Parkinsonism, Antipsychotics, Antidepressants, Opioids, Drugs of Abuse Flashcards Preview

Pharmacology 2 > Parkinsonism, Antipsychotics, Antidepressants, Opioids, Drugs of Abuse > Flashcards

Flashcards in Parkinsonism, Antipsychotics, Antidepressants, Opioids, Drugs of Abuse Deck (74):
1

Drugs causing Parkinsonism

Typical antipsychotics
Reserpine
MPTP ( methylphenyltetrahydropyridine)

2

Primary drug for Parkinson's, MOA?

Levodopa-Carbidopa
Levodopa is a dopamine precursor. Carbidopa inhibits peripheral metabolism via dopa decarboxylase

3

On-off phenomena

Alternating periods of improved mobility and akinesia

4

Wearing-off phenomena

Deterioration of drug effects in between medication doses
Due to progressive destruction of nigrostriatal neurons that occur with disease progression

5

Partial agonist at dopamine D2 in brain

Bromocriptine
Pergolide

6

Partial agonist at dopamine D3 receptors in brain

Pramipexole
Ropinirole

7

Used in off periods, alcoholism, opiate addiction. MOA?

Apomorphine
Partial D3 agonist
Antagonist at 5-HT and alpha adrenoceptors
Premedicate with trimethobenzamide to prevent severe nausea

8

MAO type B inhibitor
Decrease degradation of dopamine

Selegiline
Rasagiline

9

COMT inhibitor
Prolongs response to levodopa

Entacapone
Tolcapone

10

Antiparkinsonism and antiviral drug.
MOA?

Amantadine
Adenosine antagonist

11

Anticholinergic antiparkinsonism drugs

Benztropine
Biperiden
Trihexyphenidyl
Orphenadrine
Blocks muscarinic receptors on cells in the striatum

12

MOA of typical antipsychotics. Examples?

Block of D2 receptors >> 5-HT2 receptors
Chlorpromazine
Thioridazine
Haloperidol

13

Primary signs of Parkinsonism

Tremors
Rigidity
Akinesia
Postural instability
TRAP!

14

Locations of D2 receptors

Putamen, nucleus accumbens, cerebral cortex, hypothalamus

15

Pleasure center

Nucleus accumbens

16

Toxic effect of antipsychotics in endocrine system

Hyperprolactinemia- amenorrhea, galactorrhea, infertility, impotence

17

Perioral tremor, manifests around 4 mos-4 years

Rabbit syndrome

18

Used in rabbit syndrome

Benztropine

19

Typical antipsychotic with increased risk of corneal and lens deposits

Chlorpromazine

20

Typical antipsychotics with increased risk for retinal deposits

Thioridazine

21

Only antipsychotic with fatal overdose

Thioridazine

22

Used in schizophrenia, huntington's disease, tourette's syndrome.
Least sedating among typical antipsychotics

Haloperidol

23

MOA of atypical antipsychotics

Block of 5-HT2 receptors >>D2 receptors

24

Only antipsychotic that reduces risk of suicide.
SE include agranulocytosis, hypersalivation, hyperglycemia, weight gain, ileus, seizures.

Clozapine

25

Used in anorexia nervosa, depression, schizophrenia

Olanzapine

26

Atypical antipsychotic whose SE include priapism, somnolence, fatigue, sleep paralysis, hypnagogic hallucinations.

Quetiapine

27

Only antipsychotic approved for schizophrenia in the young

Risperidone

28

Antipsychotic whose SE include QT prolongation, Torsades, postural hypotension.

Ziprasidone

29

Least sedating among atypical antipsychotics. Used in autism, cocaine dependence, depression, schizophrenia and other psychotic disorders.

Aripiprazole

30

Atypical antipsychotics

Clozapine
Olanzapine
Quetiapine
Risperidone
Ziprasidone
Aripiprazole

31

Features of neuroleptic malignant syndrome?
Drug that can cause it?

Haloperidol
FEVER
Fever
Encephalopathy
Vitals unstable
Elevated CPK
Rigidity

32

Treatment of bipolar disorder. Has slow onset of action.

