Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Pharm list for Neuro Exam 4 > Pharm list for Neuro Exam 4 > Flashcards

Pharm list for Neuro Exam 4 Flashcards

(54 cards)

Start Studying
1
Q

Chlorpromazine

A

“Typical” First Generation Anti-Psychotic

Schizophrenia

Blockade of D2 receptors explains most significant pharmacological effects of antipsychotics, though these drugs also blocks other Dopamine 5HT, alpha-1, muscarinic, and histamine receptors

D2>5HT = good against POSITIVE symptoms

ADVERSE: ANS symptoms (Dry mouth, tachycardia, constipation, orthostatic hypotension, etc) and Sedation (Musc and Hist block)
High lipid solubility; passes into CNS and will cross placenta and exert effects on fetus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Haloperidol

A

“Typical” First Generation Anti-Psychotic

Schizophrenia
Treat stimulant-induced psychosis

Blockade of D2 receptors explains most significant pharmacological effects of antipsychotics, though these drugs also blocks other Dopamine 5HT, alpha-1, muscarinic, and histamine receptors

D2>5HT = good against POSITIVE symptoms

ADVERSE: Effects associated with D2 block, including acute dystonia, akathisia, Pseudoparkinsonism, and tardive dyskinesia
High lipid solubility; passes into CNS and will cross placenta and exert effects on fetus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Clozapine

A

“Atypical” Second Generation Anti-Psychotic

Schizophrenia

5HT2A> D2= good against
negative symptoms

Causes less psuedoparkinsonism

ADVERSE: Agranulocytosis, Weight gain, Altered thermoregulation, Phtosensitivity, Lowered seizure threshold Neuroleptic malignant syndrome
High lipid solubility; passes into CNS and will cross placenta and exert effects on fetus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Quetiapine

A

“Atypical” Second Generation Anti-Psychotic

Schizophrenia
Bipolar Depression

5HT2A> D2= good against
negative symptoms

ADVERSE: Weight gain, Altered thermoregulation, Phtosensitivity, Lowered seizure threshold Neuroleptic malignant syndrome
High lipid solubility; passes into CNS and will cross placenta and exert effects on fetus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Fluoxetine

A

Selective Serotonin Reuptake Inhibitors (SSRIs)

Blocks SERT, preventing reuptake of 5HT
Safe, multiple indications: GAD, Social anxiety, Panic, OCD, PTSD, PDD

ADVERSE:

  • Acute: diarrhea, nausea, jitters/anxiety, dry mouth, P450 inhibition
  • Delayed: sexual side effects, weight gain, cognitive blunting
  • Death with overdose is rare; withdrawal=flu-like symptoms
  • SSRIs+MAOIs = serotonin syndrome (hyperthermia, rigidity, confusion, HTN)

*Note: Olanzapine+fluoxetine used for Bipolar depression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Paroxetine

A

Selective Serotonin Reuptake Inhibitors (SSRIs)

Blocks SERT, preventing reuptake of 5HT
Safe, multiple indications: GAD, Social anxiety, Panic, OCD, PTSD, PDD

ADVERSE:

  • Acute: diarrhea, nausea, jitters/anxiety, dry mouth, P450 inhibition
  • Delayed: sexual side effects, weight gain, cognitive blunting
  • Death with overdose is rare; withdrawal=flu-like symptoms
  • SSRIs+MAOIs = serotonin syndrome (hyperthermia, rigidity, confusion, HTN)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Esciralopram

A

SSRI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Bupropion

A

Aka Wellbutrin

Nicotinic receptor antagonist/DA reuptake inhibitor

Treatment for:

  • Nicotine addiction
  • Stimulant (cocaine, meth, nicotine, MDMA) withdrawal
  • Depression
  • ADHD
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Venlafaxine

A

Serotonin-Norepinephrine Reuptake Inhibitors (SNRI)

Block NET and SERT, preventing reuptake of Norepi and 5HT

Better tolerated than TCADs, multiple indications

ADVERSE: Sexual side effects, seating, increased diastolic blood pressure, withdrawal syndrome (flu-like, “electric shocks”) from missed doses, More rapid appearance of withdrawal than SSRIs
Specific to Venlafaxine: HTN, anxiety

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Trazadone

A 
Mixed Antidepressant 
Insomnia treatment (with non-GABA action)

Complex 5HT mech

Can cause drowsiness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Amitriptyline

A

Tricyclic Antidepressants

Block NET and SERT, preventing reuptake of Norepi and 5HT

Time tested, very effective esp. in severe depression, can monitor blood levels

Now SECOND line for depression

Can be used in insomnia

ADVERSE: Hypotension, weight gain, sexual side effects, anticholinergic effects (constipation, dry mouth, etc), sedation, dangerous in overdose (arrhymias, seizures)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Phenelzine

A

Monamine Oxidase Inhibitors

Inhibit MAO, which degrades dopamine
Effective in non-responsive patients, especially atypical depression

ADVERSE: Postural hypotension, weight gain, sexual side effects, anticholinergic effects
Hypertensive crisis—Tyramine reaction (eating foods rich in tyramine such as
sausage, aged cheese, wine can provoke HTN attack)
Seizures, shock, hyperthermia in overdose

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Lithium carbonate

A

Best studied, best proven drug for MANIA
Anti-mania, some antidepressant and anti-suicidal. BEST preventative agent for mania

Can be used in bipolar depression, but is least affective out of other agents

Thought to interfere with recycling of phosphoinositides= decrease action of GPCRs; may be involved in genes for growth factors/neuronal plasticity

ADVERSE: Tremor, nausea, diarrhea, taste, thirst, cognitive dulling, narrow therapeutic window, renal effects, diabetes insipidus, hypothyroidism. Diuretics can decrease renal clearance=higher plasma levels of Li
NSAIDs can also increase plasma Li

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Alpraxolam

A

Benzodiazepine

CYP450 phase I and II&raquo_space; renal excretion

Uses: Acute anxiety

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Flurazepam

A

Benzodiazepine

Insomnia treatment, second line after “Z” drugs.

