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M4: Pharmacology-Pharmacokinetics > CNS > Flashcards

CNS Flashcards

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1
Q

What are the inhibitory neurotransmitter of the brain

A
  1. GABA (brain)
  2. Glycine (spinal cord)
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2
Q

What are the excitatory neurotransmitter of the brain

A
  1. Glutamate
  2. 5-HT (serotonin)
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3
Q

Primary neurotransmitter of the brain

A

GABA

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4
Q

Primary neurotransmitter of spinal cord

A

Glycine

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5
Q

What are the Target Actions of CNS Drugs

A
  1. PISO (cations)
  2. MICO (cations)
  3. PhIClo [anions]
  4. SuliBio [anions]
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6
Q

Depolarization
- stimulatory effects (+)
- (kapag positive sa loob)

A

DeCaNa
(Depolarization Calcium Sodium)

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7
Q

Hyperpolarization
- inhibitory effects (-)
- (kapag negative sa loob)

A

HyKCl
(Hyperpolarization Potassium Chloride)

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8
Q

What Disease is stated below:

▪️↑ Dopamine
▪️↑ 5-HT (Serotonin)
▪️↓ Glutamate

A

Schizophrenia

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9
Q

What is the goal for drugs of Antipsychotics/ Neuroleptics / Major Tranquilizers

A

Goal: ↓ DA, ↓ 5-HT

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10
Q

What drug is under of this:

▪️1st Gen/Classical/Traditional Antipsychotics
▪️MOA: Block D2 receptors
▪️Additional effects: Anti-HAM (Histamine (H1)- sedation, Alpha-1-vasodilation, ↓BP, Muscarinic 1&3- urinary retention
▪️Use: For Positive Symptoms

A
  1. Phenothiazine (-azine)
  2. Butyrophenones (-peridol)
  3. Thioxenthenes (-thix)
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11
Q

What drug is it:

▪️1st Gen/Classical/Traditional Antipsychotics
▪️For Manic Phase, Huntington Disease, Tourette Syndrome (TS)

A

Haloperidol and/or Droperidol

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12
Q

1st Gen/Classical/Traditional Antipsychotics

▪️↑ Potency = ↑ D2 affinity & ↓ HAM
▪️Mnemonics: BP PTA

A

Butyrophenones = Piperazines > Piperidines > Thioxanthines > Aliphatic

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13
Q

What drug is under of this:

▪️2nd Gen/Atypical Antipsychotics
▪️MOA: Block 5-HT > D4 receptors
▪️Use: For Negative Symptoms
▪️Advantage: NO EPS (extrapyramidal symptoms)

A

-zapine, -xapine, -peridone

  1. Clozapine
  2. Olanzapine
  3. Risperidone
  4. Loxapine
  5. Aripiprazole
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14
Q

What drug is it:

▪️2nd Gen/Atypical Antipsychotics
▪️Only antipsychotic that ↓ suicide risk
▪️Never given as 1st line bcoz. of SAM (seizures, agranulocytosis, myocarditis)
▪️No EPS
▪️↑ risk of seizure

A

Clozapine

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15
Q

What drug is it:

▪️2nd Gen/Atypical Antipsychotics
▪️Partial D2 Agonist
▪️Least Seadating

A

Aripiprazole

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16
Q

What drug is it:

▪️2nd Gen/Atypical Antipsychotics
▪️S/E: Weight gain
▪️ NOF: Overweight/Obesity, DM

A

Olanzapine

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17
Q

What drug is it:

▪️2nd Gen/Atypical Antipsychotics
▪️For intractable hiccups

A

Risperidone

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18
Q

What drug is it:

▪️2nd Gen/Atypical Antipsychotics
▪️ Used to induce sedation

A

Quetiapine

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19
Q

What is the Adverse Effects/SE for 1st & 2nd Gen Antipsychotics due to DA receptor blockade

