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Neuromodulators Flashcards

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1
Q

indication: anxiety, panic disorder

dosing (1/4, 1/2, 1, 2, mg) - 1 tab tid

A

alprazolam

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2
Q

Selectively binds to GABA-A-BZD receptors, thereby enhancing GABA effects

A

alprazolam (benzodiazepine anxiolytic)

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3
Q

gaba pathways are?

A

inhibitory

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4
Q

competitive drug

A

drug is competing for same binding site as the endogenous substrate (ex: gaba receptor: gaba)

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5
Q

is benzodiazepine competitive?

A

no, it binds to a different site than gaba

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6
Q

benzodiazepine + alcohol =

A

deadly! because they bind the same receptor

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7
Q
  • Common:diplopia,drowsiness, anterograde amnesia,confusion,dizziness,hypotension
  • Hypersensitivity:StevensJohnson Syndrome, angioedema
A

alprazolam

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8
Q
  • Common: diplopia,drowsiness, anterograde amnesia,confusion,dizziness,hypotension
  • Hypersensitivity: Stevens Johnson Syndrome, angioedema
A

alprazolam

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9
Q
  • Cyclosporine, Azoles, and Erythromycins: Reduce this drugs metabolism
  • Chlorpheniramine, Diphenhydramine, Opioids –> Additive
A

alprazolam

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10
Q

CONTRAINDICATIONS/CAUTIONS

• Unstable Myasthenia Gravis

A

alprazolam

*can cause double vision; mg has dysfunctional acetycholine pathway

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11
Q

zolpidem (ambien), eszopiclone (lunesta), zaleplon (sonata)

A

non-benzodiazepine

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12
Q

• INDICATION: Insomnia
• DOSING[5/10mg] • 1 tab qhs


A

zolpidem

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13
Q

• CLINICAL PHARMACOLOGY– Non WBZD Sedative Hypnotic
• Mechanism of Action
– Selective agonist ofG ABAAWBZD-1 receptor

A

zolpidem

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14
Q

ADVERSE EFFECTS
• Common:headache,sinusitis, pharyngitis
• CNS:amnesia, suicidal ideation, aggression,hallucinations

A

zolpidem

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15
Q

not as dangerous as other benzadiazepine drugs

A

zolpidem

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16
Q

DRUG INTERACTIONS
• Cyclosporine, AzoleAntifungals: Reduced#metabolism#of#Zolpidem#
• Classic#An:histaminics,#Opioids:# Addi:ve#

A

zolpidem

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17
Q

DRUG INTERACTIONS
• Cyclosporine, Azole, Antifungals: Reduced metabolism of drug
• Classic Antihistaminics,Opioids: Additive

A

zolpidem

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18
Q

which drug has the same moa as amphetamine?

A

pyramed (hydroxyamphetamine + tropicamide)

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19
Q

– Stimulates#CNS#through#a# sympathomimetic#mechanism#involving#
the#enhanced#release#and#reduced# reuptake#of#norepinephrine#and# dopamine#

A

amphetamine

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20
Q

what drug blocks the reuptake receptors for NE ?

A

cocaine

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21
Q

photosensitivity, elevated BP, infection, headache

adverse: dependency, abuse, psychosis, growth suppression, heart failure, stevens johnsons syndrome

A

amphetamine adverse effects

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22
Q

CAIs (renal excretion decreased in alkaline urine)
Sympathomimetics (hypertensive crisis, arrhythmia)
Ophthalmic Beta-Blockers & Alpha-2 Agonists (hypertensive crisis)
NSAIDs (caffeine-based additive effects)
Decongestants (additive)

A

drug interactions with amphetamine

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23
Q

pt with adhd and large cups presents at clinic. what do we do?

A

workup for glaucoma and call pcp –> unusually large cupping is a risk factor for it; the use of amphetamine could be contributing factor

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24
Q

pt with adhd and large cups presents at clinic. what do we do?

A

workup for glaucoma and call pcp –> unusually large cupping is a risk factor for it; the use of amphetamine could be contributing factor

