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Pharmacology > Brain, Mind, and Behavior > Flashcards

Brain, Mind, and Behavior Flashcards

1
Q

Chlorpromazine

A

Typical antipsychotic - D2 receptor antagonists

Adverse Effects:

  • Nigrostriatal: Motor “EPS” (tardive dyskinesia)
  • Hypothalamus: Endocrine (hyperprolactinemia and therefore diminished GnRH)

Rare: Neuroleptic Malignant Syndrome (NMS)

  • Symptoms = hyperthermia and muscle rigidity
  • Treatment = withdraw typical antipsychotic, cooling/hydration, DANTROLENE (muscle relaxant) and BROMOCRIPTINE (dopamine agonist)

Note: Can treat Huntington’s chorea and Tourette’s (hyperkinetic movement disorders)

Note: The -azines cause anticholinergic and alpha-receptor blockage –> Dry mouth, constipation, orthostatic hypotension

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2
Q

Fluphenazine

A

Typical antipsychotic

Adverse Effects:

  • Nigrostriatal: Motor “EPS” (tardive dyskinesia)
  • Hypothalamus: Endocrine (hyperprolactinemia and therefore diminished GnRH)

Rare: Neuroleptic Malignant Syndrome (NMS)

  • Symptoms = hyperthermia and muscle rigidity
  • Treatment = withdraw typical antipsychotic, cooling/hydration, DANTROLENE (muscle relaxant) and BROMOCRIPTINE (dopamine agonist)

Note: Can treat Huntington’s chorea and Tourette’s (hyperkinetic movement disorders)

Note: The -azines cause anticholinergic and alpha-receptor blockage –> Dry mouth, constipation, orthostatic hypotension

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3
Q

Haloperidol

A

Typical antipsychotic

Adverse Effects:

  • Nigrostriatal: Motor “EPS” (tardive dyskinesia)
  • Hypothalamus: Endocrine (hyperprolactinemia and therefore diminished GnRH)

Rare: Neuroleptic Malignant Syndrome (NMS)

  • Symptoms = hyperthermia and muscle rigidity
  • Treatment = withdraw typical antipsychotic, cooling/hydration, DANTROLENE (muscle relaxant) and BROMOCRIPTINE (dopamine agonist)

Note: Can treat Huntington’s chorea and Tourette’s (hyperkinetic movement disorders)

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4
Q

Aripiprazole

A

Atypical antipsychotic (can be used in bipolar disorder too)

  • Fewer EPS and Endocrine side effects than typicals (not zero though)
  • Wider therapeutic window than typicals
  • Similar efficacy to typicals

Adverse effects:

  • Metabolic: weight gain, diabetes mellitus 2, elevated LDL
  • Especially bad in pediatric and geriatric patients
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5
Q

Clozapine

A

Atypical antipsychotic

  • Fewer EPS and Endocrine side effects than typicals (not zero though)
  • Wider therapeutic window than typicals
  • Similar efficacy to typicals

Adverse effects:

  • Metabolic: weight gain, diabetes mellitus 2, elevated LDL
  • Especially bad in pediatric and geriatric patients
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6
Q

Olanzapine

A

Atypical antipsychotic

  • Fewer EPS and Endocrine side effects than typicals (not zero though)
  • Wider therapeutic window than typicals
  • Similar efficacy to typicals

Adverse effects:

  • Metabolic: weight gain, diabetes mellitus 2, elevated LDL
  • Especially bad in pediatric and geriatric patients
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7
Q

Risperidone

A

Atypical antipsychotic

  • Fewer EPS and Endocrine side effects than typicals (not zero though)
  • Wider therapeutic window than typicals
  • Similar efficacy to typicals

Adverse effects:

  • Metabolic: weight gain, diabetes mellitus 2, elevated LDL
  • Especially bad in pediatric and geriatric patients
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8
Q

Quetiapine

A

Atypical antipsychotic (treats bipolar disorder too)

Atypical antipsychotic

  • Fewer EPS and Endocrine side effects than typicals (not zero though)
  • Wider therapeutic window than typicals
  • Similar efficacy to typicals

Adverse effects:

