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pharmacology 6
| Term | Definition |
|---|---|
| Monoamine neurotransmitters | serotonin, norepinephrine, and dopamine |
| Tricyclic antidepressants (TCAs) | Prevent the re-uptake of monoamine neurotransmitters - the oldest class in the treatment of depression |
| Biogenic amine theory | proposes that clinical depression is caused by a deficiency of monoamine neurotransmitters in the brain. These neurotransmitters include: Serotonin Norepinephrine Dopamine |
| •Three primary types of depressive disorders: | •Major depression •Bipolar disorder •Dysthymia |
| Dysthymia | Chronic low-grade depression lasting at least 2 years |
| Bipolar affective disorder(mania) | associated with increased levels of monoamine neurotransmitters. |
| Low levels in the brain can contribute to depression high levels in the body’s periphery may lead to hypertension. | norepinephrine |
| - an excitatory neurotransmitter - regulates seep wake cycle and pain perception -drugs that antagonize these receptors are used to treat depression | serotonin (5-HT) |
| D2, D3 and D4 | inhibitory dopamine receptors |
| d1 and d5 | excitatory dopamine receptors |
| Inhibiting the reuptake of specific monoamine neurotransmitters and blocking the degradation of monoamine neurotransmitters. | how antidepressants product their effect |
| enuresis | bedwetting - TRICYDLIC ANTTIDPRESSANTS TREAT THIS |
| what antidepressant is used to treat OCD | Tricyclic antidepressants |
| mechanism of action Tricyclic antidepressants | prevent the reuptake of norepinephrine and serotonin, keeping these neurotransmitters active longer in the synaptic cleft. This enhances communication between neurons, counteracting the neurotransmitter deficiency seen in depression. |
| receptors TSAs block | histaminic, muscarinic, adrenergic |
| blurred vision, Dry mouth, Constipation | Muscarinic receptor blockade adverse reactions |
| sedation, eight gain , hypertension | histaminergic recpetor blockade adverse reactions |
| hypertension, reflex trachycardia, cardiotoxic | adrenergic receptor blockade adverse reactions |
| most widly perscribed antidepressant No cardiotoxic affects | SSRI'S |
| blocks the selective reuptake of seratonin at the synaptic cleft | mechanism of action SSRI |
| Possible side effects can include insomnia, decreased appetite, nausea, agitation or anxiety, diarrhea, sexual dysfunction, serotonin syndrome, and suicidal thoughts. | Adverse effects of SSRI'S |
| Citalopram (Celexa®), escitalopram (Cipralex®), fluoxetine (Prozac®), paroxetine (Paxil®), sertraline (Zoloft®), vilazodone (Viibryd®), vortioxetine (Trintellix®), and fluvoxamine (Luvox®) | ssri drug names |
| •Moclobemide Manerix® •Phenelzine Nardil® •Tranylcypromine Parnate® | MAOIS drug names |
| where is enzyme MAO found in body? | axon terminals, liver, intestines |
| MOA A | Found in intestines, liver treatment for depression |
| MOA B | Found in brain treatment for parkinsons interfers with the metabolism of norephineprine and serotonin |
| MAOIs- monoamine oxidase inhibitors | block the action of the enzyme monoamine oxidase |
| work by blocking the enzyme monoamine oxidase, preventing the breakdown of neurotransmitters (NE, 5‑HT, dopamine) and dietary amines. This increases neurotransmitter availability at receptor sites, improving mood and depression | mechanism of action of MAOIs |
| Reversible MAOIs | bind to the monoamine oxidase enzyme but detach after a short time, allowing the enzyme to regain function. takes 3-5 days for mao levels to return to normal |
| : Moclobemide | a reversible MAOI |
| Irreversible MAOIs | drugs bind permanently to the enzyme, causing long‑lasting inactivation. It can take up to 2 weeks for the body to synthesize new enzyme and restore normal MAO activity after stopping the drug. |
| Phenelzine Tranylcypromine | A Irreversible MAOI |
| •Sedation •Drymouth •Urinaryretention •Constipation •Orthostatichypotension • Impotence •Weightgain •Hypertensivecrisis(eatingtyraminerichfoods) | Adverse effects of MAOI |
| HypertensiveCrisis | Can be fatal and is caused by drug interactions or drug–food interactions with monoamine oxidase inhibitors. Foods that contain tyramine (anything aged, cured, or fermented) should be avoided. |
| Serotonin-NoradrenalineReuptake Inhibitors(SNRIs) | Inhibit the reuptake of 5-HT and NE Duloxetine (Cymbalta®) •Desvenlafaxine (Pristiq®) •VenlafaxineXR (EffexorXR®) •Levomilnacipran (Fetzima®) |
| Noradrenaline Dopamine Reuptake Inhibitors (NA/DRI) | Introduced in the 1970s as an alternative to TCAs, these medications do not cause drowsiness. One example is Bupropion (Wellbutrin®). |
| Heterocyclic Antidepressants | Increases norepinephrine and serotonin release. • Mirtazapine (Remeron®) |
| Antiseizure drugs used to treat bipolar disorder | Valproic acid (Epival®), carbamazepine (Tegretol®), and lamotrigine (Lamictal®) \ often prescribed as an adjunct to lithium therapy. |
| Adverse Effects of Drugs Used to Treat Bipolar Disorder | •Sedation or dizziness •Nausea •Ataxia •Visual disturbances •Lithium may also cause: • Increased urination •Drymouth •Difficulty concentrating •Tremor |
| Warning Labels for Tricyclic Antidepressants | May cause drowsiness; alcohol may intensify this effect. May impair ability to drive. Do not discontinue without medical supervision. Avoid prolonged exposure to sunlight. May discolor urine (blue-green). |
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