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Flashcards in Neuropharm IV Deck (24)
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What are anticonvulsants used for mood stabilization in mania?

carbamazepine, lmotrigine, vlproate (some gabapentin, though no data to suggest efficacy)


What is the MOA of Li?

bypasses the synapse and helps with both mania and depression. Unknown MOA, but it may inhibit inositol phosphatases and their signlaing pathways (PLC to PIP2 to DAG and IP2 to PKC/ increased Ca). may also influence gene expression and glycogen synthase kinase, reduce cAMP production and amine release, and disrupt excitability.


Pharmkinetics/dynamics of Li. Use. Cautions.

readily absorbed
renal excretion
avoid during pregancy because it causes developmental abnormalities- though, think carefully about this, because mania can be very dangerous and threaten life of mom AND fetus. narrow therapeutic window.


What are characteristics of Li toxicity?

ataxia, (diarrhea, nausea, vomiting), confusion, arrhythmias, hydration issues


What are some side effects of Li?

polydipsia, polyuria, thyroid enlargement, benign ECG/EEG changes,


What is the MOA of valproate?

unclear, though we know it inhibits metabolism
may be an Na channel blocker or incr. GABA responses.


What are toxicities and sides of valproate?

toxicity: hepatic, GI, CNS (tremor/fatigue)
sides: hair loss, weight gain (may be treatment limiting, PCOS, inhib of hepatic metabolism


What is one main caution with carbamazepine?

induces hepatic metabolism: other drugs, INCLUDING OCPs, become less effective.


What is toxicity and sides of carbamazepine?

toxicity: fatigue, nausea, diplopia, ataxia, hepatic
sides: hyponatremai, weight gain


What is lamotrigin used for? MOA?

for type II bipolar (depression w/ hypomania)
unclear, but again, may be Na channel b;ocker or decr. glutamate release.


Waht is the toxicity and sides of lamotrigine?

toxicity: headache, fatigue
sides: rash- 0.8% chance of Stevens-Johnsons


What is the interaction btw valproate and lamotrigne?

valproate reduces clearance of lamotrigine. this is maximal even at very low doses of valproate.


What are examples and effects of psychomotor stimulants?

;caffeine and other methyl xanthines
cause euphoria, energy, increased motor activity


What are some examples of hallucinogens?

LSD (lysergic acid diethylamide)
thetraydrocannabinol (THC)
phencyclidine (PCP)


What are methylxanthines? MOA?

coffe, tea, cocoa
uncertain MOA but probably incr. cyclic AMP, GM{, block of adensine receptors, release of Ca from intracellular stores


What do methylxanthines do?

alerting, but may cause anxiety, tremmor, increased HR, arrythmias, relaxed smooth muscles, increase acid secretion (careful with coffee + GERD), weak diuretic.


Clinical uses and toxicities of methylxanthines?

insomnia, anxiety tremor, seizures at very high levels. Also withdrawal symptoms.
used to be used to treat asthma because it would relax bronchial smooth muscle.


MOA for nicotine

agonist of nicotinic receptors that activates autonomic ganglia. may also act at muscarinic receptors. can lead to blockade at very high levels.


What are the effects of nicoteine

Although at low levels may promote alertness, learning, and memory, at higher levels it cal nead to respiratory distress and medullary hypotension. it also increases BP and HR. Body quickly develops tolerance.


What is the difference between crack and cocaine?

Crak is a free base that is volatile and can be smoked
cocaine is a salt and must be snorted or ingested


What does cocoain do?

stim of dopamine in limibic system leads to euphoria, greater alertness, increased motor. But can lead to a tremor or seqires at high levels. also leads to increased HP, BP, and pupillary dilation.


What is the half life of cocain? Whata re some adverse effects?

half life is 30-89 minutes- users must dose frequently. Adverse effects:
vasoconstriction ielding MI or stroke, hypertension that yeilds CNS hemorrhage, sezures, anxiety, psychosi/mania.


How might I treat cocoaine withdrawal?

antipsychotics, benzodiazepines,


What do amphetamines do?

action similar to cocaine but with greater CNS effects.