  • Metabolic: weight gain, diabetes mellitus 2, elevated LDL
  • Especially bad in pediatric and geriatric patients
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9
Q

Imipramine

A

Tricyclic Antidepressant (depression) - Inhibits reuptake of NE

Risk: Cardiac arrhythmia

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10
Q

Escitalopram

A

SSRI (depression)

Adverse event: GI and Sexual

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11
Q

Fluoxetine

A

SSRI (depression)

NOTE: Only FDA approved med for Bulimia Nervosa

Adverse event: GI and Sexual

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12
Q

Paroxetine

A

SSRI (depression)

Adverse event: GI and Sexual

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13
Q

Sertraline

A

SSRI (depression)

Adverse event: GI and Sexual

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14
Q

Paroxetine

A

SSRI (depression)

Adverse event: GI and Sexual

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15
Q

Sertraline

A

SSRI (depression)

Adverse event: GI and Sexual

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16
Q

Venlafaxine

A

SNRI (depression)

Adverse event: GI and Sexual

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17
Q

Duloxetine

A

SNRI (depression)

Adverse event: GI and Sexual

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18
Q

Phenelzine

A

MAOI (depression)

Risk: Hypertensive crisis from dietary amines (such as yeast extracts like Vegemite)

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19
Q

Bupropion

A

Atypical antidepressant (also used as nicotine pharmacotherapy)

  • Inhibits reuptake of dopamine and NE

NOTE: Contraindicated in anorexia nervosa & bulimia nervosa patients and in patients with decreased seizure threshold.

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20
Q

Mirtazapine

A

Atypical antidepressant

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21
Q

Lithium

A

Treats bipolar disorder

  • Low sodium makes lithium more toxic
  • Teratogenic
  • Drug-drug interactions (esp. renal drugs)
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22
Q

Carabamazepine

A

Anticonvulsant (treats bipolar disorder)

  • Induces Cytochrome P450 to interact with many other drugs
  • Teratogenic
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23
Q

Valproic acid

A

Anticonvulsant (treats bipolar disorder)

  • Induces Cytochrome P450 to interact with many other drugs
  • Teratogenic
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24
Q

Lamotrigine

A

Anticonvulsant (treats bipolar disorder)

