All Drugs (by name) Flashcards

Question

Etomidate

Answer 1

GABAa modulator (increased Cl- entry-->hyperpolerization) short-acting intravenous anaesthetic agent used for the induction of general anaesthesia and sedation

Answer 2

Versed Class: Benzodiazapines Mechanism of action Facilitates GABA induced Cl- entry into neurons, leading to CNS depression Less cardiovascular and respiratory depression than barbiturates Most important characteristic is amnestic action Insufficient for anesthesia when given alone Used as induction agent prior to anesthesia

Answer 3

Class: dissociative agent? Structurally and pharmacologically related to phencyclidine (PCP) Dissociative anesthetic Patient appears to be awake - eyes open Unaware of environment and doesn't feel pain Pharmacological effects Anesthetic, analgesic, amnestic and sedative Airway reflexes and respiration is maintained Cardiovascular system is not depressed and may actually be stimulated (↑ HR and BP) – ideal for patients with unstable CV function Mechanism of action – NMDA Glutamate receptors ??? Rapid onset of action (1-2 min) when given intravenously or intramuscularly Relatively short duration of action (approximately 20 min) Principal drawback is the occurrence of emergence reactions (delirium and hallucinations) Relatively high therapeutic index Abuse - currently abused in the US Depression treatment????

Answer 4

Class: opiod High dose opioid Analgesia Anesthesia Hemodynamic stability - good for patients with compromised myocardial function Respiration must be maintained artificially and may be depressed into the postoperative period Usually supplemented with inhalation anesthetic, benzodiazepine or propofol

Answer 5

Class: opiod High dose opioid Analgesia Anesthesia Hemodynamic stability - good for patients with compromised myocardial function Respiration must be maintained artificially and may be depressed into the postoperative period Usually supplemented with inhalation anesthetic, benzodiazepine or propofol

Answer 6

Class: Tricyclic Antidepressant Blocks reuptake of NE

Answer 7

Class: Tricyclic Antidepressant Blocks reuptake of NE and 5HT

Answer 8

Class: MAO inhibitor tx: depression Non-selectively inhibits both MAO-A and B -irreversibly blocks deamination of monoamines increases DA, NE, 5HT Low therapeutic index ***don't mix with SSRIs Watch out food tyramine rich foods (aged cheese, red wine, beer, bananas)

Answer 9

Prozac Class: SSRI 5-HT is released and can act… Postsynaptically to trigger actions in an effector cell Presynaptically on 5-HT1 autoreceptors to inhibit additional 5-HT release Reuptake process can remove 5-HT from the synapse This is blocked by SSRIs

Answer 10

Class: SSRI 5-HT is released and can act… Postsynaptically to trigger actions in an effector cell Presynaptically on 5-HT1 autoreceptors to inhibit additional 5-HT release Reuptake process can remove 5-HT from the synapse This is blocked by SSRIs

Answer 11

Class: SSRI 5-HT is released and can act… Postsynaptically to trigger actions in an effector cell Presynaptically on 5-HT1 autoreceptors to inhibit additional 5-HT release Reuptake process can remove 5-HT from the synapse This is blocked by SSRIs

Answer 12

Effexor Class: Atypical (Dual/mixed action) Antidepressant Serotonin-norepinephrine reuptake inhibitor (SNRI) Blocks serotonin reuptake like SSRIs Also blocks NE reuptake ``` How different than TCAs? Venlafaxine does NOT affect Adrenergic receptors Histaminergic receptors Cholinergic receptors ***Action of the TCAs on these receptors trigger majority of adverse effects ``` Contraindicated in patients on MAOIs, and vice versa ***raising dose improves efficacy due to secondary MOAs

Answer 13

Cymbalta Class: Atypical (Dual/mixed action) Antidepressant Blocks presynaptic a2 receptors - On adrenergic neurons (autoreceptors) - On serotonergic neurons (heteroceptors) Blocking a2 receptors increases NE and 5-HT levels

Answer 14

Treats Bipolar Disorder Mechanism of action is unknown - Most likely involves effect on postsynaptic rather than presynaptic neuron - Interferes with the production and release of IP3 (phosphatdylinositol-4,5-bisphosphate) and DAG (diacyl glycerol) - Can inhibit norepinephrine-sensitive adenylyl cyclase - May uncouple receptor recognition site from GTP-binding protein (G-protein) by competing with Mg++ - May affect several cell or nuclear regulatory factors - Working hypothesis: alters gene expression implicated in long-term neuroplastic events that could underlie long-term mood stabilization ***low therapeutic index

Answer 15

Anticonvulsant tx of Bipolar disorder better than Lithium for rapid cycle BD can be combined with Li after failed monotherapy

Answer 16

Anticonvulsant Prophylactic tx of Bipolar disorder

Answer 17

Class: Barbiturate increase DURATION of GABA-gated Cl- channel openings at high conc, may also directly activate chloride channels also depress excitatory GLU by binding AMPA receptors ability to induce full surgical anesthisia more pronounced CNS depression -->low margin of safety effective tx of tonic-clonic seizures respiration fx are dose related