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25
class of drugs that are often overprescribed
antidepressants
26
``` Escitalopram [Lexapro®] Sertraline [Zoloft®] Fluoxetine [Prozac®] Paroxetine [Paxil®] Fluvoxamine [Luvox®] Citalopram [Celexa®] ```
SSRI ANTIDEPRESSANTS
27
INDICATION Major Depressive Disorder, Generalized Anxiety Disorder DOSING [5/10/20mg] 10-20mg qd
Escitalopram indication
28
what drug is the “S” enantiomer of citalopram which is a racemic mixture. What does this suggest?
escitalopram; our body responds to S structure
29
``` ESCITALOPRAM CLINICAL PHARMACOLOGY Antidepressant: SSRI Mechanism of Action Selective serotonin reuptake inhibitor (SSRI) ```
escitalopram moa
30
ADVERSE EFFECTS Common: dizziness Distinguishing: suicidal risk, serotonin syndrome, neuroleptic malignant syndrome (NMS), seizures Ocular: dry eye, blur, diplopia, conjunctivitis, ptosis
adverse effects of escitalopram
31
ADVERSE EFFECTS Common: dizziness Distinguishing: suicidal risk, serotonin syndrome, neuroleptic malignant syndrome (NMS), seizures Ocular: dry eye, blur, diplopia, conjunctivitis, ptosis
adverse effects of escitalopram
32
what combo of drugs could result in heme?
escitalopram + nsaid + omega 3
33
what combo of drugs could result in heme?
escitalopram + nsaid + omega 3
34
INDICATION Depression, Anxiety, Neuropathic Pain (DM), Fibromyalgia DOSING [20/30/60mg] 60mg qd
duloxetine indications
35
CLINICAL PHARMACOLOGY Antidepressant, Analgesic: SNRI Mechanism of Action Selective Serotonin & Norepinephrine reuptake inhibitor (SNRI)
duloxetine moa
36
ADVERSE EFFECTS Common: blurred vision, headache, dizziness, sweating, ED, HTN, orthostatic hypotension, syncope, yawning, constipation Distinguishing: serotonin syndrome Hypersensitivity: Angioedema, Stevens-Johnson syndrome Ocular: Glaucoma
duloxetine adverse effects
37
DRUG INTERACTIONS Opioids (additive) NSAIDs & Omega-3/6 (hemorrhage) Beta-Blockers (reduced beta-blocker metabolism
duloxetine drug interactions
38
CAUTIONS Bleeding risk Angle closure glaucoma
duloxetine contraindiction
39
types of antidepressants that arent used as much
tricyclic antidepressant
40
most prescribed atypical antidepressant
trazadone
41
``` INDICATION Major Depressive Disorder*, Insomnia# DOSING [50-300mg] *50-100mg bid-tid #25-50mg qhs ```
trazadone indication
42
CLINICAL PHARMACOLOGY Antidepressant, Anti-Insomnia Mechanism of Action Selective Serotonin (5-HT) Reuptake Inhibitor (SSRI); adrenergic α1-blocker & 5-HT2A/C blocker
trazadone moa
43
TRAZODONE ADVERSE EFFECTS Common: headache, dizziness, blurred vision, ocular irritation Distinguishing: Suicidal ideation, 5-HT syndrome CVS: hemorrhage
TRAZODONE | ADVERSE EFFECTS
44
acts similar to tomaxafen used to treat breast cancer
trazadone
45
DRUG INTERACTIONS Cyclosporine, Macrolides, Azoles (QT prolongation & impaired hepatic metabolism) NSAIDs (hemorrhage)
trazadone drug interaction
46
_______ activity in the mesolimbic system is the pleasure center that is thought to drive psychotic behavior
Dopamine
47
1st generation antipsychotics initially were relatively selective dopamine receptor inhibitors Newer antipsychotics have a variety of selectivities accounting for a range of activities and side effects
1st generation antipsychotics initially were relatively selective ____________. Newer antipsychotics have a ___________ accounting for a range of activities and side effects
48
most prescribed antipsychotic
quetiapine
49
most prescribed antipsychotic
quetiapine
50
INDICATION Schizophrenia, Bipolar Disorder DOSING [25-400mg] 200-400 mg bid
quetiapine INDICATION
51
QUETIAPINE CLINICAL PHARMACOLOGY 2nd Gen Anti-Psychotic, Bipolar Disorder Mechanism of Action Antagonizes D2 receptors & 5-HT2 receptors Ancillary effects may arise from antagonism of H1 and α1
QUETIAPINE | Mechanism of Action
52
which antipsychotic drug produces cataracts?
quetiapine
53
``` QUETIAPINE ADVERSE EFFECTS Common: headache, anemia Ocular: cataracts Hypersensitivity: Stevens-Johnson syndrome ```
QUETIAPINE | ADVERSE EFFECTS
54
which antipsychotic drug can cause stevens johnson synderome?
quetiapine
55
QUETIAPINE DRUG INTERACTIONS Macrolides, Azoles, CsA (Prolonged QT segment) Classic (sedating) Anti-histaminics (additive CNS depression)
QUETIAPINE | DRUG INTERACTIONS
56
Patients with Alzheimer disease have a significant loss of cholinergic neurons in the temporal lobe and entorhinal cortex. Most of the drugs available to treat the disease are acetylcholinesterase (AChE) inhibitors Antagonists of the NMDA-glutamate receptor are often neuro-protective, preventing the loss of neurons following ischemic and other injuries.
Patients with _______ disease have a significant loss of cholinergic neurons in the temporal lobe and entorhinal cortex. Most of the drugs available to treat the disease are ______. _________ of the NMDA-glutamate receptor are often neuro-protective, preventing the loss of neurons following ischemic and other injuries.
57
used to treat glaucoma and alzheimers; only drug selective for nmda
memantine
58
``` DONEPEZIL INDICATION Alzheimer Dementia DOSING [5/10/23 mg] 1 tabs qhs ```
DONEPEZIL | INDICATION
59
``` DONEPEZIL CLINICAL PHARMACOLOGY Alzheimer Disease / Dementia Mechanism of Action Indirect (central) acting; reversibly binds to and inactivates acetylcholinesterase ```
DONEPEZIL CLINICAL PHARMACOLOGY Mechanism of Action
60
``` DONEPEZIL ADVERSE EFFECTS Common: headache, dizziness, arthritis SERIOUS ADVERSE EFFECTS CNS: Seizures, dream disturbances Circulatory: Hemolytic anemia CV: AV block, bradycardia, syncope DONEPEZIL ADVERSE EFFECTS Common: headache, dizziness, arthritis SERIOUS ADVERSE EFFECTS CNS: Seizures, dream disturbances Circulatory: Hemolytic anemia CV: AV block, bradycardia, syncope ```
donepezil adverse effects
61
``` DONEPEZIL ADVERSE EFFECTS Common: headache, dizziness, arthritis SERIOUS ADVERSE EFFECTS CNS: Seizures, dream disturbances Circulatory: Hemolytic anemia CV: AV block, bradycardia, syncope DONEPEZIL ADVERSE EFFECTS Common: headache, dizziness, arthritis SERIOUS ADVERSE EFFECTS CNS: Seizures, dream disturbances Circulatory: Hemolytic anemia CV: AV block, bradycardia, syncope ```
donepezil adverse effects

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