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31 Cards in this Set
- Front
- Back
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What are the 4 classes of antidepressant drugs?
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1. tricyclics
2. SSRI's 3. SNRI's 4. MAOI's |
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How do tricyclic antidepressants work?
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They inactivate the amine pump on the presynaptic nerve terminal and limit reuptake of both NE and 5-HT.
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What are the two types of tricyclics?
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1. tertiary amines
2. secondary amines |
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What are the tertiary amine tricyclics?
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1. amitryptyline
2. clomipramine 3. doxepin 4. imipramine 5. trimipramine |
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What are the secondary amine tricyclics?
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1. amoxapine
2. desipramine 3. maprotiline 4. nortryptyline 5. protryptyline |
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What are the SSRI's?
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1. citalopram (Celexa)
2. escitalopram (Lexapro) 3. fluoxetine (Prozac) 4. fluvoxamine (Luvox) 5. paroxetine (Paxil) 6. sertraline (Zoloft) |
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What are the SNRI's?
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1. duloxetine (Cymbalta)
2. milnacipran (Ixel) 3. venlafaxine (Effexor) |
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What are the MAOI's?
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1. isocarboxazid
2. phenelzine 3. tranylcypromine |
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What are the atypical antidepressants?
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1. bupropion
2. nefazodone 3. mirtazapine 4. reboxetine 5. trazadone |
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Of the adverse effects that can occur from taking antidepressants, _______ is the largest inital problem.
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sedation
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Besides sedation, what are the other side effects that can occur from taking antidepressants?
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1. cardiovascular effects
2. seizures 3. blood abnormalities |
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Antidepressants should not be given with ________, _________, or a ___________.
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- other CNS depressants
- any antimuscarinic agent - MAOI |
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Interactions with various sympathomimetic agents is very problematic. What are some examples of indirect-acting and mixed acting sympathomimetics?
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indirect-acting:
-amphetamine - tyramine (dietary is esp a problem) mixed-acting: -pseudoephedrine -phenylpropanolamine |
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What is the most common treatment for bipolar depression?
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lithium
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True or false:
The therapeutic dose of lithium is very near the toxic dose. |
true
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What are the side effects of lithium?
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-GI problems such as nausea, vomiting, and diarrhea
-drowsiness -polyuria -dry mouth and thirst -weight gain -insomnia -(thyroid enlargment) -(increase in polymorphonuclear leukocytes) |
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What are the effects of acute lithium intoxication?
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-vomiting
-profuse diarrhea -coarse tremor ataxia -coma -convulsions |
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true or false:
Convulsions may occur in nonepileptic patients taking lithium at therapeutic doses. |
true
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What are the drug interactions for lithium?
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-diuretics
-NSAID's |
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How do diuretics interact with lithium?
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They either increase excretion:
-osmotic diuretics -acetazolamide or decrease excretion: -loop diuretics -thiazide diuretics |
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How do NSAID's interact with lithium?
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They may diminish clearance and increase plasma lithium.
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Increased serotonin leads to...
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increased mood and sleep and decreased libido and appetite
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Increased NE leads to...
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increased heart rate and sympathetics
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Increased parasympathetics lead to SLUDE effects. What does SLUDE stand for?
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Salivation
Lacrimation Urination Defecation Emesis |
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Tertiary amines are more selective for...
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5-HT
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Secondary amines are more selective for...
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NE
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With tertiary amines, there is an increase in 5-HT, which means...
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there is increased sedation.
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Secondary amines have more _______ effects.
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cardiovascular
(anti-SLUDE) |
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The problem with tricyclics is that they also "sit" on ____, ____, and _____ receptors.(and cause which additional effects?)
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-alpha1 (orthostatic hypotension)
-histamine1 (sedation) -muscarinic (anti-SLUDE) |
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What is the first choice of treatment for depression?
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SSRI's
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Which antidepressant has no sexual side effects because it doesn't deal with 5-HT?
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bupropion
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