Antidepressants

Card Set Information

Author:
krug0043
ID:
17398
Filename:
Antidepressants
Updated:
2010-05-03 00:51:07
Tags:
CNS
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Description:
Pharmacology II
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  1. Nortiptyline Class and MOA
    Tricyclic (TCA)

    Blocks NE reuptake in periphery and CNS.
  2. Phenelzine Class and MOA
    MAOI

    Blocks deamination of monoamines.
  3. Fluoxetine Class

    Is Fluoxetine selective?
    SSRI

    Little effect on muscarinic, histaminergic, alpha adrenergic or 5-HT receptors
  4. Venlafaxine Class and MOA
    Seritonin and NE Reuptake Inhibitor (SNRI)
  5. Trazadone Class and MOAs
    Atypical

    • -5-HT reuptake inhibitor
    • -Partial agonist at 5-HT1A Receptor
    • -H1 Receptor agonist
  6. Nefazodone Class and MOAs
    Atypical

    • -5-HT reuptake inhibitor
    • -5-HT antagonist (activating effects)
  7. Bupropion Class and MAOs
    Atypical

    DA and NE reuptake inhibitor
  8. Mirtazapine Class and MAOs
    Atypical

    • -Alpha 2 antagonist
    • -5-HT2 and 5-HT3 receptor antagonist
  9. Lithium Class and MOA
    Mood Stabilizer

    Probably modifies 5-HT and NE transmission.
  10. Nortriptyline Efficacy
    • Onset in 2-3 weeks.
    • No PRN use.
    • DC results in relapse.
  11. Nortriptyline Adverse Effects
    • 1.
    • Orthostatic hypotension

    • 2.
    • Antihistamine Drowsiness

    • 3.
    • Anticholinergic

    • 4.
    • Tachycardia

    • 5. Weight
    • GAIN
  12. Phenelzine Efficacy
    • Not first line.
    • Used for atypical depressions.
  13. Phenelzine Adverse Effects
    Hepatotoxicity.

    Low Therapeutic Index.

    OD effects are agitation, convulsions.

    Beer and Cheese rxn.
  14. Fluoxetine Efficacy
    More tolerable than MAOIs and TCAs, NOT more efficacious.

    Onset 1-3 weeks (same as TCAs)
  15. Fluoxetine Adverse Effects
    May produce stimulation and suicidal thoughts.

    • N/V; Weight LOSS.
    • Sexual dysfunction.
  16. Venlafaxine Efficacy
    Requires 2-3 doses per day.
  17. Venlafaxine Adverse Effects
    Fewer than TCAs but do increase BP.

    SSRI-like SEs.
  18. Trazodone Efficacy
    Used for depression with anxiety, agitation, and insomnia.
  19. Trazodone Adverse Effects.
    Marked sedation.

    Dizziness.

    Hypotension.

    Nausea
  20. Nefazodone Efficacy
    Produces CNS activation.
  21. Nafazodone Adverse Effects
    NOT sedating.
  22. Bupropion Efficacy
    Depression with psychomotor retardation (lethargy).
  23. Bupropion Adverse Effects
    Low incidence of SE.

    CNS stimulation can cause nervousness and insomnia.

    Seizures at high doses.
  24. Mirtazapine Efficacy
    Sedative and anxiolytic effects.
  25. Mirtazapine Adverse Effects
    Similar to TCAs but less pronounced.
  26. Lithium Efficacy
    DOC for "classic" mania.

    Onset in 7-10 days.
  27. Lithium Adverse Effects
    Marked fatigue, muscle weakness, slurred speech, and tremor.

    Thirst and urination (nephrogenic diabetes insipidus)

    • tolerance develops to many of the SEs after 4 weeks.
    • -no tolerance to tremor (Beta blocker may help)
    • -no tolerance to excesive urination and thirst (must regulate water intake to prevent washout)

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