Neuro 4: Antidepressants

Front 1

What type of depression do patients respond + to pleasure/social reinforcement and what would you tx it with?

Back 1

Atypical; treat with MAOIs

Front 2

Under the biogenic amine hypothesis, what are depression and manic disorder associated with?

Back 2

Depression is a < in NE and or serotonin and Manic disorder is an > in physiological available biogenic amines

Front 3

What type of drug is Fluoxetine?

Back 3

SSRI

Front 4

What type of drug is Sertraline?

Back 4

SSRI

Front 5

What type of drug is Imipramine?

Back 5

TCA

Front 6

What type of drug is Amitriptyline?

Back 6

TCA

Front 7

What type of drug is Bupropion?

Back 7

NE/Dopamine reuptake inhibitor

Front 8

What type of drug is Mirtazapine?

Back 8

NE alpha 2 antagonist (blocks alpha 2 receptors and "cuts the brake cable" on the release of NE

Front 9

What drug "cuts the brake cable" on the release of NE?

Back 9

Mirtazapine

Front 10

What type of drug is tranylcypromine?

Back 10

MAOI

Front 11

How long do anti-depressants usually take to work?

Back 11

several weeks

Front 12

What type of drug is Paroxetine?

Back 12

SSRI

Front 13

What type of drugs are considered for initial therapy for depression and for generalized anxiety?

Back 13

SSRIs (Fluoxetine, Sertraline and Paroxetine)

Front 14

What have replaced the TCA?

Back 14

SSRIs

Front 15

What group of drugs may be effective in tx ADHA, OCD and PTSD?

Back 15

SSRIs

Front 16

What is the timeline for maximum benefit of an SSRI?

Back 16

6-8 weeks

Front 17

What group of drugs may be effective in t Bulimia and panic and social phobias?

Back 17

SSRIs

Front 18

What two side effects do SSRIs NOT have that many other agents do not?

Back 18

Little sedation, reduced anticholinergic effect

Front 19

What are some adverse effects of SSRIs?

Back 19

GI, insomnia and nervousness, SEXUAL side effects

Front 20

Use with what may cause SSRIs to cause Serotonin Syndrome?

Back 20

Use with MAOIs

Front 21

Where may you see a withdrawal syndrome?

Back 21

SSRIs

Front 22

What does Fluoxetine due to the liver?

Back 22

Depresses cytochrome p450 system

Front 23

What drug is also effective for PMDD?

Back 23

Fluoxetine

Front 24

What SSRI is associated with greater weight gain, more significant sexual side effects and teratogenic effects?

Back 24

Paroxetine

Front 25

Which TCAs cause sedation?

Back 25

Tertiary amines (Imipramine and Amitriptyline)

Front 26

What drugs show a quidone like depressant effect on cardiac muscle cells (a problem in OD)?

Back 26

TCA

Front 27

What TCA block the amine pump for Serotonin and NE?

Back 27

Tertiary (Impiramine and Amitriptyline)

Front 28

What TCAs block the amine pump for only NE?

Back 28

Secondary (Desipramine and Nortriptyline)

Front 29

What drugs can also be used to tx enuresis?

Back 29

TCAs (Impiramine)

Front 30

What chronic disease can TCAs tx?

Back 30

Neuropathic pain

Front 31

What drugs are alpha1-adrenergic receptor agonists?

Back 31

TCAs

Front 32

What do TCAs do to the seizure threshold?

Back 32

Lower it

Front 33

Which TCAs cause weight gain?

Back 33

Tertiary (Imipramine and Amitriptyline)

Front 34

What should you do in the case of a TCA OD?

Back 34

activated charcoal, Bicarb

Front 35

What should you use to control seizures with TCA use?

Back 35

Benzodiazepine

Front 36

What should you use to control arrhythemias in TCA use?

Back 36

Lidocaine, propranolol, phenytoin

Front 37

What would you tx hypotension in an TCA OD with?

Back 37

NE

Front 38

What drug potentiates the action of alcohol?

Back 38

TCAs

Front 39

What does Bupropion prevent?

Back 39

Dopamine and NE reputake in high doses

Front 40

Bupropion may reduce sexual SE in...

Back 40

men

Front 41

What drug is also marketed as ZYBAN for smoking cessation?

Back 41

Bupripion

Front 42

What drug has a significant sedative effect?

Back 42

Mirtazapine

Front 43

What drug may be useful in getting an elderly patient to gain weight?

Back 43

Mirtazapine

Front 44

How does Mirtazapine work?

Back 44

NOT a reuptake inhibitor; 5-HT2 and alpha 2 antagonist

Front 45

What drugs may be useful for atypical depression?

Back 45

MAOIs

Front 46

What type of drug is Tranylcypromine?

Back 46

MAOI

Front 47

What group of drugs do you have to worry about foods containing tyramine?

Back 47

MAOIs (Tyramine releases NE)

Front 48

What may the combo of foods with tyramine and MAOIs cause?

Back 48

Stroke

Front 49

What group of drugs may cause liver damage (significant)?

Back 49

MAOIs

Front 50

What drug would you worry about the combo of a decongestant in OTC cold meds?

Back 50

MAOIs

Front 51

What is the first line approach to treating manic disorder?

Back 51

Valproic acid

Front 52

What would you use Lithium to treat?

Back 52

Mania

Front 53

Treating mania with a newer antipsychotic like Risperidone (w) or Aripirazole have the advantages of what over Lithium and VA?

Back 53

No plasma levels (Lith) or liver function tests (NA valproate)

Front 54

Why may newer anti-psychotics tx manic disorder?

Back 54

They block serotonin and adrenergic receptors

Front 55

What is a benefit of Lithium?

Back 55

Tx manic disorder without sedation

Front 56

What drugs show favorable evidence for use in the pediatric population?

Back 56

Fluoxetine and Paroxetine (SSRIs)

Front 57

What is an especially teterogenic drug?

Back 57

Paroxetine (SSRI)