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www.pharmteacher.com

Depression and Anxiety

QuestionAnswer
State the mechanism of action of the SNRIs: inhibit reuptake of serotonin & norepinephrine into CNS nerve terminals
List the side effects of SNRIs: insomnia, nervousness, sexual dysfunction, serotonin syndrome, physical dependence/withdrawal symptoms, dry mouth, anorexia, CV effects (HTN, tachycardia)
State the mechanism of action of the SSRIs: inhibit reuptake of serotonin into CNS nerve terminals
List the side effects of the SSRIs: insomnia, nervousness, sexual dysfunction, serotonin syndrome, physical dependence/withdrawal symptoms
State the mechanism of action of the TCAs: inhibit reuptake of serotonin, norepinephrine, & dopamine into CNS nerve terminals
List the side effects of the TCAs: drowsiness, sedation, sexual dysfunction, physical dependence/withdrawal symptoms, anticholinergic side effects, CV effects (HTN & tachycardia), orthostatic hypotension
State the mechanism of action of the MAO-inhibitors: inhibit breakdown of serotonin, norepinephrine, & dopamine in the CNS nerve synapses and inhibit tyramine breakdown in intestines
What typically guides drug selection in treatment of depression? select drugs with fewer side effects; low cost; and can consider family response
Which class of antidepressants has the LEAST cardiac effects? SSRIs (The TCAs & SNRIs have more because they both affect norepinephrine)
This SNRI is specifically FDA approved to treat fibromyalgia pain: duloxetine (Cymbalta)
What is the difference between venlafaxine & desvenlafaxine? one is a prodrug of the other
This class of antidepressants is most likely to cause orthostatic hypotension: TCAs
This class of antidepressants is most likely to cause anticholinergic side effects & sedation: TCAs
This class of antidepressants is most likely to cause sexual dysfunction: SSRIs
This class of antidepressants is most likely to worsen dementia: TCAs (anticholinergic effects)
This antidepressant causes sedation (take at bedtime): trazodone (Desyrel) and mirtazepine (Remeron) and all the TCAs
Which antidepressants have life-threatening food interactions? MAO-inhibitors (tyramine containing foods)
This antidepressant is used for smoking cessation: bupropion (Wellbutrin, Zyban)
This antidepressant can be problematic for older men with BPH: TCAs (because of their anticholinergic side effects – urinary retention)
This antidepressant causes weight gain and drowsiness as side effects (take at bedtime): mirtazepine (Remeron)
List some tyramine containing foods: cheese, liver, smoked meats; soy sauce; bananas; some wines and beers
List some food/OTC vasopressors: chocolate, ginseng, caffeine beverages, oral decongestants, some diet pills
Life-threatening hyperpyrexia can occur when MAO-Is are taken with … meperidine and dextromethorphan containing cough suppressants
Life-threatening hypertensive crisis can occur when MAO-Is are taken with … ephedrine, amphetamines, cocaine, pseudoephedrine, TCA, SSRI, SNRIs
List symptoms of serotonin syndrome: hypo/hypertension, agitation, muscle tightness & twitching, hyperthermia, shivering, tachycardia & other arrhythmias, seizures, coma and death
List the general therapeutic uses of the antidepressants: anxiety (generalized anxiety, phobic disorders, obsessive compulsive disorder), premenstrual dysphoric disorder, bulimia, Tourette's syndrome, bipolar disease, neuropathic pain (diabetic peripheral neuropathy pain, post-herpetic neuralgia/shingles pain)
About how long does it take for antidepressants to take effect? several weeks (3 – 4 weeks)
Are antidepressants addictive? No, antidepressants do not cause psychological dependence. However, they can cause physical dependence and withdrawal symptoms so should not be stopped suddenly
Describe the general treatment for generalized anxiety disorders: daily antidepressant or buspirone with or without a prn benzodiazepine for acute/breakthrough anxiety
This drug is used specifically for anxiety only and is NOT an antidepressant or benzodiazepine: buspirone (Buspar)
Autonomic symptoms associated with acute PTSD and panic disorders can be treated with: beta-blockers
Discuss the mechanism of action of buspirone (Buspar): mechanism is unclear but involves serotonin
How fast will buspirone begin to work? slowly, similar to the antidepressants
Classify this drug: amitriptyline TCA
Classify this drug: bupropion misc antidepressant
Classify this drug: buspirone non-sedating anxiolytic
Classify this drug: citalopram SSRI
Classify this drug: desipramine TCA
Classify this drug: desvenlafaxine SNRI
Classify this drug: doxepin TCA
Classify this drug: duloxetine SNRI
Classify this drug: escitalopram SSRI
Classify this drug: fluoxeinte SSRI
Classify this drug: fluvoxamine SSRI
Classify this drug: imipramine TCA
Classify this drug: mirtazapine misc antidepressant
Classify this drug: nortriptyline TCA
Classify this drug: paroxetine SSRI
Classify this drug: phenelzine (Nardil) MAO-inhibitor
Classify this drug: selegiline (Emsam) selective MAO-B inhibitor
Classify this drug: sertraline SSRI
Classify this drug: tranylcypromine (Parnate) MAO-inhibitor
Classify this drug: trazodone misc antidepressant
Classify this drug: venlafaxine SNRI
Created by: www.pharmteacher.com on 2012-11-09



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