pharm II test II antidepressants

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pharm II test II antidepressants
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pharm II test II antidepressants
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  1. 4 tricyclic antidepressants
    • amitriptyline - elavil
    • desipramine - norpramin
    • imipramine - tofranil
    • nortriptyline - aventyl
  2. 8 heterocyclics antidepressants
    • amoxapine - asendin
    • buproprion - wellbutrin
    • maprotiline - ludiomil
    • mirtazapine - remeron
    • nefazodone - serzone
    • trazadone - desyrel
    • venlafaxine - effexor
    • duloxetine - cymbalta
  3. 3 MOAI antidepressants
    • phenelzine - nardil
    • tranylcypromine - parnate
    • selegiline - eldepryl
  4. 6 SSRI antidepressants
    • fluoxetine - prozac
    • fluvoxamine - luvox
    • paroxetine - paxil
    • citalopram - celexa
    • escitalopram - lexapro
    • sertraline - zoloft
  5. 4 major therapeutic uses for TCAD's
    • depression
    • bipolar disorder
    • neuropathic pain
    • enureses
  6. 4 Tx of TCAD toxicity
    • gastric lavage
    • ingestion of activated charcoal
    • physostigme - crossses BBB
    • propranolol, lidocaine, phenytion(supress seizure activity and arrythmias)
  7. advantage of SSRI's over TCAD
    • less hypotension, sedation, or anticholinergic effects; less seizure risk
    • OD doesn't cause cardiac toxicity
  8. disadvantage of SSRI's over TCAD
    more agitation/insomnia and sexual dysfunction
  9. 3 AE of SSRI
    • HA
    • seratonin syndrome
    • bleeding disorders
  10. drugs of choice for atypical depression
    MAOI's
  11. TCAD effects in normal sujects 3
    • anticholinergic actions
    • sleepiness, lightheadedness
    • no stimulating or mood elevation effects
  12. TCAD effets in depressed subjects
    • elevation in mood only after 2-3 wks
    • not used PRN
  13. TCAD 5 CNS AE
    • disorientation
    • sedation
    • neurological disturbances
    • aggravation of psychosis
    • seizures
  14. TCAD Cardiovascular AE 2
    • orthostaic hypotension
    • cardiac toxicity; tachy and arrhythmias
  15. 7 AE of TCAD
    • CNS
    • cardiovascular
    • anticholineric effects
    • weight gain
    • diaphoresis
    • allergic reactions
    • yawngasm
  16. SSRI
    T1/2 - 2days
    active metabolite T1/2 7 days
    4 wks to steady state and also washout
    fluoxetine - prozac
  17. SSRI
    blocks uptake of 5HT & DA
    minimal effects of seizure threshold
    SE - diarrhea 
          NAS & PPHN (when used in late preg)  drug interaction with pimozide (arrhythmias)
    sertraline - zoloft
  18. SSRI
    ind - OCD & anxiety
    rapidly absorbed from GI tract
    SE - constipation
          weight gain
          abnormal liver function
    fluvoxamine - luvox
  19. SSRI
    ind - social phobia
           panic disorder
    paroxetine - paxil
  20. SSRI
    labeled for major depression but used in anxiety
    SE - somnolence
          dry mouth
          NAS
    citalopram - celexa
  21. 2 S/NRI's
    • venlafaxine - effexor
    • duloxetine - cymbalta
  22. S/NRI
    low dose - SSRI
    higher dose - NE, DA
    little cholinergic, histaminic or alpha block
    serious reactions with MAOI's
    SE - weight loss  
          hyponatremia - elderly
           neonatal withdrawal syndrome
    venlafaxine - effexor
  23. S/NRI
    does not inhibit MAO
    ind -pain of diabetic peripheral neuropathy  
    fibromyalgia
    highly protein bound
    AE - blurred vision 
         
    duloxetine - cymbalta
  24. heterocyclic
    2nd gen
    metabolite of loxapine - DA antagonism
    ind - useful for depression in psychotic pts?
           EPS and amenorrhea
    amoxapine - asendin
  25. heterocyclic
    2nd gen
    most important action blocks NE reuptake
    high doses associated with seizures
    maprotiline - ludiomil
  26. heterocyclic
    3rd gen
    low dose - like SSRI
    high dose - block NE
                    block DA
    venlafaxine - effexor
  27. heterocyclic
    3rd gen
    fewer adverse sexual effects than SSRI
    rare but dangerous hepatotoxicity
    nefazodone - serzone
  28. heterocyclic
    3rd gen
    5HT2A and alpha-adrenoreceptor antagonism
    mirtazapine - remeron
  29. heterocyclic
    3rd gen
    suppress appetite
    less adverse sexual effects
    bupropion - wellbutrin
  30. 3 therapeutic uses of bupropion - wellbutrin
    • depression
    • smoking cessation - zyban
    • seasonal affective disorder
  31. MAO MOA
    • converts monoamine neurotransmitters into inactive products
    • MAO-A - inhibits NE &5HT
    • MAO-B - inhibits DA and NE,5HT in high doses
    • inactivates tyramine & biogenic amines
  32. MAOI
    transdermal
    lower risk of hypertensive crisis
    selegiline - emsam

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