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57 Cards in this Set
- Front
- Back
What type of depression do patients respond + to pleasure/social reinforcement and what would you tx it with?
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Atypical; treat with MAOIs
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Under the biogenic amine hypothesis, what are depression and manic disorder associated with?
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Depression is a < in NE and or serotonin and Manic disorder is an > in physiological available biogenic amines
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What type of drug is Fluoxetine?
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SSRI
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What type of drug is Sertraline?
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SSRI
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What type of drug is Imipramine?
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TCA
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What type of drug is Amitriptyline?
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TCA
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What type of drug is Bupropion?
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NE/Dopamine reuptake inhibitor
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What type of drug is Mirtazapine?
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NE alpha 2 antagonist (blocks alpha 2 receptors and "cuts the brake cable" on the release of NE
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What drug "cuts the brake cable" on the release of NE?
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Mirtazapine
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What type of drug is tranylcypromine?
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MAOI
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How long do anti-depressants usually take to work?
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several weeks
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What type of drug is Paroxetine?
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SSRI
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What type of drugs are considered for initial therapy for depression and for generalized anxiety?
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SSRIs (Fluoxetine, Sertraline and Paroxetine)
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What have replaced the TCA?
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SSRIs
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What group of drugs may be effective in tx ADHA, OCD and PTSD?
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SSRIs
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What is the timeline for maximum benefit of an SSRI?
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6-8 weeks
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What group of drugs may be effective in t Bulimia and panic and social phobias?
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SSRIs
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What two side effects do SSRIs NOT have that many other agents do not?
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Little sedation, reduced anticholinergic effect
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What are some adverse effects of SSRIs?
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GI, insomnia and nervousness, SEXUAL side effects
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Use with what may cause SSRIs to cause Serotonin Syndrome?
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Use with MAOIs
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Where may you see a withdrawal syndrome?
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SSRIs
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What does Fluoxetine due to the liver?
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Depresses cytochrome p450 system
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What drug is also effective for PMDD?
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Fluoxetine
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What SSRI is associated with greater weight gain, more significant sexual side effects and teratogenic effects?
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Paroxetine
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Which TCAs cause sedation?
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Tertiary amines (Imipramine and Amitriptyline)
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What drugs show a quidone like depressant effect on cardiac muscle cells (a problem in OD)?
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TCA
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What TCA block the amine pump for Serotonin and NE?
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Tertiary (Impiramine and Amitriptyline)
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What TCAs block the amine pump for only NE?
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Secondary (Desipramine and Nortriptyline)
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What drugs can also be used to tx enuresis?
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TCAs (Impiramine)
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What chronic disease can TCAs tx?
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Neuropathic pain
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What drugs are alpha1-adrenergic receptor agonists?
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TCAs
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What do TCAs do to the seizure threshold?
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Lower it
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Which TCAs cause weight gain?
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Tertiary (Imipramine and Amitriptyline)
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What should you do in the case of a TCA OD?
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activated charcoal, Bicarb
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What should you use to control seizures with TCA use?
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Benzodiazepine
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What should you use to control arrhythemias in TCA use?
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Lidocaine, propranolol, phenytoin
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What would you tx hypotension in an TCA OD with?
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NE
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What drug potentiates the action of alcohol?
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TCAs
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What does Bupropion prevent?
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Dopamine and NE reputake in high doses
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Bupropion may reduce sexual SE in...
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men
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What drug is also marketed as ZYBAN for smoking cessation?
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Bupripion
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What drug has a significant sedative effect?
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Mirtazapine
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What drug may be useful in getting an elderly patient to gain weight?
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Mirtazapine
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How does Mirtazapine work?
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NOT a reuptake inhibitor; 5-HT2 and alpha 2 antagonist
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What drugs may be useful for atypical depression?
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MAOIs
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What type of drug is Tranylcypromine?
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MAOI
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What group of drugs do you have to worry about foods containing tyramine?
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MAOIs (Tyramine releases NE)
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What may the combo of foods with tyramine and MAOIs cause?
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Stroke
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What group of drugs may cause liver damage (significant)?
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MAOIs
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What drug would you worry about the combo of a decongestant in OTC cold meds?
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MAOIs
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What is the first line approach to treating manic disorder?
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Valproic acid
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What would you use Lithium to treat?
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Mania
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Treating mania with a newer antipsychotic like Risperidone (w) or Aripirazole have the advantages of what over Lithium and VA?
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No plasma levels (Lith) or liver function tests (NA valproate)
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Why may newer anti-psychotics tx manic disorder?
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They block serotonin and adrenergic receptors
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What is a benefit of Lithium?
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Tx manic disorder without sedation
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What drugs show favorable evidence for use in the pediatric population?
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Fluoxetine and Paroxetine (SSRIs)
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What is an especially teterogenic drug?
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Paroxetine (SSRI)
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