LECOM Pharm Ch 13 Serotonin
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| What happened to 5-HT in depression and anxiety disorders to cause them | decreased levels
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| DOC family for Typical Depression | SSRI’s
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| DOC family for Atypical Depression | MAOIs, but dangerous SE
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| Inhibits DA, 5HT, NE storage; used as 2nd line in atypical depression and elderly depression; can cause psychosis (3) drugs? | modafinil; amphetamine; methylphenidate
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| * 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
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| *TCA used in chronic pain, enuresis, and ADD | Imipramine
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| *DOC for bipolar affective disorder | Lithium
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| *SE of lithium | Tremor, sedation, ataxia, aphasia, thyroid enlargement, and reversible diabetes insipidus
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| * Major route of elimination for Lithium | kidney
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| *Patients being treated with lithium, who are dehydrated, or taking diuretics concurrently, could develop | lithium toxicity
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| ***5HT-3 antagonist used in chemotherapeutic induced emesis | Ondansetron, granisetron,
dolasetron and alosetron
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| ** DOC of chemo induced nausea and vomiting | ondansetron
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| * Ergot alkaloid used as an illicit drug | LSD
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| *Disease caused by excess ergot alkaloids | St. Anthony’s Fire
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| **5HT-1d agonist used for migraine headaches | Sumatriptan, naratriptan, and rizatriptan
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| MAO-B inhibitor, MAO-A inhibitor at higher doses | Selegiline
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| Pt has a hard time keeping with a Rx diet, which MAOI should be used? | Selegaline
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| 3 MAOI’s that are reversible | Moclobemide, Befloxatone, brofaromine
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| Irreversible MAOI’s | Iproniazid, , Isocarboxazid phenelzine
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| Problems with Rx an MAOI | liverand drug interactions; P450 inducer
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| TCA used for OCD | clomipramine
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| Elderly Pt’s taking TCA’s are especially susceptible to this | orthostatic hypotension
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| TCA used for nocturnal enuresis | imipramine
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| Drug Class: amitriptyline | TCA
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| Drug Class: clomipramine | TCA
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| Drug Class: Desipramine | TCA
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| Drug Class: Doxepine | TCA
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| Drug Class: Imipramine | TCA
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| Drug Class: Nortriptyline | TCA
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| Drug Class: Protriptyline | TCA
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| Drug Class: Trimipramine | TCA
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| Drug Class: Citalopram | SSRI
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| Drug Class: Fluoxetine | SSRI
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| Drug Class: Fluvoxamine | SSRI
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| Drug Class: Paroxetine | SSRI
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| Drug Class: Sertraline | SSRI
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| SSRI associated with diarrhea | sertraline
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| SSRI associated with constipation | paroxetine
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| SSRI’s are used as | 1st line for depression, anxiety, and OCD
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| Difference in SSRI from TCA | SSRIs are more selective for 5HT transporters and larger therapeutic index
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| SNRIs inhibit what? | 5HT and NE uptake
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| Venlafaxine acts as what at what doses? | SSRI at low concentration; increases 5HT and NE at high concentration
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| Used to treat neuropathic pain and depression, but can cause neuroleptic malignant syndrome | duloxetine
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| Used to treat depression and smoking cessation | bupropion
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| Drug used to treat depression with the least sexual side effects and induces less mania | bupropion
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| Used to treat elderly with depression, helping with appetite and sleep, but can cause agranulocytosis | mirtazapine
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| Used to treat insomnia but causes priapism | trazadone
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| 2 drugs that block post-synaptic 5HT2 receptors | trazadone, nefazodone
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| Non-TCA that can cause orthostatic hypotension and liver failure | nefazodone
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| Treats anxiety with little sedating effects and is non-addictive. Drug and serious side effects | Buspirone; MI, CVA
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| Class of drugs taken at onset of migraine aura and their side effects | triptans; coronary artery spasm, MI/CVA/seizure/hypertensive crisis
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| 5HT 2A/2C receptor antagonist; treats glaucoma(topically) Drug name and SE | Ketanserin; orthostatic hypotension, V-tach
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| 5HT 3 Receptor antagonist. Name and what it treats | Ondansetron; anti-emetic, useless in nausea
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| Ondansetron’s adverse side effects | arrhythmia, bronchospasm
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| 2 drugs used to treat IBS with constipation and the receptor they act on | Tegaserod, Prucalopride; 5HT 4 Receptor antagonist
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| Drug used to treat IBS with diarrhea and the receptor it acts on | Alosetron; 5HT 3 Receptor antagonist
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| 4 “mood stabalizers” | carbamazepine, Valproic Acid, Lamotrigine, Lithium
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| Treatment of Bipolar affective disorder that has extensive toxicities | Lithium
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