Mechanisms Flashcards

Question

Parkinson's drug Adverse effects

Answer 1

``` Levo carbi Nausea loss of appetite Hypotension Mental disturbance Discolored urine ``` ``` Selegeline rasagiline Nausea Insomnia Dyskinesia Hallucinations ``` Entacapone tolcapone Diarrhea (tolcapone severe) Hepatotoxic (tolca) Discolored urine ``` Dopamine mimics Nausea Hypo Daytime sleepiness Mental disturbance Bromocriptin (cardiac and pulmonary fibrosis) ``` Anticholinergic Dry mouth Constipation Blurred vision

Answer 2

``` Focal seizure (one hemisphere) May or may not be unconscious ``` Generalize Both hemisphere Always unconscious

Answer 3

Too much Glutamate can cause abnormal influx of Na ions (AMPA rec) & Ca ions (NMDA rec) . GABA a opens Cl channels and influx of Cl ions can neutralize it. But if Little or no GABA. Seizures.

Answer 4

``` Carbamazepine Oxcarbazepine Lamotrigine Phenytoin Topiramate Valproic Acid Zonisamide ```

Answer 5

High voltage activated Ca channel blockers Lamotrigine Topiramate T-type Ca ch blocker Valproic Acid Zonisamide

Answer 6

Gabapentin Pregabalin Act on HVA Ca ch subunit alpha2 delta1

Answer 7

Binds to SV2A protein in walls of glutamate containing vesicles. Glutamate release impaired Felbamate: blocks NMDA rec

Answer 8

Act on GABA rec Prolongs opening of Cl channels Inhibitory action

Answer 9

Tigabine (GAT1 inhibitor) Inhibits GABA transporter and blocks GABA reuptake Vigabatrin Inhibits GABA aminotransferase (GABA-T) which catabolizes GABA. Thus GABA conc is increased.

Answer 10

All Sedation Dizziness Carbamazepine oxcarbazepine Hyponatremia Vigabatrin lamotrigine Visual disturbances phenytoin Double vision Gingival hyperplasia Hirsutism Zonisamide topiramate Cognitive disturbance Wt loss (topiramate) Valproic Acid Wt gain pregabalin gabapentin peripheral edema Hepatotoxic Felbamate Rare aplastic anemia

Answer 11

Mesolimbic pathway (⬆️ Dopamine) (hallucinations) Mesocortical pathway (⬇️ Dopamine) (social withdrawal, no motivation) Nigrostriatal pathway . ⬆️ Dopamine hyperkinetic movement dyskinesia ⬇️ Dopamine dystonia Parkinson Tubero infundibular pathway. Dopamine here inhibits prolactin

Answer 12

D2 blockers in all 4 pathways So mesocortical dopamine ⬇️⬇️⬇️ social withdrawal, no energy, sad Nigrostriatal Dopamine ⬇️⬇️⬇️ tremors, muscles rigidity Tuberoinfundibular Dopamine ⬇️⬇️⬇️ gynecomastia, galactorrhea, sexual dysfunction

Answer 13

``` High potency Haloperidol Flupenazine Prochlorperazine Trifluoperazine ``` Low potency Chlorpromazine Bind to other receptors a B adrenergic and Histamine receptors causing more side effects

Answer 14

D2 blockers and 5HT2A serotonin receptors Reduced side effects ``` Aripiprazole Clozapine Lurasidine Olanzapine Quetiapine Risperidone ziprasidone ```

Answer 15

5HT2A blockers Clozapine, Olanzapine Hyperglycemia Hyperlipidemia H1 blockers Clozapine Quetiapine: Sleepiness Wt gain a1 blockers Clozapine Risperidone Orthostatic Hypotension Risperidone extrapyridimal side effects. Hyperprolactinemia Clozapine Agranulocytosis

Answer 16

Mechanisms: Act between gamma and alpha subunits of GABA a receptors and increase GABA binding to the receptors. Cl channels frequency increases and Cl influx happens ``` Adverse effects Dizziness Drowsiness ⬇️Motor coordination ⬇️ Alertness ```

Answer 17

Mechanisms Bind to GABA a receptors between a and b subunits. They keep the Cl channels open for long period of time. In high doses they become GABA mimics as well. ``` Side effects Dizziness Lightheaded Respiratory depression Narrow therapeutic index Overdose coma death ```

Answer 18

Selectively bind to a1 subunit in GABA A receptors a1 subunit GABA A receptors are involved in sleep While a2 & a3 subunit receptors are involved in anxiety control. Thus these hypnotics only induce sleep not anxiolytics ``` Side effects Memory loss Day time sedation Cognitive impairment ⬇️Motor function ``` Zolpidem Zalpelon Eszopiclone

Mechanisms Flashcards

(42 cards)