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Flashcards in Pharm 2 - Exam 2 Deck (71):
1

Which two antidepressant drug classes should be considered for those with depression and insomnia?

TCA
Tetracyclic antidepressants

2

What is a serious side effect of MAOIs?

hypertensive emergencies

3

This class of antidepressants increases the likelihood of arrhythmias.

TCAs

(Also TeCAs, though far less common than with TCAs.)

4

Foods containing this amino acid should be avoided by those taking MAOIs.

Tyramine (require MAO to be broken down)

5

Name the Tetracyclic/SARI antidepressant.

Trazodone/Desyrel

6

What is the MOA of Trazodone/Desyrel?

Serotonin (partial) ANTAgonist and re-uptake inhibitor. (SARI)

7

In what class of drugs is Fluoxetine/Prozac?

SSRI

8

Name the SNRI drug.

Duloxetine/Cymbalta

9

Which drug is indicated for mild-moderate depression?

none

10

This anti-depression drug is also indicated for pain syndromes such as painful peripheral neuropathy and fibromyalgia.

Duloxetine/Cymbalta

11

Anti-depression drugs have the potential for increasing the risk of what in people with major depressive disorder?

suicide

12

In what class of anti-depression meds is Bupropion/Wellbutrin/Zyban?

Norepinephrine and dopamine reuptake inhibitors (NDRI) and nicotine receptor ANTAgonist

13

Why should barbiturates not be mixed with alcohol?

Can potentiate sedation and respiratory depression

14

T/F. Barbiturates and benzodiazepine receptor sites are the same location as GABA sites on the cell membrane of neurons in the CNS.

False. They appear to be adjacent to but NOT the same. The configuration of the GABA receptor site then changes (in response to the stimulation of the adjacent site) and the affinity for GABA of the GABA receptor site increases.

15

This long-acting barbiturate is the most widely used anticonvulsant worldwide.

Phenobarbital/Luminal

16

Name the short-acting barbiturate.

Pentobarbital/Nembutal

17

Name the intermediate-acting barbiturate.

Butalbital/Fiorinal

18

This short-acting benzodiazepine is used for sedation and anxiety prior to procedures. It also has amnestic properties.

Midazolam/Versed

19

What is the MOA for Diazepam/Valium?

Binds to benzodiazepine receptors in the CNS to enhance GABA activity

20

T/F. Zolpidem/Ambien and Eszopiclone/Lunesta use barbiturate and benzodiazepine receptors to enhance GABA activity.

False. Rather, benzodiazepine-like hypnotics bind to neither barbiturate and benzodiazepine receptors.

21

In what class of drugs is Ramelteon/Rozerem and how does it work?

Melatonin agonist
Mimics endogenous melatonin by binding to MT1 and MT2 receptor sites

22

Which drug can reverse the effects of benzodiazepine overdose?

Flumazenil/Romazicon

23

Tardive dyskinesia is a potential side effect for what class of drugs?

Neuroleptic antipsychotics

24

What symptoms are seen with neuroleptic malignant syndrome?

Catatonia, fluctuating blood pressure, dysarthria and fever

25

What is the treatment for neuroleptic malignant syndrome?

dopamine agonist such as Bromocriptine

26

In addition to anti-psycotic, what is another action of neuroleptic drugs?

anti-emetic, anti-nasuea

27

What are the major side effects of Chlorpromazine/Thorazine?

Parkinsonian symptoms
elevated prolactin

28

What is the class and MOA of both Chorpromazine/Thorazine and Prochlorperazine/Compazine?

typical neuroleptic
D2 receptor ANTAgonist, H1-histmaine receptor ANTagonist and alpha adrenergic receptor ANTagonist

29

What are the side effects of Prochlorperazine/Compazine?

anti-cholinergic: drowsiness, dry mouth, constipation, urinary hesitancy

30

What is the class and MOA of Haloperidol/Haldol?

Typical Neuroleptic
D2 dopaminergic receptor blocker

31

What is the class and MOA of both Olanzapine/Zyprexa and Clozapine/Clozaril?

Atypical Neuroleptic
Multiple receptor site blockade (D2 and 5HT2)

32

What is the class and MOA of Respiradone/Risperdal?

Atypical Neuroleptic
Unknown MOA

33

This drug is known to cause significant weight gain (ex. 50lbs in a month) hyperglycemia, diabetes, and stroke.

Respiradone/Risperdal

34

This drug used to treat bipolar and manic episodes has a very narrow therapeutic index.

