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Pharm 30- Antidepressants
Antidepressants
74
Pharmacology
Professional
01/11/2012

Additional Pharmacology Flashcards

 


 

Cards

Term
imipramine and amitriptyline are in which class?
Definition
tricyclics
Term
What are the active metabolites of amitriptyline and imipramine?
Definition
desipramine and nortriptyline
Term
amoxapine, bupropion, maprotiline and trazodone are ___ generation, and in the class of _____
Definition
2nd, heterocyclics
Term
duloxetine, mirtazapine, nefazodone, and venlafaxine are ___ generation, and in the class of _____
Definition
3rd, heterocyclics
Term
Which heterocyclics have short half lives and require administration 2-3 times per day?
Definition
nefazodone and trazodone
Term
Which class of drugs resembles phenothiazines and blocks reuptake of both NE and 5HT?
Definition
tricyclics
Term
Fluoxetine is the prototype for which class of drugs? What is special about it?
Definition
SSRIs, it forms an active metabolite and has a once-weekly preparation
Term
citalopram, escitalopram, fluvoxamine, paroxetine, and sertraline are in which class?
Definition
SSRIs
Term
phenelzine and tranylcypromine are in which class?
Definition
MAOIs
Term
MAO-A metabolizes...
Definition
NE, 5HT and tyramine
Term
MAO-B metabolizes...
Definition
dopamine
Term
Which MAOI is the fastest in onset and has the shortest DOA?
Definition
Tranylcypromine
Term
MAOIs have what effect on hepatic drug-metabolizing enzymes?
Definition
inhibition
Term
Which drug is a selective inhibitor of MAO-B?
Definition
selegiline
Term
Which drug has an unknown MOA?
Definition
bupropion
Term
Long term use of tricyclics and _____s leads to down-regulation of ____ receptors
Definition
MAOIs, beta receptors
Term
What is the MOA of TCAs?
Definition
inhibit reuptake transporters for NE and 5HT
Term
MAOIs are related to...
Definition
amphetamines
Term
The __ generation drugs duloxetine and venlafaxine are potent inhibitors of both _____ and _____ transporters.
Definition
3rd, 5HT and NE
Term
What is the unique action of mirtazapine?
Definition
increases amine release from nerve endings by antagonism of presynaptic alpha-2 adrenoreceptors
Term
How do MAOIs increase brain amine levels?
Definition
Interfere with their metabolism in nerve endings, so when vesicles are discharged, they release more amines
Term
What effect do drugs that block NE transporters in the CNS or MAOIs have on sympathetic tone?
Definition
Can increase peripheral autonomic sympathomimetic effects
Term
Long term use of MAOIs can ____ blood pressure
Definition
decrease
Term
Sedation is a common CNS effect of which types of drugs?
Definition
tricyclics, some heterocyclics, especially mirtazapine and trazodone
Term
Trazodone is commonly prescribed as a ___ aid
Definition
sleep
Term
Which types of drugs are more likely to cause CNS stimulating effects, as opposed to sedating effects?
Definition
MAOIs, SSRIs and bupropion
Term
Antagonist of muscarinic receptors occurs with all ______ and is particularly marked with ______ and ______.
Definition
tricyclics, amitriptyline, doxepin
Term
Cardiovascular effects occur most commonly with which kind of drugs? What effects are seen?
Definition
tricyclics, hypotension from a-adrenoreceptor blockade, depression of cardiac conduction, arrhythmias
Term
The convulsive threshold is lowered by which kind of drugs? ODs of _____ and the SSRIs have also caused seizures.
Definition
TCAs and MAOIs. Maprotiline and SSRIs.
Term
Which drugs are now most widely prescribed for depression due to more tolerable side effects and safety in overdose?
Definition
SSRIs and certain heterocyclics
Term
Tricyclics continue to be most useful in pts with...
Definition
psychomotor retardation, sleep disturbance, poor appetite, weight loss.
Term
MAOIs are most useful in pts with...
Definition
anxiety, phobic features, hypochondriasis
Term
Which MAO type B inhibitor is used in Parkinson's and is now available as a patch for depression?
Definition
Selegiline
Term
SSRIs may _____ appetite.
Definition
decrease
Term
Some believe that SSRIs and newer heterocyclics raise the risk of suicide in...
Definition
children and adolescents
Term
In addition to depression, TCAs are also used for...
Definition
bipolar, panic attacks, phobias, enuresis, ADHD, chronic pain
Term
Which drug is effective for neuropathic pain? Which drug is approved for pain of diabetic neuropathy?
Definition
