CSB601 EXAM PREP

What is SSRI

First line antidepressant - selective serotonin reuptake inhibitor

SSRI suffix

usually ending in -pram or -ine

SSRI active ingredient

escitalopram, citalopram, fluoxetine, sertraline

SSRI MOA

blocks presynaptic reuptake of 5HT (serotonin)

SSRI therapeutic indication

Major depressive disorder/ OCD (higher dose)

Side effects of SSRI

- GI upset

- sweating

- agitation

SSRI contradictions

must avoid within 14 days of MAO-I & active bleeding disorders (GI bleeds, NSAIDs, Aspirin, Warfarin). Pregnancy category C

What is SNRI

first line antidepressant - serotonin and noradrenaline reuptake inhibitor

SNRI suffix

-ine

SNRI active ingredient

venlafaxine, desvenlaaxine, duloxetine

SNRI MOA

Blocks presynaptic reuptake of both 5HT (serotonin) and NA (noradrenaline)

SNRI therapeutic indication

major depressive disorder

SNRI side effects

fatigue, dizziness, headache

SNRI contradictions

contraindicated with MAOIs (avoid within 14 days) and patients with uncontrolled glaucoma, severe liver or kidney disease, uncontrolled hypertension, and bleeding disorders. Pregnancy category C

What is TCA

Tricyclic antidepressant

TCA suffix

- ine

TCA active ingredient

amitriptyline, nortriptyline, imipramine

TCA MOA

Blocks presynaptic reuptake of 5HT, NA and DA (dopamine)

TCA side effects

- dry mouth

- blurred vision/dizziness

- GI upset

- tachycardia

TCA contradictions

avoid MAO-I within 14 days, recent MI, pregnancy category C

What is MAO-I

Last line antidepressant - monoamine oxidase inhibitor

MAO- Suffix

- ine

MAO-I Active Ingredient

phenelzine, tranycypromine

MAO-I MOA

Blocks MOA-A and MAO-B from breaking down serotonin, noradrenaline, dopamine and adrenaline

MAO-I Therapuetic indication

major depressive disorder and panic disorder

MAO-I Side effects

- weight gain

- sleep disturbance

- impotence

MAO-I Contradictions

avoid anything smoke, aged/fermented, alcohol/wine, aged cheese, sauerkraut, tofu, Vegemite

what is tetracyclic antidepressant

increase central noradrenaline and acts on other receptors as well

tetracyclic antidepressant active ingredient

mirtazapine

Therapeutic indication for tetracyclic antidepressant

Major depressive disorder

tetracyclic antidepressant side effects

increased appetite, weight gain, sedation

tetracyclic antidepressant contradictions

must avoid MAO-I within 14 days

what is lithium

an antipsychotic mood stabiliser

Lithium MOA

inhibits dopamine release and helps control impulsive behaviour, enhances serotonin release

Therapuetic indication for lithium?

mood stabiliser, bipolar, prophylaxis of mania

lithium side effects

GI upset, polyuria, fatigue, dry mouth

lithium contradictions

renal disease, hyponatraemia, hypothyroidism

what is quetiapine and clozapine

an antipsychotic

MOA of quetiapine and clozapine

blocks dopamine transmission in the brain

quetiapine and clozapine therapeutic indication

bipolar treatment, depressive and manic disorders, schizophrenia

quetiapine and clozapine side effects

dizziness, drowsiness, GI upset, dry mouth

quetiapine and clozapine contradictions

pregnancy category C, dementia related psychosis, pts with history of heart disease and stroke

what is benzodiazepine class used for?

panic attacks, ptsd, old, phobias, general anxiety disorder, bipolar mania, insomnia

benzodiazepine class suffix

- azepam

- lam

- zam

benzodiazepine class active ingredients

diazepam, lorazepam, alprazolam, midazolam

benzodiazepine class MOA

benzodiazepines enhance the effect of a natural brain chemical called gamma-aminobutyric acid (GABA). GABA acts as a "brake" on the nervous system, meaning increased levels lead to sedation, muscle relaxation, and reduced stress

benzodiazepine class side effects

drowsiness, dizziness, respiratory depression, blurred vision

benzodiazepine class contradictions

pregnancy category C, highly addictive, avoid alcohol, respiratory failure, sleep apnea

what is a BETA-BLOCKER

antihypertensive

BETA-BLOCKER sufix

-olol

BETA-BLOCKER active ingredient

atenolol, bisoprolol, metoprolol, carvedilol

BETA-BLOCKER MOA

selectively antagonist B1-adrenoreceptors in the heart, therefore preventing noradrenaline from binding & initiating downstream effects, lowers heart rate and stroke volume

