Materials for Major Depression for DSM II

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mcucullu
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162479
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Materials for Major Depression for DSM II
Updated:
2012-07-14 16:04:39
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disease state management II dsm major depression drugs doses symptoms signs
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These flashcards cover all materials for major depression presented in the DSM II course of the pharmacy curriculum.
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  1. What are the risk factors associated with major depression?
    • 1) family history
    • 2) previous depressive episode
    • 3) previous suicide attempt
    • 4) comorbid medical or substance abuse
  2. What are some physical symptoms of major depression?
    • 1) fatigue
    • 2) pain
    • 3) sleep disturbances
    • 4) psychomotor retardation/agitation
  3. What are some emotional symptoms of major depression?
    • 1) anhedonia
    • 2) depressed mood
    • 3) hopelessness/helplessness
    • 4) inappropriate feelings of guilt and worthlessness
    • 5) anxiety/worry
    • 6) suicidal ideation
  4. What are some cognitive symptoms associated with major depression?
    • 1) indecisiveness
    • 2) decreased ability to concentrate
  5. What are some laboratory studies that are undergone to rule out any other causative factors?
    • 1) CBC with differential
    • 2) thyroid function tests
    • 3) rapid plasma reagin (RPR) test for syphilis
    • 4) urine drug screen
  6. What are some medical conditions that may contribute or worsen depression?
    • 1) MI
    • 2) CVA
    • 3) Parkinson's Disease
    • 4) MS
    • 5) SLE
    • 6) HIV
    • 7) RA
    • 8) thyroid abnormalities
    • 9) DM
    • 10) cancer
    • 11) vitamin deficiencies
  7. What drugs may induce depression?
    • 1) corticosteroids
    • 2) oral contraceptives
    • 3) propranolol
    • 4) clonidine
    • 5) methyldopa
  8. What are the risk factors for suicide attempt?
    • 1) male
    • 2) age > 50 years
    • 3) recent loss of job/spouse
    • 4) unemployment
    • 5) social isolation
    • 6) presence of weapon
    • 7) comorbid substance abuse
  9. What are the DSM IV diagnostic criteria for major depression?
    At least 5 symptoms ocurring everyday for 2 weeks, in which one of the five must be either anhedonia or depressed mood.
  10. How are TCAs dosed?
    TCAs must be titrated over a period of 1-3 weeks.
