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Pharm Unit 3 Drugs > CNS 1 and 2 > Flashcards

CNS 1 and 2 Flashcards

1
Q

Levodopa (L-DOPA) (Dopar) Class

A

Dopamine precursor

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2
Q

Levadopa (L-DOPA) MOA

A

Oral, absorbed in small bowel

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3
Q

Levadopa (L-DOPA) Therapeutics

A

Given with carbidopa; first-line treatment for Parkinson’s unless patient is young (want to delay as long as possible)

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4
Q

Levadopa (L-DOPA) Important SE

A

Hallucinations, dyskinesias; on-off phenomenon, neuroleptic malignant syndrome (NMS)*, psychosis possible with chronic use

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5
Q

Levadopa other SE

A

Nausea/GI distress, hypotension, dizziness

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6
Q

Levadopa Misc

A

Given with carbidopa; may accelerate PD progression; relatively short half-life (3 hours)

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7
Q

Carbidopa (Lodosyn) Class

A

Aromatic amino acid decarboxylase inhibitor

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8
Q

Carbidopa (Lodosyn) MOA

A

Inhibits peripheral conversion of L-DOPA to dopamine; does not cross BBB

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9
Q

Bromocriptine (Parlodel) Class

A

Ergot Derivative

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10
Q

Rasagiline (Azilect) Class

A

MAO-b inhibitor

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11
Q

Deep Brain Stimulation Misc

A

Patients must still be sensitive to levodopa therapy (or they aren’t a candidate)

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12
Q

Haloperidol (Haldol) Class

A

First-generation antipsychotics (phenothiazine)

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13
Q

Haloperidol (Haldol) Therapeutics

A

Schizophrenia (hallucinations, delusions), movement disorder in Huntingtons

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14
Q

Haloperidol (Haldol) Misc

A

Little effect on negative symptoms

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15
Q

Carbidopa (Lodosyn) Therapeutics

A

Parkinson’s (given with Levadopa)

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16
Q

Carbidopa (Lodosyn) Important SE

A

Dyskinesias, on-off phenomenon, neuroleptic malignant syndrome (NMS), psychosis possible with chronic use

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17
Q

Carbidopa (Lodosyn) Misc

A

MAO-A inhibitors are contraindicated (except MAO-B, which only hits DA)

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18
Q

Bromocriptine (Parlodel) MOA

A

D2 agonist, D1 antagonist

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19
Q

Bromocriptine (Parlodel) Therapeutics

A

Mild Parkinson’s; DA agonism in NMS; hyperprolactinemia

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20
Q

Bromocriptine (Parlodel) SE

A
  1. Pleural effusions, cough, shortness of breath, pulmonary fibrosis
  2. Peripheral DA-like effects
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21
Q

Bromocriptine (Parlodel) Misc

A

Must be titrated slowly due to hypotension

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22
Q

Pramipexole (Mirapex) Class

A

Non-ergot DA

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23
Q

Pramipexole (Mirapex) MOA

A

Selective D2 agonist

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24
Q

Pramipexole (Mirapex) Therapeutics

A

Mild Parkinson’s (first-line); to delay L-dopa treatment, usually in combination with ropinorole

