for MHD & Therapeutics · 100 100 200 300 800 700 500 800 SSRI’s Atypical Antidepressants TCA’s...
Transcript of for MHD & Therapeutics · 100 100 200 300 800 700 500 800 SSRI’s Atypical Antidepressants TCA’s...
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for MHD & Therapeutics
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is proud
to present
And Now Here
Is The Host . . .
Insert Name Here
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The categories for today’s Jeopardy will be:
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SSRI’s
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SNRI’s
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Atypical Antidepressants
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MAOI’s
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TCA’s
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SSRI’s Atypical
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SNRI’s
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Row 1, Col 1
The half-life of this SSRI is
about one week
What is fluoxetine (prozac)?
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1,2
SSRI is the abbreviation for this
What is Selective Serotonin Reuptake Inhibitor?
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1,3
If an SSRI with a short half life
is abruptly stopped it
may result in this
What is Discontinuation Syndrome?
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1,4
When switching to a MAOI from an
SSRI, info about this
pharmacokinetic property of the
SSRI will provide guidance on how
long of a washout is needed before
starting the MAOI
What is half life (wait 5 half lives)?
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1,5
Arguable the single biggest
improvement of SSRI’s over
their TCA predecessors is this
What is safety from overdose?
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1,6
SSRI’s include Fluoxetine (Prozac),
Paroxetine (Paxil), Citalopram
(Celexa), Escitalopram (Lexapro),
Fluvoxamine (Luvox), and this
What is a sertraline (Zoloft)?
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1,7
This SSRI is the S-enantiomer of
citalopram (celexa)
What is escitalopram (lexapro)?
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1,8
These two SSRI’s have very
short half lives & should
be tapered to be
discontinued
What is paroxetine (paxil) & fluvoxamine (luvox)
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1,9
This is a common side effect of
all SSRI’s & the doctor should
specifically ask about it as
the patient may otherwise
be too embarrassed to
talk about it
What are sexual side effects?
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2,1
The mechanism of action of
SNRI’s is this
What is Serotonin Norepinephrine Reuptake Inhibitor?
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2,2
This SNRI is the psychoactive
metabolite of another SNRI
What is desvenlafaxine (pristiq)
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2,3
Whether the dose is very high,
moderate, or low, this
neurotransmitter’s reuptake is
blocked by venlafaxine (effexor)
What is serotonin?
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2,4
At very high doses (>375mg/d)
of venlafaxine (effexor) this
neurotransmitter’s reuptake
may begin to be blocked
What is dopamine?
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2,5
What is duloxetine (cymbalta)
This SNRI is preferred for painful
symptoms of depression or diabetic
neuropathy pain
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2,6
SSRI’s MAOI’s TCA’s
=========================
Venlafaxine (Effexor)’s mechanism
of action is most similar to this
class of antidepressants
What is TCA’s?
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2,7
When stopping venlafaxine (effexor)
it should be gradually tapered in
order to avoid this
What is discontinuation syndrome?
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2,8
The SNRI side effect of diaphoresis
is due to this
What is NE reuptake inhibition?
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2,9
Venlafaxine (effexor) has
this relatively common, dose
dependent, cardiac system
related side effect
What is increased blood pressure?
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3,1
SSRIs or venlafaxine (effexor) may
cause these common side effects
which mirtazepine’s (remeron)
5HT3 antagonism may help
reduce or remove
What is GI side effects? (nausea, diarrhea, stomach cramps)?
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3,2
Marketed under the name Zyban,
(Bupropion) is useful in treating
cravings from dependence
on this substance
What is nicotine (smoking cessation)?
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3,3
Mirtazepine (Remeron)’s 5HT2A
antagonist activity & Wellbutrin
(Bupropion)’s lack of any 5-HT
activity is why neither has this
common SSRI side effect
What is sexual dysfunction?