  11. What is a major side effect of TCAs?
    sedation
  12. What are the side effects of TCAs?
    • 1) orthostatic hypotension
    • 2) tachycardia
    • 3) sedation
    • 4) anticholinergic effects
    • 5) prolong QT interval
    • 6) weight gain
    • 7) sexual dysfunction
  13. What are some contraindications of TCAs?
    • 1) concomitant use of an MAOI within 14 days
    • 2) pregnancy
    • 3) lactation
    • 4) narrow-angled glaucoma
  14. With what conditions would you want to exercise precaution when administering TCAs?
    • 1) cardiac conductin defects
    • 2) seizure disorders
    • 3) hyperthyroidism
    • 4) renal impairment
    • 5) hepatic impairment
  15. What drugs are increased in the serum because of TCAs?
    • 1) SSRIs
    • 2) cimetidine
    • 3) diltiazem
    • 4) verapamil
    • 5) labetolol
    • 6) propoxyphene
    • 7) quinidine
    • 8) haloperidol
    • 9) methylphenidate
  16. Which drugs are effected by decreased levels of TCAs?
    • 1) CBZ
    • 2) phenytoin
    • 3) barbiturates
  17. What drugs, in combination with TCAs, will cause serotonin syndrome?
    MAOIs
  18. What are some parameters that should be monitored while a patient is taking TCAs?
    • 1) BP
    • 2) pulse
    • 3) ECG changes
    • 4) mental status changes
  19. What pregnancy category are amitriptyline (Elavil)?
    Pregnancy category D
  20. What are the indications for amitriptyline (Elavil)?
    • 1) depression
    • 2) chronic/neuropathic pain
    • 3) migraine prophylaxis
    • 4) peripheral neuropathy
  21. What is the initial dose of amitriptyline (Elavil)?
    50-75 mg
  22. What is the dosage range for amitriptyline (Elavil)?
    75-300 mg
  23. What pregnancy category is nortriptyline (Pamelor, Aventyl)?
    Pregnancy category D
  24. What are the indications for nortriptyline (Pamelor, Aventyl)?
    • 1) depression
    • 2) chronic pain
  25. What is the initial dose of nortriptyline (Pamelor, Aventyl)?
    25-50 mg
  26. What is the dose range for nortriptyline (Pamelor, Aventyl)?
    40-200 mg
  27. What are the indications for imipramine (Tofranil)?
    • 1) depression
    • 2) childhood enuresis
    • 3) chronic/neuropathic pain
  28. What is the initial dose for imipramine (Tofranil)?
    50-75 mg
  29. What is the dose range for imipramine (Tofranil)?
    75-300 mg
  30. What is the pregnancy category for doxepin (Sinequan)?
    Pregnancy category C
  31. What are the indications for doxepin (Sinequan)?
    • 1) depresion
    • 2) anxiety
  32. What is the inital dose of doxepin (Sinequan)?
    75 mg in divided doses BID or TID
  33. What is the dose range for doxepin (Sinequan)?
    75-300 mg
  34. What pregnancy category is clomipramine (Anafranil)?
    prengancy category C
  35. What are the indications for clomipramine (Anafranil)?
    • 1) OCD
    • 2) depression
    • 3) chronic pain
  36. What is the initial dose for clomipramine (Anafranil)?
    25-100 mg titrated up for 1-2 weeks
  37. What is the usual effective dose for clomipramine (Anafranil)?
    200-250 mg/day
  38. What is the maximum dose of clomipramine (Anafranil)?
    250 mg
  39. What pregnancy category is desipramine (Norpramin)?
    Pregnancy category C
  40. What are the indications of desipramine (Norpramin)?
    • 1) depression
    • 2) chronic pain
  41. What is the initial dose for desipramine (Norpramin)?
    50-75 mg
  42. What is the dose range for desipramine (Norpramin)?
    75-300 mg
  43. What are the adverse effects of MAOIs?
    • 1) weight gain
    • 2) orthostatic hypotension
    • 3) sexual dysfuntion
    • 4) anticholinergic effects
    • 5) hypertensive crisis
  44. What are the contraindications of MAOIs?
    • 1) renal dysfunction
    • 2) hepatic dysfunction
    • 3) CVD
    • 4) concomitant sympathomimetic therapy
    • 5) use of SSRI within the last two weeks
  45. What foods should be avoided when using MAOIs?
    Tyramine containing foods such as red wine and aged cheeses.
  46. What are some drug interactions of MAOIs?
    • 1) TCAs
    • 2) SSRIs
    • 3) sympathomimetics
    • 4) meperidine
  47. What are some MAOIs?
    • 1) Penelzine (Nardil)
    • 2) Tranylcypromine (Parnate)
  48. What should you do when wanting to d/c an SSRI?
    You should taper down the dose of the SSRI.
  49. What are some side effects of SSRIs?
    • 1) GI complaints
    • 2) nervousness
    • 3) insomnia
    • 4) headache
    • 5) fatigue
    • 6) sexual dysfunction
  50. What are some side effects caused by abrupt withdrawal of SSRIs?
    • 1) flu-like symptoms
    • 2) dizziness
    • 3) nausea
    • 4) tremor
    • 5) anxiety
    • 6) palpitations
  51. What is the initial dose of citalopram (Celexa)?
    10 mg
  52. What is the usual dose range of citalopram (Celexa)?
    20-40 mg/day
  53. What is the maximum dose of citalopram (Celexa)?
    60 mg/day
  54. What is the initial dose of escitalopram (Lexapro)?
    10 mg
  55. What is the usual dose of escitalopram (Lexapro)?
    10-20 mg/day
  56. What is the dose equivalence between citalopram (Celexa) and escitalopram (Lexapro)?
    40 mg citalopram (Celexa) = 10 mg escitalopram (Lexapro)
  57. What is the initial dose of fluvoxamine (Luvox)?
    50 mg
  58. What is the usual dose of fluvoxamine (Luvox)?
    100-300 mg/day
  59. What is the initial dose of Paroxetine (Paxil)?
    10-20 mg
  60. What is the usual dose of paroxetine (Paxil)?
    10-40 mg
  61. What is the maximum dose of paroxetine (Paxil)?
    50 mg/day
  62. What is the dosing equivalence between paroxetine (Paxil) and paroxetine Cr (Paxil Cr)?
    10 mg paroxetine (Paxil) = 12.5 mg paroxetine Cr (Paxil Cr
  63. What is the initial dose of fluoxetine (Prozac)?
    10-20 mg
  64. What is the usual dose of fluoxetine (Prozac)?
    20-80 mg
  65. What is the initial dose of sertraline (Zoloft)?
    25-50 mg
  66. What is the usual dose of sertraline (Zoloft)?
    50-100 mg/day
  67. What is the maximum dose of sertraline (Zoloft)?
    200 mg/day

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