Term
What is the Mono-Amine hypothesis of Depression?
What drug can induce Depression? |
|
Definition
Depression is due to a low level of Mono-amines- Serotonin & Norepi
Reserpine - Depletes the neuronal storage of Serotonin & Norepi |
|
|
Term
| What are the different classes of Antidepressants? |
|
Definition
TCA's
MOA inhibitors
SSRI
SNRI (serotonin & Norepi re-uptake inhibitors)
NARI (Norepi/ Noradrenalin re-uptake inhibitors)
NDRI (Norepi & Dopamine re-uptake inhibitors)
|
|
|
Term
Name the TCA's
What is their MOA? |
|
Definition
Amitriptyline
Amoxapine
Desipramine
Doxepin
Imipramine
Nortriptyline
Non selective re-uptake inhibitors - inhibiting Norepi & Serotonin |
|
|
Term
Name the SSRI's
MOA?
ADR? |
|
Definition
|
Fluoxetine
Fluvoxamine
Sertraline
Paroxetine
Citalopram
Selectivly block the re-ptake of serotonin from the synaptic cleft ONLY!!
Decreased libido!
** most widely used Antidepressants** |
|
|
Term
Name the MAO's
MAO inhibitors MOA?
What is a specific ADR? |
|
Definition
Phenelzine & Tranylcypromine - Nonselective MAO inhibitors
Clorgiline & Moclobemide - Selective MAO–A inhibitors
Selegiline - Selective MAO –B inhibitors
Cheese reaction & serotonin syndrome (when taken with SSRI's) |
|
|
Term
Name the Atypical antidepressants
What are their MOA's? |
|
Definition
Buproprion - NDRI - DA & Norepi re-uptake inhibitor
Mirtazapine - Blocks 5-HT2 & Alpha 2 receptors (antagonist)
Nefazodone & Trazodone - Block the 5-HT2 receptors (antagonist)
Amoxapine - block DA receptors (antagonist)
Venlafaxine & Duloxetine - SNRI - serotonin and norepi re-uptake inhibitor
Maprotiline
|
|
|
Term
| What must patients on antidepressants be informed about? |
|
Definition
| there is a lag time of about 1-4 weeks before the antidepressants start to work, and the depressive symptoms start to subside |
|
|
Term
| What are the ADR's of TCA's & Why? |
|
Definition
Orthostatic/Postural hypotension, QT prolongation & sexual dysfunction - Alpha 1 blockade
Weight gain & Sedation - H1 blockade
Dry mouth, blurred vision, Urinary retention, constipation - (similar to atropine) - Anticholinergic effects
Lowers the seizure threshold - in OD |
|
|
Term
| What would the clinical features of TCA OD be? |
|
Definition
Coma
Convulsions
Cardiac toxicity |
|
|
Term
What class antidepressant does Trazodone belong to?
MOA?
What is its ADR? |
|
Definition
Atypical antidepressant
Blocks 5- HT2 receptors
Causes priapism (persistent painful penile erection)
|
|
|
Term
What class of antidepressant does Amoxapine belong to?
MOA?
ADR? |
|
Definition
Atypical antidepressant & TCA
Blocks DA receptors
Causes drug induced Parkinsonism |
|
|
Term
What class of antidepressant does Maprotiline belong to?
ADR? |
|
Definition
Atypical antidepressant
Seizure risk & Cardio toxic |
|
|
Term
What class of antidepressant does Mirtazapine belong to?
MOA?
ADR? |
|
Definition
Atypical antidepressant
5-HT2 & Alpha 2 anagonist
Sedation & Weight gain |
|
|
Term
What class of antidepressant does Buproprion belong to?
MOA?
Advantages?
ADR?
Other uses? |
|
Definition
Atypical antidepressant
Increases DA & Norepi
No sexual dysfunction
Decreases seizure threshold
Quitting smoking
|
|
|
Term
| What is used as an alternative to SSRI's & Why? |
|
Definition
| Buproprion - no sexual dysfunction |
|
|
Term
| What are the Drug interactions involved with SSRI's? |
|
Definition
•Fluoxetine, paroxetine- CYP 2D6 enzyme inhibitors- possible drug interactions
•Serotonin Syndrome (with MAOIs)
|
|
|
Term
What class of antidepressant does Fluoxatine belong to?
MOA?
ADR? |
|
Definition
SSRI
Blocks the reuptake of serotonin ONLY
CYP 2D6 inhibitor - drug interactions |
|
|
Term
Name the MAO's
MOA's?
ADR? |
|
Definition
Phenelzine & Tranylcypromine - Nonselective MAO inhibitors
Clorgiline & Moclobemide - Selective MAO –A inhibitors
Selegiline - Selective MAO –B inhibitors
Cheese reaction & serotonin syndrome
|
|
|
Term
| What are the only MAO's used in depression? |
|
Definition
Phenelzine & Tranylcypromine -Nonselective MAO inhibitors
|
|
|
Term
What is serotonin syndrome?
What causes it? |
|
Definition
SSRI + MAO inhibitors?
Hyperthermia
Muscle ridigity
Hyperflexia
Myoclonus
Mental status changes |
|
|
Term
|
Definition
Venlafaxine
Duloxetine (Cymbalta)
Blocks the re-uptake of both Serotonin and Norepi
|
|
|
Term
|
Definition
Bupropion (welbutrin)
Blocks the re-uptake of Norepi and DA
|
|
|
Term
| What is used to treat major depressive disorder? |
|
Definition
|
|
Term
| What is used to treat Bipolar disorder |
|
Definition
| SSRI/TCA + Lithium for manic phase |
|
|
Term
| What is used to treat panic disorder? |
|
Definition
|
|
Term
| What is used to treat OCD |
|
Definition
SSRi - esp Fluvoxamine
Clomipramine - TCA |
|
|
Term
| What is used to treat Enuresis/ Bed wetting? |
|
Definition
|
|
Term
| What is used to treat ADHD? |
|
Definition
|
|
Term
| What is used to help patients quit smoking? |
|
Definition
|
|
Term
| What is used to treat Chronic Pain? |
|
Definition
|
|
