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22 Cards in this Set

  • Front
  • Back
What is the amine hypothesis of mood?
A functional decrease in amines-particularly norepinephrine and serotonin-results in depression
What are tricyclic antidepressants related to?
What do TCAs do?
Block monoamine pumps
What transporters are blocked by TCAs?
NE and 5HT--some block DA
Are TCAs 1st line therapy?
What other receptor actions to TCAs have?
antimuscarinic, anti-alpha-adrenergic, and antihistaminic
What are the side effects of TCA?
sedation, dry mouth, urinary retention, etc.
what causes TCA sedative effects?
H1 blockade, which is additive with other sedatives like EtOH
What about TCA and seizures?
TCAs lower seizure threshold
Is there interaction between TCA and MAOI?
Yes, don't give TCAs within 3 weeks of cessation of MAOI because of exaggerated monoamine effect
What has limited TCA use?
can be fatal upon overdose
What are effects of TCA overdose?
agitation, delirium, coma, respiratory distress, high fever, seizures, cardiovascular abnormalities
What are the MAOI isoforms?
MAO A and MAO B--both are found in the human brain
What are the substrates for MAOIs?
Tyramine and DA for both; MAO A also metabolizes 5HT and NE
Where are MAOIs found?
What does inhibition of MAOIs lead to?
accumulation of 5HT, NE, and DA in synaptic vesicles and cytoplasm of synaptic ending--this exarggerates monoamine response
When do MAOIs begin working?
several weeks after initiation
What are the MAOIs available?
phenylzene and tranycypromine
What indications are there for MAOIs?
Tyramine-free diet. (Tyramine can cause a hypertensive crisis) Also, can't take ephedrine or pseudoephedrine
How else can MAOIs cause a hypertensive crisis?
Cause the release of NE
Which isoforms are inhibited by MAOIs?
Both A and B
What side effects to MAOIs have
Hypotension due to ganglionic blockade caused by exaggerated release of monoamines from inhibitory ganglionic interneurons