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36 Cards in this Set
- Front
- Back
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Common adverse effects of tricyclic antidepressants
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antimuscarinic
alpha1 block antihistamine direct cardiac depressant |
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Overdose of tricyclic antidepressants would cause death by?
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cardiotoxicity
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Mechanism of action for tricyclics
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Norepi with some serotonin reuptake block
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Overdose treatment of tricyclics
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if acidotic give sodium bicarbonate
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Indications for tricyclics
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long term tx for depression (rare)
enuresis (suppress stage 4 and REM) chronic pain |
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long term effect of tricyclics (mechanism)
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tone down Beta receptor response
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Tricyclic drugs
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-pramine
-triptyline doxepin and maprotiline |
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phenelzine sulfate & tranylcypromine are in what class?
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non selective MAO inhibitors
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Type A MAO metabolizes
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NE, 5-HT, tyramine
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Type B MAO metabolizes
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dopamine
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Why is tranylcypromine a faster acting MAO inhibitor agent?
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It has direct receptor agonist actions
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How much time is needed to go from an SSRI to an MAOI?
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2 weeks unless the SSRI is fluoxetine (then 5 weeks wait)
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How much time is needed to go from an MAOI to an SSRI?
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2 weeks
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How much time is needed to go between tricyclics and MAOIs?
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2 weeks
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Why does there need to be so much time between using MAOIs and other CNS drugs?
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MAOIs are IRREVERSIBLE inhibitors to MAO
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Contraindication to MAOIs that if this drug is used with an MAO license should be handed over.
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meperidine
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common side effects to MAOI
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orthostatic hypotension
weight gain HTN |
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Second generation heterocyclic that blocks reuptake of serotonin (blocks presynaptic serotonin receptors to promote release)
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trazodone
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Unusual side effect from trazodone
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priapism
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Neurtransmitter involved in Bupropion mechanism
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dopamine
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Overdose of bupropion would cause this.
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status epilepticus
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Benefit of mertazapine
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soluble tablet form (no cheeking)
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mechanism of mirtazapine
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blocks alpha2 receptors to increase release NE and 5-HT
(blocks negative feedback) potent serotonin 2 receptor antagonist! |
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First line antidepressants
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SSRIs
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Venlafaxine added mechanism of action
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SSRI plus substantial NE component (SSNRI)
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Drug interactions of SSRIs
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protein binding
CYP450 issues cimetidine metoprolol imipramine pimozide and sertaline QT prolongation |
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What is Serotonin syndrome?
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mimics SNS discharge:
autonomic instability hyperthermia muscle rigidity |
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Sexual dysfunction associated with SSRIs
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delayed orgasm
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Weight loss or gain with SSRIs?
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weight loss
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venlafaxine shows dose dependant increase in what?
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Blood pressure
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Why should typical antidepressants not be used in manic episodes?
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They make them worse
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Lithium mechanism of action
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"bad substitute for Na"
uncouples G-protein |
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What is the leading cause of Li toxicity?
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dehydration
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Vomiting is a critical sign of Lithium toxicity therefore these should never be given with Litium?
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anti-emetics
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High or Low toxicity enhances lithium toxicity?
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Low Na (because body starts conserving Na and then it also conserves Li)
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No biotransformation of this drug used to treat bipolar disorder?
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Lithium (element idiot)
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