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Drugs and Their Actions > Exam 3 > Flashcards

Exam 3 Flashcards

1
Q

Delta-9-tetrahydrocannabinol

A

main psychoactive ingredient in Marijuana

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2
Q

THC

A

main psychoactive ingredient in Marijuana

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3
Q

Dronabinal

A

pure THC, FDA approved for medical use (anorexia in AIDS, Refractory nausea/vomiting in chemotherapy

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4
Q

Nabilone

A

synthetic analogue, FDA approved for medical use (anorexia in AIDS, refractory nausea/vomiting in chemotherapy

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5
Q

Regular Insulin

A

intermediate acting

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6
Q

lispro insulin

A

fast acting

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7
Q

aspart insulin

A

fast acting

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8
Q

glulisine insulin

A

fast acting

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9
Q

detemir insulin

A

long acting

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10
Q

glargine insulin

A

long acting

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11
Q

chlorpromazine (thorazine

A

FGA - binding affinity to D2

EPS, anticholinergic, orthostatic hypotension, sedation/drowsiness, prolactin increase, weight gain

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12
Q

Haloperidol (Haldol)

A

FGA - binding affinity to D2

EPS, anticholinergic, orthostatic hypotension, sedation/drowsiness, prolactin increase

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13
Q

Aripiprazole (ability)

A

inverse agonists of 5HT2A recepters

EPS and orthostatic hypotension

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14
Q

Clozapine (clozaril)

A

inverse agonists of 5HT2A receptors
anticholinergic, orthostatic hypotension, sedation/drowsiness, weight gain
agranulocytosis, seizures, and myocarditis

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15
Q

Olanzapine (zyprexa)

A

inverse agonists of 5HT2A receptors

EPS, anticholinergic, orthostatic hypotension, sedation/drowsiness, weight gain

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16
Q

Risperidone (risperdal)

A

inverse agonists of 5HT2A receptors

EPS, orthostatic hypotension, sedation/drowsiness, prolactin increase, weight gain

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17
Q

Ziprasidone (geodon)

A

inverse agonist of 5HT2A receptors

EPS, orthostatic hypotension, sedation/drowsiness, prolactin increase, weight gain

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18
Q

Caffeine

A

adenosine (neuromodulator) antagonist in the CNS

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19
Q

Nicotine

A

Neurotransmitte Agonist Acetylcholine Receptors in the CNS and some in the periphery

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20
Q

Bupropion (wellbutrin, zyban)

A

antidepressant that blocks the uptake of dopamine strongly; norepinephrine and serotonin weakly
antagonism of certain nicotinic receptors

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21
Q

Varenicline (chantix)

A

partial against at nicotine receptors that prevents access to receptor and prevents withdrawal symptoms

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22
Q

Donepezil (Aricept)

A

acetylcholinesterase inhibitor
all stages of AD
reversibel inhibitor of AChE
long half-life, fewer GI side effects

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23
Q

Rivastigmine (Exelon)

A

acetylcholinesterase inhibitor
(oral) mild to moderate AD and dementia in PD
more GI side effects than Donepezil (oral)
inhibition of AChE slowly reversible “PSEUDO IRREVERSIBLE”
patch available (all stages of AD, mild to moderate dementia in PD)

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24
Q

Galantamine (razadyne)

A

acetylcholinesterase inhibitor
reversible AChE inhibition
may also have actions at nicotinic receptors

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25
Q

Memantine (namenda)

A

glutamate NMDA-type receptor non -competative partial antagonist
only blocks the channel when open and is easily reversed
moderate to severe AD

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26
Q

Solanezumab

A

passive immunotherapy
antibody against AB
did not have efficacy in Alzheimers

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27
Q

Gingko Biloba

A

Supplement under F in FDA
did not reduce the overall rate of dementia or AD incidence in elderly individual with normal cognition or MCI
can have side effects and drug interactions

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28
Q

Diphenhydramine (Benadryl, certain types of unison, ZZZQuil)

A

1st generation H1 antihistamine

inverse agonistic actions

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29
Q

Doxylamine (certain types of Unison, NyQuil, Diclegis)

A

1st generation H1 antihistamine
inverse agonistic actions
this plus B6 for morning sickness