Venlafaxine (effexor), duloxetine (cymbalta)
Term
Which drugs are effective for OCD?
Definition
Clomipramine and the SSRIs
Term
Other than depression, what are SSRIs used for?
Definition
GAD, panic attacks, social phobias, bulimia, PMDD, alcohol dependence
Term
Bupropion is used for...
Definition
smoking cessation
Term
List the adverse effects of TCAs
Definition
excessive sedation, lassitude, fatigue, confusion, sympathomimetic - tachy, agitation, sweating, insomnia, atropine-like effects, orthostatic hypotension, ECG abnormalities, cardiomyopathy, tremor and paresthesias, weight gain
Term
List the manifestations of TCA overdose. What are the 3 Cs?
Definition
agitation, delirium, neuromuscular irritability, convulsions, coma, respiratory depression, circulatory collapse, hyperpyrexia, cardiac conduction effects, severe arrhythmias. Coma, convulsions and cardiotoxicity.
Term
What happens if TCAs are taken with alcohol, barbs, benzos, or opioids?
Definition
additive CNS depression
Term
What effect do TCAs have on the antihypertensive action of guanethidine (blocker of NE release)?
Definition
reversal of action, blocks its transport into sympathetic nerve endings
Term
Which drugs may interfere with the antihypertensive actions of methyldopa and clonidine (a-adrenergic agonists)?
Definition
TCAs
Term
Mirtazapine is a _____, it causes weight _____, and is markedly sedating, as is _______.
Definition
heterocyclic, gain, trazodone
Term
amoxapine, maprotiline, mirtazapine and trazodone cause some _____ effects
Definition
autonomic
Term
________ is also a dopamine receptor blocker and may cause...
Definition
Amoxapine, akathisia, parkinsonism, amenorrhea-galactorrhea syndrome
Term
Adverse effects of _____ include anxiety, agitation, dizziness, dry mouth, aggravation of psychosis, and at high doses, seizures
Definition
heterocyclics
Term
______ and ______ are prominent features of overdosage with amoxapine and maprotiline
Definition
seizures and cardiotoxicity
Term
Venlafaxine causes a dose-dependent increase in _________ and has CNS _____ effects
Definition
blood pressure, stimulant
Term
Even after missing a single dose of ____, severe withdrawal effects can occur
Definition
venlafaxine
Term
both nefazodone and venlafaxine are ________s of cytochrome p450 enzymes
Definition
inhibitors
Term
rarely, _____ has caused life-threatening hepatotoxicity
Definition
nefazodone
Term
Fluoxetine and other SSRIs may cause...
Definition
nausea, headache, anxiety, agitation, insomnia, sexual dysfunction,
Term
What kind of extrapyramidal effects can occur early in treatment with SSRIs?
Definition
akathisia, dyskinesia, and dystonic reactions
Term
Gross overdosage of SSRIs can cause ____.
Definition
seizures
Term
cardiac effects of citalopram OD include...
Definition
QT prolongation
Term
Describe the SSRI withdrawal syndrome
Definition
nausea, dizziness, anxiety, tremor, palpitations
Term
the SSRIs are _____s of cyp 450 enzymes
Definition
inhibitors
Term
Which SSRI causes fewer drug interactions than the others?
Definition
citalopram
Term
Severe muscle rigidity, hyperthermia, cardiovascular instability, marked CNS stimulation, including seizures -- what is this?
Definition
serotonin syndrome
Term
what kinds of drugs have been used to manage serotonin syndrome?
Definition
antiseizure drugs, muscle relaxants, 5HT blockers (cyproheptadine)
Term
List the adverse effects of traditional MAOIs
Definition
hypertensive reactions to indirect sympathomimentics (e.g. tyramine in food), hyperthermia, CNS stimulation, agitation, convulsions
Term
Overdosage with MAOIs can lead to..
Definition
shock, hyperthermia, seizures
Term
MAOIs administered together with SSRIs has resulted in...
Definition
the serotonin syndrome
Term
Name the prototype(s) for TCAs
Definition
amitriptyline, imipramine
Term
What are some TCAs besides the prototypical drugs?
Definition
clomipramine, desipramine, doxepin, nortriptyline
Term
Name the 2nd gen heterocyclics
Definition
amoxapine, bupropion, maprotiline, trazodone
Term
name the 3rd gen heterocyclics
Definition
duloxetine, mirtazapine, nefazodone, venlafaxine
Term
What is the prototype for SSRIs?
Definition
fluoxetine
Term
name some SSRIs besides the prototypical drug
Definition
citalopram, fluvoxamine, paroxetine, sertraline
Term
What is the prototype for MAOIs?
Definition
phenelzine
Term
name some MAOIs besides the prototype
Definition
tranylcypromine, selegiline
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