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Pharmacology > Pharm II - Test 2 > Flashcards

Pharm II - Test 2 Flashcards

(137 cards)

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1
Q

Which antidepressant class has the most significant side effects profile?

A

Monoamine oxidase inhibitors (MAOI)

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2
Q

Which antidepressant class requires dietary recommendations (restriction of tyramine-containing foods)

A

Monoamine oxidase inhibitors (MAOI)

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3
Q

What is the risk of combining MAOIs with foods high in tyramine?

A

MAO usually breaks down tyramine -> Inc. absorption of intact tyramine -> toxic elevation of catecholamines -> severe HA, N, HTN (potentially hypertensive emergencies)

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4
Q

Class: Amitriptyline (Elavil)

A

Tricyclic antidepressant

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5
Q

Indication: Amitriptyline (Elavil)

A

Major depression, bipolar d/o, migraine/tension HA (prophylaxis), chronic pain

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6
Q

MOA: Amitriptyline (Elavil)

A

CNS modulation of both serotonin and norepinephrine

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7
Q

Side effects: Amitriptyline (Elavil)

A

Anticholinergic effects (dry mouth, constipation, urinary hesistancy, blurred vision)

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8
Q

Which antidepressant does not have the side effect of weight gain?

A

Wellbutrin

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9
Q

Class: Trazodone (Desyrel)

A

Tetracyclic antidepressant

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10
Q

Indication: Trazodone (Desyrel)

A

MDD, anxiety, panic disorder, insomnia

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11
Q

MOA: Trazodone (Desyrel)

A

Serotonin reuptake inhibitor and partial antagonist (SARI)

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12
Q

Class: Fluoxetine (Prozac)

A

Selective serotonin reuptake inhibitor (SSRI)

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13
Q

Indication: Fluoxetine (Prozac)

A

MDD, OCD, bulimia, panic disorder

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14
Q

MOA: Fluoxetine (Prozac)

A

Dec serotonin reuptake at presynaptic cleft -> inc serotonin for neurotransmission

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15
Q

Side effects: Fluoxetine (Prozac)

A

Serotonin syndrome (fever, agitation, D, hypertension), sexual dysfxn (dec libido, impotency, anorgasmia)

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16
Q

What drugs can interfere and reduce the efficiency of SSRIs?

A

Aspirin, Ibuprofen, Naproxen

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17
Q

Class: Duloxetine (Cymbalta)

A

Serotonin and norepinephrine reuptake inhibitor (SNRI)

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18
Q

Indication: Duloxetine (Cymbalta)

A

MDD, general anxiety, PAINFUL PERIPHERAL NEUROPATHY, FIBROMYALGIA

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19
Q

Class: Bupropion (Wellbutrin)

A

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

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20
Q

Indication: Bupropion (Wellbutrin)

A

MDD, bipolar do, ADD, smoking cessation (Zyban)

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21
Q

MOA: Bupropion (Wellbutrin)

A

Blockade of NE and DOPA reuptake

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22
Q

Addition of what nutrient may improve SSRI response?

A

Folic acid

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23
Q

What is the brand name of activated folic acid?

A

Deplin

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24
Q

Ultra-short acting barbiturate

A

Thiopental (Pentothal)

