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30 Cards in this Set
- Front
- Back
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What is one proposed etiology of depression that invloves synaptic receptors?
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Depression may be caused by an elevated B/a1 ratio. Therapy reverses this ratio.
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What happens to a1, a2 and B receptors during the start of anti-depressant therapy?
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a2 and B receptors are desensitized at the synapse while a1 receptors are not.
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Phenelzine
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MAO inhibitor.
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Tranylcypromine
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MAO inhibitor
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Selegiline
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Selective MAOb inhibitor
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What neurotransmitters are degraded by MAOa?
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Norepinephrine and Seratonin
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What neurotransmitters are degraded by MAOb?
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Dopamine
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Why do most anti-depressants cause a 2-3 week lag phase before they are effective?
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During this period a2 and B receptors are desensitized.
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What are the toxic effects of MAOIs?
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1. Postural hypotension due to a desensitization.
2. Insomia and impotence due to excessive autonomic stimulation 3. Potentailly fatal hypertensive crisis after ingestion of tyramine or sympathomimetic drugs like ephedrine or phenylpropanolamine. |
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What is the effect of mixing meperidine and an MAOI?
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May cause hyperreflexia and convulsions.
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Do TCAs produce CNS stimulation?
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No. TCAs actually cause sedation or fatigue especially during the first few weeks of treatment, followerd by some mood elevation.
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Amitriptyline
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Tricyclic Antidepressant
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Imipramine
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Tricyclic Antidepressant
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What is the mechanism of TCAs?
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They inhibit re-uptake pumps, increasing the synaptic concentration of Norepinephrine and Seratonin.
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What are the sympathomimetic effects of TCAs?
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Arrythmia, tremor and insomnia
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What are the antihistaminic effects of TCA's
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Initail sedation but tollerance soon develops.
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What are the antimuscarinic effects of TCAs?
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dry mouth, blurred vision, tachycardia, urinary retention.
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What are the effects of mixing TCAs with drugs that interfere with hepatic metabolism?
(antipsychotics) |
Enhanced toxic effects of TCAs
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What are the effects of mixing TCAs with drugs that increase hepatic metabolism?
(barbituates) |
May produce additive sedation effects.
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Trazadone and Nefazodone
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Anitdepressants that inhibit serotonin > norepi uptake.
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Venlafaxine
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Seratonin>>>NE pump inhibitor. Used to treat major depression
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Buproprion
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Unknown mechanism. Contraindicated in patients taking Zyban for smoking cessation.
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Amoxapine
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Antipsychotic with antidepressant effect.
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Maprotiline
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Potent NE reuptake inhibitor
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Mirtazipine
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Blocks serotonin and a2 receptors. Also blocks H1 receptors and produces sedation. May also cause weight gain
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What are the 4 main SSRIs?
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Fluoxetine, Sertaline, Paroxetine, and Fluvoxamine.
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What are the side effects associated with SSRIs?
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Nausea, insomnia, anxiety, decreased libido. Secondary to excessive serotonin.
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What is the promary use of Lithium?
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Stabilization of mood swings. Very effective in preventing manic episodes.
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How is Lithium eliminated from the body?
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It is excreted entirely by the kidney. Na loading causes an increase lithium secretion. Na depletion causes lithium retention.
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What is the effect of mixing Thiazides and Lithium?
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Causes Lithium toxicity due to renal excretion of Na and Litium retention. NSAIDS also increase Lithium reabsorption.
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