Answer 18

Class: Benzodiazapine Enhance GABA's effects allosterically without directly activating GABAA receptors or opening the associated chloride channels. Increase in the FREQUENCY of chloride channel-opening events. Unlike barbiturates, benzodiazepines have little impact on hepatic drug-metabolizing enzyme activity with continuous use. Also exert dose-dependent anterograde amnesic effects (inability to remember events occurring during the drug's duration of action)

Answer 19

Class: Benzodiazapine Enhance GABA's effects allosterically without directly activating GABAA receptors or opening the associated chloride channels. Increase in the FREQUENCY of chloride channel-opening events. Unlike barbiturates, benzodiazepines have little impact on hepatic drug-metabolizing enzyme activity with continuous use. Also exert dose-dependent anterograde amnesic effects (inability to remember events occurring during the drug's duration of action)

Answer 20

Class: Benzodiazapine Enhance GABA's effects allosterically without directly activating GABAA receptors or opening the associated chloride channels. Increase in the FREQUENCY of chloride channel-opening events. Unlike barbiturates, benzodiazepines have little impact on hepatic drug-metabolizing enzyme activity with continuous use. Also exert dose-dependent anterograde amnesic effects (inability to remember events occurring during the drug's duration of action)

Answer 21

Class: Benzodiazapine Enhance GABA's effects allosterically without directly activating GABAA receptors or opening the associated chloride channels. Increase in the FREQUENCY of chloride channel-opening events. Unlike barbiturates, benzodiazepines have little impact on hepatic drug-metabolizing enzyme activity with continuous use. Also exert dose-dependent anterograde amnesic effects (inability to remember events occurring during the drug's duration of action)

Answer 22

Benzo binding site ANTAGONIST (doesn't block barbiturate function) tx of benzo OD

Answer 23

Selective anxiolytic effects Relieves anxiety without significant sedative or hypnotic effects No anticonvulsant or muscle relaxant properties. Buspirone does not interact directly with GABAergic systems Mechanism? Partial agonist at brain 5-HT1A receptors Also has affinity for brain dopamine D2 receptors Minimal abuse liability Anxiolytic effects may take more than a week to become established unsuitable for management of acute anxiety states Used in generalized anxiety states but is less effective in panic disorders. Less psychomotor impairment than benzodiazepines (does not affect driving skills)

Answer 24

Ambien Mechanism of action New drugs interact with benzodiazepine binding site on GABAA receptor Non-benzo chemical structure Benzodiazepines bind to all GABA-A receptor subtypes These selectively bind to certain subtypes of the receptor Advantages Rapid onset Short duration of action (no residual effects upon wakening) Slow tolerance development

Answer 25

Ramelteon (Rozerem), a novel hypnotic drug specifically useful for patients who have difficulty in falling asleep Melatonin receptors are involved in maintaining circadian rhythms underlying the sleep-wake cycle Ramelteon is an agonist at MT1 and MT2 melatonin receptors located in the suprachiasmatic nuclei (“master clock”) of the brain No direct effects on GABAergic neurotransmission in the CNS No rebound insomnia or significant withdrawal symptoms Minimal potential for abuse, regular use does not result in dependence Adverse effects of ramelteon include dizziness, drowsiness, fatigue, and endocrine

Answer 26

Thorazine Class: First Gen Antipsychotic FGA block D2 in 4 out of 4 Pathways • Decreasing DA activity has been shown to increase 5-HT • Increase in 5-HT inhibits DA release * Mesolimbic * Blocking D2 decreases positive symptoms • Mesocortical • Blocking D2 receptors here does not improve negative symptoms, in fact can worsen negative symptoms (increases in 5-HT?) * Nigrostriatal * Blocking D2 receptors here causes Parkinsonism (EPSE) * Tuberoinfundibular * DA inhibits prolactin * Blocking D2 receptors here causes: * Galactorrhea * Amenorrhea * Sexual dysfunction

Answer 27

Haldol Class: First Gen Antipsychotic FGA block D2 in 4 out of 4 Pathways • Decreasing DA activity has been shown to increase 5-HT • Increase in 5-HT inhibits DA release * Mesolimbic * Blocking D2 decreases positive symptoms • Mesocortical • Blocking D2 receptors here does not improve negative symptoms, in fact can worsen negative symptoms (increases in 5-HT?) * Nigrostriatal * Blocking D2 receptors here causes Parkinsonism (EPSE) * Tuberoinfundibular * DA inhibits prolactin * Blocking D2 receptors here causes: * Galactorrhea * Amenorrhea * Sexual dysfunction

Answer 28

Mellaril Class: First Gen Antipsychotic FGA block D2 in 4 out of 4 Pathways • Decreasing DA activity has been shown to increase 5-HT • Increase in 5-HT inhibits DA release * Mesolimbic * Blocking D2 decreases positive symptoms • Mesocortical • Blocking D2 receptors here does not improve negative symptoms, in fact can worsen negative symptoms (increases in 5-HT?) * Nigrostriatal * Blocking D2 receptors here causes Parkinsonism (EPSE) * Tuberoinfundibular * DA inhibits prolactin * Blocking D2 receptors here causes: * Galactorrhea * Amenorrhea * Sexual dysfunction

