
45
What meds increase lithium toxicity?
Diuretics (especially thiazides) ACEi (especially lisinopril) NSAIDs
46
Does lithium cause suicidal ideations?
Nope, actually can reduce the risk
47
Clinical use for valproate in bipolar disorder?
Acute bipolar disorder ONLY | -not maintainence
48
Clinical use for lamotrigine in bipolar disorder?
Maintenance of bipolar disorder ONLY | -not acute
49
Clinical use for carbamazepine in bipolar disorder?
Acute and maintenance of bipolar disorder
50
Carbamazepine is a CYP450 _______ (inducer or inhibitor)?
Inducer
51
MOA of amoxapine?
SNRI's (TCAs) and increases DA - NE>5HT - also block H1, muscarinics, and a1
52
What two antidepressant drugs increase dopamine?
Buproprion and Amoxapine

Pharmacology (50 decks)

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