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25
Pramipexole (Mirapex) SE
1. More acute: psychosis, nausea/GI, edema, compulsive behavior (nucleus accumbens, D3)
26
Pramipexole (Mirapex) Misc.
Less effective with motor symptoms of PD
27
Apomorphine (Apokyn) Class
Non-ergot DA
28
Apomorphine (Apokyn) Therapeutics
Rescue therapy for 'off' periods (immobility)
29
Apomorphine (Apokyn) SE
1. Psychosis, drowsiness, hypersexuality (increase in erections); emesis (pre-administer trimethobenzamide or domiperidone); hypotension with serotonin receptor antagonists 2. Peripheral DA effects
30
Apomorphine Misc
Injectable only; serotonin receptor antagonists contraindicated (e.g., ondansetron)
31
Entacapone (Comtan) Class
COMT Inhibitor
32
Entacapone (Comtan) MOA
Prevents breakdown of DA
33
Entacapone (Comtan) Therapeutics
Prolong half-life of levodopa, reduce 'off' time; primarily works peripherally
34
Entacapone (Comtan) SE
1. Increase in dyskinesias, diarrhea, urine discoloration | 2. DA SE
35
Entacapone Misc
Short-acting (2 hours)
36
Selegiline (Eldepryl) CLass
MAO-B inhibitor
37
Selegiline (Eldepryl) MOA
Prevents breakdown of DA
38
Selegiline (Eldepryl) Therapeutics
Mild early Parkinson's (monotherapy); may delay onset of levodopa therapy
39
Selegiline (Eldepryl) SE
1. Hypotension, GI distress, dyskinesia, psychosis | 2. N/V
40
Selegiline (Eldepryl) Misc
Antidote to environmental toxins; contraindications: decongestants, dextromethorphan, St. John's wort, analgesics, methadone, tramadol, propoxyphene; caution with SSRIs, MAO-A inhibitors
41
Rasagiline (Azilect) Class
MAO-b inhibitor
42
Rasagiline (Azilect) MOA
Prevents breakdown of DA
43
Rasagiline (Azilect) Therapeutics
Mild early Parkinson's (monotherapy); may delay onset of levodopa therapy; also, as an adjunct with levodopa (reduces 'off' time)
44
Rasagiline (Azilect) SE
1. Hypotension, GI distress, dyskinesia, psychosis | 2. N/V
45
Rasagiline (Azilect) Misc.
Contraindications: decongestants, dextromethorphan, St. John's wort, analgesics, methadone, tramadol, propoxyphene; caution with SSRIs, MAO-A inhibitors
46
Benztropine (Cogentin) Class
Anticholinergics
47
Benztropine (Cogentin) Therapeutics
Tremor and drooling in Parkinson's, and really only used if drooling is a major problem (otherwise, very bad mental symptoms)
48
Benztropine (Cogentin) SE
1. Confusion, impaired memory, hallucinations | 2. Typical anticholinergic (dry mouth, etc)
49
Benztropine (Cogentin) Misc
Contraindicated in demented Parkinson's; abrupt discontinuation exacerbates symptoms
50
Trihexyphenidyl (Artane) Class
Anticholinergics
51
Trihexyphenidyl (Artane) Therapeutics
Tremor and drooling in Parkinson's, and really only used if drooling is a major problem (otherwise, very bad mental symptoms)
52
Trihexyphenidyl (Artane) SE
1. Confusion, impaired memory, hallucinations | 2. Typical anticholinergic (dry mouth, etc)
53
Trihexyphenidyl (Artane) Misc.
Contraindicated in demented Parkinson's; abrupt discontinuation causes exacerbation of symptoms
54
Amantadine (Symmetrel) Class
Anti-viral
55
Amantadine (Symmetrel) MOA
Dopaminergic, anticholinergic, anti-NMDA
56
Amantadine (symmetrel) Therapeutics
Mild early Parkinson's (2nd-line); best as an adjunct to levodopa/carbidopa for long-term treatment; movement disorders in Huntingtons; only adjunct that reduces dyskinesias
57
Amantadine (Symmetrel) SE
1. DA side effects, edema, psychosis, NMS upon withdrawal
58
Amantadine (Symmetrel) Misc
