際際滷

際際滷Share a Scribd company logo
P H R M 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



                          | 愕悖 悋惆惺悋悄
P H R M 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                                                                                                                                                   留  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.



| 愕悖 悋惆惺悋悄

More Related Content

Pharmacology .. Anti-Depressants Drugs

  • 1. P H R M 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 | 愕悖 悋惆惺悋悄
  • 2. P H R M 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 留 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. | 愕悖 悋惆惺悋悄