Antidepressants Classifications Pharm Exam #5

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Questions and Answers

Which of the following are classifications of antidepressant medications? (Select all that apply)

SSRIs (correct)

Monoamine oxidase inhibitors (MAOIs) (correct)

Atypical antidepressants (correct)

Tricyclic antidepressants (TCAs) (correct)

What is the select prototype medication under the SSRI classification of antidepressants?

fluoxetine (Prozac)

The following are which type of antidepressants? citalopram (Celexa), escitalopram (Lexapro), paroxetine (Paxil), sertraline (Zoloft), vilazodone (Viibryd)

SSRI

What conditions are SSRIs used to treat?

major depression, OCD, bulimia nervosa, premenstrual dysphoric disorders, panic disorders, PTSD Signup and view all the answers

What are some of the adverse effects associated with SSRI antidepressants?

sexual dysfunction, CNS stimulation, weight loss early, weight gain later, serotonin syndrome, withdrawal syndrome, hyponatremia, rash, drowsiness, GI bleeding, bruxism Signup and view all the answers

What is a contraindication for SSRIs?

concurrent use of MAOIs or TCAs Signup and view all the answers

In which patients should SSRIs be used cautiously?

patients with liver and renal dysfunction, cardiac disease, seizure disorders, diabetes, ulcers, history of GI bleed Signup and view all the answers

What can fluoxetine (Prozac) do?

displace warfarin (Coumadin), increase levels of TCA and lithium, suppress platelet aggregation Signup and view all the answers

What is the select prototype medication under the atypical antidepressant classification?

bupropion HCl (Wellbutrin) Signup and view all the answers

What are the uses of bupropion (Wellbutrin)?

to treat depression, as an alternative to SSRIs, to aid in quitting smoking, for prevention of seasonal pattern depression Signup and view all the answers

What are the adverse effects of Wellbutrin?

headache, dry mouth, GI distress, constipation, increased heart rate, nausea, restlessness, insomnia, suppression of appetite, weight loss, seizures Signup and view all the answers

What is a contraindication for bupropion (Wellbutrin)?

MAOI Signup and view all the answers

What types of disorders are contraindications for bupropion (Wellbutrin)?

seizure disorders Signup and view all the answers

Which of the following are other atypical antidepressant medications? (Select all that apply)

Trazodone (Desyrel) Signup and view all the answers

What is the select prototype medication under the tricyclic antidepressant (TCA) classification?

amitriptyline Signup and view all the answers

Which of the following are other TCAs? (Select all that apply)

Nortriptyline (Aventyl) Signup and view all the answers

What can TCAs be used to treat?

depression, depressive episodes of bipolar disorder, neuropathic pain, fibromyalgia, anxiety disorders, insomnia Signup and view all the answers

What are the adverse effects of TCAs?

orthostatic hypotension, anticholinergic effects, sedation, decreased seizure threshold, excessive sweating Signup and view all the answers

What types of disorders are contraindications for TCAs?

seizure disorders Signup and view all the answers

In which patients should TCAs be used cautiously?

patients with CAD, DM, liver, kidney, respiratory disorders, urinary retention, angle-closure glaucoma, BPH, hyperthyroidism Signup and view all the answers

How long should TCAs be administered in intervals to reduce the risk of life-threatening overdose?

1 week Signup and view all the answers

What are the medication and food interactions for TCAs?

concurrent use with MAOIs, antihistamines, increased effects of epinephrine and dopamine, other CNS depressants Signup and view all the answers

What is the select prototype MAOI antidepressant medication?

Phenelzine (Nardil) Signup and view all the answers

Which of the following are other MAOIs? (Select all that apply)

Isocarboxazid (Marplan) Signup and view all the answers

What are MAOIs used to treat?

depression and bulimia nervosa Signup and view all the answers

What are common adverse effects of MAOIs?

CNS stimulation, orthostatic hypotension, hypertensive crisis from dietary tyramine Signup and view all the answers

Study Notes

Antidepressants Overview

Antidepressant categories include SSRIs, atypical antidepressants, tricyclic antidepressants (TCAs), and monoamine oxidase inhibitors (MAOIs).

SSRIs (Selective Serotonin Reuptake Inhibitors)

Fluoxetine (Prozac) is the prototype SSRI.
Common SSRIs:
- Citalopram (Celexa)
- Escitalopram (Lexapro)
- Paroxetine (Paxil)
- Sertraline (Zoloft)
- Vilazodone (Viibryd)
Indications for SSRIs:
- Major depression
- Obsessive Compulsive Disorder (OCD)
- Bulimia nervosa
- Premenstrual Dysphoric Disorder (PMDD)
- Panic disorders
- Post-Traumatic Stress Disorder (PTSD)
Adverse effects of SSRIs include:
- Sexual dysfunction
- CNS stimulation
- Early weight loss, potential later weight gain
- Serotonin syndrome, withdrawal syndrome
- Hyponatremia, rash, drowsiness
- Gastrointestinal bleeding, bruxism
Contraindicated when concurrently used with MAOIs or TCAs.
Use cautiously in patients with:
- Liver or renal dysfunction
- Cardiac disease
- Seizure disorders
- Diabetes
- Ulcers
- History of gastrointestinal bleed
Fluoxetine can displace warfarin, increase TCA and lithium levels, and suppress platelet aggregation.

Atypical Antidepressants

Bupropion HCl (Wellbutrin) is the prototype atypical antidepressant.
Uses for Bupropion:
- Treats depression and offers an alternative to SSRIs.
- Aids in smoking cessation.
- Prevents seasonal pattern depression.
Adverse effects of Bupropion:
- Headache, dry mouth, GI distress, constipation
- Increased heart rate, nausea, restlessness, insomnia
- Suppressed appetite leading to weight loss
- Risk of seizures
Contraindications for Bupropion include concurrent use with MAOIs and seizure disorders.

Tricyclic Antidepressants (TCAs)

Amitriptyline serves as the prototype for TCAs.
Other TCAs:
- Imipramine (Tofranil)
- Doxepin (Silenor)
- Nortriptyline (Aventyl)
- Amoxapine, Trimipramine (Surmontil)
Indications for TCAs:
- Depression, depressive episodes of bipolar disorder
- Neuropathic pain, fibromyalgia
- Anxiety disorders and insomnia
Common adverse effects of TCAs:
- Orthostatic hypotension
- Anticholinergic effects like dry mouth and constipation
- Sedation, decreased seizure threshold
- Excessive sweating
Contraindicated in seizure disorders.
Use cautiously in patients with:
- Coronary artery disease (CAD)
- Diabetes mellitus (DM)
- Liver, kidney, or respiratory disorders
- Urinary retention, angle-closure glaucoma, BPH, hyperthyroidism
Administer TCAs in 1-week intervals to reduce the risk of overdose due to suicide.

MAOIs (Monoamine Oxidase Inhibitors)

Phenelzine (Nardil) is the prototype MAOI.
Other MAOIs include:
- Isocarboxazid (Marplan)
- Tranylcypromine (Parnate)
- Selegiline (Emsam, transdermal)
MAOIs are indicated for treating depression and bulimia nervosa.
Common adverse effects of MAOIs:
- CNS stimulation and orthostatic hypotension
- Risk of hypertensive crisis from dietary tyramine intake
- Local rash from transdermal applications.

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Description

Explore the key classifications of antidepressant medications in this flashcard quiz designed for pharmacy exam preparation. You'll learn about SSRIs, atypical antidepressants, TCAs, and MAOIs, along with identifying prototype medications like fluoxetine. Perfect for reinforcing your knowledge before the exam!