Wk 11 Antidepressant Flashcards Preview

Pharmacology > Wk 11 Antidepressant > Flashcards

Flashcards in Wk 11 Antidepressant Deck (33):
1

1. An antidepressant should be taken for what period of time?

At least 4-9 months after symptoms are under control.

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2. An antidepressant may take how many weeks to have an effect?

1-3 weeks

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3. Explain the effects of increasing the following neurotransmitters in the brain: serotonin, norepinephrine, and dopamine.

Serotonin – decreased anxiety and depression
Norepinephrine – increased energy
Dopamine – decreased cravings and dependence

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4. Why are selective serotonin reuptake inhibitors (SSRIs) frequently given first in depression?

Fewer side effects and safer in overdose

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5. How do selective serotonin reuptake inhibitors (SSRIs) affect sexual functioning?

Decrease libido.

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6. How much weight gain can be expected with selective serotonin reuptake inhibitors (SSRIs)?

20 pounds

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7. What herb can precipitate a serotonin syndrome?

St. John’s Wort

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8. Selective serotonin reuptake inhibitors (SSRIs) should not be used with what other antidepressant category?

Monoamine oxidase inhibitors (MAOIs)

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9. What are some symptoms of the Serotonin Syndrome?

Agitation, anxiety, incoordination, tremors, myoclonus, fever, shivering, tachycardia, hypertension, sweating, diarrhea

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10. Name two neurotransmitters which may be increased in the synapses by tricyclic antidepressants.

Serotonin, norepinephrine

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11. When can the maximal effects of tricyclic antidepressants be expected after the initial dose?

1-2 months

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12. List four major categories of adverse effects expected with tricyclic antidepressants.

Cardiac arrhythmias, orthostatic hypotension, sedation, and anticholinergic effects such as dry mouth, decreased tears, urinary retention, and constipation.

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13. What high-risk group of patients should not be given tricyclic antidepressants?

Suicidal patients

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14. What is the drug that increases acetylcholine in the synapse to counteract the anticholinergic effects seen in a tricyclic overdose?

Physostigmine

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15. What would you tell a patient who is complaining of the sedative effects of a tricyclic antidepressant?

Sedation will diminish with time

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16. What drug category absolutely cannot be given with tricyclic antidepressants?

Monoamine oxidase inhibitors (MAOIs)

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17. Tricyclics should be given at what time of day? Why? How is it given to the elderly to prevent cardiotoxic effects?

Bedtime due to sedation. BID.

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18. Bupropion (Wellbutrin) is used to counteract what side effect of selective serotonin reuptake inhibitors (SSRIs)?

Sexual dysfunction

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19. Which two neurotransmitters does buproprion (Wellbutrin) possibly increase?

Dopamine, norepinephrine

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20. A history of head trauma would preclude a patient from taking buproprion (Wellbutrin) due to a risk of what?

Seizures

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21. Buproprion (Wellbutrin) is used to help people stop what activity?

Smoking

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22. Monoamine oxidase inhibitors (MAOIs) increase what neurotransmitters?

Serotonin, norepinephrine, dopamine

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23. Monoamine oxidase inhibitors (MAOIs) are the first choice for what diagnosis?

Atypical depression

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24. The coadministration of meperidine (Demerol) and monoamine oxidase inhibitors (MAOIs) can cause what?

Hyperthermia

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25. The ingestion of tyramine-containing foods while taking a monoamine oxidase inhibitor (MAOI) can cause what?

Hypertensive crisis

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26. Name possible symptoms of a hypertensive crisis.

Severe headache, dizziness, high blood pressure, chest pain, tachycardia, nausea, vomiting, sweating

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27. How do low levels of sodium intake affect the pharmacokinetics of lithium?

Low sodium levels can inhibit the excretion of lithium

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28. How does lithium affect urination?

Causes polyuria

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29. How does lithium affect thyroid functioning?

Causes hypothyroidism by inhibiting the incorporation of iodine into the thyroid hormone.

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30. What neuromuscular side effect is common with lithium?

Fine tremor

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31. What are common side effects of divalproex sodium (Valproate)? Why is it not used in pregnancy?

Nausea, vomiting, diarrhea, indigestion, weight gain. Neural tube defects and delayed neurodevelopment.

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32. How does carbamazepine (Tegretol) affect the metabolism of other drugs? How does it affect contraception?

Induces hepatic enzymes that increase the clearance of other drugs. Metabolizes oral contraceptives too rapidly, need back-up contraception.

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33. Identify side effects caused by the decreased norepinephrine reuptake with SNRIs?

Nervousness, insomnia, anorexia and weight loss, sweating, tachycardia, hypertension, urinary retention, vertigo