Ch. 48: antidepressants
Quiz yourself by thinking what should be in
each of the black spaces below before clicking
on it to display the answer.
Help!
|
|
||||
|---|---|---|---|---|---|
| signs and symptoms of depression? | feelings of sadness, hoplessness, despair, and the inability to experience pleasure in usual activities (anhedonia)
🗑
|
||||
| biogenic amine theory.. | .depression is due to the deficiency of monoamines such as NE, seratonin at their key sites in the brain.
🗑
|
||||
| all antidepressants do this... | potentiate (either directly or indirectly) the actions of NE, dopamine, and/or seratonin in the brain.
🗑
|
||||
| TCAs? use? | severe major depressive disorder.
🗑
|
||||
| TCAs include... | amitryptyline, clomipramine, despiramine, imipramine.
🗑
|
||||
| MOA of TCAs? | work to elevate mood, improve alertness, increase physical activity, and reduce morbid preoccupation. they have no effect in normal individuals. they block reuptake of Ne, and SERT, increasing neurologic response. they also block muscarinic, alpha, H1rece
🗑
|
||||
| can physical and psychological dependence occur with antidepressants? | yes
🗑
|
||||
| onset of action of TCAs? | slow onset of action, requireing two or more weeks before onset of action.
🗑
|
||||
| side effects of TCAs? | anticholinergic effects due to muscarinic antagonism; these effects include xerostomia, constipation, urinary retention, aggravation of glaucoma, blurred vision, risk of seizures. others include reflex tachycardia and orthostatic hypotension
🗑
|
||||
| TCAs relatively contraindicated in.. | manic depressive (bipolar) patients and in suicidal patients (they can easily kill themselves by overdosing)
🗑
|
||||
| TCAs may also be used for.. | enuresis (because they cause contraction of the internal sphincter of the urinary bladder-all due to strong anticholinergic action)
🗑
|
||||
| MOA of SSRI? | block re-uptake of seratonin. they are preferred by most non specialists, mostly becuase htey have fewer side effects. t
🗑
|
||||
| indications for SSRIs? | depression, bulemia nervosa, OCD, anorexia, panic disorder, diabetes related neuropathy, PMS.
🗑
|
||||
| side effects of SSRIs? | loss of libido, delayed ejaculation, weight gain, anorgasmia, overdose may cause seizures.
🗑
|
||||
| examples of SSRIs? | citalopram, escitalopram, fluoxetine, paroxetine, sertraline
🗑
|
||||
| SSRIs should be avoided in... | third trimester of pregnancy because they hav ebeen associated with multiple neonatal complications, including neonatal pulmonary hypertension and a range of gastrointestinal problems.
🗑
|
||||
| which SSRI should not be used any time during pregnancy? | paroxetine
🗑
|
||||
| how should you discontinue SSRIs? | dose may be tapered gradually to avoid withdrawal symptoms.
🗑
|
||||
| MAO inhibitors include... | phenelzine, isocarboxazid, tranylcypromine.
🗑
|
||||
| MOA of MAOIs? | inactivate MAO, allowing transmitters to escape degradation and to leak into the synaptic cleft. they are indicated for phobias and depressed patients unresponsive or allergic to TCAs or SSRIs or who have a strong axxiety component tot heir problems.
🗑
|
||||
| MAOIs can be use din conjunciton with... | SSRIs, SNRIs, or TCAs., and there has to be at least a two week period of "wash out" (ex: no drug administratoin)_ between the use of MAois and these antidepressants.
🗑
|
||||
| what is MAO? | mitochondrial enzyme found in neural and other tissues, such as gut and liver. it functions as a "safety valve" to oxidatively deaminate and inactivate any excess neurotransmitter molecules (NE, DA, SERT) that may leak out of hte vseicles into cell cytopl
🗑
|
||||
| MAO degrades what | tyramine. thats why MAOIs have a high drug/drug and drug/food interaction. as a result, there are strict dietary restirctions for those taking MAOIs.
🗑
|
||||
| those taking MAOIs may not consume... | with high tyramine content (cheese, beer, wine, and chicken liver. doing so may lead to hypertensive crisis (the high catecholamine levels resuilt in tachycardia, HTN, cardiac arrhythmias, and stroke.
🗑
|
||||
| side effects of MAOIs? | constipation, blurred vision, xerostomia, drowsiness, and dysuria.
🗑
|
||||
| MAOIs are contraindicated in these patients.. | those who refuse to eliminate tyramine from their diet, such as suicidal patients.
🗑
|
||||
| SNRIs include... | desvenlafaxine, velafaxine, duloxetine.
🗑
|
||||
| MOA of SNRI? | prevent seratonin and norepinepherine reuptake at the level of the synapse. like with SSRI, triptans and MAOIs should be avoided in order to prevent the possibility of serotonin syndrome. likewise, like SSRIs, these should not be used during the 3 TM preg
🗑
|
||||
| blocks reuptake of norepinephrine and the reuptake of seratonin with three times more effect on the latter. it has a strucutre similar to that of amphetamine, accounting for it sactivating action o n patients. used for major depressive disorder. | velafaxine
🗑
|
||||
| this is the antidepressant most likely to induce mania in susceptible patients. side effects includ ehadache, weight loss, loss of libido, and increased BP. latter effect makes this drug unsuitable for patietns with hypertension. | velafaxine
🗑
|
||||
| patients using venlafaxine can prodoce a positive test for.. | PCP.
🗑
|
||||
| inhibits reuptake of both NE and SERT, and also has weka reuptake inhibition activity on dopamine. it is used for both major depressive disorder as well as diabetes associated neuropathic pain. | duloxetine
🗑
|
||||
| duloxetine is contraindicated in who? | those with renal disease, liver failure, and heavy alcohol use.
🗑
|
||||
| atypical andidepressant that works to block reuptake of NE and Dopamine, with twice as much effect on the latter; it is also a nicotinic agonist | buproprion.
🗑
|
||||
| buproprion used for..? | major depressive disorder. it is effective for monotherapy, but also is particularly helpful as an adjunctive medication in thise not fully responsive to SSRi therapy.
🗑
|
||||
| buproprion is especially useful for thes patients.. | smoking cessation and seasonal affective disorder.
🗑
|
||||
| does buprioprion lower seizure threshold? | yes, but when used at recommended doses, its propensity to cuase seizure is similar to that observed with other antidepressants. does not cause weight gain or sexual dysfunction, can cause dry mouth, tinnitus, and nausea.
🗑
|
||||
| buproprion can promote... | hallucinations and psychosis which can often be ameliorated by reducing the dose. cases of hypertension have also been reported.
🗑
|
Review the information in the table. When you are ready to quiz yourself you can hide individual columns or the entire table. Then you can click on the empty cells to reveal the answer. Try to recall what will be displayed before clicking the empty cell.
To hide a column, click on the column name.
To hide the entire table, click on the "Hide All" button.
You may also shuffle the rows of the table by clicking on the "Shuffle" button.
Or sort by any of the columns using the down arrow next to any column heading.
If you know all the data on any row, you can temporarily remove it by tapping the trash can to the right of the row.
To hide a column, click on the column name.
To hide the entire table, click on the "Hide All" button.
You may also shuffle the rows of the table by clicking on the "Shuffle" button.
Or sort by any of the columns using the down arrow next to any column heading.
If you know all the data on any row, you can temporarily remove it by tapping the trash can to the right of the row.
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
Created by:
aferdo01
Popular Medical sets