Excreted unchanged in urine (renal dysfunction requires lower dose); contraindicated in elderly with dementia (anticholinergic effects)
59
Deep Brain Stimulation Class
Surgery
60
Deep Brain Stimulation MOA
Hits subthalamic nucleus
61
Deep Brain stimulation Therapeutics
Treatment for motor fluctuations or dyskinesias refractory to other medications; reduces 'off' time, may reduce levodopa dosage
62
Deep Brain Stimulation SE
1. Fatal intracerebral hemorrhage, cognitive impairment
63
Deep Brain Stimulation Misc
Patients must still be sensitive to levodopa therapy (or they aren't a candidate)
64
Chlorpromazine (Thorazine) Class
First-generation antipsychotics (phenothiazine)
65
Chlorpromazine (Thorazine) MOA
Catalepsy (trance, muscle rigidity, lack of voluntary movement)
66
Chlorpromazine (Thorazine) Therapeutics
Schizophrenia (hallucinations, delusions), movement disorder in Huntingtons
67
Chlorpromazine (Thorazine) SE
1. NMS 2. Extrapyramidal, tardive dyskinesia; sedation, postural hypotension, weight gain, anticholinergic effects; sexual dysfunction, hyperprolactinemia
68
Chlorpromazine (Thorazine) Misc.
Little effect on negative symptoms
69
Fluphenazine (Prolixin) Class
First-generation antipsychotics (phenothiazine)
70
Trifluoperazine (Stelazine) Class
First-generation antipsychotics (phenothiazine)
71
Perphenazine (Trilafon) Class
First-generation antipsychotics (phenothiazine)
72
Thioridazine (Mellaril) Class
First-generation antipsychotics (phenothiazine)
73
Haloperidol (Haldol) Class
First-generation antipsychotics (phenothiazine)
74
Fluphenazine (Prolixin) MOA
Catalepsy (trance, muscle rigidity, lack of voluntary movement)
75
Trifluoperazine (Stelazine) MOA
Catalepsy (trance, muscle rigidity, lack of voluntary movement)
76
Perphenazine (Trilafon) MOA
Catalepsy (trance, muscle rigidity, lack of voluntary movement)
77
Thioridazine (Mellaril) MOA
Catalepsy (trance, muscle rigidity, lack of voluntary movement)
78
Haloperidol (Haldol) MOA
Catalepsy (trance, muscle rigidity, lack of voluntary movement)
79
Fluphenazine (Prolixin) Therapeutics
Schizophrenia (hallucinations, delusions), movement disorder in Huntingtons
80
Trifluoperazine (Stelazine) Therapeutics
Schizophrenia (hallucinations, delusions), movement disorder in Huntingtons
81
Perphenazine (Trilafon) Therapeutics
Schizophrenia (hallucinations, delusions), movement disorder in Huntingtons
82
Thioridazine (Mellaril) Therapeutics
Schizophrenia (hallucinations, delusions), movement disorder in Huntingtons
83
Haloperidol (Haldol) Therapeutics
Schizophrenia (hallucinations, delusions), movement disorder in Huntingtons
84
Fluphenazine (Prolixin) SE
1. NMS 2. Extrapyramidal (more than chlorpromazine), tardive dyskinesia; sedation (less than chlorpromazine), hypotension, anticholinergic effects; sexual dysfunction, hyperprolactinemia
85
Fluphenazine (Prolixin) Misc
Little effect on negative symptoms
86
Trifluoperazine (Stelazine) SE
1. NMS | 2. Extrapyramidal, tardive dyskinesia; sexual dysfunction, hyperprolactinemia
87
Trifluoperazine (Stelazine) Misc
Little effect on negative symptoms
88
Perphenazine (Trilafon) SE
1. NMS 2. Extrapyramidal (less than chlorpromazine), tardive dyskinesia; sedation (less than chlorpromazine); sexual dysfunction, hyperprolactinemia
89
Perphenazine (Trilafon) Misc
Little effect on negative symptoms
90
Thioridazine (Mellaril) SE
1. NMS | 2. Extrapyramidal, tardive dyskinesia; sexual dysfunction, hyperprolactinemia
91
Thioridazine (Mellaril) Misc
