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Flashcards in Parkinsons and Psychiatric Drugs Deck (64)
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1

What is the drug of choice for parkinsonism?

LEVODOPA - CARBIDOPA
MOA: Levodopa is a dopamine precursor and carbidoba inhibits peripheral metabolism of DOPA decarboxylase

2

What is the phenomenon which manifests as alternating periods of improved mobility and akinesia, occurring over a few hours to days during treatment?

On-Off Phenomenon

3

What is the partial agonist at dopamine D3 receptors used in treatment of parkinsons disease during off periods?

Apomorphine

4

What is the phenomenon which manifests as deterioration of drug effect in between medication doses due to progressive destruction of nigostriatal neurons?

Wearing off phenomenon

5

What is the drug that blocks L-dopa metabolism by inhibiting COMT in periphery which is used as the drug of choice for wearing off phenomenon?

Entacapone

6

What is the difference between Entacapone and Tolcapone

Entacapone acts only on the periphery while Tolcapone acts both on the CNS and periphery

7

What are the side effects of Levodopa-carbidopa?

Emesis, Dyskinesia (Choreoathetosis), Behavioral changes, on off phenomenon, wearing off phenomenon, postural hypotension

8

What is the side effect of Apomorphine?

Severe nausea

9

What is the drug given as premedication to avoid severe nausea when giving Apomorphine?

Trimethobenzamide (an anti-emetic)

10

What is a partial agonist of D2 receptors used in the treatment of parkinsons? What are the side effects of giving this drug?

Bromocriptine
Side effects: Erythromelalgia (due to intermittent blockage of vessels) and pulmonary fibrosis

11

What drugs is classified as a MAO Type B inhibitors which are used in the treatment of parkinsons?

Selegiline and Rasagiline

12

What is an anti-parkinsonism drug which antagonizes the effects of adenosine at adenosine A2 receptors which is also used in the treatment of influenza? Side effect?

Amantadine
Side Effect: Livedo reticularis and peripheral edema

13

What drugs can cause livedo reticularis

Amantadine
Hydroxyurea
Minocycline
Gemcitabine
Quinidine

14

What is a partial agonist of Dopamine D3 receptors used in the treatment of Parkinsons and Restless leg syndrome? What are its side effects?

Pramipexole
SE: compulsive gambling, hypersexuality, overeating, uncontrollable tendency to fall asleep

15

What is a typical antipsychotic which blocks D2 receptors>> 5HT2 receptors which causes failure of ejaculation, postural hypertension, marked sedation, CORNEAL AND LENS DEPOSITS?

Chlorpromazine
Class: phenothiazine

16

What is the only antipsychotic which has fatal overdose and has the strongest autonomic effects?

Thioridazine
Class: Phenothiazine
Similar Drugs: Fluphenazine, Perphenazine, Prochlorperazine, Trifluoroperazine

17

What antipsychotic drug that can be used as an anti-emetic?

Prochlorperazine

18

Which among the typical antipscyhotics which has the weakest autonomic effects and is least sedating?

Haloperidol
Droperidol
Class: Butyrophenone

19

Which among the typical antipschotics which is used in the treatment of Huntington's disease and Tourette's syndrome?

Haloperidol
Droperidol

20

What is the difference between atypical and typical antipsychotics?

Typical antipsychotics blocks D2 receptors >> 5HT2 receptors
Atypical antipsychotics blocks 5HT2 receptors
>> D2 receptors

21

What are examples of atypical antipsychotic drugs?

Clozapine, olanzapine Quetiapine, Risperidone, Ziprasidone, Aripiprazole

22

What is the only anti-psychotic drug that reduces the risk of suicide?

Clozapine

23

What atypical antipsychotic drug that causes weight gain, hyperglycemia, hyperlipidemia, myocarditis, agranulocytosis, seizures, ileus and hypersalivation (sialorrhea)?

Clozapine

24

Drugs that causes agranulocytosis

Clozapine
Colchicine
Co-trimoxazole
Aminopyrine
Phenylbutazone
PTU
Indomethacin
Tocainide

25

What is the antipsychotic drug that causes hypnagogic hallucinations, sleep paralysis, cataracts and priapism?

Quetiapine

26

Aside from clozapine, give an antipsychotic drug that also causes weight gain, hypoglycemia and hyperlipidemia

Olanzapine

27

What is the only antipsychotic drug that is approved for schizophrenia in the youth?

Risperidone

28

What is the anti-psychotic drug that can cause postural hypertension and torsade de pointes?

