Psych - Antidepressants

Front 1

TCA with more anticholinergic se than others

Back 1

amitryptaline

think tachy, urinary retention, constipation, blurred vision, etc

Front 2

TCA SE

CI in pt with ______

Back 2

anti_HAM
antiHistamine: sedation
antiAndrenergic: orthostatc (most sig), rebound tachy, arrythmia
antiMuscarnic: dry mouth, constipation, urinary retention, blurred vision, tachy

prolonged QRS (>100)

conduction abnl

Front 3

which tCA is least sedating with lowest anticholinergic SE and has a lower seizure threshold

Back 3

Desipramine

Front 4

SSRIs are used for _______

mechanism?

list them

Back 4

5HT specific reuptake inhibitor

depression, OCD, bulimia, social phobia

Front 5

use which tca in elderly to avoid confusion and hallucinatoins?

why?

Back 5

confusion and hallucinations = anticholinergic SE. 3rd gen (amitryptaline) has more of this than 2nd gen (nortryptaline).

Front 6

TCA toxicity gives you _____

tx?

Back 6

convulsions
coma
cardiotoxicity (prolonged QRS)

tx is IV sodium bicarb

Front 7

major SE of SSRI

Back 7

GI distress
akithesia
sexual dysfunction

serotonin syndrome (w/ any drug that increase 5HT)

Front 8

which drugs increase 5HT

Back 8

SSRI
TCA
SNRI
MAOI
Mirtazepine (remeron)
Trazadone

Front 9

sx of 5HT syndrome and tx?

Back 9

hyperthermia
muscle rigidity
CV collapse
flushing diarrhea seixures

tx with cyproheptadine = 5HT2 antag

Front 10

most common SE of SNRIs

others?

Back 10

htn

sedation, stimulant, nausea

Front 11

list SNRIs

mech?

major use?

which has greater effect on NE?

Back 11

venlaxafine (effexor)
duloxetine (cymbalta)

inhibits 5HT and NE reuptake

depression

duloxetine (cyjmbalta)

Front 12

MAOIs are prohibited with which drugs to prevent 5ht syndrome? to prevent hypertensive crisis?

tx for each?

list them

Back 12

SSRI
meperedine

tx: d/c use

BBs
tyramine rich foods (cheese, cured meet, ripe fruit, wine
cocaine/amphetamines

tx: phentolamine or IV nitroprusside

selegiline
phenelzine (nardil)
tranylcypromine (parnate)
isocarboxazid (marplan)

Front 13

MAOI use and mech?

major SE?

Back 13

use = TX REFRACTORY DEPRESSION!! atypical depression, anxiety, hypochondriasis

mech = nonselective mao inhibition (increases level of amine NTs -- NE and 5HT)

hypertensive crisis with tyramine ingestion and B agonists

se = orthostatic hypotension, drowsiness, dry mouth, sleep dysfunction, sexual dysfunction

Front 14

Burpropion (wellbutrin)

use
mech
se

why do we like it?

CI?

Back 14

depression, smoking cessation, seasonal affective d/o, ADHD

NDRI: NE/DA reuptake inhibitor

SE: tachy, insomnia, psychosis and seizure, ha

no sexual dysfunction

CI: seizure pts, anxiety, psychosis, eating disorders

Front 15

mirtazapine mech

use?

se?

Back 15

NASA: NE and serotonin antagonist

use: refractory major depression and in those needing to gain wt

sedation (only at doses less than 15mg), increased appetite, weight gain, dry mouth, tremor, agranulocytosis

Front 16

trazadone mech?
use?
se?

Back 16

inhibits 5HT reuptake

used for insomnia (high doses needed for tx of depression), major refractory depression

se: SEDATION, nausea, PRIAPISM, orthostatic, cardiac arryth

Front 17

tramadol

use?
mech?
se?

resistance/tolerance to which 2 SE does not develop

Back 17

used for chronic pain

weak opioid agoinst and inhibits 5HT and NE reuptake
SE:decreases seizure threshold, same as opiods (resp depression, constipation, miosis

no tolerance to miosis or constipation

Front 18

list SSRIs (6)

Back 18

fluoxetine (prozac)
paroxetine (paxil)
sertraline (zoloft)
Fluvoxamine (luvox)
citolopram (celexa)
escitolopram (lexapro)

Front 19

which SSRI can be used for wt gain in anorexia

Back 19

fluoxetine (prozac)