Term
| What are the tertiary TCAs? |
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Definition
| Amitriptyline, clomipramine, doxepine, imipramine |
|
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Term
| what are the secondary tcas? |
|
Definition
| desipramine, nortriptyline, protriptyline |
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|
Term
| Which TCAs are used more often and why? |
|
Definition
| The secondaries, due to less incidence of SE's |
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Term
| What is the concern with TCAs after discontinuation? |
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Definition
|
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Term
| What is the MoA of the TCAs? |
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Definition
| NE and 5HT reuptake is BLOCKED. |
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Term
| What are the MAOI's? Which ones are selective and nonselective? |
|
Definition
| Phenelzine and tranylcypromine are non selective. Selegiline is MAOB selective at low dose, but will also inhibit MAOA at higher dose. |
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Term
| With which medication should you avoid tyramine? Why? |
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Definition
| MAOIs. tyramine is inactivated in the gut by MAO. Tyramine causes a large catecholamine release resulting in HA, tach, N/V, Cardiac arrhythmias, CVA. |
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Term
| upon MAOI withdrawal, what are the symptoms? |
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Definition
| NV, irritability, psychosis |
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Term
| which class of drugs are considered last line? |
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Definition
|
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Term
| What is the only drug approved for pediatric use? |
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Definition
|
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Term
| In which patient groups should caution be exercised when it comes to the TCAs? |
|
Definition
| elderly due to AEs, those with cardiac problems and the suicidal. |
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Term
| Which SSRI has a long washout time and why? |
|
Definition
| fluoxetine due to its active metabolite |
|
|
Term
| which drugs are activating? |
|
Definition
| fluoxetine, sertraline, venlafaxine, bupropion |
|
|
Term
| which drug is preg cat D? |
|
Definition
|
|
Term
| Which drug is NOT approved by the FDA for depression? |
|
Definition
|
|
Term
| which drugs are considered good for the elderly |
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Definition
| Very Elderly Bums Can't S**t: sertraline, citalopram (less interactions, less GI upset) escitalopram, venlafaxine, bupropion |
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Term
| _________is a 5HT reuptake inhibitor @ low dose and NE at high dose. _______inhibits 5HT and NE reuptake at all doses. Both drugs are in the __________ class |
|
Definition
| Venlafaxine, Duloxetine, SNRIs |
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Term
| Which drug, due to its renal elimination, needs to be adjusted in the impaired? |
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Definition
|
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Term
| Desvenlafaxine and Venlafaxine share a noteworthy AE. what is it? What are desvenlafaxine's other AEs? |
|
Definition
| BP increase is most noteworthy, diastolic for venlafaxine. in addition, desvenlafaxine also causes sweating, reduced appetite. |
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|
Term
| Which drug class is 5HT2 receptor antagonist and are 5HT reuptake inhibitors? |
|
Definition
| triaolopyridines (Nefazodone and trazodone) |
|
|
Term
|
Definition
|
|
Term
| What are trazodone's AE's? |
|
Definition
| PoS: PRIAPISM, orthostasis and sedation. |
|
|
Term
|
Definition
| A2 receptor antagonist, as well as blocking 5HT2-3 |
|
|
Term
|
Definition
| DA an NE reuptake inhibitor |
|
|
Term
| what are bupropion's AE's? |
|
Definition
| SEIZURES, and less sexual side effects |
|
|
Term
| which drug is also marketed for smoking cessation? |
|
Definition
|
|
Term
| Bupropion has dose related _______. What are the max doses allowed? |
|
Definition
| seizures. do not exceed 450 mg/d (400mg if ER) and 150mg/dose. |
|
|
Term
| which drug is contraindicated in eating disorders? |
|
Definition
|
|
Term
| what are the criteria for Major Depressive Disorder? |
|
Definition
| SIGECAPS- Sleep, Interest (lack of), Guilt, Energy decreased, Concentration (lack of), Appetite changes, Psychomotor retardation, Suicidality |
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|
Term
| What labs should be drawn to rule out depression? |
|
Definition
| CELT-CBC w/differential, Electrolyte, Thyroid fxn |
|
|
Term
| Which meds are often resemble Depression? |
|
Definition
Big Bad Sickness:
B-blockers, BZDs, Steroids (cortico and anabolic) |
|
|
Term
| which conditions often resemble depression? |
|
Definition
"Depression Can Hurt Even Poor Fools:"
DM, CHF, Hypothyrodism,
Epilepsy, PD, Fibromyalgia |
|
|
Term
| what are the phases of treatment with depression? |
|
Definition
| acute: 6-10wks is remission; Continuation: 4-9 mos is elim residual sx or prevent relapse; Maintenance: 12-36 mos is prevent recurrence |
|
|
Term
| What is first line tx for mild to moderate depression? |
|
Definition
|
|
Term
| Approx how long may it take for symptoms to subside in depression? |
|
Definition
| some improvement, 1-3 wks; may take 4-8 wks before max efficacy. |
|
|
Term
| about how long for optimal response in antidepressants? |
|
Definition
|
|
Term
| which SSRI is less likely to show withdrawal syndromes, incl irritability, HA and agitation, when discontinued? |
|
Definition
|
|
Term
| Serotonin syndrome's symptoms include______. A washout period of ________ must be observed before starting another serotonergic med. |
|
Definition
| Clonus, hyperthermia and mental status changes (Can Hurt Me); 2-5 wks |
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|
Term
| Mirtazapine is also available in ______ dosage form |
|
Definition
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