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25
Short-acting barbiturate
Pentobarbital (Nembutal)
26
Intermediate-acting barbiturate
Butalbital (Fiorinal)
27
Long-acting barbiturate
Phenobarbital (Luminal)
28
What is the most widely used anticonvulsant worldwide?
Phenobarbital (Luminal)
29
What are the most widely used group of anxiolytic drugs?
Benzodiazepines
30
Indication: Midazolam (Versed)
Sedation/anxiety prior to upper/lower GI endoscopy Acute mgmt of aggressive, violent, or delirious patients
31
Midazolam (Versed) is not indicated for ___.
long-term mgmt of seizure disorders
32
Class: Diazepam (Valium)
Benzodiazepine anticonvulsant
33
Indication: Diazepam (Valium)
Anxiolytic, sedative, muscle relaxant, STATUS EPILEPTICUS
34
MOA: Diazepam (Valium)
Binds to benzodiazepine receptors in CNS to enhance GABA activity -> inc Cl- influx -> inhibition of CNS synaptic transmission
35
MOA: Benzodiazepine-like sedatives
Increase GABA receptor affinity for GABA by binding to site different than benzo or barbiturate site
36
Class: Zolpidem (Ambien)
Short-acting, non-benzodiazepine hypnotic
37
Class: Eszopiclone (Lunesta)
Benzodiazepine-like hypnotic
38
Indications: Zolpidem (Ambien)
Trouble falling asleep, but not necessarily maintaining sleep
39
Indication: Eszopiclone (Lunesta)
Insomnia
40
MOA: Eszopiclone (Lunesta)
Potentiation of GABA effect on Cl- ion channels
41
Class: Ramelteon (Rozerem)
Melatonin receptor agonist
42
Class: Fumazenil (Romazicon)
Benzodiazepine receptor antagonist
43
Indication: Fumazenil (Romazicon)
Reverse effects of benzos
44
The chief antipsychotic effects of neuroleptics appear related to blockade of ___ in the ___
dopamine D2 receptors, mesolimbic pathway
45
Neuroleptic malignant syndrome
Rare side effect of neuroleptic use characterized by catatonia, fluctuating BP, dysarthria, fever
46
Tx: Neuroleptic malignant syndrome
Dopamine agonist (Bromocriptine)
47
Class: Chlorpromazine (Thorazine)
Typical neuroleptic
48
MOA: Chlorpromazine (Thorazine)
D2 dopaminergic receptor blocker Alpha-adrenergic blocker H1-histamine blocker
49
Side effect: Chlorpromazine (Thorazine)
INC RELEASE OF PRL Neuroleptic side effects (Sedation, dizziness, HA, D, Extrapyramidal effects)
50
Class: Prochlorperazine (Compazine)
Typical neuroleptic
51
Indication: Prochlorperazine (Compazine)
Better anti-emetic than other neuroleptics
52
MOA: Prochlorperazine (Compazine)
H1-histaine receptor antagonist Alpha-adrenergic receptor antagonist D2 dopaminergic receptor antagonist
53
Class: Haloperidol (Haldol)
Typical neuroleptic
54
Indication: Haloperidol (Haldol)
Psychosis, Tourette's syndrome, Huntington's disease, ACUTE AGITATED BEHAVIOR
55
MOA: Haloperidol (Haldol)
D2 dopamine receptor blocker
56
Side effects: Haloperidol (Haldol)
neuroleptic malignant syndrome
57
Class: Clozapine (Clozaril)
Atypical neuroleptic
58
Indication: Clozapine (Clozaril)
Schizophrenia, esp. when other anti-psychotics have failed (3rd line)
59
MOA: Clozapine (Clozaril)
Multiple receptor site blockage, greatest at D2 and 5-HT2 serotonin sites
60
Class: Respiradone (Risperdal)
Atypical neuroleptic
61
Side effects: Respiradone (Risperdal)
WEIGHT GAIN, HYPERGLYCEMIA, DIABETES, extrapyramidal effects, tardive dyskinesia, sedation, INC RISK FOR STROKE IN ELDERLY
62
Class: Olanzapine (Zyprexa)
Atypical neuroleptic
63
MOA: Olanzapine (Zyprexa)
Multiple site blocker (esp. D2 and 5-HT2)
64
Side effects: Olanzapine (Zyprexa)
WEIGHT GAIN, HYPERGLYCEMIA, DIABETES, INC RISK FOR STROKE IN ELDERLY
65