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25
Amitriptyline
Tricyclic Antidepressant (depression) - Inhibits reuptake of NE Risk: Cardiac arrhythmia Note: Can be used for headache analgesia
26
Amphetamines
Release dopamine and NE
27
Cocaine
Inhibits reuptake of dopamine and NE
28
Desipramine
TCA - inhibits NE reuptake
29
Alpha-methyltyrosine
Decreased dopamine and NE - inhibits tyrosine hydroxylase
30
Reserpine
Decreased dopamine, NE, and serotonin - inhibits vesicular uptake
31
Prednisone
Headache analgesia
32
Aminosalicylic acid (ASA)
NSAID (Aspirin) Used in headache analgesia and as a blood thinner. - Irreversibly acetylates COX - fries platelet for good. * *Warning: Reye's Syndrome = if you give aspirin to child after viral illness, you can cause hepatotoxicity and death!! - Aspirin not for kids with viral illness (URI, chickenpox, etc.) Note: Other NSAIDs reversibly inhibit COX and cannot prevent clotting. Ex: no amount of Ibuprofen can prevent clotting.
33
Acetaminophen
Headache analgesia (Tylenol) - NOT an NSAID. We don't know how it works (COX, 5-HT, ... ?) - Is an OK antipyretic and analgesic - No effect on GI, Platelet, Renal, CV (like NSAIDs) - Overdose can cause fatal hepatic necrosis (its metabolite covalently binds to liver cells)
34
Ibuprofen
NSAID Headache analgesia (Advil)
35
Ergotamine
Headache analgesia
36
Sumatriptan
Headache analgesia
37
Prochlorperazine
Headache analgesia
38
AAC
Acetaminophen, aspirin, and caffeine: Headache analgesia
39
Verapamil
Headache analgesia
40
Perphenazine
Typical antipsychotic - D2 receptor antagonists Adverse Effects: - Nigrostriatal: Motor "EPS" (tardive dyskinesia) - Hypothalamus: Endocrine (hyperprolactinemia and therefore diminished GnRH) Rare: Neuroleptic Malignant Syndrome (NMS) - Symptoms = hyperthermia and muscle rigidity - Treatment = withdraw typical antipsychotic, cooling/hydration, DANTROLENE (muscle relaxant) and BROMOCRIPTINE (dopamine agonist) Note: Can treat Huntington's chorea and Tourette's (hyperkinetic movement disorders) Note: The -azines cause anticholinergic and alpha-receptor blockage --> Dry mouth, constipation, orthostatic hypotension
41
Thioridazine
Typical antipsychotic - D2 receptor antagonists Adverse Effects: - Nigrostriatal: Motor "EPS" (tardive dyskinesia) - Hypothalamus: Endocrine (hyperprolactinemia and therefore diminished GnRH) Rare: Neuroleptic Malignant Syndrome (NMS) - Symptoms = hyperthermia and muscle rigidity - Treatment = withdraw typical antipsychotic, cooling/hydration, DANTROLENE (muscle relaxant) and BROMOCRIPTINE (dopamine agonist) Note: Can treat Huntington's chorea and Tourette's (hyperkinetic movement disorders) Note: The -azines cause anticholinergic and alpha-receptor blockage --> Dry mouth, constipation, orthostatic hypotension
42
Thiothixene
Typical antipsychotic - D2 receptor antagonists Adverse Effects: - Nigrostriatal: Motor "EPS" (tardive dyskinesia) - Hypothalamus: Endocrine (hyperprolactinemia and therefore diminished GnRH) Rare: Neuroleptic Malignant Syndrome (NMS) - Symptoms = hyperthermia and muscle rigidity - Treatment = withdraw typical antipsychotic, cooling/hydration, DANTROLENE (muscle relaxant) and BROMOCRIPTINE (dopamine agonist) Note: Can treat Huntington's chorea and Tourette's (hyperkinetic movement disorders)
43
Trifluoperazine
Typical antipsychotic - D2 receptor antagonists Adverse Effects: - Nigrostriatal: Motor "EPS" (tardive dyskinesia) - Hypothalamus: Endocrine (hyperprolactinemia and therefore diminished GnRH) Rare: Neuroleptic Malignant Syndrome (NMS) - Symptoms = hyperthermia and muscle rigidity - Treatment = withdraw typical antipsychotic, cooling/hydration, DANTROLENE (muscle relaxant) and BROMOCRIPTINE (dopamine agonist) Note: Can treat Huntington's chorea and Tourette's (hyperkinetic movement disorders)
44
Asenapine
Atypical antipsychotic - Fewer EPS and Endocrine side effects than typicals (not zero though) - Wider therapeutic window than typicals - Similar efficacy to typicals Adverse effects: - Metabolic: weight gain, diabetes mellitus 2, elevated LDL - Especially bad in pediatric and geriatric patients