Little effect on negative symptoms
92
Haloperidol (Haldol) SE
1. NMS 2. Extrapyramidal (more than chlorpromazine), tardive dyskinesia; sedation (less than chlorpromazine), hypotension, anticholinergic effects; sexual dysfunction, hyperprolactinemia
93
Haloperidol (Haldol) Misc
Little effect on negative symptoms
94
Tetrabenazine (Xenazine) MOA
Dopamine-depleting, VMAT2 inhibitor
95
Tetrabenazine (Xenazine) Therapeutics
Movement disorder in Huntingtons; tardive dyskinesia
96
Tetrabenazine (Xenazine) SE
NMS
97
Dantrolene (Dantrium) Therapeutics
Malignant hyperthermia (associated with NMS)
98
Dantrolene (Dantrium) MOA
Muscle relaxant
99
Clozapine (Clozaril) Class
Second-Generation Antipsychotics (tricyclic)
100
Clozapine (Clozaril) MOA
D2 receptor antagonist, 5HT2 receptor antagonist
101
Clozapine (Clozaril) Therapeutics
Treatment-resistant psychoses (including schizophrenia); decreases risk of suicide; can be used in pregnancy
102
Clozapine (Clozaril) SE
1. Agranulocytosis; weight gain, type II DM, seizure risk, hyperlipidemia 2. Akathesia (rare, at high doses); GI hypomotility; myocarditis
103
Clozapine (Clozaril) Misc
No catalepsy, no EPS, no TD
104
Olanzapine (Zyprexa) Class
Second-Generation Antipsychotics (tricyclic)
105
Olanzaprine (Zyprexa) MOA
D2 receptor antagonist, 5HT2 receptor antagonist
106
Olanzaprine (Zyprexa) Therapeutics
Schizophrenia (effective against positive symptoms, modest effect on negative); severe bilpolar
107
Olanzapine (Zyprexa) SE
1. Metabolic complications (weight gain, hyperglycemia, type 2 DM, hyperlipidemia) 2. Somnolence, dizziness, increased serum hepatic transaminases, postural hypotension, constipation; EPS, hyperprolactinemia, akathesia may occur
108
Quetiapine (Seroquel) Class
Second-Generation Antipsychotics (tricyclic)
109
Quetiapine (Seroquel) MOA
D2 receptor antagonist, 5HT2 receptor antagonist
110
Quetiapine (Seroquel) Therapeutics
Schizophrenia (effective against positive symptoms, modest effect on negative)
111
Quetiapine (Seroquel) SE
1. Weight gain, hyperglycemia, postural hypotension, constipation, somnolence, dizziness
112
Risperidone (Risperdal) Class
Second-Generation Antipsychotics (non-tricyclic)
113
Risperidone (Risperdal) MOA
D2 receptor antagonist, 5HT2 receptor antagonist
114
Risperidone (Risperdal) Therapeutics
Schizophrenia (effective against positive symptoms, modest effect on negative); severe bilpolar
115
Risperidone (Risperdal) SE
1. Weight gain, hyperglycemia, postural hypotension, constipation, insomnia, dizziness, hyperprolactinemia; EPS at greater doses
116
Risperidone (Risperdal) Misc
Less metabolic complications
117
Ziprazidone (Geodon) Class
Second-Generation Antipsychotics (non-tricyclic)
118
Ziprazidone (Geodon) MOA
D2 receptor antagonist, 5HT2 receptor antagonist
119
Ziprazidone (Geodon) Therapeutics
Schizophrenia (effective against positive symptoms, modest effect on negative)
120
Ziprazidone (Geodon) SE
1. Somnolence, cardiac arrhythmias (QTc prolongation); EPS in 5%Fewer metabolic comlications
121
Ziprazidone (Geodone) Misc
Fewer metabolic complications
122
Aripiprazole (Abilify) Class
Second-Generation Antipsychotics (non-tricyclic)
123
Aripiprazole (Abilify) MOA
Partial D2 and D3 receptor agonist, partial 5HT1a agonist, 5HT2a antagonist
124
Aripiprazole (Abilify) Therapeutics
Not as effective as other atypicals and typicals at treating schizophrenia; severe bipolar

Pharm Unit 3 Drugs (13 decks)

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