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Pharm 13 Serotonin

LECOM Pharm Ch 13 Serotonin

What happened to 5-HT in depression and anxiety disorders to cause them decreased levels
DOC family for Typical Depression SSRI’s
DOC family for Atypical Depression MAOIs, but dangerous SE
Inhibits DA, 5HT, NE storage; used as 2nd line in atypical depression and elderly depression; can cause psychosis (3) drugs? modafinil; amphetamine; methylphenidate
* Heterocyclic antidepressants least likely to affect sexual performance, used for management of nicotine withdrawal, SE's include dizziness, dry mouth, aggravation of psychosis, and seizures Buropion
*TCA used in chronic pain, enuresis, and ADD Imipramine
*DOC for bipolar affective disorder Lithium
*SE of lithium Tremor, sedation, ataxia, aphasia, thyroid enlargement, and reversible diabetes insipidus
* Major route of elimination for Lithium kidney
*Patients being treated with lithium, who are dehydrated, or taking diuretics concurrently, could develop lithium toxicity
***5HT-3 antagonist used in chemotherapeutic induced emesis Ondansetron, granisetron, dolasetron and alosetron
** DOC of chemo induced nausea and vomiting ondansetron
* Ergot alkaloid used as an illicit drug LSD
*Disease caused by excess ergot alkaloids St. Anthony’s Fire
**5HT-1d agonist used for migraine headaches Sumatriptan, naratriptan, and rizatriptan
MAO-B inhibitor, MAO-A inhibitor at higher doses Selegiline
Pt has a hard time keeping with a Rx diet, which MAOI should be used? Selegaline
3 MAOI’s that are reversible Moclobemide, Befloxatone, brofaromine
Irreversible MAOI’s Iproniazid, , Isocarboxazid phenelzine
Problems with Rx an MAOI liverand drug interactions; P450 inducer
TCA used for OCD clomipramine
Elderly Pt’s taking TCA’s are especially susceptible to this orthostatic hypotension
TCA used for nocturnal enuresis imipramine
Drug Class: amitriptyline TCA
Drug Class: clomipramine TCA
Drug Class: Desipramine TCA
Drug Class: Doxepine TCA
Drug Class: Imipramine TCA
Drug Class: Nortriptyline TCA
Drug Class: Protriptyline TCA
Drug Class: Trimipramine TCA
Drug Class: Citalopram SSRI
Drug Class: Fluoxetine SSRI
Drug Class: Fluvoxamine SSRI
Drug Class: Paroxetine SSRI
Drug Class: Sertraline SSRI
SSRI associated with diarrhea sertraline
SSRI associated with constipation paroxetine
SSRI’s are used as 1st line for depression, anxiety, and OCD
Difference in SSRI from TCA SSRIs are more selective for 5HT transporters and larger therapeutic index
SNRIs inhibit what? 5HT and NE uptake
Venlafaxine acts as what at what doses? SSRI at low concentration; increases 5HT and NE at high concentration
Used to treat neuropathic pain and depression, but can cause neuroleptic malignant syndrome duloxetine
Used to treat depression and smoking cessation bupropion
Drug used to treat depression with the least sexual side effects and induces less mania bupropion
Used to treat elderly with depression, helping with appetite and sleep, but can cause agranulocytosis mirtazapine
Used to treat insomnia but causes priapism trazadone
2 drugs that block post-synaptic 5HT2 receptors trazadone, nefazodone
Non-TCA that can cause orthostatic hypotension and liver failure nefazodone
Treats anxiety with little sedating effects and is non-addictive. Drug and serious side effects Buspirone; MI, CVA
Class of drugs taken at onset of migraine aura and their side effects triptans; coronary artery spasm, MI/CVA/seizure/hypertensive crisis
5HT 2A/2C receptor antagonist; treats glaucoma(topically) Drug name and SE Ketanserin; orthostatic hypotension, V-tach
5HT 3 Receptor antagonist. Name and what it treats Ondansetron; anti-emetic, useless in nausea
Ondansetron’s adverse side effects arrhythmia, bronchospasm
2 drugs used to treat IBS with constipation and the receptor they act on Tegaserod, Prucalopride; 5HT 4 Receptor antagonist
Drug used to treat IBS with diarrhea and the receptor it acts on Alosetron; 5HT 3 Receptor antagonist
4 “mood stabalizers” carbamazepine, Valproic Acid, Lamotrigine, Lithium
Treatment of Bipolar affective disorder that has extensive toxicities Lithium
Created by: csheck