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25 Cards in this Set
- Front
- Back
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3 Major Types of Depression
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1. Reactive depression (due to any event)
2. Major depressive disorder (without any obvious cause) 3. Bipolar affective disorder (manic-depressive disorder) |
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3 ways of getting major depression
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-Getting 4-5 out of the sticicaps signs
-Due to a major event (need to wait 6 months before we can consider it major depression!) -With or without event (wife dies, wants to kill himself), or for no reason (reactive depression) Note reactive depression is part of natural grieving period, if it lasts longer than that, we have depression |
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Drug targets
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Inhibit metabolism of neurotransmitter breakdown
MAO-Inhibitors Inhibit reuptake pump TCA HCA SSRI |
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MAO inhibtors
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used when ptn is gaining too much weight
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TCA
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Imipramine , Amitriptyline , clomipramine , doxepin , amoxapine
Act by inhibiting the reuptake mechanisms Nonspecific reuptake inhibition for NE and 5-HT This results in increased levels neurotransmitter at postsynaptic receptors Imipramine and aitriptyline are prodrugs- actiavted by CPY450 Therefore, drugs that inhibit CYP450, decrease benefit, and drugs that increase CYP450 cause drug overdose -sexual dysfunction; anogasmia |
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TCA toxicity
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Blocks HAM:
H Sedation A orthostatic hypotension M dry mouth, palpitations, Constipation, urinary retention Increases apetite Wt gain Over dose – 3 C’s (caused by CYP inducers) Coma, Convulsions, Cardiac toxicity (long QT syndrome) |
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45 y. old male normal test results, but lost of weight, need to be put on anitdepressent
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put em on cyclic anti depressant
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Heterocyclic Antidepressants
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Trazadone, bupropion, amoxapine
drugs act by higher degree of specificity to inhibition of NE or 5-HT Mirtazapine specifically inhibits presynaptic 2 receptors |
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-ONLY correct answer if given w/ info (hyperprolactinemia, parkinsonism), prolonged erection, or drug contraindicated in sickle cell anemia, which drug to prevent sexual dysfunction
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Heterocyclic Antidepressants
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bupropion;
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hAS NO sexual dysfunction
increased risk of seizures: so contraindicated in seizures or alcoholics |
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Trazadone;
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painful, prolonged erection, contradiciated in men and in gerearl sickle cell enmia
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-q, ptn needs anti-, is anemic, male; which drug contraindicateD?
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trazadone
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Amoxapine
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dopamine blocking effect, so can cause akathesia, pseudoparkinsonism and hyperprolactinemia
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SSRI
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Fluoxetine, Paroxetine and Sertraline, Citalopam, Escitalopram
Act by selectively inhibiting the reuptake of serotonin Little or no effect on NE uptake Lesser side effects Hepatic CYP450 enzyme inhibitors: possible drug interactions |
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SSRI ADR
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Nausea, headache, anxiety, agitation
Anorgasmia- inablity to orgasm Therefore SSRI in genearl can be used for premature ejaculation Fluoxetine: dopamine blocking effects Overdosage: seizures SSRIs are inhibitors of CYP450 (decreases action of TCA and increases action of warfarin) Serotonin syndrome with MAO inhibitors |
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ptn w/ premature ejaculation,DOC?
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SSRI
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MAO-Inhibitors
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Phenelzine and Tranylcypromine , isocarboxazid
Inhibit both MAO A & B Act by inhibiting the MAO enzyme responsible for metabolism of the neurotransmitters (NT) Thus increases vesicular storage of NE and 5-HT Thus increases the brain levels of these NT -cause WEIGHT loss |
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Fluoxetine
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SSRI
Act by selectively inhibiting the reuptake of serotonin Little or no effect on NE uptake |
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Paroxetine
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Act by selectively inhibiting the reuptake of serotonin
Little or no effect on NE uptake |
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Sertraline
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Act by selectively inhibiting the reuptake of serotonin
Little or no effect on NE uptake |
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Citalopam
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Act by selectively inhibiting the reuptake of serotonin
Little or no effect on NE uptake |
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Escitalopram
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Act by selectively inhibiting the reuptake of serotonin
Little or no effect on NE uptake |
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Phenelzine
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MAO-Inhibitors
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Tranylcypromine
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MAO-Inhibitors
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Isocarboxazid
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MAO-Inhibitors
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