SNRIs + MAO inhibitors Flashcards Preview

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Flashcards in SNRIs + MAO inhibitors Deck (18)
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1
Q

SNRIs - 4 drugs

A

Duloxetine
Venlafaxine
Desvenlafaxine
Milnacipran

2
Q

SNRIs - MOA

A

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

3
Q

SNRIs - Indications

A

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

4
Q

Duloxetine - indications

A

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

5
Q

Venlafaxine, desvenlafaxine - MOA

A

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

6
Q

Venlafaxine, desvenlafaxine - Adverse effects

A

Similar to adverse effects of SSRIs.

Few autonomic, sedative or cardiovascular side effects

7
Q

Milnacipran - indications

A

ONLY fibromyalgia

8
Q

MAOIs - 5 drugs

A
Isocarboxazid
Phenelzine
Tranylcypromine
Moclobemide
Selegiline
9
Q

Difference between MAO-A and MAO-B

A

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
Q

MAOIs - indications

A

Treatment-resistant depression

11
Q

What should be avoided when taking MAOIs?

A

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

12
Q

MAOIs - adverse effects

A
Serotonin syndrome (agitation, restlessness, confusion, insomnia, seizures, severe hypertension, GI symptoms).
Hypertensive crisis (occipital headache, palpitation, neck stiffness, soreness, nausea, vomiting, sweating, photophobia)
13
Q

1st generation MAOIs

A

Isocarboxazid
Phenelzine
Tranylcypromine

14
Q

2nd generation MAOIs

A

Moclobemide (RIMA - reversible inhibitor of MAO-A)

15
Q

Selevtive MAO-B inhibitor

A

Selegiline

16
Q

1st generation MAOIs - MOA

A

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
Q

Moclobemide - indications

A

Depression

18
Q

Selegiline - indications

A

Parkinson disease

Depression