45
Paliperidone
Atypical antipsychotic - Fewer EPS and Endocrine side effects than typicals (not zero though) - Wider therapeutic window than typicals - Similar efficacy to typicals Adverse effects: - Metabolic: weight gain, diabetes mellitus 2, elevated LDL - Especially bad in pediatric and geriatric patients
46
Ziprasidone
Atypical antipsychotic - Fewer EPS and Endocrine side effects than typicals (not zero though) - Wider therapeutic window than typicals - Similar efficacy to typicals Adverse effects: - Metabolic: weight gain, diabetes mellitus 2, elevated LDL - Especially bad in pediatric and geriatric patients
47
Seligiline
MAOI (antidepressant) AND Parkinson's drug
48
Tranylcypromine
MAOI (antidepressant)
49
Fluvoxamine
SSRI (antidepressant)
50
Citalopram
SSRI (antidepressant)
51
Trazodone
Atypical antidepressant
52
Lisdexamfetamine
Treats binge eating disorder and ADHD
53
Acamprosate
Alcohol withdrawal pharmacotherapy - dampens excitatory neurotransmission associated with alcohol withdrawal - Second line to naltrexone * AND what about the alcohol?
54
Disulfiram
Alcohol withdrawal pharmacotherapy - inhibits aldehyde DH - If you take this with alcohol, acetaldehyde builds and you get sick. - Not that great... *AND what about the alcohol?
55
Naltrexone
Alcohol withdrawal pharmacotherapy - opiate antagonist - Opiate receptors stimulate reward system so by blocking, you inhibit dependence on alcohol to stimulate reward - New first line *AND what about the alcohol?
56
Varenicline
Nicotine pharmacotherapy - Partial agonist at nAChR (alpha-4/beta-2 subtype) - Dual agonist and antagonist properties: physically prevents nicotine from binding and releases intrinsically less dopamine at the nAcc.
57
Nicotine replacement therapy
Nicotine pharmacotherapy Contraindications: - Cardiac arrhythmias, post-MI, angina - Pregnant women Adverse reactions (patch): - Skin irritation - Sleep disturbances (vivid dreaming) Adverse reactions (gum and lozenge) - Hiccups and nausea - Jaw aches and mouth soreness
58
Morphine
Mu receptor agonist - Metabolites: Liver turns Morphine --> Morphine 3-glucoronide and Morphine 6-glucoronide. They both go to kidneys and get peed out. - If patient has renal insufficiency... You build up these water-soluble metabolites. - If morphine 6 glucoronide crosses the BBB, it is 100x more potent than morphine!!!! - So anyone with renal insufficiency (like OLD PEOPLE), stay the fuck away from morphine!
59
Meperidine
Mu receptor agonist - Metabolites: Liver turns Meperidine --> Normeperidine which goes to kidneys to be peed out. - Normeperidine can cause seizures if levels too high. - Patients with renal insufficiency... Normeperidine builds up and causes SEIZURES.
60
Hydromorphone
Mu receptor agonist - No significant active metabolites: In patients with renal failure, this replaces morphine as treatment.
61
Pentazocine
Kappa agonist/Mu antagonist - Kappa = krappy at analgesia and makes you krazy - Do NOT give in chronic opioid users --> triggers withdrawal - Causes less respiratory depression & sedation & euphoria via kappa. - Give to reverse opioid side effects while maintaining analgesia
62
Butorphanol
Kappa agonist/Mu antagonist | - Kappa = krappy
63
Nalbuphine
Kappa agonist/Mu antagonist | - Kappa = krappy
64
Buprenorphine
Partial mu agonist (binds mu receptor very tightly but only turns it on a little bit) - Used for heroin addicts/opioid addicts. - It blocks heroin/opioid from binding AND it is weak so it doesn’t create withdrawal. - When you take them off the buprenorphine finally, their withdrawal is super mild!
65
Naloxone
Mu receptor antagonist | - Give in opioid overdose
66
Naltrexone
Mu receptor antagonist | - Give in opioid overdose
67
Methadone
Mu receptor agonist | - Uniquely has 24 hour half life (all other opioids have 2-3 hour)
68
Codeine
Mu receptor agonist
69
Oxycodone
Mu receptor agonist
70
Hydrocodone
