4Dd. S3/b3 Affective Disorders

Front 1

What are the 2 most common affective disorders?

Back 1

Major depressive and bipolar

Front 2

Describe major depressive disorder?

Back 2

1. Recurrent thoughts of suicide and depressed mood
2. Feelings of worthless, can't concentrate

Front 3

Describe bipolar disorder and how would you treat them?

Back 3

1. Recurrent fluctuations in mood, energy and behavior
2. Tx them with mood stabilizing drugs

Front 4

What is hypomania?

Back 4

1. Elevated mood
2. Increased activity or energy
3. Rapid and excitable but NOT violent

Front 5

What about bipolar and twin studies?

Back 5

95% concordance, occurs in a total of 1% of the population

Front 6

What is bipolar 1? and 2?

Back 6

1. Manic without major depressive disorder
2. hypomania with at least one major depressive disorder

Front 7

What do you use to tx bipolar for the mood, manic and acute manic stages?

Back 7

1. Litium mood stabilizer, takes a lag phase
2. Anticonvulsants for manic before lithium because these act fast
3. Clonazepam for acute mania(haloperidol)

Front 8

When do you use anticonvulsants with bipolar?

Back 8

1. Before lithium because they act quicker

Front 9

What is the main problem with lithium?

Back 9

Narrow therapeutic index so it doesn't take a lot to OD

Front 10

What causes a lithium build up?

Back 10

Nephropathy because it would cause decreased excretion

Front 11

What is the MOA of lithium?

Back 11

1. Inhibits IP3/DAG
2. Prevents muscarinic and alpha adrenergic transmission
3. Inhibits phosphatases

Front 12

What does PLC do?

Back 12

Makes DAG and IP3

Front 13

Purpose of IP3 and DAG in the lithium pathway?

Back 13

Signals PKC to phosphorylate serine and threonine, makes Serotonin

Front 14

What does lithium toxicity present like?

Back 14

1. Tremor, sedation, ataxia and aphasia
2. Choreoathetosis(Sinuous dance like movements)
3. Mental confusion and bizarre motor

Front 15

What is the amine hypothesis of mood?

Back 15

Mood is mainly affected by the levels of NE and 5HT

Front 16

What does 5HT1-R do? 5HT2-R? 5HT3-R?

Back 16

1. Decrease cAMP
2. Increase IP3 DAG
3. Depolarize plasma membrane

Front 17

What are the non selective amine reuptake drugs?

Back 17

1. Tricyclics
2. Second generations

Front 18

What are the four main drugs used to treat depression?

Back 18

1. TCA 1st and 2nd Gen
3. SSRI
4. MAOI

Front 19

What is the number 1 antidepressant? 2, and 3?

Back 19

1. Lexapro
2. Zoloft
3. Fluoxetine
4. All SSRIs

Front 20

What is the number one NA/DA antidepressant?

Back 20

Welbutrin

Front 21

What are the 4 most effective antiD?

Back 21

1. Mirtazapine(Remeron)
2. Escitalopram(lexapro)
3. Venlafaxine(Effexor)
4. Sertraline(Zoloft)

Front 22

What are the 4 most acceptable antiD?

Back 22

1. Zoloft
2. Lexapro
3. Wellbuitrin
4. Celexa

Front 23

What are TCAs? example and why not as good?

Back 23

1. Highly effective and toxic antiD
2. Amitriptaline and Nortriptaline

Front 24

What is good about TCA?

Back 24

1. Long half life allows for little dosing

Front 25

What is the TCA MOA?(3)

Back 25

1. Block Serotonin and NE uptake
3. Affects 5HT1-R
4. Increases firing of 5HT neurons and reuptake; 2-4 weeks later

Front 26

Side effects of TCA with a long 1/2 life?(6)

Back 26

1. Blocks muscarinic and alpha adrenergic receptors
3. Sedation, Seizures Psychosis
6. Weight gain = noncompliance

Front 27

What are antimuscarinic effects?(5)

Back 27

1. Blind as a bat(blurry)
2. Hot as a hare
3. Dry as a bone
4. Red as a beet
5. Mad as a hatter
6. CV = hypertension, and arrythmia

Front 28

What will a TCA overdose cause?

Back 28

1. arrythmia
2. TCA and MAO is a severely toxic combo

Front 29

How do you tx TCA toxicity?

Back 29

1. Sodium bicarb IV
2. decreases TCA binding to Na channels in cardiac

Front 30

What is Clomipramine?

Back 30

A TCA for OCD

Front 31

What are two third generation antiD?

Back 31

1. Remeron
2. Effexor

Front 32

What is buproprion?

Back 32

1. Wellbutrin is a weak NA,DA and 5HT reupatake inhibitor
2. Rare CV or sexual effects

Front 33

What us venlafaxine(effexor)?(3) ?Benefit, MoA and Tx?

Back 33

1. No H1 receptor = no sedation
2. Blocks NE and Serotonin reuptake
3. GAD and Panic disorder

Front 34

Would you use an SSRI or a TCA?

Back 34

1. An SSRI because they seldom cause cardiac arrythmia

Front 35

Name 6 SSRIs?

Back 35

1. Prozac
2. Paxil
3. Lexapro
4. Luvox
5. Celexa
6. Zoloft

Front 36

When do you administer SSRIs?

Back 36

In the morning because they increase alertness

Front 37

What are the problems with Fluoxitine SSRI?(3) What is teh unique thing?

Back 37

1. Drug interactions
2. Blood glucose regulations
3. Suicidal and violent behavior

4. Can treat Bullemia or Anorexia

Front 38

Most common adverse side effects of SSRI?(5)

Back 38

1. GI
2. Insomnia
3, Sexual sides
4. Hepatic disorder
5. Diabetes

Front 39

What do MAOIs do?(2) What are the contra indications?

Back 39

1. Oxidizes Serotonin way before NE,DA and Tyr
2. Inhibits MAO-A to inhibit depression
3. Never use with SSRI!
4. Can cause delirium, hypertensive crisis, seizures, and serotonin syndrome