SNRIs + MAO inhibitors Flashcards Preview

22 Psychotherapeutic drugs > SNRIs + MAO inhibitors > Flashcards

Flashcards in SNRIs + MAO inhibitors Deck (18)
Loading flashcards...
1

SNRIs - 4 drugs

Duloxetine
Venlafaxine
Desvenlafaxine
Milnacipran

2

SNRIs - MOA

Selective for SER and NE, but do not activate many other receptors

3

SNRIs - Indications

Depression, eating disorders (bulimia and anorexia nervosa), anxiety disorders (panic disorder, phobic disorders, OCD).
Also effective for: fibromyalgia, autism, premenstrual dysphoric disorder

4

Duloxetine - indications

Major depressive disorder.
Diabetic peripheral neuropathic pain.
Generalized anxiety disorders.
Fibromyalgia.

5

Venlafaxine, desvenlafaxine - MOA

Strongly inhibit reuptake of both norepinephrine and serotonin. Do not antagonize muscarinic, adrenergic or histamine receptors

6

Venlafaxine, desvenlafaxine - Adverse effects

Similar to adverse effects of SSRIs.
Few autonomic, sedative or cardiovascular side effects

7

Milnacipran - indications

ONLY fibromyalgia

8

MAOIs - 5 drugs

Isocarboxazid
Phenelzine
Tranylcypromine
Moclobemide
Selegiline

9

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)

10

MAOIs - indications

Treatment-resistant depression

11

What should be avoided when taking MAOIs?

SSRIs (serotonin syndrome).
Sympathomimetics, TCAs.
Aged cheeses, beer, wines, meats and fish, rasins, broad beans, avocados, canned figs, choclate and coffie

12

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)

13

1st generation MAOIs

Isocarboxazid
Phenelzine
Tranylcypromine

14

2nd generation MAOIs

Moclobemide (RIMA - reversible inhibitor of MAO-A)

15

Selevtive MAO-B inhibitor

Selegiline

16

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

17

Moclobemide - indications

Depression

18

Selegiline - indications

Parkinson disease
Depression