Term
| What are the four different classes of antidepressants? |
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Definition
*Tricyclic Antidepressants
*SSRIs
*Atypical Antidepressants
*Monoamine oxidase Inhibitors (MAOIs) |
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Term
| What is the MOA of Tricyclic antidepressants? |
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Definition
*Blockage of neuronal uptake of NE and S
*Can also have anticholinergic, antihistamine, and alpha adrenergic action as well. |
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Term
| What is the MOA of SSRIs? |
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Definition
| *Inhibition of seretonin reuptake |
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Term
| What is the MOA of Atypical Antidepressants? |
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Definition
| *can have action at multiple receptors ie: D, Ne, S |
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Term
| What is the MOA of MOAIs? |
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Definition
| *Inhibition of monoamine oxidase leading to decreased reuptake of NE, E, and S |
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Term
| Effected NT for Amitriptyline (Elavil)? |
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Definition
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Term
| Affected NT for Doxepin (Sinequan)? |
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Definition
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Term
| Affected NT for Imipramine (Tofranil)? |
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Definition
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Term
| Amlodipine (Asendin) affects what NT? |
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Definition
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Term
| Desipramine (Norpramin) affects which NT? |
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Definition
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Term
| Maprotiline (Ludiomil) affects which NT? |
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Definition
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Term
| Nortriptyline (Pamelor) affects which NT? |
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Definition
*NE
*S
*Anticholinergic
*Antihistmine |
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Term
| Bupropion(Wellbutrin) affects which NT? What side effects can it have? |
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Definition
*D
*NE
*CNS stimulation --> restlessness, insomnia and possible seizures
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Term
| Duloxetine (Cymbalta) affects which NT? What is it approved for? |
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Definition
*SSNRI
*Approved for major depressive disorder, GAD, and peripheral neuropathic pain |
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Term
| Aripiprazone (Ambilify) affects which NT? What is it approved for and what are its adverse affects? |
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Definition
*S
*D
*Approved for antipsychotic use in schitzophrenia, bipolar disorder, major depressive disorder, not for <18yo, not for psychotic condition
*Adverse effects: Heart failure, sudden death, pneumonia, tardive dyskinesia, hyperglycemia, NMS |
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Term
| Venlafaxine (Effexor) affects which NT? What are the side effects? |
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Definition
*SSNRI
*Side effects similar to SSRIs, well absorbed, extensively metabolized in the liver |
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Term
| What NT does Quetiapine Fuarate (Seroquel) affect? What are the side effects? |
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Definition
*S
*D
*Weak antagonism of histamine H1 receptors--> Somulence
*Alpha-1 adrenergic antagonism--> orthostatic hypotension
*This is the only atypical antidepressant with orthostatic hypotension as a side effect |
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Term
| What NT does Mirtazapine (Remeron) affect? |
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Definition
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Term
| What NT does Trazodone (Desyrel) affect? Why is it classified as an atypical antidepressant? |
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Definition
*S only
*It has a different chemical structure that other SSRIs |
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Term
| What are two life threatening toxicities seen with MAOIs? |
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Definition
*Hepatotoxicity
*Tyramine Induced Hypertensive Crisis |
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Term
| What are possible s/e of a hypertensive crisis? What drug class is this associated with? |
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Definition
*S/E: HTN, CVA, Hyponatremia
*Associated with MAOIs
*MAOIs + cold meds can precipitate Hypertensive Crisis |
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Term
| What can coadministration of SSRIs and MAOIs lead to? What are the S/S of this problem? |
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Definition
*Over stimulation of the serotonin receptors in the brain stem and spinal cord which can lead to Serotonin Syndrome.
*S/S of serotonin syndrome: Confusion, tremor, cyoclonus, hyperthermia, CV collapse |
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Term
| What was the black box warning placed on antidepressants? |
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Definition
| *Antidepressants may increase the risk of suicide at the beginning of therapy in some children, adolescents, and young adults. |
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Term
| What is the most serious adverse effect of antipsychotics? |
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Definition
*Tardive Dyskinesia
*Occurs in 20-40% of chronically treated patients
*No established treatment and reversibility may be limited
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Term
| What is the only antipsychotic that does not pose the risk of tardive dyskinesia? |
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Definition
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Term
| What are the symptoms of NMS? |
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Definition
*Hyperthermia
*Diffuse muscular rigidity
*Increased BP and HR
*Fluctuating levels of consciousness |
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Term
| What is the treatment of NMS? |
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Definition
*D/C drug, rehydration, and body cooling
*Dantrolene and bromocriptine to control rigidity and fever
*Bromocriptine is a dopamine agonist used as an antiparkinson's agent |
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Term
| What is the MOA of antipsychotics? |
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Definition
*Blocks the synaptic actions of dopamine D2 receptors
*Variable antagonist actions at muscarinic, alpha adrenergic, and histaminergic receptors in the brain and peripheral tissues |
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