Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
22 Cards in this Set
- Front
- Back
|
Imipramine
|
3o TCA more potent in inhibiting S uptake
|
|
|
Amitriptyline
|
3o TCA more potent in inhibiting S uptake
|
|
|
Desipramine
|
- desmethyl imipramine
- 2o TCA more selective inhibitors of NE uptake |
|
|
Nortriptyline
|
- desmethyl amitriptyline
- 2o TCA more selective inhibitors of NE uptake |
|
|
TCA SE's
|
- narrow theraputic range
– CV (arrhythmias, long QRS) - small quantities prescribed to minimize use in suicide - muscarinic blockade – a-blocaide (orthostatic hypotension) – 5) H blockade (Sedation, Weight gain) |
|
|
MAOI mechanism
|
- both A and B vital to inactivation of S, EPI, NE, D, and phenethylamine
- classic MAOIs inhibit both |
|
|
MAOI SE's
|
– potentiate symp amines
– potentiates Tyramine, in wine and cheeses, which means hypertensive crisis - Strong CNS stimulation, convulsions, and coma ( serotonin syndrome) w/ MAOIs + TCAs, SSRIs – wait 2 wks to switch (4 w/ fluoxetine b/c long ½ life) – dont use w/ meperidine (Demerol) |
|
|
Phenelzine
|
MAOI
|
|
|
SSRI action
|
- Selectively inhibit serotonin (5-HT) reuptake
- most do not manifest noradrenergic or D effects – little affinity for muscarinic receptors |
|
|
SSRI SE's
|
- altered GI motility, nausea, agitation, anxiety, sleep disturbance, tremor, and HA
- sexual dysfunction |
|
|
Fluoxetine
|
SSRI
|
|
|
Sertraline
|
SSRI
|
|
|
Paroxetine
|
SSRI
|
|
|
Citalopram
|
SSRI
|
|
|
Venlafaxine
|
- SNRI devoid of antiH, antiCh, and antiadrendergic effects
– effective in depressed inpatients and outpatients, and relatively rapid therapeutic response – SE’s like SSRI’s, but Idiopathic HTN may occur at higher doses |
|
|
Bupropion
|
- noradrenergic uptake inhibitor
– doesn’t affect sexual function – Zyban for smoking – small risk of seizures – not ok if hx seizures, head injury, or eating disorder |
|
|
Mirtazapine
|
- enhances central noradrenergic and S neurotransmission
– Block presynaptic a2 R’s increased 5-HT and NE release – 5H2 and 5HT3 antagonist – net effect is selective increase in 5HT1A fcn – H1 blocker at lower doses – Side effects wt gain, sedation, none sexual |
|
|
Trazodone
|
– mixed 5-HT agonist/antagonist
– Weak 5-HT reuptake – significant a1 blocker and H1 blocker -> orthostatic hypotension and sedation – small doses as a hypnotic - Priapism |
|
|
Valproate
|
– anticonvulsant for acute manic episodes in BPD
– less effective in acute bipolar depression – may decrease catabolism and turnover to increase GABA and increases GABAB-R density – few SE’s compared to lithium, but include GI distress, benign elevations in hepatic transaminases, sedation, tremor, wt gain – rare but serious are hepatic failure, pancreatitis, and thrombocytopenia |
|
|
Lamotrigine
|
– anticonvulsant for bipolar depression and BPD maintenance
– no evidence of “switching” – if used w/ carbamazepine, double dosage b/c of enzyme induction – if used w/ valproic acid, it must be halved b/c of enzyme inhibition |
|
|
Carbamazepine
|
– Extended-release anticonvulsant for BPAD manic and mixed episodes
|
|
|
Atypicals for acute mania
|
Olanzapine, Quetiapine
|