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30
Q

Loratadine (claritin)

A

2nd generation H1 antihistamine

inverse agonist

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31
Q

Cetirizine (zyrtec)

A

2nd generation H1 antihistamine

inverse agonist

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32
Q

ranitidine (Zantac)

A

H2 antihistamine
antagonist
suppress nocturnal stomach acid secretion
relatively safe

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33
Q

Marijuana

A

Presynaptic Inhibitory Neuromodulators
CB1 = brain, some peripheral organs = frontal cortex, hippocampus, cerebellum, basal ganglia
CB2 = peripheral immune cells
G protein-coupled receptors (Mu and Delta opioid receptors)

34
Q

Postive Symptoms (psychosis)

A

disorganized thought and behavior, delusion and hallucinations
easiest to treat

35
Q

Negative symptoms (psychosis)

A

affective flattening, alogia, anhedonia, avolition
decrease or loss in normal function
harder to treat

36
Q

Cognitive symptoms (psychosis)

A

impaired attention, working memory, and executive function
mental skills to get things done
hardest to treat

37
Q

Nigrostriatal Pathway

A 
Substantia nigra to the striatum
extrapyramidal system
coordination of movement 
functions normally in schizophrenia
D2 blocking = EPS
5HT2A receptor antagonism = blocks dopamine release
38
Q

Mesolimbic Pathway

A

behavior and psychosis
cell bodies in midbrain ventral tegmenjtum project tot he limbic system and neocortex
too high dopamine = positive symptoms
D2 blocking = treat positive symptoms
5HT2A receptor antagonism = indirectly LIMIT dopamine release

39
Q

Mesocortical Pathway

A

Behavior and psychosis
Cell bodies in midbrain ventral tegmenjtum project to the limbic system and neocortex
too low dopamine = negative and cognitive symptoms
D2 blocking = create negative and cognitive symptoms
5HT2A receptor antagonism = facilitate dopamine releases

40
Q

Tuberoinfundibular System

A

cell bodies in hypothalamus releases dopamine into the pituitary portal circulation to inhibit prolactin secretion form anterior pituitary
functions normally in schizophrenia
D2 blocking = increase prolactin
5HT2A receptor antagonism = limit increase in prolactin release

41
Q

Tardive Dyskinesia

A

most concerning movement disorder side effect
body attacks itself
hyperkinetic movements
difficult to treat- need to catch super early

42
Q

movement disorder side effects

A

acute dystonia, Parkinsonism, neuroleptic malignant syndrome, tar dive dyskinesia, and akathisia

43
Q

H1 antagonists (inverse agonists) 1st generation

A

Higher likelihood of CNS impacts
Higher likelihood of having M1 antagonistic actions
Many block soda channels
Clinical Impacts = relief of allergic disease symptoms, higher likelihood of causing sedation then 2nd generation , anti-emetic effects (motion sickness), and can be used as a local anesthetic

44
Q

H1 antagonists (inverse agonists) 2nd generation

A

Lower likelihood of CNS impacts
Lower likelihood having M1 antagonistic actions
Clinical impacts = relief of allergic disease symptoms and less likely to cause sedation than 1st generation

45
Q

H2 antagonists (inverse agonists)

A

primary clinical impact = reducing stomach acid secretion

46
Q

Smoked Marijuana

A 
fast absorption - high lipid solubility
1-2 min: physiological and psychological effects 
10-20 min: peak
2-4 hours: how long
33% more tar than in tobacco
47
Q

Vaporized Marijuana

A

no combustion or smoke
delivery and pharmacokinetics similar to smoking
less tar - “healthier”

48
Q

Oral Marijuana

A

slow absorption = high “overdose” potential
30min-2hr: onset
1-3 hours: peak
up to 12 hours: how long

49
Q

Marijuana Tolerance

A

seen only in daily use and noticeable after 1-2 weeks

50
Q

Marijuana Withdrawal Symptoms

A

non-physical=craving, anxiety, insomnia, irritability
physical=sweating, stomach pain, diarrhea
1-3 days: onset
2-6 days: peak
7-14 days: duration

