Flashcards in Study Guide 1 Deck (26):
1
What is often used for chronic pain when conservative tx doesn't work?
Antidepressants
2
SSRIs are used to regulate:
- mood
- depression
3
SSRIs are good for these pts
People who have slightly decreased serotonin levels
4
This SSRI is often used for chronic pain
Paroxetine (Paxil)
5
What does SNRI stand for?
Serotonin-Norepinephrine Reuptake Inhibitors
6
What are SNRIs used for?
Depression
7
Off-label uses for SNRIs
- chronic pain
- OA
- peripheral neuropathies
- fibromyalgia
8
Why are SSRIs/SNRIs used to treat pain? (How does this work physiologically?)
Restores serotonin influence in descending pathways that inhibit pain
9
What are tricyclics used for?
Depression
10
When are tricyclics used over SSRI/SNRI?
Only for pts who fail with SSRI/SNRI
11
Tricyclics can also be used to treat this
Pain
12
MAOI
Monoamine Oxidase Inhibitors
13
What class of drugs are MAOIs?
Antidepressants
14
Lithium is used to treat ________
Bipolar disorder
15
This class of drug is used to treat schizophrenia
Antipsychotics
16
How do SSRIs work?
block reuptake of serotonin into the presynaptic terminal
17
How does increased serotonin in the presynaptic terminal create change?
- remains in cleft longer
- increases receptor sensitivity
- increases neuronal growth/function
18
How do SNRIs act physiologically?
- decrease serotonin and norepinephrine reuptake
- same mechanism as SSRI
19
SNRIs decrease serotonin and norepinephrine reuptake without affecting these:
Dopamine synapses
20
What do tricyclics block?
Reuptake of amine neurotransmitters into the presynaptic terminal
21
What is an important thing to note about the mechanism of action of tricyclics?
- nonselective
- block serotonin, norepinephrine, and dopamine!
22
What is MAO (monoamine oxidase)?
- enzyme that destroys released NTs
- hits a lot of targets
23
How do MAOIs work?
inhibit MAO to allow more NT to stay in the synaptic cleft
24
MAOIs favor _______
Dopamine
25
Mechanism of action: lithium
Multiple possible pathways of interaction
- may prevent neuronal degeneration and sustain function
- may be neuro protective
26