Term
|
Definition
Phenelzine, Selegilin.
Be mindful of foods with tyramine (anything fermented). Slow acetylators may have increased effects of the drug. |
|
|
Term
| Define each component of SIG E CAPS |
|
Definition
Sleep disturbance.
loss of Interest in pleasurable activites.
Guilt or feelings of worthlessness.
lack of Energy.
loss of Concentration.
Appetite change.
Psychomotor agitation or retardation.
Suicidal thoughts. |
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|
Term
|
Definition
| Tricyclic antidepressants inhibit 5-HT and NE reuptake. |
|
|
Term
| A TCA that favors 5-HT and is used in OCD. |
|
Definition
|
|
Term
| A TCA that favors 5-HT over NE only slightly. |
|
Definition
Amitriptyline.
Recall that this is the "Fat & Lazy" drug. It is sedating (as compared to Imipramine which is excitatory) and blockage of 5-HT-2c receptors leads to weight gain. |
|
|
Term
| These drugs block muscarininc, H1, and alpha sites as well as their primary action of blocking reuptake of norepinephrine and serotonin. |
|
Definition
TCAs
Clomipramine (OCD)
Imipramine (excitatory)
Amitriptyline (sedating) |
|
|
Term
| What is a serious risk factor for antidepressant use in patients less than 24 years of age? |
|
Definition
Suicide.
This is especially a risk for TCAs |
|
|
Term
|
Definition
Depression, anxiety, OCD, neuropathic pain, nocturnal enuresis, IBS.
Its really not used much primarily due to narrow TI and side effects. |
|
|
Term
|
Definition
Phenelzine (Nardil)
Selegiline (Deprenyl)
Recall that you want to avoid foods with tyramine because it will replace monoamines in the vessicles which puts even more in the synapse. This leads to a hypertensive crisis. |
|
|
Term
| MAO-I's block MAO A and MAO B. What happens when you use Selegiline at a lower dose? |
|
Definition
| Selegiline at a lower dose inhibits only MAO B. This help avoid hypertensive crisis. |
|
|
Term
|
Definition
| MAO-A blockage results in 5-HT and NE buildup and release. MAO-B blockage results in buildup and release of DA |
|
|
Term
| What are some foods to avoid if you are on MAO-Is? |
|
Definition
| "Wine and cheese". Anything that is fermented. Less of a problem with second generation MAO-Is |
|
|
Term
| Chronic antidepressant usage can lead to... |
|
Definition
| up-regulation of second messenger pathways systems. |
|
|
Term
| What is the MOA of SSRIs? |
|
Definition
| Block serotonin uptake to make you happy as a fat kid at a Hostess factory |
|
|
Term
|
Definition
Fluoxetine (prozac, prototype)
Paroxetine (Paxil)
Sertraline (Zoloft)
Fluvoxamine (Luvox)
Escitalopram |
|
|
Term
| The two best SSRI's based on compliance. |
|
Definition
Sertraline (Zoloft)
Escitalopram (Laxapro)
They both treat major depression and anxiety but could lead to Serotonin Syndrome. |
|
|
Term
| A "frustrating" side effect of SSRI's. Note that it will reduce compliance of the drug. |
|
Definition
|
|
Term
| A patient on SSRI's comes to you with mental confusion, headaches, hallucinations, cardiac issues, hyperthermic, and has myoclonus with tremor. What is the name of this conglomeration of symptoms? |
|
Definition
Serotonin syndrome.
Remember that this is treated with dantrolene, which blocks the Ryr-receptors to inhibit Calcium release. |
|
|
Term
| Vanlafaxine has a good efficacy and safety profile. What is its MOA? |
|
Definition
Blocks reuptake of serotonin and norepinephrine...SPECIFICALLY.
In other words this is not a dirty drug like TCAs |
|
|
Term
Mirtazapine.
What is its classification and MOA? |
|
Definition
A third generation ATYPICAL antidepressant.
Inhibits PREsynaptic Alpha 2 receptors to reduce feedback.
Mirtazapine is also a 5HT2/3 antagonist. |
|
|
Term
Agomelatine (Valdoxan)
What is its classification and MOA?
You may need to know both names of this drug. |
|
Definition
Melotonin agent
This is a brand-spanking new drug that is an antagonist of 5HT-2C, MT1 and MT2.
Use in depression and to correct circadian rhythm. |
|
|
Term
|
Definition
Antidepressant by inhibiting DA and NE reuptake.
Could have weight loss and insomnia. Sometimes helps people quit smoking. |
|
|
Term
|
Definition
Same thing as Bupiopion. Inhibits NE and DA reuptake.
Nice because there is no sexual dysfunction associated with it unlike SSRIs |
|
|
Term
|
Definition
Another name for Wellbutrin and Bupropion.
Once again, this is an atypical which blocks the reuptake of DOPAMINE. Try not to give this to patients which eating disorders because it tends to reduce appetite. |
|
|
Term
78 year old male presents with feelings of sadness, irritability, achiness, sleep disturbances and GI distress. What drug would you give?
Hint, this drug is an anxiolytic. |
|
Definition
| Buspirone. It is a 5-HT-1A partial agonist with minimal side effects. |
|
|
Term
| 37 year old female, has been severely depressed despite 6 weeks on escitalopram and then 6 weeks on venlafaxine. There has been little improvement in insomnia or mood. What are some viable next options? |
|
Definition
Switch to mertazapine or valdoxan.
I'm not sure why, but I think the point of this TP question was to suggest that you should try drugs in the same class first before trying another class. |
|
|
Term
| 29 year old female, is being treated for depression with sertraline and is a slow metabolizer. The PCP has warned her to be careful about drug interactions and the concern for too high levels of serotonin. What drug should be a concern for adverse interactions? |
|
Definition
St. John’s Wort
This is another turning point question and I just figured its best for you to just memorize this answer. |
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