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17 Cards in this Set
- Front
- Back
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What bad effect of taking St. John's Wart with antidepressants?
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SEROTONIN SYNDROME
Increases serotonin levels in the brain. Not regulated by the FDA…sold over the counter…dangerous because it can interfere with their treatment. ..If they take St John Wort along with their other SSRI it can cause SEROTONIN SYNDROME. It is also a potent inducer of CYP450…so can make other drugs inactive. |
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Define Mania
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Abnormally Elevated, Expansive or Irritable Mood
Including (3 of the following): * Inflated Self Esteem or Grandiosity * Decreased Need for Sleep * Pressured Speech * Racing Thoughts * Distractibility * Excessive Involvement in Pleasurable Activities with High Potential for Painful Consequences |
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Define Depression
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Abnormal Depressed Mood or Anhedonia
Including (4 of the following) for 2 weeks: * Appetite Disturbance (Decrease or Increase) * Sleep Disturbance (Insomnia or Hypersomnia) * Activity Disturbance (Slowing or Agitation) * Abnormal Fatigue * Abnormal Self-Reproach or Guilt * Poor Concentration or Indecisiveness * Recurrent Thoughts of Suicide |
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What will tell you that an antidepressant is working?
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The vegatative signs will change
Activity Sleep Eating |
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Major Depressive Disorder is defined as
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One or more episodes of depression w/o episodes of mania.
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Define Bipolar I Disorder
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Pt has experienced one or more manic or mixed manic episodes.
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Define Bipolar II Disorder
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Pt has experienced one or more episodes of both Hypomania and Depression.
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Define Cyclothymic Disorder
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Pt has
2 yrs of cycling mood between hypomanic periods and depressive symptoms. |
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Describe the monoamine theory of depression
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Depression is caused by a depletion of 5-HT and NE in the brain.
Drugs that increase these will tx depression. If you have too much of these, this causes mania. |
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What is the MOA of TCA's?
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Block the reuptake of 5-HT and NE via SERT and NE transporters.
Increase EXTRANEURONAL levels of 5-HT and NE. These increased levels then bind to inhibitory autoreceptors and are neutralized...so no effect occurs. Dysregulation Hypothesis: Bind to autoreceptors overtime will slowly be internalized.... Over 2-4 wks inhibitory autoreceptors DOWNREGULATE. This stops the depression (more NT is released). (Downregulation of beta, alpha2, and 5-HT1 autoreceptors). |
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What is the MOA of SSRI's?
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Block the SERT transporter..blocking reuptake of serotonin. This increases extraneuronal levels of 5-HT.
Increased levels bind to SERT autoreceptors, inhibiting more 5-HT release..neutralizing the effects. Dysregulation Hypothesis: Binding to autoreceptors causes them to be internalized... Over 2-4 wks 5-HT1 inhibitory autoreceptors DOWNREGULATE. This stops the depression (more 5-HT is released). |
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What is the MOA of MAOI's?
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Inhibition of MAO-A increases intraneuronal levels of NE and 5-HT. These are later released by the cell.
Increased NT in synapse binds to inhibitory autoreceptors, decr further release and neutralizing the effects. Dysregulation Hypothesis: Binding to the autoreceptors causes them to be internalized... Over 2-4 wks inhibitory autoreceptors DOWNREGULATE. This stops the depression. (Downregulation of beta, alpha2, and 5-HT1 autoreceptors). |
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Reuptake inhibitors increase ________levels of NE and 5-HT.
MAOI's increase ________ levels of NE and 5-HT. |
Reuptake inhibitors increase extraneuronal levels of NE and 5-HT.
MAOI's increase intraneuronal. levels of NE and 5-HT. |
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What is the mechanism of depression?
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There are too many inihibitory autoreceptors on the presynatic terminals, preventing the release of the NT.
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TCA's have side effects similiar to?
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Phenothiazines
Similiar structure. |
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What do antidepressants do in a normal person?
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They are percieved as unpleasant.
Increased Anxiety Sedation Clumsiness Difficulty Thinking Poor Judgement. |
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T/F to find the proper antidepressant you have the find the one that is effective for that patient...ie has therapeutic effects.
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False.
They are all equally effectively (60-70% change). You have to find the one with the side effects that match the pts history. |