Side effects: Lithium carbonate (Eskalith)
NEPHROGENIC DIABETES INSIPIDUS IMPAIRED CONCENTRATION CAPACITY DT REDUCED RENAL RESPONSE TO ADH HYPOTHYROIDISM
66
Class: Phenobarbital (Phenobarb)
Barbiturate anticonvulsant
67
MOA: Phenobarbital (Phenobarb)
Enhanced GABA activity
68
Which drug mb the initial drug of choice in children with seizures?
Phenobarbital (Phenobarb)
69
Side effects: Phenobarbital (Phenobarb)
lower IQ scores in children
70
Class: Primidone (Mysoline)
Barbiturate anticonvulsant
71
MOA: Primidone (Mysoline)
Pro-drug of phenobarbital
72
Contraindications: Primidone (Mysoline)
Category D
73
Class: Clonazepam (Klonopin)
Benzodiazepine anticonvulsant (long-acting)
74
MOA: Clonazepam (Klonopin)
Binds to benzodiazepine receptors in CNS to enhance GABA activity -> inc Cl- influx -> inhibition of CNS synaptic transmission
75
Class: Phenytoin (Dilantin)
Anticonvulsant
76
MOA: Phenytoin (Dilantin)
Reduces Na and Ca and currents across neuronal membranes
77
Indication: Phenytoin (Dilantin)
Status epilepticus, focal (partial) seizures
78
Side effects: Phenytoin (Dilantin)
NYSTAGMUS, GINGIVAL HYPERPLASIA, ataxia, hepatotoxicity, possible BM suppression
79
Class: Carbamazepine (Tegretol)
Anticonvulsant
80
MOA: Carbamazepine (Tegretol)
Similar to phenytoin (reduction of Na, Ca currents)
81
Indication: Carbamazepine (Tegretol)
prophylaxis against all seizure types except absence
82
Contraindications: Carbamazepine (Tegretol)
Use with monoamine oxidase inhibitors (inc. risk for HTN crisis)
83
Class: Valproic acid (Depakote)
Anticonvulsant
84
Indication: Valproic acid (Depakote)
Generalized (tonic-clonic) seizures, bipolar do, chronic pain syndromes
85
Contraindications: Valproic acid (Depakote)
Pregnancy
86
Class: Ethosuximide (Zarontin)
Anticonvulsant
87
Indication: Ethosuximide (Zarontin)
Absence seizures, status epilepticus
88
MOA: Ethosuximide (Zarontin)
Possibly affects T-type Ca ion channels
89
Side effects: Ethosuximide (Zarontin)
HA, N, V, fatigue, ataxia, blurred vision, confusion, skin rashes, insomnia, GINGIVAL HYPERPLASIA, LUPUS-LIKE SYNDROME, hepatotoxicity
90
Class: Gabapentin (Neurontin)
Anticonvulsant, atypical analgesic
91
MOA: Gabapentin (Neurontin)
Appears to potentiate GABA and affects N-type Ca channels
92
Indication: Gabapentin (Neurontin)
Adjunctive tx for partial seizures, CHRONIC PAIN SYNDROMES (POST-HERPETIC NEURALGIA), migraines
93
Class: Lamotrigine (Lamactil)
Anticonvulsant
94
Indication: Lamotrigine (Lamactil)
Generalized (tonic-clonic) seizures
95
Class: Levetiracetam (Keppra)
Anticonvulsant
96
Indication: Levetiracetam (Keppra)
Generalized (tonic-clonic) seizures
97
The symptoms of Parkinson's disease result from __
loss of dopamine-secreting cells in the pars compacta region of substantia nigra
98
What enzyme converts Levodopa into dopamine?
Dopa-decarboxylase
99
Levodopa is usually combined with a ___
peripheral dopa-decarboxylase inhibitor
100
MOA: peripheral dopa-carboxylase inhibitor
prevents Levadopa from being prematurely converted into dopamine in the adrenal glands
101
How long does treatment with Levodopa typically work?
Average of approximately 5 years
102
Contraindications: Levodopa and combinations
Use with MAO inhibitor b/c of hypertensive crisis Use in patients with psychiatric conditions (bc worsening of psychotic sxs) Use with dopamine-blocking antipsychotic agent
103
Class: L-dopa with Carbidopa (Sinemet)
Dopamine precursor with peripheral dopamine decarboxylase inhibitor
104
Indication: L-dopa with Carbidopa (Sinemet)
