Term
| Neurochemical Basis of Depression |
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Definition
Bioamine Deficiencies
Neural Transmission in Medial Forebrain Bundle and Preventrical System |
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Term
| Parts of the brain affected by depression |
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Definition
cerebral cortex
thalamus
hippocampus
amygdala |
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Term
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Definition
| Liver enzymes (P450) created in the endoplasmic reticulum biotransform drugs to into metabolites in preparation for elimination. |
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Term
| First Order Biotransformation |
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Definition
| Drug elimation is proportional to its concentration (antibiotics are first order biotransformed). |
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Term
| Zero order biotransformation |
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Definition
| Drug is biotransformed at a specific rate regardless of concentration. |
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Term
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Definition
| The time it takes to eliminate 1/2 of a drug from the body. It takes 5 1/2 lives to totally eliminate a drug. |
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Term
| Tricyclic Antibiotics (TCAs) |
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Definition
Block (or inhibit) reuptake of norephinephrine
Sedate (H1 - antihistimine receptors)
Lipophilic
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Term
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Definition
Appetite returns in 5-7 days
Insomnia improves in 3-4 days
Take 10-14 days to fully work.
Full effects take 6 weeks.
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Term
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Definition
Insidious onset
anorexia
middle or late insomnia
psychomotor retardation
emotional withdrawal
anhedonia
past success with antidepressants
guilt |
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Term
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Definition
Hypersomnia
hyperphagia
rejection sensititivity
profound anergy
hypochondriasis
childhood depression
anxiety
agitation
panic attacks |
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Term
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Definition
Most common complaint in elderly.
SSRIs & buproprion (wellbutrin), mirtazapine (remeron), moclobemide (Manerix) are best tolerated because fewer anticholinergic effects (heart especially). |
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Term
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Definition
Anticholingeric Effects
Cardiac arrhymia
hypertension
orthostatic hypotension
sedation |
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Term
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Definition
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Term
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Definition
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Term
| Monoamine-Oxidase Inhibitors (MAOIs) |
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Definition
Interfere with MAO-A and MAO-B
Successful in 55-75% people
Many side effects
Diet restrictions |
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Term
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Definition
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Term
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Definition
Parnate
MAOI
Does not seem to be a risk for mania. |
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Term
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Definition
Caused by combining MAOI and SSRI
Elevated temperature
Abnormal muscle movements
Hyper-reflexivity
Generalized Seizure
Confusion/Delerium
Shock
Death |
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Term
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Definition
Combining MAOI and TCA or tyramine containing food
Hypertension
Occipital headaches
stiff or sore neck
flushing or sweating
cold clammy skin
tachycardia
chest pain
photophobia
stroke/coma/death |
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Term
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Definition
Prozac
SSRI
Long half-life
may cause immediate worsening of depression
decreased appetite
comnolence & lethergy
GI distress
weight loss
Approved for: MDD, bulemia, panic D/O, OCD in adults and children
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Term
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Definition
Block reuptake of Serotonin
symptom improvement in 10-14 days
energy 4-7 days
moor, concentration, and interest improve in 7-10 days |
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Term
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Definition
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Term
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Definition
Paxil
SSRI
causes the most sedation of SSRIs
Half-life 21 hours
Low mania induction in bipolar
Anticholinergic effects more common
Approved for: MDD, OCD, GAD, PTSD, Social Anxiety D/O, Panic D/O |
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Term
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Definition
Zoloft
SSRI
Not very potent, low side effects
Lowest SSRI for anorexia
low mania induction
take on full stomach
dryer mouth
some somnolence
Approved for: MDD, OCD, Panic D/O, PTSD, PMDD, & Social Anxiety D/O |
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Term
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Definition
Celexa
SSRI
Low side effects
minimal effect of DA and NE
low anticholinergic effects
Approved for MDD and depression |
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Term
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Definition
Lexapro
SSRI
Potent
Isomer of Celexa
Approved for GAD and MDD |
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Term
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Definition
Viibyrd
SSRI
Titrate up
Powerful/Expensive |
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Term
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Definition
Brintillex/ now Trintillex
Serotonin modulator and stimulator |
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Term
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Definition
Anafranil
TCA with serotonin reuptake
used for OCD, Panic, Phobias
used with panic and phobias
lots of side effects |
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Term
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Definition
Wellbutrin
Atypical
Low side effects
can cause seizures and death if seizure hx.
low mania induction
Good for tx. resistant depression |
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Term
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Definition
Serzone
No anxiety
no sexual side effects
short-half life
bradycardia risk
requires BID dosing |
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Term
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Definition
Deseryl
atypical
sleep inducing
blockades serotonin and NE
used for cocaine withdrawal
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Term
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Definition
Remeron
Atypical
tetracyclic chemical structure
affects serotonin and NE
overeating/weight gain
Many severe and common side effects |
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Term
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Definition
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Term
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Definition
Effexor
first SNRI
1/2 5 hours
Protein bound
useful in geriatric population
BID dosing
may cause heart problems
nausea risk
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Term
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Definition
blurred vision
constipation
decreased sweating
dizziness
dry mouth
difficulty urinating |
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Term
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Definition
Cymbalta
Do not take with mellaril or MAOI
MDD and GAD, fibromyalgia, neuropathy
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Term
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Definition
Pristiq
Third SNRI
50MG QD
10X more binding to 5HT over NE
Careful may make worse health conditions |
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Term
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Definition
Headache for a few days
sleeplessness and drowsiness
agitation
nausea for a few days
sexual problems |
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Term
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Definition
Fetzima
Greater affinity for NE over 5HT
QD
Approved for MDD in 2013 |
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