Answer 29

Prolixin Class: First Gen Antipsychotic FGA block D2 in 4 out of 4 Pathways • Decreasing DA activity has been shown to increase 5-HT • Increase in 5-HT inhibits DA release * Mesolimbic * Blocking D2 decreases positive symptoms • Mesocortical • Blocking D2 receptors here does not improve negative symptoms, in fact can worsen negative symptoms (increases in 5-HT?) * Nigrostriatal * Blocking D2 receptors here causes Parkinsonism (EPSE) * Tuberoinfundibular * DA inhibits prolactin * Blocking D2 receptors here causes: * Galactorrhea * Amenorrhea * Sexual dysfunction

Answer 30

Clozaril Class: Atypical/Second Gen Antipsychotic Effective for both positive and negative symptoms o No Parkinson’s disease like side effects o SGA mechanism of action o Block D2 receptors AND 5-HT2A receptors - No D2 activation - DA release into the synapse (not inhibited by 5-HT anymore) No EPSE ***AGRANULOCYTOSIS

Answer 31

Risperidal Class: Atypical/Second Gen Antipsychotic Effective for both positive and negative symptoms o No Parkinson’s disease like side effects o SGA mechanism of action o Block D2 receptors AND 5-HT2A receptors - No D2 activation - DA release into the synapse (not inhibited by 5-HT anymore) **EPSE and hypotension at higher doses

Answer 32

Zyprexa Class: Atypical/Second Gen Antipsychotic Effective for both positive and negative symptoms o No Parkinson’s disease like side effects o SGA mechanism of action o Block D2 receptors AND 5-HT2A receptors - No D2 activation - DA release into the synapse (not inhibited by 5-HT anymore)

Answer 33

Seroquel Class: Atypical/Second Gen Antipsychotic Effective for both positive and negative symptoms o No Parkinson’s disease like side effects o SGA mechanism of action o Block D2 receptors AND 5-HT2A receptors - No D2 activation - DA release into the synapse (not inhibited by 5-HT anymore)

Answer 34

Geodon Class: Atypical/Second Gen Antipsychotic Effective for both positive and negative symptoms o No Parkinson’s disease like side effects o SGA mechanism of action o Block D2 receptors AND 5-HT2A receptors - No D2 activation - DA release into the synapse (not inhibited by 5-HT anymore) **less weight gain

Answer 35

Abilify Class: Atypical/Second Gen Antipsychotic Effective for both positive and negative symptoms o No Parkinson’s disease like side effects o SGA mechanism of action o Block D2 receptors AND 5-HT2A receptors - No D2 activation - DA release into the synapse (not inhibited by 5-HT anymore) **less weight gain

Answer 36

Indication: partial (focal) and secondarily generalized tonic-clonic seizures; (but may make absence or myoclonic seizures worse.) stabilizes "inactivated" state of VG Na+ channels --> decrease in repetitive firing Adverse Effects: Mild leukopenia and hyponatremia common.

Answer 37

Indication: Primary tx for Absence (generalized, non-convulsive) seizures; ethosuximide is NOT effective in generalized tonic-clonic or partial (focal) seizures. Bocks VG T-type dependent calcium channel, disrupting pacemaker activity; Works on thalamic neurons, which may stop them from generating rhythmic cortical discharges that occur during absence seizures Adverse effects: behavorial changes, Psychotic behavior, systemic lupus erythematosus (SLE)

Answer 38

Indication: primary therapy for focal seizures, primary or secondary generalized tonic-clonic seizures and myoclonic seizures. Affects synaptic vesicle protein SV2A, resulting in decreased glutamate release but increased GABA release Adverse effects: behavioral changes, psychosis, especially in patients with underlying psych diagnoses. ***NO drug interactions

Answer 39

Indications: focal and primarily generalized tonic clonic seizures Increased inactivation of VG Na+ channels - blocks presynaptic (N; P/Q) VG Ca2+ channels - enhances GABAa-receptor currents (not via BZD receptor) - limits activation of AMPA-kainate subtypes of the glutamate receptor Adverse effects: Psychomotor slowing

Answer 40

Indication: partial and secondarily generalized tonic-clonic seizures, but is no longer considered a drug of first choice Prolongs Inactivation phase of v-gated Na+ channels prevents rapid firing of action potentials decreased glutamate release Adverse effects: Nystagmus common; Cerebellar atrophy has been reported with long-term use and after acute intoxication. Gingival hyperplasia, coarsening of facial features and hirsutism can also occur.

Answer 41

Indication: works for most! Drug of choice for primarily generalized tonic-clonic seizures Decreases repetitive firing, potentially via multiple mechanisms: block of VG Na+, NMDA receptor block, decreases GABA reuptake (GAT-1); reduces the flow of Ca2+ through T-type Ca2+ channels Adverse effects: Alopecia, appetite stimulation, weight gain. Elevation of hepatic transaminases (indicator or liver damage)

All Drugs (by name) Flashcards

(65 cards)