BETA-BLOCKER side effects

bradycardia, bronchospasm, hypotension

BETA-BLOCKER therapeutic indication

hypertension, HF, angina, arrhythmias

BETA-BLOCKER contradictions

unmanaged asthma, severe or symptomatic bradycardia heart blocks and severe hypotension

what is an ACE Inhibitor

first line antihypertensive, angiotensin converting enzyme inhibitors

ACE Inhibitor suffix

-pril

ACE Inhibitor active ingredient

ramipril, perindopril, lisinopril, enalapril

ACE Inhibitor therapeutic indication

hypertension, HF

ACE Inhibitor side effects

hypotension, hyperkalaemia, persistent dry cough

ACE Inhibitor contradictions

avoid in pregnancy, do not use with ARB 'triple whammy'

what is ARB/ARA

antihypertensive, angiotensin 2 antagonist and angiotensin receptor blockers

ARB/ARA suffix

- sartan

ARB/ARA therapeutic indication

hypertension, HF

ARB/ARA MOA

Antagonises the angiotensin type 1 receptor thereby preventing angiotensin 2 from binding and initiating downstream effects, lowers HR, stroke volume and systemic vascular resistance

ARB/ARA side effects

hypotension, hyperkalaemia

ARB/ARA contradictions

do not use with ACE-I

what is selective calcium channel blockers

dihydropyridines, antihypertensive

selective calcium channel blockers suffix

-dipine

selective calcium channel blockers active ingredient

amlodipine, felodipine, lercanidipine

selective calcium channel blockers therapeutic indication

hypertension

selective calcium channel blockers MOA

Selectively inhibits influx of calcium ions into only arteriolar smooth muscle, therefore vasodilation making it easier to pump blood lowering BP

selective calcium channel blockers side effects

headache, dizziness, hypotension, peripheral oedema

what is non-selective calcium channel blockers

non-dihydropyidinesm, antihypertensive

non-selective calcium channel blockers active ingredient

dilitazem, verapamil

non-selective calcium channel blockers therapeutic indication

hypertension

non-selective calcium channel blockers MOA

inhibits influx of calcium ions into both arteriolar smooth muscle and cardiac muscle, decreases vasoconstriction and reduces HR and contractility

non-selective calcium channel blockers side effects

bradycardia, GI upset, hypotension

non-selective calcium channel blockers contradictions

hypotension, CHF, severe bradycardia

what is furosemide

loop diuretic

loop diuretic MOA

Inhibits reabsorption of sodium and chloride within the ascending loop of henle, decreasing stroke volume

loop diuretic therapeutic indication

HF, hepatic impairment, renal failure, oedema

loop diuretic side effects

electrolyte disturbances, dehydration, hypotension

loop diuretic contradictions

decrease plasma volume, reduce renal and plasma flow

what is hydrochlorothiazide

thiazide diuretic

thiazide diuretic MOA

inhibit reaborption of Na+ and Cl- from distal convoluted tubules in kidneys, reduces stroke volume

thiazide diuretic therapeutic indication

hypertension, HF, oedema

thiazide diuretic side effects

electrolyte disturbances

thiazide diuretic contradiction

reduces renal plasma flow

what are nitrates

vasodilators

nitrates suffix

-nitrate

nitrates active ingredient

glycerol trinitrate, isosorbide-mononitrate

nitrates MOA

vasodilation and ventilation which decrease venous return and subsequently decreases preload, decreasing stroke volume and systemic vascular resistance

nitrates therapeutic indication

angina, treatment and prevention

nitrates side effects

headache, dizziness, hypotension

what are fibrates

first line of cholesterol-lowering

fibrates MOA

reduces plasma trigylcerides moderately increases HDL

Fibrates therapeutic uses

dyslipidaemia, hypertriglyceridaemia

fibrates side effects

GI upset, increased creatinine, gallstones

Fibrates drug interactions

do not use with ezetimibe