pharm test 4

characteristics of depression?

lack of energy

despair

guilt

struggle with food

substance abuse

depression can be caused by?

• situational (loss of a loved one)

• hormonal (PPD)

• biological (neurotransmitter imbalance)

neurotransmitters in brain associated w/ depression

norepinepherine

serotonin

norepinepherine and serotonin are known as the

“feel good” neurotransmitters (improve mood)

bipolar disorder is also called

manic depression

bipolar disorder is a combination of

clinical depression + mania

characteristics of bipolar disorder

extreme and opposite moods

what does mania look like

lack of need for sleep, impulse decisions, etc

what is used to treat bipolar disorder

Lithium

what are antidepressants

drugs that fight depression by enhancing mood

list 3 classes of antidepressants

1. Monamine Oxidase Inhibitors (MAO)

2. TCA

3. SSRI

where is monoamine oxidase found

the axon terminal

what does monoamine oxidase do

an enzyme that destroys norepinepherine, epinepherine, and serotonin. to be destroyed, those NT must be taken back up

what drug is an example of MAO

Isocarboxazid

indication for Isocarboxazid

clinical depression

why is Isocarboxazid not a 1st choice?

because of they sympathetic nervous system SE

when taking Isocarboxazid, avoids foods that

contain tyramine because it can cause a hypertensive crisis

(ex: cheese, wine, chocolate)

what drug is an example of TCA

Imipramine

Imipramine indication

depression

Imipramine MOA

NE and serotonin reuptake inhibitor

T/F: TCA have fewer cardiovascular SE compared to the MAO inhibitors

TRUE

SSRI stands for what?

selective serotonin reuptake inhibitor

what drug is an example of SSRI

Fluoxetine (Prozac)

Fluoxetine (Prozac) indication

depression

Fluoxetine (Prozac) has no ____ ____ _____ effects

sympathetic nervous system

Fluoxetine (Prozac) only interferes without ____ reuptake

serotonin

(only sertonin levels rise)

what are sedatives

CNS depressants called this because aid in relaxation

what is anxiety

state of apprehension, tension, or uneasiness that stems from anticipation of danger

types of anxiety

1. generalized anxiety

2. panic attacks

3. phobias

4. ocd

5. ptsd

characteristics of generalized anxiety

• 6 months or more

• interacts with day-to-day activities

characteristics of panic attacks

• episodes of immediate apprehension

• over in 10 mins

characteristics of phobias

fear attached to specific objects or situations

characteristics of OCD

repetitive behavior aimed at reducing stress

characteristics of PTSD

• anxiety associated with severe injury or threat of death

• ex: war, abuse, natural disasters

Diazepam (Valium) indication

anxiety or sedation

Diazepam (Valium) belongs to a class of drugs called

Benzodiazepines

Diazepam (Valium) MOA

suppresses activity in the limbic system and RAS (makes you less alert) by increasing GABA (inhibitory NT)

is there potential for Diazepam(Valium) to be abused?

YES

what is the limbic system

system of neurons that control emotions

what is the RAS

• reticular activating system

• system of neurons in the brain that keeps you awake and alert

What is the difference between Tricyclic antidepressants and SSRI antidepressants?

SSRI only increases serotonin and Tricyclic increase NE and serotonin.

What is the difference between depression and bipolar syndrome? Is the treatment different?

Clinical depression does not have mania. Treatment is different because Lithium is indicated for bipolar.

Jack is a wine taster who struggles with depression. His doctor placed him on Isocarboxazid. What is the mechanism of action for this drug? Why might Jack need to change to another anti-depressant?

The MOA is Monoamine Oxidase Inhibitor. Jack needs to change because wine is high in Tyramine

What is difference between Acetylcholinesterase and Monoamine oxidase?

Acetylcholinesterase destroys acetylcholine and is found in the synaptic cleft. Monoamine oxidase destroys NE and Serotonin and found in the axon terminal

What is the benefit of SSRI drugs?

Only increases Serotonin so it doesn’t have the sympathetic SE.

What are some non-drug treatments for depression and anxiety?

Exercise, counseling, faith (prayer), light therapy, electrotherapy, animal therapy, music therapy

ADHD is a combination of?

ADD + Hyperactivity

causes of ADHD

imbalance of NT (NE, dopamine, and sterotonin)

ADHD treatment

Methylphenidate (Ritalin)

Methylphenidate (Ritalin) is a ___ stimulant

CNS

T/F: Methylphenidate (Ritalin) is a controlled substance

TRUE

Methylphenidate (Ritalin) MOA

increases NT that activate RAS keeping you more alert and awake

Methylphenidate (Ritalin) SE

weight loss, mood changes, jittery

what is a pharmaceutical?

drug that is FDA regulated

what is a neutraceutical?

herbs, vitamins, minerals, natural supplements. NOT FDA REGULATED

what is a vitamin

organic substances needed in a small amounts for good health

list fat soluble vitamins

• a

• b

• d

• e

• k

Because fat soluble vitamins can be stored in the liver and fat, you are at higher risk

for toxicitity side effects

list water soluble vitamins

C and B family

Because water soluble vitamins can be excreted in urine…

they are less likely to reach toxic levels

RDA is the

reccomended daily allowance

what is RDA

the minimal amoint of vitamins and minerals needed daily to meet nutrient requirements for individuals to stay healthy

what is a deficiency

fallen below your RDA

what is toxicity

results when you go a certain amount above your RDA

vitamin A is needed for

healthy vision and healthy skin

vitamin A deficiency can lead to

night blindness

good source of vitamin A is

orange vegetables (sweet potato, pumpkin, carrots)

vitamin A toxicity can be

a teratogen (fetal malformations)

vitamin C is important for

healthy tissues and a healthy immune system

vitamin C is an

antioxidant

deficiency of vitamin C can lead to

scurvy

good source of vitamin C is

citrus fruits

T/F: A smoker has a higher RDA than a non-smoker

TRUE

vitamin B12 is needed for

healthy RBCs and energy

for vitamin B12 to be absorbed…

intrinsic factor must be present (made in stomach)

deficiency of vitamin B12 can lead to

pernicious anemia

treatment for b12 deficiency is

a vitamin b12 shot

who is at risk of vitamin b12 deficiency

vegans because vitamin is found in meat

Cyanocobalamin

synthetic b12.

indication: pernicious anemia

vitamin K is needed for

blood clotting

vitamin K is produced by

bacteria in our intestines

why are newborns given a vitamin K shot at birth?

prevent a hemorrhagic disease (not a vaccine)

vitamin K can opposite

anticoagulant therapy

Niacin in toxic levels can lead to

Niacin flush

folate is also known as

folic acid

folate prevents what?

neural tube defects (pregnancy - embryonic development)

the most common neural tube defect is

spina bifida

vitamin D is needed for

healthy bones (helps absorb calcium) and immunity

vitamin D can be made how

in your skin from presence of sunlight (15-20 min exposure)

deficiency of vitamin D in children can lead to

rickets

deficiency of vitamin D in adults can lead to

osteoporosis

thiamine is needed for

healthy nerves

_____ decreases thiamine bioavailability

alcohol

what are minerals?

inorganic substances needed in small amounts for good health

what are electrolytes

sodium and potassium

why are electrolytes important

for healthy nerves and muscles

hypernatremia is what and what can it cause

too much sodium in the blood → can cause high BP

hyperkalemia is what and what can it cause

too much potassium in the blood → can cause heart arrythmias

what is hypokalemia and what can it cause

low blood potassium → can cause severe muscle cramping

iodine is needed for

thyroid hormone synthesis