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Pharmacology .. Anti-Depressants Drugs
This document discusses different classes of anti-depressant drugs, including: 1) Amine Re-uptake Inhibitors (ARI) such as tricyclic antidepressants (TCAs) and heterocyclic antidepressants that work by inhibiting the reuptake of neurotransmitters like serotonin and norepinephrine. 2) Selective Serotonin Reuptake Inhibitors (SSRIs) that more selectively inhibit the reuptake of serotonin. 3) Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs) like venlafaxine that inhibit the reuptake of both serotonin and norepinephrine. 4) Monoamine
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Pharmacology .. Anti-Depressants Drugs
- 1. P H RM A C O L O G Y - NOTE 11 - Anti-Depressants Drugs ANTI-DEPRESSANT DRUGS ARI MAOI Selective Tricyclic Heterocyclic SNARI SSRI Tranylcypromine NERI Amitriptyline Amoxapine Venlafaxine Fluoxetine Imipramine Selegiline Nortriptyline Maprotiline Fluvoxamine Atomoxetine Moclobemide Imipramine Trazodone Citalopram • action of Tyramine MAOI cause (sympathomimetics) • Serotonin syndrom with SSRI Clomipramine Bupropion Sertraline • does not cause selective MAO-B I tyramine related reactions • hyperthermia. Serotonin • muscle rigidity. syndrom has • myoclonus. Endogenous (melanocholic) • griefe •biochemical • bipolar • CVS & Resp. failure. disorder Reactive (secondary) • illness affective Manic-depression (genatically) disorder •due to depletion •inability to depression of amine stores in CNS depression depression cope with minor life 33 events | نسألكم الدعاء
- 2. P H RM A C O L O G Y - NOTE 11 - Anti-Depressants Drugs Amine Re-uptake Inhibitors (ARI) DRUG PHARMACOKINETIC MECHANISM OF ACTION USES SIDE EFFECT Amitriptyline Caution in glaucoma & BPH re-uptake of NE & 5-HT. Depression. Anti-muscarinic due to anti-muscarinic side effect. also concentration in synapse. Anxiety disorders. blurred vision, dry mouth. anti-depreesant Nortriptyline Caution in driving & skill full word Chronic pain. HR, confusion. due to sedation constipation, urine retention . Tricyclic Enuresis. Imipramine α – blocking ejaculation & orthostatic BP sedation. Clomipramine Seizure. Weight gain. Sex disturbances. Amoxapine re-uptake of NE & 5-HT. Depression. Parkinsonism. moderate anti-depreesant D2 receptors. Anxiety disorders Akathesia. sedation Heterocyclic So, it acts as anti-psychotic prolactin. & Maprotiline re-uptake of NE & 5-HT Seizures. anti- Arrhythmias muscarinic Trazodone Induce sleep. Bupropion re-uptake of NE, 5-HT & DA. Seizures. Aggravate psychosis. Venlafaxine Low dose acts as SSRI. re-uptake of 5-HT (& NE but less). Depression. Low dose 5-HT & N-ad RI High dose acts as TSAs Anxiety disorders. o Sedative & anti-muscarinic. (SNARI) Chronic pain High dose o Sedative & anti-muscarinic. o Nausea. o BP o Sex distrabunces. Fluoxetine re-uptake of 5-HT (more selective). obsessive & compulsive D Transient nausea. depression Bulimia Libido. (initial) anxiety SSRI Fluvoxamine obsessive & compulsive D Sex dysfunction. (maintenance Citalopram therapy) Sertraline S NERI Imipramine re-uptake of NE (more selective). Attention deficit hyperkinetic Atomoxetine disorder. Mono-Amine Oxide Inhibitors (MAOI) DRUG PHARMACODYNAMIC MECHNISM OF ACTION USES SIDE EFFECT Tranylcypromine Inhibits MAO-A & MAO- B. They metabolism of amines by MAO. Headache. duration of action of Drowsiness. Selegiline Inhibit MAO- B. NE, 5-HT & DA. Weight gain. 34 also concentration. Postural PB. o MAO-A metabolizes NE , 5-HT & Tyramine. Sex disturbances. o MAO-B metabolizes DA more than others. | نسألكم الدعاء