4dd. S3/B3 Affective Disorders Flash Cards

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Title: 4dd. S3/B3 Affective Disorders
Description: psychotherapeutic drugs and affective disorders
Number of Cards: 39
Save Count: 0
Author: chandadn9
Created: 2009-07-31
Tags: affective disorders psychpharm
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    • Question
    • Answer
    • Side 3
    • What are the 2 most common affective disorders?
    • Major depressive and bipolar
    • Describe major depressive disorder?
    • 1. Recurrent thoughts of suicide and depressed mood
      2. Feelings of worthless, can't concentrate
    • Describe bipolar disorder and how would you treat them?
    • 1. Recurrent fluctuations in mood, energy and behavior
      2. Tx them with mood stabilizing drugs
    • What is hypomania?
    • 1. Elevated mood
      2. Increased activity or energy
      3. Rapid and excitable but NOT violent
    • What about bipolar and twin studies?
    • 95% concordance, occurs in a total of 1% of the population
    • What is bipolar 1? and 2?
    • 1. Manic without major depressive disorder
      2. hypomania with at least one major depressive disorder
    • What do you use to tx bipolar for the mood, manic and acute manic stages?
    • 1. Litium mood stabilizer, takes a lag phase
      2. Anticonvulsants for manic before lithium because these act fast
      3. Clonazepam for acute mania(haloperidol)
    • When do you use anticonvulsants with bipolar?
    • 1. Before lithium because they act quicker
    • What is the main problem with lithium?
    • Narrow therapeutic index so it doesn't take a lot to OD
    • What causes a lithium build up?
    • Nephropathy because it would cause decreased excretion
    • What is the MOA of lithium?
    • 1. Inhibits IP3/DAG
      2. Prevents muscarinic and alpha adrenergic transmission
      3. Inhibits phosphatases
    • What does PLC do?
    • Makes DAG and IP3
    • Purpose of IP3 and DAG in the lithium pathway?
    • Signals PKC to phosphorylate serine and threonine, makes Serotonin
    • What does lithium toxicity present like?
    • 1. Tremor, sedation, ataxia and aphasia
      2. Choreoathetosis(Sinuous dance like movements)
      3. Mental confusion and bizarre motor
    • What is the amine hypothesis of mood?
    • Mood is mainly affected by the levels of NE and 5HT
    • What does 5HT1-R do? 5HT2-R? 5HT3-R?
    • 1. Decrease cAMP
      2. Increase IP3 DAG
      3. Depolarize plasma membrane
    • What are the non selective amine reuptake drugs?
    • 1. Tricyclics
      2. Second generations
    • What are the four main drugs used to treat depression?
    • 1. TCA 1st and 2nd Gen
      3. SSRI
      4. MAOI
    • What is the number 1 antidepressant? 2, and 3?
    • 1. Lexapro
      2. Zoloft
      3. Fluoxetine
      4. All SSRIs
    • What is the number one NA/DA antidepressant?
    • Welbutrin
    • What are the 4 most effective antiD?
    • 1. Mirtazapine(Remeron)
      2. Escitalopram(lexapro)
      3. Venlafaxine(Effexor)
      4. Sertraline(Zoloft)
    • What are the 4 most acceptable antiD?
    • 1. Zoloft
      2. Lexapro
      3. Wellbuitrin
      4. Celexa
    • What are TCAs? example and why not as good?
    • 1. Highly effective and toxic antiD
      2. Amitriptaline and Nortriptaline
    • What is good about TCA?
    • 1. Long half life allows for little dosing
    • What is the TCA MOA?(3)
    • 1. Block Serotonin and NE uptake
      3. Affects 5HT1-R
      4. Increases firing of 5HT neurons and reuptake; 2-4 weeks later
    • Side effects of TCA with a long 1/2 life?(6)
    • 1. Blocks muscarinic and alpha adrenergic receptors
      3. Sedation, Seizures Psychosis
      6. Weight gain = noncompliance
    • What are antimuscarinic effects?(5)
    • 1. Blind as a bat(blurry)
      2. Hot as a hare
      3. Dry as a bone
      4. Red as a beet
      5. Mad as a hatter
      6. CV = hypertension, and arrythmia
    • What will a TCA overdose cause?
    • 1. arrythmia
      2. TCA and MAO is a severely toxic combo
    • How do you tx TCA toxicity?
    • 1. Sodium bicarb IV
      2. decreases TCA binding to Na channels in cardiac
    • What is Clomipramine?
    • A TCA for OCD
    • What are two third generation antiD?
    • 1. Remeron
      2. Effexor
    • What is buproprion?
    • 1. Wellbutrin is a weak NA,DA and 5HT reupatake inhibitor
      2. Rare CV or sexual effects
    • What us venlafaxine(effexor)?(3) ?Benefit, MoA and Tx?
    • 1. No H1 receptor = no sedation
      2. Blocks NE and Serotonin reuptake
      3. GAD and Panic disorder
    • Would you use an SSRI or a TCA?
    • 1. An SSRI because they seldom cause cardiac arrythmia
    • Name 6 SSRIs?
    • 1. Prozac
      2. Paxil
      3. Lexapro
      4. Luvox
      5. Celexa
      6. Zoloft
    • When do you administer SSRIs?
    • In the morning because they increase alertness
    • What are the problems with Fluoxitine SSRI?(3) What is teh unique thing?
    • 1. Drug interactions
      2. Blood glucose regulations
      3. Suicidal and violent behavior

      4. Can treat Bullemia or Anorexia
    • Most common adverse side effects of SSRI?(5)
    • 1. GI
      2. Insomnia
      3, Sexual sides
      4. Hepatic disorder
      5. Diabetes
    • What do MAOIs do?(2) What are the contra indications?
    • 1. Oxidizes Serotonin way before NE,DA and Tyr
      2. Inhibits MAO-A to inhibit depression
      3. Never use with SSRI!
      4. Can cause delirium, hypertensive crisis, seizures, and serotonin syndrome