A
  1. EPS (Extrapyramidal Syndrome)
  2. Hyperprolactinemia-↑ PRL
  3. Neuroleptic malignant syndrome
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20
Q

What is the 1st line tx for EPS

Goal: ↓Ach -> centrally acting anticholinergics (BBT)

A
  1. Biperiden
  2. Benztropine
  3. Trihexyphenidyl
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21
Q

What is the management for neuroleptic malignant syndrome

A
  1. Dantrolene (DOC)
  2. Bromocriptine (D2 Agonist)
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22
Q

What is common adverse effect/SE in 2nd Gen Antipsychotic

A

Weight gain

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23
Q

Drugs in 2nd Gen Antipsychotics that does not have a S/E of weight gain

Mnemonics: AMA

A
  1. Aripiprazole
  2. Molindone
  3. Amisulpride
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24
Q

Mood Regulation Neurotransmitters

A
  1. 5-HT
  2. NE
  3. DA
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25
Biologic Theory for Mood Disorders
↓ Ne, 5-HT, DA
26
What is the Goal for Antidepressants
Goal: ↑ 5-HT, NE, DA
27
What drug is it: ▪️MOA: Block reuptake of NE > 5-HT ▪️Additional Effect: Anti-HAM ▪️Use: Mgt. of neuropathic pain, enuresis, anxiety attacks (panic attacks), OCD
-triptyline (Ami-, Nor-) - pramine (Imi-, Desi-) Doxepine
28
Antidepressant Management of neuropathic pain
Amitriptyline
29
Antidepressant Mgt. of enuresis
Imipramine (DOC)
30
Antidepressant Mgt. of anxiety attacks (panic attacks)
Imipramine
31
Antidepressant Mgt. of OCD
Clomipramine
32
Toxicities due to narrow TI in Antidepressant of Mood Disorder
Triads 3C's 1. Cardiotoxicity 2. Convulsions 3. Coma
33
What are the Tetracyclic Antidepressants Drugs Mnemonics: Ma Mia Amor
Maprotiline Mianserin Amoxapine
34
What are the Non-Selective MAOI that also use for Mood Disorder Use: Mgt. of atypical depression (psychotic features, phobias)
Phenelzine Isocarboxazid Tranylcypromine (PT)
35
Drug-Food Interactions with MAOI
MAOI + Tyramine rich foods = HTNsive crisis
36
What drug is under of this: ▪️Selective 5-HT Reuptake Inh. ▪️MOA: Blocks 5-HT reuptake ▪️1st line w/ MDD ▪️ All are Category C except Paroxetine
Flu-Flu (Fluoxetine & Fluvoxamine) Paro-Ser (Paroxetine & Sentraline) Citalopram & Escitalopram
37
What is safer to use than TCAs & MAOIs
SSRI
38
SSRI ▪️Mgt. of OCD (Flu Flu)
Fluoxetine (laging piliin pag mang huhula) Fluvoxamine
39
SSRI ▪️Mgt. of PDD (Premenstrual Dysphonic Disorder)
Fluoxetine Fluvoxamine
40
SSRI ▪️Mgt. of bulimia nervosa ▪️Mgt. of OCD ▪️Mgt. of PDD
Fluoxetine
41
Black Box Warning: Fluoxetine (Prozac) - ↑ risk of (?)
↑ risk of suicidality
42
What is the Mgt. for Serotonin Syndrome
Cyproheptadine (5-HT Antagonist)
43
What is SNRI
Serotonin Norepinephrine Reuptake Inhibitor
44
What drug is it: ▪️SNRI ▪️Use: Mgt. of depression in px. w/ back pain or muscle pain, chronic muscle pain
Duloxetine Venlafaxine
45
What drug is it: ▪️SNRI ▪️Hepatotoxic
Duloxetine
46
What drug is it: ▪️SNRI ▪️Cardiotoxic
Venlafaxine
47
