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49 Cards in this Set
- Front
- Back
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MAOI MOA
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Inhibiting MAO-A
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Phenezline
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Nonselective MAOI
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Tranylcypromine
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Nonselective MAOI
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Moclobemide
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Sel MAO-A-I
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Selegiline
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Sel MAO-B-I
Parkinsons |
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Selegiline MOA
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usual Rx dose protects DA, dec isozyme selectivity @ higher doses of antidepressant effects
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MAOI AEs
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Wt gain
Seratonin syndrome Postural Hypotension |
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Serotonin syndrome
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Dec tyr met, NE release by sympathetics, dramatic HTN
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MAOI Contraindications
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Meperidine, opiates, sympathomimetics, TCAs, L-DOPA, SSRIs
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TCAs MOA
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-Nonselective inhibit NE, 5-HT reuptake
-Sel inh NE reuptake -Block postsyn 5-HT2 Rec |
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Amitriptyline
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TCA
Non-selectively inhibits N#, 5HT reuptake NE> 5-HT Chroinc pain |
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Nortriptyline
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TCA
Non-selectively inhibits N#, 5HT reuptake NE> 5-HT Chronic pain |
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Desipramine
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TCA
Non-selectively inhibits N#, 5HT reuptake NE> 5-HT |
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Imipramine
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TCA
Non-selectively inhibits N#, 5HT reuptake NE> 5-HT Nocturnal enuresis |
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Clomipramine
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TCA
Non-selectively inhibits N#, 5HT reuptake 5-HT>NE OCD |
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Desmethylimipramine
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Sel inh NE reuptake
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Desmethylchlorimipramine
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Sel inh NE reuptake
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Protriptyline
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Sel inh NE reuptake
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Maprotiline
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Sel inh NE reuptake
Ant of postsyn 5-HT2, alpha-2 adrenergic receptors |
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Amitriptyline
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Block postsyn 5-HT2 Rec
Also potent inh of NE>5-HT reuptake |
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Nefazodone
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Block postsyn 5-HT2 Rec
Weak inh of 5-HT reuptake |
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Maprotiline
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Block postsyn 5-HT2 Rec
Antagonist of NE reuptake Alpha-2 ad receptors |
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TCA AEs
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3 C's
Coma, Convulsions, Cardiotoxicity P450 interaxns Potentiate -Sympathomimetic amines -EtOH on CNS Dec seizure threshold, suicide risk Weight gain Sedation Antiadrenergic-antihist, antimusc efx Quinidine-like conduxn efx (NaCO3 antidote) Serotonin syndrome |
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Mirtazapine
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Non-TCA Block alpha-2 ad rec.
Blocks 5-HT3 no GI AE (N/V) |
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Where is serotonin found
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raphe nucleus
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Where is NE found
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locus ceruleus
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Rx Lag
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All antidepressants take 2-3 wk for Rx efx, 4-6 wk for max benefit, 8-12 wk for some disorders other than depression
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Trazodone
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5HT-2-R antagonist
Block reuptake of serotonin Hypnotic, insomnia Low BA, 2X/day AE: sedation, GI upset, CYP3A4 interaxn |
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Mirtazapine
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5-HT-2-R antagonist, blocks Hist release
Melancholic depression, insomnia, enhances appetite Long T1/2 Wt gain, sedation, P450 |
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Venlafaxine MOA
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Sel inh 5-HT reuptake @ [usual]
Inh NE reuptake @ [high] |
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Duloxetine
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Inh S,N @ [usual] (SNRI)
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SNRI Uses
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Depression
GAD Stress incontinence Vasomotor Sx of menopause Pain of diabetic peripheral neuropathy |
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SNRI AEs
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Milder, overlap w/SSRIs
NE effx Up Cardio efx Serotonin Syndromes |
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Fluvoxamine
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SSRI
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Fluoxetine
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SSRI
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Paroxetine
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SSRI
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Citalopram
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SSRI
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Escitalopram
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SSRI
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Sertraline
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SSRI
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Norfluoxetine
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SSRI active metabolite
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Desmethylcitalopram
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Active SSRI metabolite
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Desmethylsertraline
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Active SSRI metabolite
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SSRI Uses
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Depression
PTSD Bulimia nervosa GAD OCD Panic disorder PMDD |
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SSRI AEs
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P450 interactions
Discontinuation syndrome Serotonin syndrome w/MAOIs Safer @OD Diarrhea, initial anxiety Sedation/agitation N/V Sexual dysfunxn Red platelet agg |
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Bupropion
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Unicyclic
Weake to mod aability to block DA reuptake Poor ability to block 5-HT, NE reuptake |
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Bupropion Uses, AEs
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Amphetamine like
Depression Smoking cessation* P450 interaxn Lower inc of sexual dysfxn Agitation Insomnia Anorexia |
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Neurochem Changes w/ long-term MAOI Rx
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Downreg of postsyn Beta-Rec
Desensitization of autorec@5-HT term |
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Neurochem Changes w/long-term TCA Rx
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Downreg of postsyn Beta-Rec
Desens of alpha-2 autoRec |
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Intelligence Tests (Standford-Binet/Weschler Tests)
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1. STANFORD-BINET: An individually-administered intelligence test for individuals aged 2 through adult. The current version (Fourth Edition) yields a Composite Standard Age Score (SAS), Area SASs and subtest SASs. Composite and Area SASs have a mean of 100 and a standard deviation of 16.
2. WECHSLER TESTS: (a) WAIS-R: An individual intelligence test that yields Verbal, Performance and Full Scale IQs, as well as individual subtest scores. Verbal, Performance and Full Scale IQs have a mean of 100 and a standard deviation of 15. The WAIS-R is appropriate for individuals aged 16 and over. (b) WISC-III: A downward extension of the WAIS-R for children aged 6 through 16 years, 11 months. (c) WPPSI-R: A downward extension of the WAIS-R and WISC-III for children aged 3 through 7 years, 3 months. |
