Wolters Summary - Antidepressants

Question 1

other factors causing depression

Answer 1

beta blockers can cause depression

Question 2

SSRI MOA

Answer 2

inhibit reuptake of serotonin

SERT rec.

Question 3

list SSRI

Answer 3

fluoxetine/prozac 
sertraline/zoloft 
paroxetine/paxil 
escitalopram/lexapro
citalopram/celexa
fluvoxamine

Question 4

fluoxetine

Answer 4

prozac

Question 5

sertraline

Answer 5

zoloft

Question 6

paroxetine

Answer 6

paxil

x

Question 7

escitalopram

Answer 7

lexapro

Question 8

citalopram

Answer 8

celexa

Question 9

SSRI side effects

Answer 9

1. GI
2. CNS
3. erectile dysfunciton
4. Anticholinergic
5. Hyponatremia
6. QTc prolongation
   * * can help hot flashes

Question 10

GI s.e. of SSRI

Answer 10

n/v

dry mouth

Question 11

CNS s.e. of SSRI

Answer 11

sedation
insomnia
decreased libido
suicidal ideation

Question 12

drug causing most s.e. of SSRI

Answer 12

paxil/paroxetine

Question 13

SSRI with longest half life

Answer 13

Prozac

shortest- paxil so have more s.e.

Question 14

SSRi causing QTc prolongation

Answer 14

escitalopram
citalopram

esp. citalopram

Question 15

SSRi drug interactions

Answer 15

other serotonergic meds (esp. MAOis and linezolid)

fluoxetine

Question 16

Fluoxetine and clopidogrel

Answer 16

Prozac is a CYP219 INHIBITOR and Clopidogrel is PRODRUG

so if taking prozac, clopidogrel will not work

same for tamoxifen

Question 17

SNRI

list

Answer 17

Venlafaxine (Effexor)
Desvenlafaxine
Duloxetine (Cymbalta)
Levomilnacipran

Question 18

Duloxetine

Answer 18

(Cymbalta)

Question 19

Venlafaxine

Answer 19

(Effexor)

Question 20

SSRI MOA

Answer 20

selectively inhibit reuptake of serotonin and norepinephrine

Question 21

SNRI s.e.

Answer 21

GI/CNS/Urgenital

+ Increase BP (n.e. - no biggie unless uncontrolled HTN)

Question 22

duloxetine specific s.e.

Answer 22

anticholinergic symptoms

liver toxicity

Question 23

SNRI drug interactions

Answer 23

other serotonergic meds

duolextine specific

Question 24

duloxetine SNRI

Answer 24

CYP1A2 inhibitors will increase concentration because duolextine is a 1a2 SUBSTRATE

ex. Cipro/fluvoxamine

Question 25

bupropion brand

Answer 25

Wellbutrin

Question 26

MOA bupropion

Answer 26

weak inhibitor of norepinephrine and dopamine reuptake NO MAO or serotonin

Question 27

bupropion s.e.

Answer 27

INCREASED seizure risk !!! also CNS (HA, appetite) can be used to prevent smoking (Zyban)

Question 28

what antidepressant would you use for an old lady who is underweight and can't sleep

Answer 28

mirtazapine pre-synaptic alpha agonist (increases N.e. and serotonin) causes sedation and weight gain

Question 29

which other antidepressant causes priapism

Answer 29

trazodone (trazoBONE)

Question 30

other antidepressant with BBW of liver toxicity

Answer 30

nefazodone cyp3a4 inhibitor

Question 31

TCA MOA

Answer 31

selective inhibition of serotonin and norepinephrine reuptake antihistamine and anticholinergics effects Na Channel blocker

Question 32

TCA s.e.

Answer 32

anticholinergic ** narrow therapeutic index ** (suicidal ideation and seizures, tornadoes de pines) cardiac problems due to Na Channel blockage

Question 33

TCA drug list

Answer 33

Amitripyline * imipramine despiramine nortriptyline (ine/amine)

Question 34

TCA overdose = which drug

Answer 34

sodium bicarbonate given with dextrose

Question 35

MAOis (list)

Answer 35

isocarbozazid phenelzine selegiline (parkinsons!) ** tranylcypromine

Question 36

MAOi MOA

Answer 36

increase endogenous concentrations of dopamine, serotonin, norepinephrine thru inhibiton of monoamine oxidase (that breaks these down) not first line

Question 37

MAOi S.E.

Answer 37

hypertensive crisis *** unable to break down tyramine foods weight gain, thermostatic hypotension, CNS

Question 38

MAOi drug interactions

Answer 38

2 week wash out req. other serotonin drugs also CI with antihypertensive meds

Question 39

serotonin syndrome

Answer 39

excess serotonin typically caused by overdose

Question 40

serotonin syndrome symptoms

Answer 40

hyperthermia (fever) agitaiton, diaphoresis increased bowel sounds (diarrhea) tremor

Question 41

serotonin syndrome treatment

Answer 41

serotonin antagonist -CYPROHEPTADINE

Question 42

resistent depression what do we use if antidepressants don't work

Answer 42

SGAs | exercise

Question 43

beers list antidepressants

Answer 43

Anticholinergic symptoms chronic seizures SIADH SSRI