Pharm Unit 6-9

Front 1

psychotropic agents

Back 1

What are the drugs which alter the functioning of the mind (effect thinking, emotions, perceptions, etc)?

Front 2

affective disorders

Back 2

What disorders do psychotropic agents help with?

Front 3

affective disorders

Back 3

characterized by extremes of mood (depression and anxiety).

1. Catecholamine Theory of Mood (affective disorders) - moods correlated with neurotransmitters Norepi.

depression - caused by low levels of brain NE

anxiety - caused by high levels of brain NE.

2. Drugs work by altering Norepi levels toward normal

antidepressant - increases NE toward normal.

antianxiety agents - decreases NE function toward normal

Theory now expanded to include other "monoamines" such as serotonin.

Front 4

(affective disorders) - moods correlated with neurotransmitters Norepi.

depression - caused by low levels of brain NE

anxiety - caused by high levels of brain NE.

Back 4

What is the Catecholamine Theory of Mood?

Front 5

depression

Back 5

caused by low levels of brain NE

Front 6

anxiety

Back 6

caused by high levels of brain NE.

Front 7

antidepressant

Back 7

increases NE toward normal.

Front 8

antianxiety agents

Back 8

decreases NE function toward normal

Front 9

antidepressant agents

Back 9

What agents are used to treat depression?

Front 10

Tricyclics

Back 10

What is the drug of choice for severe depression?

Front 11

situational or reactive

endogenous or neurotic

Back 11

What are the two major types of depression that tricyclics treat?

Front 12

situational or reactive

Back 12

i.e. depression for a reason like illness, death in family, etc. - often not treated.

Front 13

endogenous or neurotic

Back 13

some people depressed all their life

may evolve LATER in life (involutional)

Front 14

neurotic
involutional

Back 14

Drug treatment used chiefly in ________ or ________ type of depression and usually only if vegetative functions disrupted (i.e. eating, sleeping, constipation, weight loss, lack of energy, etc.)

Front 15

amphetamines

Back 15

__________ are no longer used to treat depression since duration is short and is followed by worse depression. Also, too easily abused.

Front 16

Inhibits reuptake of NE upon release in synapse.

Back 16

How do tricyclics work or what is the mechanism of action?

Front 17

Tricyclics mechanism of action

Back 17

Inhibits reuptake of NE upon release in synapse.

Front 18

without
therapeutic

Back 18

80% of depressed individuals recover ________ treatment. Takes 2-3 weeks before __________ effects of drug are evident.

Front 19

1. sedation (occasionally)
2. anticholinergic - blurred vision, dry mouth, urinary retention, constipation. Tolerance may develop and withdrawl may occur which might be controlled with anticholinergic drugs. Cholineric rebound symptoms include nausea, anorexia, insomnia, more depression, and anxiety.

3. Cardiovacular - hypotension (mechanism not understood) arrhythmias may also occur (high or low rates)

4. Sexual dysfunction comon with all antidepressants.

Back 19

What are the side or toxic effects of tricyclics

Front 20

side or toxic effects of tricyclics

Back 20

1. sedation (occasionally)
2. anticholinergic - blurred vision, dry mouth, urinary retention, constipation. Tolerance may develop and withdrawl may occur which might be controlled with anticholinergic drugs. Cholineric rebound symptoms include nausea, anorexia, insomnia, more depression, and anxiety.

3. Cardiovacular - hypotension (mechanism not understood) arrhythmias may also occur (high or low rates)

4. Sexual dysfunction comon with all antidepressants.

Front 21

sedation
dry
anticholinergic
depression
arrhythmias
dysfunction

Back 21

1. __________(occasionally)
2. anticholinergic - blurred vision, ____ mouth, urinary retention, constipation. Tolerance may develop and withdrawl may occur which might be controlled with ___________drugs. Cholineric rebound symptoms include nausea, anorexia, insomnia, more ___________, and anxiety.

3. Cardiovacular - hypotension (mechanism not understood) _________ may also occur (high or low rates)

4. Sexual __________ comon with all antidepressants.

Front 22

1. hypotension, cardiac arrhythmias
2. drug interactions, esp. other sympathomimetics (e.g. amphetamines, MAO inhibitors, and adrenergic agents in general).

Back 22

What are the contraindications of Tricyclics?

Front 23

contraindications of Tricyclics

Back 23

1. hypotension, cardiac arrhythmias
2. drug interactions, esp. other sympathomimetics (e.g. amphetamines, MAO inhibitors, and adrenergic agents in general).

Front 24

MAO inhibitors

Back 24

Used only if:

tricyclics have failed
patient can be trusted not to take overdose or with certain foods (tyramine)

previous history of good response to drug

often useful with "atypical depression", i.e. sleep and eat too much rather than too little.

name drug.

Front 25

depression
hypertension

Back 25

What are the clinical uses of MAO inhibitors?

Front 26

hypotension

Back 26

What is the major side effect with MAO inhibitors?

Front 27

side effects of MAO inhibitors

Back 27

1. CNS stimulation (agitation, restlessnes, insomnia) - this is in contrast to the tricyclics which were sedating

2. hypotension ***
3. hypertensive crisis
4. GI - nausea, CONSTIPATION
5. anticholinergic - blurred vision, dry mouth, urinary retention usually less of a problem than with the tricyclics. Often important to older patient.

Front 28

1. drug and food interactions - includes tricyclics and all adrenergic agents. Must wait 10-14 days if switching from tricyclics to MAO inbititors.

2. Renal failure - drug will accumulate

Back 28

What are the contraindications for MAO inhibitors?

Front 29

contraindications for MAO inhibitors

Back 29

1. drug and food interactions - includes tricyclics and all adrenergic agents. Must wait 10-14 days if switching from tricyclics to MAO inbititors.

2. Renal failure - drug will accumulate

Front 30

Serotonin reuptake inhibitors
Tetracyclic

Back 30

What are some NEW antidepressant agents?