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25 Cards in this Set
- Front
- Back
- 3rd side (hint)
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What are the 4 classes of anti-depressants?
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1. SSRI 2. SNRI 3. NaSSa 4. TCA |
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List the 5 SSRIs |
1. Fluoxetine 2. Fluvoxamine 3. Setraline 4. Paroxetine 5. Escitalopram |
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How long should a person take a SSRI drug? |
6 weeks minimum |
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What is the mechanism of action of SSRIs? |
SSRI selectively blocks re-uptake of serotonin at pre-synaptic terminals, thus increasing synaptic concentrations of serotonin concentrations |
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5 HT 1 agonism effects 5 HT 2 agonism effects 5 HT 3 agonism effects |
5 HT 1 agonism = anti-depressant 5 HT 2 agonism = agitation, tremor, insomnia, sexual dysfunction 5 HT 3 agonism= nausea, abdo pain, constipation |
5 HT 2 antagonism = sleep restoring, less sexual dysfunction, weight gain 5 HT 3 antagonism = less GI side effects |
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Name the side effects of fluoxetine. what is the dosage? What is the half life of fluoxetine? what is the pharmacokinetic of fluoxetine? |
SE: - anxiety and agitation - hypersomnolence - nausea and dry mouth - delayed ejaculation and impotence 20-60 mg/day half life = 72 hours pharmacokinetic: it is metabolised by cP450, and at the same time inhibits cP450 |
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Name the side effects of fluvoxamine. what is the dosage? What is the half life of fluvoxamine? what is the pharmacokinetic of fluvoxamine? |
SE: - nausea - delayed ejaculation and impotence - worsens GERD dosage = 50-300mg/day half life = 19 hours pharmacokinetic: - metabolized into inactive products by ??? - potent inhibitor of cP450 |
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Name the side effects of setraline. what is the dosage? What is the half life of setraline? what is the pharmacokinetic of setraline? |
SE: - GI side effects - Headache - Insomnia - Dry mouth - Ejaculation failure dosage = 50-200 mg/day half life = 26-32 hours pharmacokinetic: inhibits cP450 |
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Name the side effects of paroxetine. what is the dosage? What is the half life of paroxetine? what is the pharmacokinetic of paroxetine? |
SE: - anticholinergic SE - sedative - nausea - acute closed angle glaucoma - congenital heart defects in first trimester - ejaculation failure and impotence dosage = 12.5-50mg/day half life = short???? pharmacokinetic: this medication undergoes extensive first-pass metabolism, so controlled release is needed |
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Name the side effects of Escitalopram. what is the dosage? What is the half life of Escitalopram? what is the pharmacokinetic of Escitalopram? |
SE: - nausea and vomiting - increased sweating - dry mouth - ejaculation failure and impotence - dose dependent QTc prolongation dosage = 10-20mg/day half life = short?? pharmacokinetic: relatively weak inhibition of cP450 *** fewer side effects, more potent, but short acting |
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Give one example of NaSSa what does NaSSa stand for? |
Mirtazapine Noradrenergic specific serotonin anti-depressant |
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what is the MOA of NaSSa? |
blocks negative feedback of noradrenaline on presynaptic a2 receptors, and activates noradrenaline system also stimulates serotonin, which increases noradrenaline activity |
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Name the side effects of mirtazapine. what is the dosage? What is the half life of mirtazapine? what is the pharmacokinetic of mirtazapine? |
SE: - Sedation - Weight gain - increase appetite - dry mouth - postural hypotension dose = 15-45 mg/day half life = 22 hours pharmacokinetics: - metabolized by cP450 Benefits: Less sexual SE, sedative, helps to regain weight |
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Name 3 examples of SNRI |
1. Venlafaxine 2. Duloxetine 3. Agomelatine |
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Name the side effects of Venlafaxine. what is the dosage Venlafaxine extended release? What is the half life of Venlafaxine? |
SE: - Dose related hypertension - nausea - dry mouth - constipation - sexual dysfunction - prominent discontinuation syndrome (so give XR) - toxic DDI with MAO-I dosage = 75-375 mg/day half life = 5-7 hours |
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Name the side effects of Duloxetine. what is the dosage? what is the pharmacokinetic of Duloxetine? what are some of the other indications for duloxetine? |
SE: - nausea - dizziness - dry mouth - fatigue - somlonence - constipation - small increase in HR - low rates of sexual dysfunction dose = 30-120 mg/day pharmacokinetic: metabolized by cP450 Other indications: - Depression - Chronic pain - Fibromyalgia |
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Name the side effects of agomelatine. what is the dosage? what are the 2 contraindications? what test is needed before starting the drug? |
SE: - Hyperhidrosis - Nausea/vomiting - diarrhea/constipation - increased LFTs - sedation dosage = 25 mg tablets contraindicated in renal/liver failure patients Need to check LFTs before giving the medication |
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What is the MOA of TCA? |
Inhibits re-uptake of noradrenaline and serotonin blocks histaminergic, alpha-adrenergic, cholinergic, muscarinic receptors on post synaptic membrane |
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Name two types of TCA |
Amitryptilline Clomipramine |
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What are the side effects of TCAs? |
1. Anti-cholinergic 2. Anti-histamine, anti-dopamine 3. Cardiac arrhythmia 4. sexual dysfunction 5. hyponatremia |
anti-cholinergic SE: dry mouth, blurry vision, flushed skin, urinary retention, constipation, dizziness, syncope, postural hypo, sedation Anti-histaminergic and anti-dopaminergic effects: Sedation, weight gain, nausea/vomiting |
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what are the types of cardiac arrythmia for TCAs? |
QTc prolongation Heart block |
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what are the signs of TCA overdose? what is the antidote for TCA overdose? |
- Arrhythmia (QTc prolongation) - dilated pupils - central respiratory depression ABG shows acidemia Antidote: Sodium Bicarbonate 50 mmol/50 mL for rapid administration |
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What are the Contraindications of TCA? |
1. cardiac diseases 2. epilepsy 3. severe liver disease 4. prostate hypertrophy 5. mania |
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What are the other indications for TCA? |
1. chronic pain 2. neuropathic pain 3. migraine prophylaxis 4. enuresis |
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Name 1 other anti-depressant name 3 advantages of this drug name 1 disadvantage |
Bupropion Good for: - no sexual dysfunction - no weight gain (in fact wt loss) - help with smoking cessation Bad for: - induce seizures if dose is above 450 mg/day - agitation, tremors, insomnia |
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