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1
Q

TCAs mainly uptake

A

NA

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2
Q

TCAs eg

A

Desipramine
Amitriptyline
Imipramine

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3
Q

TCAs SEs

A
  • m blockade: dry mouth, blurred vision, urinary retention, constipation
  • H1 blockade: mild sedation
  • a1 blockade: orthostatic hypotension
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4
Q

TCAs alarming effect

A

the combo of antimuscarinic + NA reuptake blockade can over excite heart -> arrhythmias, systoles

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5
Q

what are the firstline drugs for depression

A

SSRIs

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6
Q

what do SSRIs do

A

block uptake of 5HT only

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7
Q

SSRIs eg

A

Fluoxetine
Citalopram
Paroxetine

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8
Q

SSRI adverse efx

A

often acute anxiety due to acute elevation in 5HT before downreg happens

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9
Q

serotonin syndrome

A

occurs during excess increase in 5HT

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10
Q

MAOI moa

A

non selectively binds and destroys MAO-A

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11
Q

MAOI eg

A

Tranylcypromine

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12
Q

MAOI adverse efxMA

A
  • insomnia / drowsiness
  • postural hypotension
  • atropine like effects
  • loss libido
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13
Q

cheese reaction happens with?

A

MAOIs
bc they block MAO enzymes in the liver and gut
this reduces digestion of dietary MAs including tyramine
tyramine causes massive exocytosis of NA + 5HT from nerves which can case hypertensive crisis

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14
Q

RIMA moa

A

reversibly inhibs action of MAO enzymes in nerve terminals - more so MAO-A

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15
Q

RIMA eg

A

Moclobemide

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16
Q

RIMA adverse efx

A
  • nausea and vomiting
    NO cheese reaction, post hypo or atropine like effects
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17
Q

SARI moa

A

selective 5HT reuptake inhib with less potency
(5HT2 antag)

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18
Q

why SARI good?

A

prevents effects like anxiety in SSRI

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19
Q

SARI adverse efx

A
  • sleepiness
  • dizziness
  • dry mouth
  • liver damages (Nefazodone)
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20
Q

SARI eg

A

Nefzodone

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21
Q

bipolar disorder med

A

lithium

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22
Q

lithium moa

A

permeates through voltage gated sodium channels - not pumped out by sodium-potassium-ATPase pump so accumulates in tissues
less eff in rapid cyclic bipol disorders

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23
Q

lithium adverse efx

A

buildup - toxicity
tremor
hyperactivity
decreases kidney concentration ability

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24
Q

typical schizophrenia meds

A

Chlorpromazine
Haloperidol

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25
typical schiz med moa
blocks D2 receptor Chlorpromazine also blocks a1, H1, m, and 5HT
26
more likely to get parkinsonian symptoms with ___ compared to ___ ?
Haloperidol more likely for parkinsonian symptoms bc muscarinic antagonist opposes Parkinson's symps in Chlorpromazine
27
1st line for schiz?
Atypical meds - Risperidone Olanzapine Quetiapine Clozapine
28
typical schiz meds have effect on
postitive symptoms only
29
atypical schiz meds have effect on
positive, negative and sometimes cognitive effects
30
periph decarboxylase inhibitor eg
Carbidopa
31
Carbidopa SE
dyskinesia (too effective)
32
dopamine receptor agonists eg
Pramiprexole Bromocriptine
33
Dopamine receptor agonists bind
D2 receptor
34
dopamine receptor agonists SEs
- periph: nausea, hypotension - mania - gambling (Bromocriptine)
35
MAO-B inhib eg
Rasageline Selegiline
36
MAO-B inhib moa
bind to and inhibit MAO-B specifically prevents metabolism of DA unmetab DA put back into synaptic vesicles -> more DA released next time
37
MAO-B inhib SE
insomnia, headache
38
better mao?
MAO-B no cheese reaction B - brain only
39
COM-T inhib eg
Entacapone
40
COM-T SE
nausea, diarrhoea
41
muscarinic antags eg
Benztropine Amantadine
42
muscarinic antags moa
cross BBB to reduce cholinergic activity and reduces some symptoms of parkinsons
43
tonic clonic / grand mal seizure
muscle rigidity in tonic phase + spasicity in clonic phase
44
med for tonic clonic seizure
Valproate - increases GABA activity by inhibiting GABA-T
45
valproate teratogenic t/f?
46
med for absence / petit mal seizure
Ethosuximide - blocks T-type calcium channels associated with epilepsy or Valproate
47
partial seizure use ___ med
Carbamazepine - blocks sodium channel
48
status epilepticus use __ med
benzo's: - diazepam - midazolam - clonazepam or GABA rec agonists
49
Phenytoin and Iamotropine moa
block sodium channels but not as well as Carbamazopine
50
benzo's and barbituates moa
allosteric modulator of GABA(A) receptor that potentiates its action
51
benzo's for sed and hypnotics
Midalozam - works in 5 mins IV, lasts for 1-6 hours Temazepam - 6-12 hours Diazepam - >24 hours
52
barbituate eg
Thiopental ultrashort acting ~10 mins used for induction of anesthesia
53
GABA(A) inhib moa
inhib GABA(A) receptor causes chloride influx -> hyperpolarization -> decrease in AP firing
54
gen anaesthetics moa
opening TREIC-1 potassium channels -> influx of potassium -> hyperpolarisation -> decreased ability to fire APs
55
min alveolar anesthetic concentration (MAC)
conc of gas that immobolises / works for for 50% of pts
56
the lower the MAC
the higher the solubility of the gas which means there is more diffusion in each compartment space -> slower rate of diffusion = slow induction
57
common IV anesthetics
Propofol - GABA modulator Ketamine - children lower risk of resp depression
58
compounds for maintenance of gen anesthesia
Isoflurane Desflurone Seroflurane
59
green whistle
methoxyflurane
60
nitrous oxide is for ? precaution?
maintenance of gen anesthesia hypoxia

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