for MHD & Therapeutics · 100 100 200 300 800 700 500 800 SSRI’s Atypical Antidepressants TCA’s...

54
for MHD & Therapeutics

Transcript of for MHD & Therapeutics · 100 100 200 300 800 700 500 800 SSRI’s Atypical Antidepressants TCA’s...

Page 1: for MHD & Therapeutics · 100 100 200 300 800 700 500 800 SSRI’s Atypical Antidepressants TCA’s 100 700 500 700 400 800 600 100 900 900 900 900 300 500 800 MAO-I’s100 900 500

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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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?


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