Mu receptor agonist - Fun fact = this is Vicodin
71
Heroin
Mu receptor agonist
72
Fentanyl
Mu receptor agonist
73
Methadone
Mu receptor agonist
74
Tramadol
Mu receptor agonist | - Does mild/moderate pain only
75
Dephenoxylate
Antidiarrheal - opioid
76
Loperamide
Antidiarrheal - opioid
77
Meloxicam
NSAID
78
Celecoxib
NSAID Selective COX 2 inhibitor - No platelet effect - Only NSAID that doesn't increase bleeding (can give before surgeries)
79
Naprosyn
NSAID
80
Indomethacin
NSAID
81
Diclofenac
NSAID
82
Nabumetone
NSAID
83
Ketorolac
NSAID
84
NSAIDs
General: - Inhibits COX 1 and 2 (cyclooxygenase) enzymes which take... Arachidonic acid --> Prostaglandins Pain: - COX 2 works when injury occurs AND is always active in CNS (to potentiate pain pathway). Thus, NSAIDs work peripherally and centrally. GI: - COX 1 making PG's that help keep stomach lining intact (help make bicarbonate, thicken stomach wall, increase blood flow to stomach for repair). Chronic NSAID use increase risk of upper GI bleed. - Put chronic NSAID user on PPI. Renal: - Need prostaglandins to maintain blood flow in low blood flow states through your kidneys! - Don’t give NSAIDS if you have a case of low blood flow through kidneys or your patient will get ischemic tubular necrosis. - Low perfusion states = hypovolemia (hemorrhage) AND congestive heart failure Hemostasis: - Endothelial cells have COX 2, which makes Prostacyclin (PGI2). PGI2 is a platelet inhibitor and vasodilator (enable blood flow) - Platelets have COX 1 and make Thromboxane A2, which is a platelet activator and vasoconstrictor (how they do their job). - Platelets have no nuclei and cannot counteract NSAID activity like endothelial cells can so NSAIDs inhibit platelet activity. - Aspirin is the only NSAID to irreversibly inhibit COX. Others reversibly inhibit. Note: COX 1 is 'housekeeping' which is present in tissues all the time. Note: COX 2 is 'inflammatory' one which is present during injury (makes PG's that bind to nociceptor and induce pain). Note: COX 2 also makes PGI2 (platelets) [not COX 1]
85
Opioids
- Analgesia - Sedation - Respiratory depression - Miosis Euphoria Dependence
86
Timolol
Glaucoma drug - Beta adrenergic antagonist - Reduce aqueous humor production
87
Levobunolol
Glaucoma drug - Beta adrenergic antagonist - Reduce aqueous humor production
88
Metipranolol
Glaucoma drug - Beta adrenergic antagonist - Reduce aqueous humor production
89
Carteolol
Glaucoma drug - Beta adrenergic antagonist - Reduce aqueous humor production
90
Brimonidine
Glaucoma drug - Alpha 2 agonist - Decrease aqueous production AND increase uveoscleral outflow
91
Apraclonidine
Glaucoma drug - Alpha 2 agonist - Decrease aqueous production AND increase uveoscleral outflow
92
Acetazolamide
Glaucoma drug - Carbonic anhydrase inhibitor - Decrease rate of HCO3- formation: Inhibit secretion of aqueous
93
Methazolamide
Glaucoma drug - Carbonic anhydrase inhibitor - Decrease rate of HCO3- formation: Inhibit secretion of aqueous
94
Dorzolamide
Glaucoma drug - Carbonic anhydrase inhibitor - Decrease rate of HCO3- formation: Inhibit secretion of aqueous
95
Brinzolamide
Glaucoma drug - Carbonic anhydrase inhibitor - Decrease rate of HCO3- formation: Inhibit secretion of aqueous
96
Latanaprost
Glaucoma drug - Prostaglandin analogue - Increase uveoscleral outflow - First line treatment
97
Bimatoprost
Glaucoma drug - Prostaglandin analogue - Increase uveoscleral outflow - First line treatment
98
Travoprost
Glaucoma drug - Prostaglandin analogue - Increase uveoscleral outflow - First line treatment
99
Pilocarpine
Glaucoma drug - Cholinergic agonist - Increase aqueous outflow through trabecular meshwork
100
Echothiophate
Glaucoma drug - Inhibits acetylcholinesterase - Increase aqueous outflow through trabecular meshwork
101
Amantidine
Parkinson's drug | - Induces DA release from nigrostriatal neuron
102
Benztropine
Parkinson's drug | - AChR antagonist
103
Carbidopa
Parkinson's drug - Inhibits peripheral DDC (dopa decarboxylase) so more reaches CNS - Used with L-Dopa ("Sinemet")