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3,4
Like most anti-depressants, at typical
doses bupropion (wellbutrin) carries
a small risk of this serious side
effect but the risk increases
from 0.4% to 4% at very
high doses
What is a seizure?
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3,5
In the evolution of antidepressants,
drugs that are SSRI’s with 5-HT
receptor antagonists or partial
agonists are vilazodone (viibryd)
and this
What are vortioxetine (Brintellix)?
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3,6
Mirtazepine (Remeron)’s novel
mechanism of action by which
norepinephrine and serotonin
system activity is increased is this
What is pre-synaptic alpha 2 adrenergic antagonist?
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3,7
Bupropion (Wellbutrin) commonly
does this to a patient’s weight
What is slightly decrease? (or no change)
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3,8
This mirtazapine (remeron) side effect
is more likely in women than men,
before menopause than after, and
is unlikely to be a problem if it
has not occurred within the
first 6 weeks of treatment
What is weight gain?
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3,9
Onset of therapeutic action is usually
not immediate, but is delayed
until this time period
What is 2-4 weeks
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4,1
SSRI’s and MAOI’s used in
combination carry a high
risk of this side effect
What is serotonin syndrome?
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4,2
While there are two MAOs (MAO-A
& MAO-B), inactivating this one
appears necessary for the
antidepressant effect
What is MAO-A?
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4,3
Regarding MAOI’s, a RIMA
is this
What is Reversible Inhibitor of Monoamine Oxidase?
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4,4
While the t1/2 is 2-4 hours,
the amount of time for most
MAO-I’s to wash out
is this
What are 10-14 days?
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4,5
At low doses, Selegiline (Emsam)’s
transdermal delivery greatly decreases
this possible side effect
What is HTN crisis (from dietary tyramine)?
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4,6
Patient’s taking an MAOI need to
avoid foods high in tyramine and
sympathomimetic medications
due to the risk of this
What is hypertensive crisis?
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4,7
The cellular organelle containing the
MAO enzyme that is inactivated by
MAOI’s is this
What is mitochondria?
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4,8
MAOI’s are effective in treating
depression with melancholic features,
depression with atypical features,
persistent depressive disorder, and
this type of depression
What is treatment resistant?
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4,9
While MAOI’s may result in
serotonin related side effects such
as GI distress, sexual dysfunction,
and sleep disturbance, the
unusual thing about the sleep
disturbance is this
What is day-night shifting?
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5,1
A tertiary amine, amitriptyline
(elavil), is metabolized to a
secondary amine which is
this TCA
What is nortriptyline (pamelor)?
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5,2
Blurred vision, urinary hesitancy, dry
mouth, and constipation are due to
this neurotransmitter receptor
activity by TCA’s
What is anticholinergic activity?
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5,3
A tertiary amine, imipramine
(tofranil), is metabolized to a
secondary amine which is
this TCA
What is desipramine (norpramin)?
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5,4
Most TCA’s preferentially block
reuptake of NE vs 5-HT, but these 2
TCA’s comparably block the
reuptake of both NE & 5-HT
What are Imipramine & Amitriptyline (Tertiary TCs)?
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5,5
Fluoxetine (prozac), paroxetine (paxil),
bupropion (wellbutrin), duloxetine
(cymbalta) and other medications may
increase all TCA’s concentration by
inhibiting this p450 enzyme
What is cytochrome p450 2D6?
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5,6
Side effects of dizziness, sedation,
and hypotension likely result
from TCA’s antagonist activity
of this receptor
What is alpha adrenergic-1 receptor?
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5,7
Side effects of sedation and weight
gain from TCA’s are likely due
to antagonist activity at
this receptor
What is histamine (H1)?
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5,8
TCA’s mechanism of action for
treating depression is this
What is serotonin and norepinephrine reuptake
inhibition?
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5,9
The dangerous side effects from
a TCA overdose are cardiac
arrhythmias caused by
blockade of this
What are sodium channels?