▪️Drugs for Mood Disorder ▪️MOA: (-) presynaptic alpha-2 receptor ▪️Adv: Does not cause sexual dysfunction ▪️Ex. Mirtazapine (Remeron)
NASSA (Noradrenergic & Selective 5-HT Antagonist)
48
What drug is it: ▪️Drug for Mood Disorder ▪️under Norepinephrine Dopamine Reuptake Inh. ▪️Use: for smoking cessation ▪️Does not cause sexual dysfunction
Bupropion
49
What drug is it: Reversible Inh. of MAO-A
Moclobemide
50
Drugs for Bipolar Disorder (4)
1. Lithium Carbonate (Eskalith) 2. Valproic Acid 3. Carbamazepine 4. 2nd Gen Antipsychotics
51
What drug is it: ▪️MOA: (-) phosphoinositides recycling ▪️Use: 1 mgt of Mania & Hypomania
Lithium Carbonate (Eskalith)
52
What drug is it ▪️Drugs for Bipolar Disorder ▪️Better than Li for rapid recycles
Valproic Acid
53
What drug is it ▪️Drugs for Bipolar Disorder ▪️Prophylaxis or tx. of mania
Carbamazepine
54
Biological Theory for Anxiety
Biological Theory: - ↓GABA, ↑ EPI, ↑ Cortisol
55
Drugs for Anxiety/ Anxiolytics/ Minor Tranquilizer
1. Benzodiazepines (-zepam, -zolam) 2. Barbiturates (-barbital, -bital)
56
Short-Acting BZDS [MT-zolam] - use for initiation & maintenance of sleep
Midazolam Triazolam
57
Intermediate-Acting BZDS [LTO-zepam, A-zolam] - use for seizures and insomnia
Lorazepam Temazepam Oxazepam Alprazolam
58
Long-Acting BZDS
Diazepam -> N-desmethyldiazepam
59
What are the Ultra Short Acting Barbiturates (sulfur containing) "TTM"
1. Thiopental 2. Thiamylal 3. Methohexital
60
What class of Barbiturates is stated below: ▪️Very lipophilic ▪️Rapid onset of action, short duration ▪️USE: For induction of anesthesia
Ultra short acting
61
What are the Short Acting Barbiturates "5-6-7 barbital"
1. Pentobarbital 2. Hexobarbital 3. Secobarbital
62
What class of Barbiturates is stated below: ▪️USE: Sedatives
Short Acting Barbiturates
63
What are the Intermediate Acting Barbiturates " AmoButa"
1. Amobarbital 2. Butabarbital
64
What class of Barbiturates is stated below: ▪️USE: Hypnotic
Intermediate Acting Barbiturates
65
What are the Long Acting Barbiturates
1. Phentobarbital
66
What class of Barbiturates is stated below: ▪️USE: Anticonvulsant, insomnia, migraine relief
Long Acting Barbiturates
67
What do we called to- transient loss of memory after administration of high doses of BZDs
Anterograde amnesia
68
What drug is it: ▪️Basis for date-rape drug ▪️Acceptable use: During surgery/procedure
Flunitrazepam (Rohypnol) "roofies"
69
What drug is it: Management of spasticity states (Cerebral Palsy)
Diazepam
70
What drug is it: Mgt. of seizures CD-zepam & P-bital
1. Clonazepam 2. Diazepam 3. Pino-barbital
71
What drug is it: Mgt. of Neonatal Hyperbilirubinemia
Phenobarbital
72
What type of seizure is stated below: ▪️Involves 1 hemisphere ▪️Aka: Jacksonian Seizure ▪️Remains conscious/ No loss of consciousness
Simple Focal Seizure (Partial)
73
What type of seizure is stated below: ▪️Involves 1 hemisphere ▪️Aka: Psychomotor Seizure ▪️Loss consciousness ▪️(+) altered sensorium
Complex Focal Seizure (Partial)
74
DOC/ 1st line: Focal Partial Seizure
Phenytoin Carbamazepine
75
What type of seizure is stated below: ▪️Both hemisphere ▪️Impaired consciousness ▪️Tonic-Clonic Seizure (Grand Mal)