104
Entacapone
Parkinson's drug | - Inhibits COMT (catechol-O-methyl transferase), which converts Dopamine and L-Dopa from their path.
105
Levodopa
Parkinson's drug | - Dopamine precursor
106
Pramipexole
Parkinson's drug | - D2/D3 agonist
107
Ropinirole
Parkinson's drug | - D2/D3 agonist
108
Tolcapone
Parkinson's drug | - Inhibits COMT (catechol-O-methyl transferase), which converts Dopamine and L-Dopa from their path.
109
Pergolide
Parkinson's drug | - Dopamine agonist
110
Procaine
Local anesthetic | - Ester
111
Chloroprocaine
Local anesthetic | - Ester
112
Tetracaine
Local anesthetic | - Ester
113
Lidocaine
Local anesthetic | - Amide
114
Mepivacaine
Local anesthetic | - Amide
115
Prilocaine
Local anesthetic | - Amide
116
Bupivacaine
Local anesthetic | - Amide
117
Ropivacaine
Local anesthetic | - Amide
118
Propofol
IV General Anesthetic
119
Ketamine
IV General Anesthetic
120
Etomidate
IV General Anesthetic
121
Dexmedetomidine
IV General Anesthetic
122
Nitrous oxide
Inhalational General Anesthetic
123
Isoflurane
Inhalational General Anesthetic
124
Desflurane
Inhalational General Anesthetic
125
Sevoflurane
Inhalational General Anesthetic
126
Carbamazepine
Antiepileptic
127
Levetiracetam
Antiepileptic
128
Lamotrigine
Antiepileptic
129
Phenytoin
Antiepileptic
130
Valproate
Antiepileptic
131
Aprazolam
Anxiolytic, Alcohol withdrawal, Muscle spasms - Benzodiazepine - Allosteric ligand at GABA-A receptor. Potentiate effects of GABA (indirect effect on chloride influx through channel)
132
Chlordiazepoxide
Anxiolytic, Alcohol withdrawal, Muscle spasms - Benzodiazepine - Allosteric ligand at GABA-A receptor. Potentiate effects of GABA (indirect effect on chloride influx through channel)
133
Clonazepam
Anxiolytic, Alcohol withdrawal, Muscle spasms - Benzodiazepine - Allosteric ligand at GABA-A receptor. Potentiate effects of GABA (indirect effect on chloride influx through channel)
134
Diazepam
Anxiolytic, Alcohol withdrawal, Muscle spasms - Benzodiazepine - Allosteric ligand at GABA-A receptor. Potentiate effects of GABA (indirect effect on chloride influx through channel)
135
Lorazepam
Anxiolytic, Alcohol withdrawal, Muscle spasms - Benzodiazepine - Allosteric ligand at GABA-A receptor. Potentiate effects of GABA (indirect effect on chloride influx through channel) - All benzos metabolized hepatically (either by oxidation OR glucoronidation). * LOT: LOT drugs do not undergo oxidation (better for liver). Use in patients with liver problems or old patients. Less lipophilic = Slow acting but More sustained relief. - Does not cross BBB as quickly but does not deposit into peripheral fat either.
136
Midazolam
Anxiolytic, Alcohol withdrawal, Muscle spasms - Benzodiazepine - Allosteric ligand at GABA-A receptor. Potentiate effects of GABA (indirect effect on chloride influx through channel)
137
Temazepam
Anxiolytic, Alcohol withdrawal, Muscle spasms - Benzodiazepine - Allosteric ligand at GABA-A receptor. Potentiate effects of GABA (indirect effect on chloride influx through channel) - All benzos metabolized hepatically (either by oxidation OR glucoronidation). * LOT: LOT drugs do not undergo oxidation (better for liver). Use in patients with liver problems or old patients.
138
Oxazepam
Anxiolytic, Alcohol withdrawal, Muscle spasms - Benzodiazepine - Allosteric ligand at GABA-A receptor. Potentiate effects of GABA (indirect effect on chloride influx through channel) - All benzos metabolized hepatically (either by oxidation OR glucoronidation). * LOT: LOT drugs do not undergo oxidation (better for liver). Use in patients with liver problems or old patients.
139
Flumazenil
Benzodiazepine receptor antagonist - Used in BZD complications
140
Buspirone
Anxiolytic - Serotonin agonist
141
Zolpidem
Insomnia medication - Lasts 3 hours - Use less in women
142
Zaleplon
Insomnia medication - Lasts 2 hours - Jet lag
143
Eszopiclone
Insomnia medication | - Lasts 6 hours

Pharmacology (5 decks)

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