Lithium

33

Teratogenic effect of lithium

Eibstein anomaly- low implanted tricuspid valve

34

Treatment for overdose of lithium

Hemodialysis

35

Threshold of toxicity of lithium

2 mEq/L

36

Amine hypothesis of mood

Brain amines, NE and serotonin, are neurotransmitters in pathways that function in the expression of mood

37

Classification of antidepressants

Tricyclic antidepressants
Selective serotonin reuptake inhibitors
Serotonin-norepinephrine reuptake inhibitors
Serotonin receptor antagonists
Heterocyclic antidepressants
Monoamine oxidase inhibitors

38

TCAs. MOA?

Imipramine, amitriptyline
Block Norepinephrine and serotonin receptors

39

TD and LD of TCAs

7 and 15 mg/kg

40

Features of TCA toxicity

Coma
Convulsions
Cardiotoxicity

41

Used in TCA overdose

Bicarbonate

42

SSRIs

Fluoxetine
Paroxetine
Citalopram
Escitalopram
Sertraline
Fluvoxamine

43

Halflife of SSRIs

1 week

44

Drugs that can cause erectile dysfunction

A SORE PEnis can't Fuck Hard!
SSRIs
Opiates
Risperidone
Ethanol
Propanolol
Estrogen
Spironolactone
Finasteride
Hydrochlorothiazide

45

Serotonin syndrome

FAT CHD
Fever
Agitation
Tremor
Clonus
Hypereflexia
Diaphoresis

46

SNRIs

Venlafaxine
Duloxetine
Desvenlafaxine

47

Serotonin antagonist, can cause priapism

Trazodone

48

Drugs that can cause priapism

Trazodone
Papaverine
Sildenafil
Quetiapine
Alprostadil
Warfarin
Bupropion
Tigas PeniS Co, AyaW Bumaba!

49

Can cause nightmares

mirtazapine (tetracyclic antidepressant)

50

Used in smoking cessation. MOA?

Bupropion
Inhibits neuronal reuptake of dopamine and NE.

51

Can cause hypertensive crisis when taken with tyramine.

Phenelzine. MAO type a and b inhibitor.

52

Tx for serotonin syndrome

Antiseizure drugs, muscle relaxants, serotonin blockers (cryptoheptadine)

53

Opioid with shortest halflife? Longest?

Remifentanil 3-4 mins
Buprenorphine 4-8 hours

54

Opioid receptor for inhibition of respiration

mu. Greater affinity for endorphins

55

Opioid receptor for development of tolerance

delta
Greater affinity for enkephalins

56

Opioid receptor for slowed gastrointestinal transit

Kappa
Greater affinity for dynorphins

57

Opioid side effects

ARMED Chinese
Analgesia
Respiratory depression
Miosis
Euphoria
Drowsiness
Constipation

58

Most potent opioid

Ohmefentanyl

59

Opioid that exerts hemodynamic effects on pulmonary circulation

Morphine

60

Full agonist opioids

Morphine
Fentanyl
Meperidine
Methadone

61

Strong agonist at mu and kappa receptors. Used in labor analgesia

Meperidine

62

Used in opioid dependence and opioid withdrawal

Methadone

63

Opioids: Partial agonists

Hydrocodone
Oxycodone
Dextromethorphan
Codeine

64

Opioid for cough suppression

Dexteomethorphan

65

Reduces craving in alcohol dependence

Nalbuphine
Naltrexone

66

Opioid antagonist

Naloxone
Naltrexone
Nalmefene

67

Opioid overdose triad

Pupillary constriction
Comatose state
Respiratory depression

68

Street name for methylene dioxymetamphetamine MDMA

Ecstasy

69

MDMA overdose presentation

Severe hypertension
Hyperthermia
Delirium
Psychomotor agitation
Profound hyponatremia

70

Cocaine overdose presentation

Mydriasis, vasoconstriction, thrombus formation, psychomotor agitation, severe hyperthermia, crack lung (hemorrhagic alveolitis)

71

Angel dust

Phencyclidine

72

Special K

Ketamine

73

Hallucinogenic agents

Lysergic acid diethylamide
Mescaline
Psilocybin

74

Partially purified cannabis sativa, more potent form

Hashish