Parkinson's disease
105
MOA: L-dopa with Carbidopa (Sinemet)
Increases dopamine levels in the brain, esp. in substantia nigra
106
Side effects: L-dopa with Carbidopa (Sinemet)
Hallucinations, nightmares, dyskinesias, serpentine-like movement (chorea)
107
Use of dopamine agonists (timing)
Often used early in tx so that L-dopa therapy can be delayed
108
Class: Bromocriptine (Parlodel)
Dopamine agonist
109
Indication: Bromocriptine (Parlodel)
Parkinson's dz, PRL-secreting adenomas, acromegaly
110
MOA: Bromocriptine (Parlodel)
Mimics dopamine in stimulation of dopamine receptor sites Crosses BBB
111
Class: Benzotropine (Cogentin)
Anticholinergic
112
Indication: Benzotropine (Cogentin)
Parkinson's (esp. when tremor or drooling are prominent) - minimal efficacy as monotherapy Diminish side effects of antipsychotic drugs
113
MOA: Benzotropine (Cogentin)
Anticholinergic antagonist at muscarinic receptor sites
114
MOA: Amantadine (Symmetrel)
Mb N-methyl-D-aspartate (NMDA) receptor antagonist -> dec. dopamine reuptake
115
Indications: Amantadine (Symmetrel)
Early PD (monotherapy) to delay L-dopa use Adjunct in later PD (esp. in pts w/ levodopa-related dyskinesias Influenza A
116
Class: Amantadine (Symmetrel)
Anti-Parkinson's, anti-viral agent
117
Duration: Amantadine (Symmetrel)
Many pts experience diminished/absent response within 6 months or less
118
Parkinson's tx options by efficacy (most-least)
L-dopa > Bromocriptine > Amantadine > anticholinergics
119
Class: Memantine (Namenda)
NMDA glutamate receptor antagonist
120
MOA: Memantine (Namenda)
NMDA receptor blockage -> inhibition of prolonged influx of Ca2+ ions, which play an imp. role in neuronal excitotoxicity 5HT3 receptor antagonist dopamine D2 receptor agonist Nicotinic ACh receptor antagonist
121
Indication: Memantine (Namenda)
Alzheimer's disease
122
What class of drugs are postulated to play a role in the neurologic deficits associated w/ Alzheimer's disease?
Anticholinergics
123
Class: Donepezil (Aricept)
Centrally-acting reversible acetylcholinesterase inhibitor
124
Indication: Donepezil (Aricept)
Alzheimer's disease, Autism
125
What drug may potentially increase/improve vocab and expressive language of children with autism?
Donepezil (Aricept)
126
Class: Rivastigmine (Exelon)
Centrally-acting reversible acetylcholinesterase inhibitor
127
Indication: Rivastigmine (Exelon)
Mild-mod dementia dt Alzheimer's Mild-mod dementia dt PD Younger onset dementia
128
Class: Galantamine (Razadyne)
Acetylcholinesterase inhibitor
129
Indication: Galantamine (Razadyne)
Mild-mod Alzheimer's dz, vascular dementia
130
OD Sxs: Acetylcholinesterase inhibitor
N, V, salivation, sweating, bradycardia, hypotension, convulsions, circulatory collapse
131
Tx: Acetylcholinesterase inhibitor OD
Atropine
132
Drugs for focal (partial) seizures (3)
Phenytoin (Dilantin) Phenobarbital (Phenobarb) Primidone (Mysoline)
133
Drugs for absence (petit mal) seizures (1)
Ethosuximide (Zarontin)
134
Drugs for generalized (tonic-clonic) seizures (4)
Lamotrigine (Lamictal) Levetiracetam (Keppra) Topiramate (Topamax) Valproate (Depakote)
135
What type of drugs are a first-line option for acute seizures, but not for long-term treatment?
Benzodiazepines (Diazepam, Clonazepam)
136
Drugs for status epilepticus (4)
Lorazepam (Ativan) Diazepam (Valium) Phenytoin (Dilantin) Ethosuximide (Zarontin)
137
Indications: Lithium carbonate (Eskalith)
Bipolar d/o and manic episodes, schizophrenia

Pharmacology (4 decks)

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