Sketchy Pharm: Bupropion, Mirtazipine, and Trazodone

Question 1

You might administer what NET- and DAT-reuptake inhibiting agent to someone trying to quit smoking?

Answer 1

Bupropion (NET DAT Ball, PRO)

Question 2

Why does bupropion reduce the urge to smoke?

Answer 2

It’s not clear.

Question 3

What is a major side effect of bupropion?

Answer 3

Seizures (think of the basketball player shaking) – do not give bupropion to anyone with a history of seizures, anorexia, or bulimia (both of the last two have lower seizure thresholds).

Question 4

Although bupropion (Wellbutrin) is not first-line for unipolar depression in a non-smoker, it has two advantages over other antidepressants. What are they?

Answer 4

It is not associated with sexual dysfunction (think of the kissing couple), and it does not lead to weight gain

Question 5

How does mirtazipine work?

Answer 5

It decreases alpha-2 input on presynaptic neurons, thereby leading to increased catecholamine release; additionally, it has mild 5HT-2 and 5HT-3 receptor antagonist properties.

Question 6

What side effects are associated with mirtazipine?

Answer 6

H1 histamine antagonist, sleepiness, weight gain (overweight, sleepy fan in the box with the chef swatting a bee) –like bupropion, though, it does not lead to sexual dysfunction.

Question 7

Trazodone is a __________ modulator.

Answer 7

serotonin (guy playing the happy face drum next to the trombone player)

Question 8

What side effect does trazodone have?

Answer 8

Because it antagonizes alpha-1 receptors, it leads to vasodilation –this can lead to hypotension or priapism (erection in the absence of sexual arousal); think of the nickname trazobone. Also, sexual dysfunction and serotonin syndrome (band member and spilled happy faces).

Question 9

Although trazodone started out as an anti-depressant, it is now mostly used for ____________.

Answer 9

sedating those with insomnia (because it is an H1 antagonist)