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Antidepressants
n/a
67
Pharmacology
Graduate
09/08/2010

Additional Pharmacology Flashcards

 


 

Cards

Term
Impramine -> Desipramine
Definition
TCA
Term
Amitriptyline -> Nortriptyline
Definition
TCA
Term
Doxepine
Definition
Tertiary TCA
Term
Desipramine
Definition
Secondary TCA
Term
Amoxapine
Definition
Secondary TCA
Term
Blocks NE and 5HT reuptake
Definition
TCAs
Term
Anticholinergic (sedation, visual, GI, stasis)
Anti-histamine
Alpha blockade (hypotension, sexual function)
Definition
TCAs
Term
TCA Dose
Definition
25-75 mg/day once daily
Term
Dosed at bedtime
Definition
TCA
Term
Narrow therapeutic index (2-6 times therapeutic level)
Definition
TCA
Term
Most serious side effect in TCA
Definition
Cardiac toxicity (palpitations, tachycardia) due to Increased NE in heart
Term
Reason for decreased TCA compliance
Definition
Sexual dysfunction and loss of libido
Term
Phenelzine
Definition
Nonselective MAOI
Term
Tranylcypramine
Definition
Nonselective MAOI
Term
Isocarboxazid
Definition
Nonselective MAOI
Term
Major MAOI side effect
Definition
Cheese effect (hypertensive crisis)
Term
Inhibit breakdown of 5HT and NE
Definition
MAOIs (MAO-A)
Term
Clorgyline
Definition
MAO-A
Term
MAOI drug interaction/ side effect
Definition
Excitability with meperidine due to increased serotonin
Term
MAO-A
Definition
Degradation of
Epi
NE
5-HT
dopamine, tyramine
Term
MAO-B
Definition
Breakdown of
Dopamine
Tyramine
Phenylethylamine (precursor to NE)
Term
Wine-and-cheese reaction
Definition
Due to decreased MAO-A = Increased tyramine = Increased NE in circulation = hypertensive crisis (IC bleeding and organ damage)
Term
MAOI washout period
Definition
2 weeks
Term
MAOI AEs
Definition
Orthostatic hypotension
Insomnia
Weight gain
Sexual dysfunction
Term
Fluvoxamine
Definition
Mainly used in OCD
*ON EXAM: Not a SSRI
Term
Fluoxetine (Prozac)
Definition
SSRI
Term
Sertraline (Zoloft)
Definition
SSRI
Term
Paroxetine (Paxil)
Definition
SSRI
Term
Citalopram (Celexa)
Definition
SSRI
Term
Escitalopram
Definition
SSRI
Term
Major SSRI SE
Definition
5HT Syndrome (SS): hypertensive crisis
Term
SSRI Other SEs
Definition
Little or no effect on NE/dopamine reuptake
Little or no anticholinergic, antihistamine or alpha-1 effects
Term
MAO: Selective blockade of 5HT reuptake
Definition
SSRI
Term
Other causes of SS
Definition
SSRIs
SNRIs
Tertiary TCAs
MAOIs (with serotenergic agents)
MAOIs with meperidine
Term
SSRI with long half-life
Definition
Fluoxetine : Ensure 5 weeks washout (vs. 2 weeks for other SSRIs)
Term
SSRI dosing
Definition
Once daily
Start low dose
Anxiety dose is 1/2 of depression dose
Term
Other SSRI SEs
Definition
GI
Somnolence/insomnia
Sexual dysfunction
Agitation/nervousness
Term
SSRI Drug interaction
Definition
Hyponatraemia with diuretics
Carbamzepine, phenytoin
With other psychotropics
Term
Venlafaxine (Effexor)
Definition
SNRI
Term
Duloxetine (Cymbalta)
Definition
SNRI
Term
Pristiq (desvenlafaxine)
Definition
SNRI
Term
SNRI SEs
Definition
Reduced anti-cholinergic, alpha-blocking and histamine effects than TCAs

(SNRI also used for anxiety)
Term
Venlafaxine IR dosing
Definition
25-37.5 mg/day increase by 25-37.5 mg q4-7 days (max 150 mg/day)
Term
Venlafaxine ER dosing
Definition
75 mg/day titrated up by 75 mg per week (max 375 mg/day)
Term
Mirtazapine
Definition
Mixed serotonin norepinephrine effects
MAO: Presynaptic alpha 2-antagonist (increase central noradrenergic and serotonergic NTs)
Term
Mirtazapine major SE
Definition
Increased appetite and weight gain (15-20lbs in 1 month)
Term
Bupropion
Definition
NDRI (NE DA reuptake inhibitor) : inhibits weakly uptake of DA, NE and 5HT
Term
Bupropion dosing
Definition
Start 75-150 mg/day
Target 150-300 mg/day

Max 400 mg/day (SR) and 450 mg/day (XL)
Term
Bupropion SEs
Definition
GI, seizure, sexual dysfunction
**Also used for smoking cessation
Term
Trazodone
Definition
Misc.
highly sedative and priapism in males (major SE)
Term
Ketamine
Definition
Misc.
Effect due to NMDA blockade
Term
Acute treatment phase
Definition
6-8 weeks
Term
Continuation treatment phase
Definition
6-9 month
Term
Maintenance treatment phase
Definition
1-2 years
Term
Weeks 1-2
Definition
Physical responses
Term
Week 3-4
Definition
Energy and cognitive responses
Term
Week 5-6
Definition
Emotional responses
Term
Comorbidities with neuropathy use:
Definition
Duloxetine, TCA
Term
Comorbidities with smoking or obesity use:
Definition
Bupropion
Term
Comorbidities with anxiety use:
Definition
SSRI
Term
Comorbidities with Insomnia use:
Definition
Paroxetine
Mirtazapine
Trazodone
Term
St. John's Wort dose
Definition
300 mg TID or 450 mg BID
Term
St. John's Wort MAO
Definition
inhibit NE, Serotonin and DA uptake for mild and moderate depression ONLY
Term
SAMe dose
Definition
200-400 mg 2-4 /day
Term
SaMe MAO
Definition
Increase neuronal membrane fluidity and increase NE, dopamine and serotonin
Term
Omega-3 FA dose
Definition
> 9.6 gm per dayas adjunctive therapy
Term
FA dose
Definition
0.5 mg daily as adjunctive therapy
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