Antidepressant Pharmacology Flashcards Preview

Behavioral Health > Antidepressant Pharmacology > Flashcards

Flashcards in Antidepressant Pharmacology Deck (74)
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1

Antidepressant Classes

SSRIs
SNRIs
TCA
MAOIs
Others: mirtazapine, bupropion, trazodone

2

What is the first line treatment of depressive disorders?

SSRIs

3

Examples of SSRIs

Fluoxetine (Prozac)
Sertraline (Zoloft)
Paroxetine (Paxil)
Citalopram (Celexa)
Fluvoxamine (Luvox)
Escitalopram (Lexapro)

4

Psychiatric Conditions that SSRIs Treat

Depression
Panic disorder
OCD
GAD
Social anxiety disorder
PTSD
Body dysmorphic disorder
Bulimia nervosa
Binge eating disorder
Premenstrual dysphoric disorder
Somatoform disorders

5

MOA for SSRIs

Block the presynaptic serotonin re-uptake pump

6

Pharmacokinetics of SSRIs

Absorbed in GI tract
Bind to proteins
Metabolism & elimination occur in the liver

7

Which SSRIs inhibit liver enzymes less than other SSRIs?

Citalopram
Escitalopram

8

Why is inhibition of liver enzymes important?

Less drug interactions

9

What should you be caution with prescribing with SSRIs?

Azole antifungals
Macrolide antibiotics
Omeprazole
Hepatic impairment

10

What SSRIs are contraindicated with tamoxifen?

Paroxetine
Fluoxetine

11

SSRI SE

Sexual dysfunction
Drowsiness
Weight gain
Dizziness
Insomnia
Anxiety
Diaphoresis
Diarrhea
Hyperprolactinemia
Headache
Dry mouth
Blurred vision
Nausea
Rash or pruritis
Tremor
Constipation
SIADH
Hyponatremia

12

Withdrawal Symptoms of SSRIs

Dysphoria
Dizziness
GI distress
Fatigue
Chills
Myalgias

13

How long do SSRIs take to take effect?

Some few weeks
Others 4-6 weeks

14

Most Common SE of SSRIs Initially

Headache
Dizziness
Nausea
Diarrhea

15

What drug is good to use when concerned about drug interactions?

Citalopram (Celexa)

16

What risk is important in citalopram (Celexa)?

QT prolongation
Arrhythmia + hepatic impairment OR age >60 years OR on other CYP219 inhibitors

17

What is an isomer & similar to citalopram?

Escitalopram (Lexapro)

18

Which SSRI is more likely to cause activation and have the least problems with weight gain?

Fluoxetine (Prozac)

19

What is the most common SE of fluvoxamine (Luvox)?

Weight gain (2.6%)
Nausea
Sedation

20

Which SSRI is contraindicated with Tamoxifen & has a significant withdrawal symptoms?

Paroxetine (Paxil)

21

Which SSRI is more likely to cause diarrhea?

Sertraline (Zoloft)

22

More Intense SE of SSRIs

Increase risk of suicide as the patient recovers
Increase risk of abnormal bleeding
Possible increase in bone fractures
May affect male fertility

23

Examples of SNRIs

Venlafaxine (Effexor)
Duloxetine (Cymbalta)
Desvenlafaxine (Pristiq)

24

What do SNRI's act on?

Serotonin
Norepinephrine

25

Uses for SNRIs

Depression
Panic disorder
GAD
Social anxiety disorder
OCD
PTSD
Body dysmorphic disorder
Diabetic peripheral neuropathy
Fibromyalgia
Menopausal hot flashes

26

MOA of SNRIs

Inhibit the re-uptake of serotonin & norepinephrine

27

Pharmacokinetics of SNRIs

Food can decrease the rate of absorption but not the degree of absorption
Can eat with food if severe SE post dose

28

SNRI SE

Nausea
Dizziness
Diaphoresis
Sexual dysfunction
Sedation
Agitation
Fatigue
Diarrhea
Constipation
Anorexia
Insomnia
Dry mouth
Orthostatic hypotension

29

What are the most common SE of SNRIs?

Nausea
Dizziness
Diaphoresis

30

What needs to be monitored with the use of SNRIs?

Blood pressure