Lithium carbonate/Eskalith

35

What are the potential side effects of Lithium carbonate?

Reduced response to ADH >>> DI
Hypothyroidism (irreversible)

36

Primidone/Mysoline is a pro-drug of what other drug?

Phenobarbital

37

Which type of seizure is not an indication of Phenytoin/Dilantin?

absence seizures

38

What are the main side effects to remember for Phenytoin/Dilantin?

Nystagmus
Gingival Hyperplasia

39

These two drugs are used to treat seizures and neuropathic pain.

Carbamazepine/Tegretol
Gabapentin/Neurontin

40

Name the drugs in the barbiturate anticonvulsant class.

Phenobarbital
Primidone

41

Which three drugs may cause ginigival hyperplasia?

Phenytoin/Dilantin
Valproic acid/Depakote
Ethosuximide/Zerontin

42

Name the benzodiazepine anticonvulsants.

Diazapam/Valium
Clonazepam/Klonopin
Lorazepam/Ativan

43

Which two anticonvulsants reduce the Na and Ca channel currents across the neuron (MOA)?

Carbamazapine/Tegretol
Phenytoin/Dilantin

44

What are the main side effects of Ethosuximide/Zerontin ?

gingival hyperplasia
lupus-like syndrome

45

What is the MOA of Gabapentin/Neurontin?

potentiates GABA and affects N-type Calcium Channels

46

Levadopa is a dopamine precursor that is transformed into dopamine by what enzyme?

dopadecarboxylase

47

What are the chief side effects of L-dopa?

nausea, vomiting, anorexia

48

What two receptor types are stimulated by Levodopa?

Dopamine receptors in the GI
chemotrigger receptor zone (CTZ) in the brain

49

What kind of drug is combine with Levodopa to prevent it from being prematurely converted into dopamine in the adrenal glands or other peripheral tissues?

peripheral dopa-decarboxylase inhibitor

50

Name the dopamine precursor with a peripheral dopamine decarboxylase inhibitor.

L-dopa with Carbidopa/Sinemet

51

Levadopa should never be combined with _____________ because the combination could lead to a hypertensive crisis.

MAO inhibitor

52

Levodopa should not be given in conjunction with what type of antipsychotic agent?

dopamine blocking aka Atypical and Typical Neuroleptic

53

t/f. Levodopa may cause a worsening of psychotic symptoms in patients with psychiatric conditions.

true

54

Is it dopamine or L-dopa that crosses the BBB?

L-dopa

55

MOA of L-dopa

increases dopamine levels in the brain, especially the substantia nigra

56

What type of drug is often used early in the treatment of Parkinson's disease?

Dopamine agonists

57

Name the dopamine agonist.

Bromocriptine/Parlodel

58

What are the indications for Bromocriptine/Parlodel?

Parkinson's disease
prolactin secreting adenomas
acromegaly

59

MOA of Bromocriptine/Parlodel. Does it cross the BBB?

Mimics dopamine in stimulation of dopamine receptor sites.
Yes, it crosses the BBB

60

What symptoms of Parkinson's disease are Anticholinergics useful in treating?

tremor
drooling
cognitive symptoms

Not very useful for bradykinesia and rigidity

61

Name the anticholinergic drug

Benzotropine/Cogentin

62

This anticholinergic drug may be used to diminish the side effects of antipsychotic drugs.

Benztropine/Cogentin

63

Benztropine/Congentin is an anticholinergic ____________ (agonist/antagonist)

antagonist

64

What is the MOA of Amandatine/Symmetrel?

unknown
maybe related to antagonism of NMDA receptors

65

This drug is anti-Parkinson's and anti-viral

Amandatine/Symmetrel

66

How long are patients typically on Amandatine before they start experiencing diminished response to the drug?

6 months or less

67

List the Parkinson's drugs in order of most to least effective.

L-dopa > Bromocriptine > Amantadine > anticholinergic

68

What drugs should be used for focal/partial seizures?

Phenytoin/ Dilantin
Phenobarbital/ Phenobarb
Primidone/ Mysoline

69

What drug should be used for absence seizures?

Ethosuxemide

70

These drugs are indicated for tonic-clonic seizures.

Lamotrigine / Lamictal
Levetiracetam/ Keppra
Topiramate/ Topamax
Valproate/ Depakote

71

These drugs should be used for status epilepticus.

via IV route:

Lorazepam/ Ativan
Diazepam/Valium
Phenytoin/ Dilantin
Ethosuximide/ Zarontin