Grand Mal Seizure
76
What type of seizure is stated below: ▪️Both hemisphere ▪️Blank stares, lip smacking ▪️Common in children
Absent Seizure (Petit Mal)
77
DOC/ 1st Line: Generalized Seizure/Grand-Mal
Valproic Acid
78
DOC/ 1st Line: Absence Seizure (Petit Mal)
Ethosuximide
79
DOC/ 1st line: Atonic Seizure [loss of muscle tone]
Clonazepam
80
DOC/ 1st Line: Acute Seizure
Diazepam
81
What type of seizure is stated below: ▪️medical emergency ▪️ 5 minutes or more of continuous seizure ▪️ recurrent seizures without recovery
Status Epilepticus
82
New DOC for Status Epilepticus
Lorazepam
83
Old DOC for Status Epilepticus
Diazepam
84
Drugs: Anticonvulsants What drug is it: ▪️Na channel blocker (2)
1. Carbamazepine 2. Phenytoin
85
Drugs: Anticonvulsants What drug is it: ▪️Na, Ca channel blockade ▪️↑ GABA ▪️Broadest spectrum
Valproic Acid
86
Drugs: Anticonvulsants What drug is it: ▪️T-type ▪️Ca channel blockade
Ethosuximide
87
Drugs: Anticonvulsants What drug is it: ▪️GABA-mimetics
Phenobarbital Diazepam
88
Neurodegenerative Disorder
Parkinson's Disease
89
Manifestation of Parkinson's Disease "TRAPS"
Tremors Rigidity Akinesia/ Bradykinesia Postural instability Shuffling gait
90
Drugs for Anti-Parkinsonism What drug is it ▪️MOA: Precursor of DA ▪️It can pass through BBB
Levodopa
91
Drugs for Anti-Parkinsonism What drug is it: ▪️Antiviral ▪️Used primarily in the mgt. of Influenza A
Amantadine
92
DOC for Parkinson's Disease
Levodopa
93
What type of Anesthesia is stated below: A state characterized by unconsciousness and loss of reflexes-through IV or inhalational
General Anesthesia
94
What type of Anesthesia is stated below: Loss of sensation in a limited region of the body
Local Anesthesia
95
What Inhaled Anesthetics is stated below: ▪️aka: laughing gas ▪️non-volatile gas ▪️weakest anesthetic; potent analgesic
Nitrous oxide (N2O)
96
What Inhaled Anesthetics is stated below: ▪️ popular anesthetic for outpatient procedure
Desflurane
97
What Inhaled Anesthetics is stated below: ▪️For children-sweet & less pungent
Sevoflurane
98
What Inhaled Anesthetics is stated below: ▪️For asthmatic px.
Enflurane
99
What Inhaled Anesthetics is stated below: ▪️For children also but most hepatotoxic
Halothane
100
What Inhaled Anesthetics is stated below: ▪️Used: During labor ▪️Potent anesthetic; weak analgesic
Methoxyflurane
101
Intravenous Anesthetic What drug is it: ▪️milk emulsion (milk of anesthesia) ▪️ most commonly used for induction
Propofol
102
Intravenous Anesthetic What drug is it: ▪️MOA: (-) NMDA receptors ▪️Similar to Phencyclidine aka: Angel Dust ▪️Use: For dissociative anesthesia
Ketamine
103
Intravenous Anesthetic What opioid analgesics is for General Anesthesia
Morphine Fentanyl Sulfentanyl
104
What Local Anesthetics is stated below: -MOA: Na channel blocker 1. Ester Type: 1i 2. Amide Type: 2ii
1. Procaine, Cocaine 2. Lidocaine, Bupivacaine (most cardiotoxic), Prilocaine
105
BN of Lidocaine + Prilocaine
EMLA

M4: Pharmacology-Pharmacokinetics (50 decks)

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