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35 Cards in this Set
- Front
- Back
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Name 3 SSRI drugs |
- Fluoxetine - Sertaline - Citalopram |
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Name 2 SNRI drug |
- Duloxetine - Vanlafaxine |
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Name a NASSA drug |
- Mirtazapine |
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Name 2 TCA drugs |
- Amitriptyline - Nortriptyline |
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What is the MOA of SSRI, SNRI, TCA and NASSA? |
SSRI: inhibit the re-uptake of serotonin from the synaptic cleft SNRI: inhibit the re-uptake of serotonin and noradrenaline TCA: inhibition of serotonin and noradrenaline re-uptake bit also acts on H1, alpha-1, D2 and muscurinic receptors. NASSA: antagonist of central alpha-2 receptors inhibiting negative feedback and increasing NA secretion. Also antagonist of 5HT receptors and H1 receptors. |
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What are the indications for SSRI? |
- First line for depression mild-mod - Panic disorder - OCD |
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What are the indications for TCA? |
- 2nd line for mild-mod depression - Neuropathic pain |
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What are the indications for SNRI? |
- Severe depression - Generalised anxiety |
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What are the indications for NASSA? |
- Severe depression - Sedation |
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What are the side effects of SSRI? |
- GI upset - Weight changes - Reduced appetite - Lowers seizure threshold - Hyponatremia - Suicidal thoughts - Citalopram = long QT |
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What are the side effects of SNRI and NASSA? |
- GI upset - CNS effects - Hyponatremia - Vanlafaxine = long QT - Suicidal thoughts - Mirtazapine = weight gain |
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What are the side effects of TCA? |
Anti-cholinergic - Dry mouth - Blurred vision - Urinary retention - Constipation H1/alpha-1 receptors: - Hypotension - Sedation D2 receptors: - Breast changes - Sexual dysfunction - Extra-pyramidal effects (e.g. tremor and Other: - Arrhythmia - ECG changes - Hallucinations - Mania - Convulsion |
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What are the warnings/CI of SSRI, SNRI, TCA and NASSA? |
SSRI: x epilepsy, PUD, hepatic impairment SNRI and NASSA: Caution: young people TCA: Caution: CVD, raised ICP, epilepsy, the elderly |
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What are the interactions of SSRI, SNRI, TCA and NASSA? |
- SSRI: anticoagulants, NSAID and Aspirin (due to GI bleed), other ADs (due to serotonin syndrome) - TCA, SNRI, NASSA: other AD and MAOI |
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Name the class of drugs (+ names) used to treat dementia and their MOA |
Acetylcholinesterase inhibitors- Rivastigmine, donepezil and galantamine NMDA receptor inhibitors- Memantine - Block NMDA receptors so that there is reduced glutamate production. - Glutamate accumulation leads to neurone degeneration in dementia
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What are the side-effects of dementia drugs? |
Ach cholinesterase inhibitors: - Hypotension - Dyspnoea - EP side effects - Bradycardia - Hallucinations NMDA receptor blockers: - HTN - Constipation - Dyspnoea - Raised LFT |
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What are the CI of dementia drugs |
ACI: - Asthma - COPD - CYP450 inhibitors NMDA blockers: - Asthma/COPD - Epilepsy - Ranitidine |
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Which drugs can be used to treat delirium? |
1st generation antipsychotics - Haloperidol - Chlorpromazine |
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What are the indications for 1st generation anti-psychotics |
- Psychomotor agitation - 2nd line in schizophrenia - Bipolar disorder - Palliative nausea and vomiting |
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What is the MOA of 1st generation antipsychotics? |
- Post-synpatic D2 receptor blockers in the mesolimbic and mesocortical pathways and the CTZ - Sedative effects |
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What are the side-effects of 1st generation antipsychotics |
- EP effects - Hypotension - Hyperprolactinaemia - Long QT - Erectile dysfunction - Dyskinesia |
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What are the warnings of 1st generation antipsychotics? |
Elderly Parkinson's Dementia |
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What are the interactions of 1st generation antipsychotics? |
- LOADS see BNF - Particularly with drugs that increase QT interval e.g. macrolide and amiodarone |
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What is the brand name of fluoxetine |
Prozac |
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What is the brand name of sertraline? |
Zoloft |
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What is the brand name of citalopram? |
Celexa |
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What is the brand name of mirtazepine? |
Remeron |
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What is the brand name of Venlafaxine? |
Effexor |
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What is the brand name of duloxetine? |
Cymbalta |
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What is the brand name of Amitriptyline? |
Elavil |
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Name 4 2nd generation antipsychotics |
Risperidone Clozapine Olanzapine Quetiapine |
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What is the MOA of atypical antipsychotics? |
Also dopamine antagonists in the mesolimbic and mesocortical pathway HOWEVER bind less strongly to D2 receptors so less EP side effects and they also bind to 5-HT receptors. |
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What are the side effects of atypical antipsychotics? |
- Long QT - Sedation - Weight gain, lipid disturbances and DMT2 - Clozapine = agranulocytosis - Risperidone = breast changes and sexual dy |
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What are the warnings for atypical antipsychotics? |
Caution: cardiovascular disease CI: neutropenia and severe heart disease |
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What are the interactions of atypical antipsychotics? |
- Drugs that prolong QT e.g. macrolides, - Other dopamine antagonists e.g. antiemetics such and metoclopramide |
