Term
| What disorder arises from low aminergic NT levels or low activity of NE receptors? |
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Definition
Depression is caused by a functional deficit of aminergic neurotransmitters.
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Term
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Definition
| Inhibition of MAO (by irreversibly binding to MAO), increases amine NTs acutely. Chronically, it causes a post-synaptic reduction of receptors (gProtein coupled). But bc this is coupled with an upregulation of the 2nd messengers of these receptors, the fewer number of these receptors are actually more effective in responding to the NTs. (more bang for your buck). |
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Term
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Definition
Isocarboxazid (AnB)
Phenelzine (AnB)
Tranylcypromine (AnB)
Selegiline (B - reversible)
Mnemonic- TIPS
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Term
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Definition
Insomnia,Wt gain, HTN, Tyramine effects.
Avoid use with TCAs and SSRIs
Mnemonic for SE's is WITH |
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Term
| What are the 3 classes of amine reuptake inhibitors? |
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Definition
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Term
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Definition
| 2* TCAs inhibit NE transporters (reuptake). |
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Term
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Definition
| 3* TCAs inhibit both NE and 5-HT reuptake. |
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Term
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Definition
Initially blocking reuptake of NE and 5-HT increases their concentration in the synapse.
Access NT detected by the autoreceptors (alpha2) causes the presynaptic cell to produce less NT (homeostasis).
Eventually the alpha 2 receptors become desensitized resulting in an increase in NTs. and the gProt coupled receptors will have an increase in 2nd messenger signaling. |
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Term
| What is the BBW of antidepressants? |
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Definition
| Increased risk of suicide in peds. |
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Term
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Definition
Thrombocytopenia
Cardiac
Anticholinergic
Seizures |
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Term
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Definition
Serotonin Syndrome
Stimulation of CNS
Reproductive dysfunction
Insomnia |
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Term
| What is the effect of lithium? |
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Definition
Used to Tx bipolar d/o, it decreases the frequency of manic and depressive episodes.
It reduces Catecholamines and increases Serotonin levels. |
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Term
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Definition
Leukocytosis
Insipidus Diabetes
Tremor/teratogenic
Hypothyroidism
Li has a small therapeutic index. |
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Term
| What is the FDA BBW for Carbamazapine? |
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Definition
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Term
| What are the adverse SEs of Valproic acid? |
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Definition
| Pancreatitis, Hepatotoxic and Teratogenic. |
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Term
What is the MOA of Benzodiazepines?
What is it metabolized by? |
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Definition
Modulates GABAa receptors. Increases the affinity and conductance of GABA receptors (Doesn't work w/o GABA).
metabolized by liver-- Cyp3A4 (avoid grapefruit)
Used to tx Anxiety |
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Term
| What are the SEs of Benzo? |
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Definition
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Term
| what are the safe benzos for pts with liver dysfunction? |
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Definition
LOT:
Lorazepam
Oxazepam
Temazepam |
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Term
| What are the benefits of Buspirone? |
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Definition
| No sedation, no interaction with ETOH, no dependance, No withdrawal. |
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Term
| True or False: SSRIs have similar MOA than TCAs, except more selective for 5HT |
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Definition
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Term
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Definition
| an SSRI for MDD, anxiety d/o, OCD, panic, bulimia, PTSD |
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Term
| What is Fluoxetine (prozac) metabolized by? |
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Definition
Cyp2D6 in liver.
Watch out for poor metabolizers
long half life.
Fluoxetine is unique bc it has an active metabolite --> 2nd half life (longer). |
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Term
| What are SSRIs contraindicated with? |
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Definition
MAOIs, Thioridzine, pimozide
Allow 2 wks to wash out --avoid serotonin syndrome. |
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Term
| What distinguishes Citalopram from other SSRIs? |
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Definition
| PgP protein pumps this Rx out of brain. Some pts have too many Pbps, avoid Citalopram. |
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Term
| Who is Fluovoxamine specifically approved for? |
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Definition
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Term
| What is Serotonin Syndrome? |
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Definition
Hyperthermia
Autonomic instability (delirium)
Rigidity
Myoclonus
HARM |
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Term
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Definition
SNRI,
Dont mix with MAO-Is. |
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Term
| What is the risk of using Maprolitine? |
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Definition
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Term
| What risk is Nefazodone associated with? |
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Definition
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