51
Q

Marijuana Drug Testing

A

50 ng/ml with remain positive
up to 72 hours for 1 joint
up to 30 days for daily use

52
Q

Dopamine Hypothesis

A

increase in dopaminergic activity aggravates schizophrenia - revised to talk about mesolimbic and mesocortical pathways

53
Q

Serotonin Hypothesis

A

5Ht agonists contribute to schizophrenic symptoms
Antipsychotics bind better to 5HT than dopamine
Modulates dopamine signaling
5HT receptor antagonists do not effectively treat schizophrenia

54
Q

Glutamate Dysfunction Theory

A

PCP and ketamine induce schizophrenic-like symptoms

Antipsychotics don’t bind to glutamate receptors

55
Q

First Generation Antipsychotics

A

older
higher D2 affinity
“neuroleptics”
Treats postive symptoms

56
Q

Second Generation Antipsycotics

A

newer
inverse agonists of 5HT2A receptors
treat positive, maybe negative, and possibly cognitive

57
Q

What to do about antipsychotic side effects

A

manage patients with dosing, switching drugs, treating symptoms, and tolerance

58
Q

Drug Choice (antipsychotics)

A

use Atypical as first treatment because of their superior adverse effects profile- low risk of tar dive dyskinesia

59
Q

Caffeine pharmacokinetics

A

rapid absorption 15-45 min
distributed everywhere
metabolized in liver by CYP1A2 (cytochrome p450)
half-life varies
age, genetics, and other drugs influence half-life

60
Q

Caffeine Tolerance

A

chronic use can lead to habituation, tolerance and some withdrawal symptoms, some craving
not considered and addictive drug - no dopaminergic effect

61
Q

Nicotine Pharmacokinetics

A 
readily absorbed
reaches brain in 7 seconds
internal and external effects
metabolized in the liver by CYP2A6 enzyme 
Continine primary metabolite
10-20% urine unchanged
crosses placenta
62
Q

Nicotine Tolerance and Dependence

A

some is thought to occur
induces physiological and psychological dependence
multiple withdrawal symptoms opposite of the drug
many smokers want to quit 70% about 40% attempt

63
Q

Dementia

A

progressive deterioration of memory and cognitive function

reversible and irreversible

64
Q

Alzheimers symptoms

A

forgets whole experience,rarely remembers later, unable to use notes, can’t care for one’s self

65
Q

H1 antihistamines

A

evokes the production of IgE in the body

mast cell activation- can stimulate sensory nerves (hives)

66
Q

H2 antihistamines

A

increase heart rate and output
stimulation of gastric acid secretion by partial cells
role in vasodilation

67
Q

Insulin

A

produced by islet beta cells in the pancreas

maintains blood glucose in narrow range

68
Q

Hyperglycemia

A

Ketoacidosis (medical emergency), unconsciousness or confusion, dehydration, extreme hunger/thirst, cognitive impairment

69
Q

DM Type 1 (juvenile)

A

autoimmune disease-body destroys its own beta cells and can no longer produce insulin
Destruction of cells takes months

70
Q

Banting and Macleod

A

ligated pancreatic exocrine ducts of dogs= death of exocrine pancreas = isolated insulin = showed that insulin could keep diabetic dog alive

71
Q

Endonuclease

A

can cleave DNA in middle of polymer

72
Q

Exonuclease

A

cleaves nucleotides at the end of a polymer

73
Q

Terminal Transferase

A

adds nucleotides to the end of polymer

74
Q

DNA Polymerase

A

synthesizes complementary DNA using template strand

75
Q

DNA Ligase

A

covalently joins 2 pieces of DNA

76
Q

Plasmids

A

Small circular pieces of extra-chromosomal DNA that can replicate in bacteria

77
Q

Restriction Enzymes

A

Sequence-specific endonuclease, often leaves “cohesive ends” which makes assembly of rDNA from the cut DNA relatively easy

78
Q

rDNA insulin (humulin)

A

first rDNA based drug

79
Q

Antibodies as Drugs

A

part of the immune system that helps recognize pathogens

80
Q

Gene Therapy

A

using rDNA as medicine, requires a vector

most critical problem=potential activation of (or?) disruption of normal genes

Drugs and Their Actions (2 decks)

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