Ziprasidone

29

What is the anti-psychotic drug that has no atropine-like effects, little or no tendency to cause hyperglycemia, hyperprolactinemia or weight gain and causes increased mortality in elderly patients with dementia-related psychosis

Ziprasidone

30

Which among the antipsychotic drugs is least sedating? It has also no atropine-like effects, little or no tendency to cause hyperglycemia, hyperprolactinemia and weight gain?

Aripiprazole

31

What is the drug of choice for bipolar disorder which acts by decreasing cAMP and inhibiting inositol-1-phosphatase?

Lithium

32

What congenital anomaly does Lithium cause?

Ebstein's anomaly

33

What are the other side effects of Lithium?

Thyroid enlargement, Nephrogenic diabetes insipidus, edema, acneiform skin eruptions, Leukocytosis and bradycardia.

34

What mood stabilizer is contraindicated in patients with sick sinus syndrome?

Lithium

35

What is the treatment for lithium toxicity?
Threshold for toxicity: 2 meqs

Hemodialysis

36

What are the symptoms of neuroleptic malignant syndrome?

Fever, encephalopathy, vitals unstable, elevated CPK, Rigidity

37

What is the treatment for neuroleptic malignant syndrome?

Dantrolene

38

What are examples of tricyclic antidepressants

Imipramine
Clomipramine
Despiramine
Amitryptyline
Nortryptilline

39

What are the signs of TCA overdose?

Coma, Convulsions, Cardiotoxicity

40

What is the treatment for TCA overdose?

Administration of bicarbonate (if QRS duration>100msec or a ventricular arrhythmia is present) - reverses cardiotoxicity

41

What is the drug of choice for depression?

Selective Serotonin Reuptake Inhibitors (SSRIs)
Fluoxetine
Escitalopram
Paroxetine
Sertraline
Citalopram
Fluvoxamine

42

What are the drugs that causes erectile dysfunction

SSRIs
Opiates
Risperidone
Ethanol
Propranolol
Estrogens
Spironolactone
Finasteride
Hydrochlorothiazide

43

Examples of Serotonin-Norepinephrine Reuptake Inhibitor

Venlafaxine
Duloxetine
Desvenlafaxine

44

What is the antidepressant drug used in the treatment of fibromyalgia

Venlafaxine

45

What is the side effect of venlafaxine? Duloxetine?

Venlafaxine: Hypertension
Duloxetine: hepatotoxicity

46

What are the SSRIs that are Cytochrome P450 inhibitors?

Fluoxetine
Fluvoxamine

47

What is the SNRI that is a cytochrome P450 inhibitor

Venlafaxine

48

Examples of antidepressants that block 5HT2 receptor?

Trazodone
Nefazodone

49

What are the side effects of serotonin antagonists?

Orthostatic hypotension
Priapism (Trazodone)
Hepatotoxicity (Nefazodone)

50

Drugs that cause priapism

Trazodone
Papaverine
Sildenafil
Quetiapine
Warfarin
Bupropion

51

What drug is a heterocyclic antidepressant which is a strong norepinephrine reuptake inhibitor and weak serotonin reuptake inhibitor and blocks dopamine D2 receptors?

Amoxapine

52

What are the side effects of Amoxapine?

Autonomic effects
Akathisia
Parkinsonism
Amenorrhea-galactorrhea syndrome
Seizures
Cardiotoxicity

53

Which antidepressant which lowers seizure threshold?

Amoxapine

54

Which antidepressant that increases amine release from nerve endings by antagonism of presynaptic alpha2 adrenoreceptors and blocks 5HT2 receptors

Mirtazapine

55

What are the side effects of Mirtazapine?

Weight gain and marked sedation

56

Which antidepressant that inhibits neuronal reuptake of dopamine and norepinephrine and increases dopamine and norepinephrine activity?

Bupropion

57

What is the side effect of Bupropion?

Lowers seizure threshold

58

What are the two antidepressants that lower the seizure threshold?

Bupropion and Amoxapine

59

What are examples of monoamine oxidase inhibitors that are used as antidepressants?

Phenelzine
Selegiline
Tranylcypromine

60

What happens when monoamine oxidase inhibitors are taken with cheese?

Hypertensive crisis
(due to tyramine, an indirect-acting sympathomimetic present in cheese)

61

What are the signs and symptoms of serotonin syndrome?

Fever
Agitation
Tremor
Clonus
Hyperreflexia
Diaphoresis

62

What is the treatment for Serotonin syndrome

1st line treatment: Sedation, paralysis, intubation and ventilation
Other treatment: Cooling, Cryproheptadine and Chlorpromazine

63

What are the symptoms of malignant hyperthermia

Fever
Acidosis
Rhabdomyolysis
Trismus
Clonus
Hypertension

64

What is the treatment for malignant hypertension?

Dantrolene