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pharm Flashcards

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
Q

typical schiz med moa

A

blocks D2 receptor
Chlorpromazine also blocks a1, H1, m, and 5HT

26
Q

more likely to get parkinsonian symptoms with ___ compared to ___ ?

A

Haloperidol more likely for parkinsonian symptoms
bc muscarinic antagonist opposes Parkinson’s symps in Chlorpromazine

27
Q

1st line for schiz?

A

Atypical meds -
Risperidone
Olanzapine
Quetiapine
Clozapine

28
Q

typical schiz meds have effect on

A

postitive symptoms only

29
Q

atypical schiz meds have effect on

A

positive, negative and sometimes cognitive effects

30
Q

periph decarboxylase inhibitor eg

A

Carbidopa

31
Q

Carbidopa SE

A

dyskinesia (too effective)

32
Q

dopamine receptor agonists eg

A

Pramiprexole
Bromocriptine

33
Q

Dopamine receptor agonists bind

A

D2 receptor

34
Q

dopamine receptor agonists SEs

A
  • periph: nausea, hypotension
  • mania
  • gambling (Bromocriptine)
35
Q

MAO-B inhib eg

A

Rasageline
Selegiline

36
Q

MAO-B inhib moa

A

bind to and inhibit MAO-B
specifically prevents metabolism of DA
unmetab DA put back into synaptic vesicles -> more DA released next time

37
Q

MAO-B inhib SE

A

insomnia, headache

38
Q

better mao?

A

MAO-B
no cheese reaction
B - brain only

39
Q

COM-T inhib eg

A

Entacapone

40
Q

COM-T SE

A

nausea, diarrhoea

41
Q

muscarinic antags eg

A

Benztropine
Amantadine

42
Q

muscarinic antags moa

A

cross BBB to reduce cholinergic activity and reduces some symptoms of parkinsons

43
Q

tonic clonic / grand mal seizure

A

muscle rigidity in tonic phase + spasicity in clonic phase

44
Q

med for tonic clonic seizure

A

Valproate - increases GABA activity by inhibiting GABA-T

45
Q

valproate teratogenic t/f?

A
46
Q

med for absence / petit mal seizure

A

Ethosuximide - blocks T-type calcium channels associated with epilepsy
or Valproate

47
Q

partial seizure use ___ med

A

Carbamazepine - blocks sodium channel

48
Q

status epilepticus use __ med

A

benzo’s:
- diazepam
- midazolam
- clonazepam
or GABA rec agonists

49
Q

Phenytoin and Iamotropine moa

A

block sodium channels but not as well as Carbamazopine

50
Q

benzo’s and barbituates moa

A

allosteric modulator of GABA(A) receptor that potentiates its action

51
Q

benzo’s for sed and hypnotics

A

Midalozam - works in 5 mins IV, lasts for 1-6 hours
Temazepam - 6-12 hours
Diazepam - >24 hours

52
Q

barbituate eg

A

Thiopental
ultrashort acting ~10 mins
used for induction of anesthesia

53
Q

GABA(A) inhib moa

A

inhib GABA(A) receptor causes chloride influx -> hyperpolarization -> decrease in AP firing

54
Q

gen anaesthetics moa

A

opening TREIC-1 potassium channels -> influx of potassium -> hyperpolarisation -> decreased ability to fire APs

55
Q

min alveolar anesthetic concentration (MAC)

A

conc of gas that immobolises / works for for 50% of pts

56
Q

the lower the MAC

A

the higher the solubility of the gas which means there is more diffusion in each compartment space -> slower rate of diffusion = slow induction

57
Q

common IV anesthetics

A

Propofol - GABA modulator
Ketamine - children
lower risk of resp depression

58
Q

compounds for maintenance of gen anesthesia

A

Isoflurane
Desflurone
Seroflurane

59
Q

green whistle

A

methoxyflurane

60
Q

nitrous oxide is for ?
precaution?

A

maintenance of gen anesthesia
hypoxia

exams (5 decks)

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