Pharamcology > Antidepressants > Flashcards

Antidepressants Flashcards

(42 cards)

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1
Q

What are the three hypothesis’ That have been proposed for pathogenesis of depression

A
  1. Decreased level or function of monoamines (NE, DA, 5-HT) in cortical lambic system
  2. Decrease in brain derived neurotrophic factor
  3. Abnormalities in HPA axis, thyroid function and sex steroid levels
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2
Q

Classify antidepressants

A
  1. Tricyclic antidepressants
  2. selective serotonin reuptake inhibitors
  3. serotonin and noradrenaline reuptake inhibitors
  4. atypical anti-depressants
  5. MAO-A inhibitors
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3
Q

Name tricyclic antidepressants

A
  1. Amitriptyline
  2. Amoxapine
  3. Nortriptyline
  4. Trimipramine
  5. Imipramine
  6. Doxepin
  7. Desipramine
  8. Dothiepin
  9. Protriptyline
  10. clomipramine
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4
Q

Name selective serotonin reuptake inhibitors

A
  1. Fluoxetine
  2. fluvoxamine
  3. citalopram
  4. escitalopram
  5. sertraline
  6. peroxentine
  7. dapoxetine
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5
Q

Name serotonin and noradrenaline reuptake inhibitors

A
  1. Duloxetine
  2. venlafaxine
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6
Q

Name atypical antidepressants

A
  1. Trazodone
  2. mirtazapine
  3. Bupropion
  4. Mianserin
  5. Atomixetine
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7
Q

Name MAO-A inhibitors

A
  1. Moclobemide
  2. Clorgyline
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8
Q

What are the adverse effects of tricyclic antidepressants

A
  1. Atropine like side effects (Dry mouth, blurry vision, constipation, Urinary retention)
  2. alpha-1 adrenergic blocking effects (Tachycardia, arrhythmias, postural hypotension)
  3. H-1 blocking effects (sedation and confusion)
  4. Increased appetite and weight gain
  5. May precipitate convulsions
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9
Q

What are the contraindications of tricyclic antidepressant

A
  1. Glaucoma
  2. epilepsy
  3. ischaemic heart disease
  4. enlarged prostate
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10
Q

What is the mechanism of action of serotonin reuptake inhibitors

A

Block serotonin transporter by blocking it’s reuptake. This increases the availability of serotonin at the receptors

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11
Q

Which selective serotonin reuptake inhibitors produce active metabolites

A

Fluoxetine
sertraline

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12
Q

What is the longest acting selective serotonin reuptake inhibitor? What is it half life

A

Fluoxetine.
48 to 72 hours

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13
Q

What are the adverse effects of selective serotonin reuptake inhibitors

A
  1. G.I. symptoms (nausea, vomiting, diarrhoea)
  2. headache, insomnia
  3. sexual disfunction, impotence, loss of libido
  4. inhibit drug metabolizing enzymes
  5. Drug interactions
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14
Q

Which SSRIs Have less potential for drug interactions

A

Sertraline
citalopram
escitalopram

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15
Q

Why are the adverse effects of serotonin and norepinephrine reuptake inhibitors

A
  1. Nausea, sweating, sexual disfunction, anxiety
  2. Hypertension
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16
Q

What is the MAO of SNRIs 

A

Inhibitory uptake of serotonin and noradrenaline into the neuron

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17
Q

Which Atypical antidepressant inhibits the reuptake of dopamine and norepinephrine in the neuron?

18
Q

Which a typical antidepressant is useful for smoking sensation

19
Q

What are the adverse effects of bupropion

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A

Dry mouth, tremor, sweating, convulsions

20
Q

What is the mechanism of action of mirtazapine

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A
  1. Blocks alpha-2 auto receptors
  2. Blocks hetero receptors on 5HT neurons
  3. Increases norepinephrine and 5HT release
  4. Blocks H-1 receptors
21
Q

Which atypical antidepressant may cause weight gain and sedation

22
Q

What is the mechanism of action of trazodone

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A
  1. Blocks 5HT reuptake
  2. 5HT-2 antagonist
  3. blocks alpha-1 receptors
23
Q

What are the adverse effects of trazodone

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A
  1. Sedation
  2. hypotension
  3. priapism (painful erection of penis)
24
Q

What is the mechanism of action of mianserin

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A

Increases norepinephrine release by blocking presynaptic alpha-2 receptors

25
What are the side effects of mianserin
1. Can cause seizures 2. antianxiety action 3. anticholinergic 4. cardiac side effects 5. causes sedation
26
What are the two types of MAO inhibitors and what is their selectivity
MAO-A : Metabolism of norepinephrine, serotonin, tyramine MAO-B: metabolism of dopamine
27
What is moclobemide
Selective and reversible inhibitor of MAO-A
28
What is the interaction between tricyclic antidepressants and MAO inhibitors
1. Hypertensive crisis 2. hyperpyrexia 3. Coma 4. convulsions 
29
What is the interaction between TCA and alcohol
Potentiation of CNS depressant effects
30
When SSRI and MAO inhibitors are given together it causes serotonin syndrome which is increased serotonin what are the undesirable effects
1. Coma 2. tremor 3. restlessness 4. muscle rigidity 5. hyperthermia 6. sweating, shivering 7. seizures
31
The metabolism of which drugs is inhibited by SSRIs 
1. TCAs 2. antipsychotics 3. Beta blockers 4. phenytoin 5. carbamazepine 6. Others
32
What is cheese reaction
It’s when MAO inhibitors are taken by a patient and they consume food rich in tyramine this causes fatal hypertensive crisis and cerebrovascular accidents.
33
How do you treat cheese reactions
IV Phentolamine
34
Why are SSRIs preferred over TCAs
1. Better tolerance 2. less side effects 3. longer duration of action
35
Which drugs can be used in OCD
Clomipramine fluvoxamine
36
Which drugs can be used in ADHD
1. TCAs 2. Atomoxetine 3. Methylphenidate 4. Dextroamphetamine
37
Which drug is used in nocturnal enuresis
Imipramine
38
Which drug is used in the prophylaxis of migraine
Amitriptyline
39
Which drugs are useful in chronic pain inducing neuroglias
1. TCAs are effective in trigeminal, herpetic, post-herpetic neuralgias 2. Venlafaxine and duloxetine Used in the treatment of fibromyalgia
40
Which drugs are useful for atopic dermatitis
Topical doxepin
41
Which drugs are used for premature ejaculations
SSRIs and TCAs 
42
What are the uses of antidepressants
1. Depression 2. anti-anxiety 3. OCD 4. ADHD 5. nocturnal enuresis 6. prophylaxis of migraine 7. chronic pain inducing neuroglias 8. Atopic dermatitis 9. premature ejaculation
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