Flashcards in SNRIs + MAO inhibitors Deck (18)
SNRIs - 4 drugs
SNRIs - MOA
Selective for SER and NE, but do not activate many other receptors
SNRIs - Indications
Depression, eating disorders (bulimia and anorexia nervosa), anxiety disorders (panic disorder, phobic disorders, OCD).
Also effective for: fibromyalgia, autism, premenstrual dysphoric disorder
Duloxetine - indications
Major depressive disorder.
Diabetic peripheral neuropathic pain.
Generalized anxiety disorders.
Venlafaxine, desvenlafaxine - MOA
Strongly inhibit reuptake of both norepinephrine and serotonin. Do not antagonize muscarinic, adrenergic or histamine receptors
Venlafaxine, desvenlafaxine - Adverse effects
Similar to adverse effects of SSRIs.
Few autonomic, sedative or cardiovascular side effects
Milnacipran - indications
MAOIs - 5 drugs
Difference between MAO-A and MAO-B
Inhibition of MAO-A stops oxidation of mainly serotonin (some NE and dopamine as well).
Inhibition of MAO-B stops oxidation of dopamine.
Therapeutic effects of MAOIs are mainly from inhibition of MAO-A (except for the selective MAO-B inhibitors)
MAOIs - indications
What should be avoided when taking MAOIs?
SSRIs (serotonin syndrome).
Aged cheeses, beer, wines, meats and fish, rasins, broad beans, avocados, canned figs, choclate and coffie
MAOIs - adverse effects
Serotonin syndrome (agitation, restlessness, confusion, insomnia, seizures, severe hypertension, GI symptoms).
Hypertensive crisis (occipital headache, palpitation, neck stiffness, soreness, nausea, vomiting, sweating, photophobia)
1st generation MAOIs
2nd generation MAOIs
Moclobemide (RIMA - reversible inhibitor of MAO-A)
Selevtive MAO-B inhibitor
1st generation MAOIs - MOA
All: Bind irreversibly and inhibit MAO-A and MOA-B.
Phenelzine and tranylcyrpomide: Inhibit SER more than NE, antidepressant effect from down-regulation of presynaptic autoreceptors and increased firing of serotonergic neurons
Moclobemide - indications