University:
University of North Carolina at Chapel Hill
Course:
NURS 312 | Pharmacology
Academic year:

2020
Views:

366

Pages:

1
Author:

gewoekerdodx

3.4 – “March Sadness”: Atypical antidepressants (Bupropion, mirtazapine, trazadone) • Atypical antidepressants are used in treatment of depression non-responsive to treatment • Bupropion o Blocks NET & DAT, leaving more NE, DA available in the synapse (“Net Dat Ball pro!”). Has no effect on serotonin. o Chemical structure similar to amphetamines. CNS activating affects, helps with hypersomnolence (kid cheering on the sidelines) o Can treat nicotine dependence; MOA unknown (“Pros don’t Smoke”) o Fewer sexual adverse effects than other antidepressants (lovebirds under net) o Less likely to cause weight gain (“Stay Fit” poster) o Adverse effects ▪ Lowers seizure threshold (player holding net). contraindicated in any patient with h/o seizures. ▪ Contraindicated with h/o bulimia (play with popcorn) ▪ Contraindicated with h/o anorexia (cachectic player) • Mirtazapine (mirth & misery cam) o Alpha-2 blocker (extinguished double-α candle) causing increased catecholamine release. o Also blocks 5HT-2 & 5HT-3 receptors (retired jerseys) o Potent H1 histamine antagonist (bee swatter). ▪ Can cause sedation (sleeping dude). ▪ May be therapeutic in patients with major depression & insomnia. May also be used to balance out effects of more activating agents. o Can cause weight gain (heavy eater drifting off while watching the game). May be preferable in elderly or with concurrent anorexia o Does not cause sexual adverse effects (kiss cam) • Trazadone (trombone) o Serotonin modulator. Antagonizes postsynaptic 5HT-2 R with some prevention of reuptake (smiley face drummer marching to the beat of his own drum with 52 jersey) o Antagonizes α-1 receptors (extinguished α lighter) ▪ May rarely cause priapism d/t α one effects (trombone; “trazabone”) • should be used with caution in conditions that predispose to priapism ▪ orthostatic hypotension (fainting dude) o H1 receptor antagonist, with major hypnotic effects (yellow team is out) ▪ Main therapeutic benefit is for patients with comorbid depression & insomnia. ▪ Should be avoided in the elderly (older man is sleep) ▪ Should not be used with other CNS depressants o Can cause sexual dysfunction (kid not getting kissed) o Serotonin syndrome (tipped over rack of balls)