Pharm II (Mood disorders)

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Pharm II (Mood disorders)
2011-02-01 13:07:44
Pharm II Mood disorders

Pharm II (Mood disorders)
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  1. What are the 5 Different types of Anti-Depressents?
    -Monoamine Oxidase Inhibitors (MAOI)

    -Tricyclic Antidepressants (TCA)

    -Selective Serotonin Reuptake Inhibitors (SSRI)

    -Serotonin Norepinephrine Reuptake Inhibitors (SNRI)

    -Others (sometimes referred to as atypical)
  2. What is the Mech of action of the MAO inhibitors?
    MAO metabolizes NE,5-HT, and DA

    If you inhibit MAO enzyme, you increase the prevent this degradation--> increasing the availablity of NE,5-HT and DA
  3. What are MAO inhibitors used for?
    -Major depressive disorders

    (also, Panic, social anxiety disorders) but not approved.
  4. What are the different types of MAOIs?



  5. What are the adverse effects of MAOIs
    • Dizziness, Headache, Dry mouth, Insomnia, Constipation, Weight gain
    • Edema, Sexual dysfunction, Manina/hypomania, Lower seizure threshold

    Hypertension, occipital headache, palpitations, N/V, Chills, restlessness
  6. What causes the hypertensive crisis in MAOIs?

    How do you treat this?
    Caused by interaction of MAOI with dietary tyramine

    • Treat with a MAOI diet (low tyramine)
    • (cheese, wine, beer, pickled fish, fava beans, beer, chicken liver)
  7. What are the Tricyclic antidepressants Mech of action?
    • They inhibit the reuptake of neurotransmiters by presynaptic neuon
    • Esspecially NE and 5-HT
  8. What are TCA's indications?
    Major depressive disorders (all)

    OCD (clomiprame only)

    Panic disorder (Imipramine)
  9. Name the TCA agents

    Indicate the parent drugs (P)
    Imipramine (P)

    Clomipramine (P)

    Amitriptyline (P)


  10. What are some drug interactions of:

    - SSRIs (except Fluvoxamine) inhibit CYP450 --> increased TCA levels

    • -MAOI:
    • Dont use these 14 days prior to TCA drugs.
  11. What is the SSRI mech of action?

    What are they selective for??
    • They inhibit the reuptake of 5-HT
    • this results in increased synaptic 5-HT

    Selective for 5-HT
  12. What are some of the indications for SSRIs??
    • -Major Depressive Disorder (MDD)
    • -Obsessive Compulsive Disorder (OCD) -Panic Disorder (PD)
    • -Social Anxiety Disorder (Social Phobia) -Post Traumatic Stress Disorder (PTSD) -Generalized Anxiety Disorder (GAD)
    • -Bulimia Nervosa
    • -Premenstrual Dysphoric Disorder (PMDD)
  13. What are the SSRI adverse effects?

    indicate which are included in activation effects.
    • -Agitation
    • -Anxiety
    • -Sleep disturbance
    • -Tremor
    • -Sexual dysfunction
    • -GI distress
    • -Weight changes
    • -⋙ Induction of mania/hypomania
    • -⋙ Lowers seizure threshold (<TCA)
    • -Serotonin syndrome
  14. What are some drug interactions of the SSRIs?

    *What can the elevation of 5-HT cause??
    • -All inhibit CYP450 (except fluvoxamine)
    • (thus other drug levels will increase)

    -Dont used MAOI's for 14 days prior to SSRI), and 5 weeks for Fluoxetine.

    * Can cause Serotonin syndrome
  15. Name the 6 SSRIs
    • Fluoxetine
    • Sertaline
    • Paroxetine
    • Fluvoxamine
    • Citalopram
    • Escitalopram
  16. What is seen in serotonin syndrome?
    • -Restlessness, tremor
    • -⇧ Muscle tone, myoclonus
    • -Agitation/confusion
    • -Hyperreflexia
    • -⇧ Temperature
    • -Cardiac arrhythmia
    • -Death