Anti-anxiety

Bind alpha 1 AND alpha 2/5 GABA receptors&raquo_space; sleep AND anxiolysis
Facilitate process of GABA opening, but does NOT initiate chloride current (unlike barbs)

(long): half-life=75-90 hrs with active metabolite

ADVERSE: can accumulate due to impaired hepatic clearance, leading to daytime sedation/overdose. BLACK BOX: strange sleep behavior / severe allergic rxns Combined CNS depression (i.e. with EtOH); sedation; tolerance Dependence (Schedule IV)
Rebound insomnia with abrupt discontinuation

Treat toxicity with flumazenil (bdz antagonist)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Diazepam

A

Benzodiazepine

Enhance GABA activity

Lipid soluble, can pass into CNS

Metabolized via CYP450, then renal excretion

Treats:

  • Seizures; status epilepticus (can develop tolerance)
  • Seizures from stimulant overdose
  • Anxiety (rapid, can be used prn)

IV anesthesia adjunct for anxiety

Toxicity is common; death from toxicity is NOT
ADDITIVE effects with other CNS depressants

Dependence (Schedule IV)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Oxazepam

A

Benzodiazepine

Enhance GABA activity

Lipid soluble, can pass into CNS

NOT P450 metabolized—good for elderly and in liver impairments

Uses:

  • Anticonvulsant
  • Anxiolytic
  • Muscle relaxant

Toxicity is common; death from toxicity is NOT
ADDITIVE effects with other CNS depressants

Dependence (Schedule IV)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Triazolam

A

Benzodiazepine

Rapid absorption, can be used prn

Uses:

  • Anxiolytic
  • Muslce relaxant

Toxicity is common, death from toxicity is NOT. Can have additive effects with other CNS depressants

Dependence (Schedule IV)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Midazolam

A

Benzodiazepine

Enhance GABA activity

Lipid soluble, can pass into CNS

CYP450 metabolism then renal excretion

Uses:

  • Anticonvulsant
  • Anxiolytic
  • Muscle relaxant

Toxicity is common; death from toxicity is NOT
ADDITIVE effects with other CNS depressants

Dependence (Schedule IV)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Lorazepam

A

Benzodiazepine

Enhance GABA activity

Lipid soluble, can pass into CNS

NOT P450 metabolized—good for elderly and in liver impairments

Uses:

  • Anticonvulsant
  • Anxiolytic
  • Muscle relaxant

Toxicity is common; death from toxicity is NOT
ADDITIVE effects with other CNS depressants

Dependence (Schedule IV)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Temazepam

A

Benzodiazepine

Treat insomnia

Bind alpha 1 AND alpha 2/5 GABA receptorssleep AND anxiolysis

Facilitate process of GABA opening, but does NOT initiate chloride current (unlike barbs)

Intermediate half-life=9-13 hrs

BLACK BOX: strange sleep behavior / severe allergic rxns Combined CNS depression (i.e. with EtOH); sedation; tolerance Dependence (Schedule IV)
Rebound insomnia with abrupt discontinuation

Treat toxicity with flumazenil (bdz antagonist)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Flumazenil

Study These Flashcards
A

Antagonist at the benzodiazepine binding site, reverses the CNS effects of benzodiazepines

23
Q

Zolpidem (Ambien)

Study These Flashcards
A

“Z drug” of Insomnia treatment; first line treatment!

Bind gamma subunit to facilitate process of GABA opening, but does NOT initiate chloride current (unlike barbs)

Bind alpha 1 GABA receptors&raquo_space; sleep without anxiolysis

Short half life; good for “I can’t fall asleep!”

BLACK BOX warning for all BDZ-site binding GABA agonists&raquo_space; strange sleep behavior and severe allergic reactions
Schedule IV
Many have some drowsiness, dizziness, headache

24
Q

Eszopiclone (Lunesta)

Study These Flashcards
A

“Z drug” of Insomnia treatment; first line treatment!

Bind gamma subunit to facilitate process of GABA opening, but does NOT initiate chloride current (unlike barbs)

Bind alpha 1 GABA receptors&raquo_space; sleep without anxiolysis

Longer half life, more for long-term use (little to no tolerance)

BLACK BOX warning for all BDZ-site binding GABA agonists&raquo_space; strange sleep behavior and severe allergic reactions
Schedule IV
Many have some drowsiness, dizziness, headache

25
Zaleplon (Sonata)
"Z drug" of Insomnia treatment; first line treatment! Bind gamma subunit to facilitate process of GABA opening, but does NOT initiate chloride current (unlike barbs) Bind alpha 1 GABA receptors >> sleep without anxiolysis Short half life for duration of 6-8 hours; good for "I can't stay asleep!" BLACK BOX warning for all BDZ-site binding GABA agonists >> strange sleep behavior and severe allergic reactions Schedule IV Many have some drowsiness, dizziness, headache
26
Phenobarbital
Barbiturate Enhance GABA, decrease GLU Classic CYP450 inducer Used mostly in neonatal status epilepticus. Sometimes add-on for seizures but sedation limits use Used to be used as anxiolytic agent, but not really anymore because abuse potential ADVERSE: CYP450 = DDIs, Sedation, irritability, interferes with learning
27
Ramelteon
Insomnia treatment Non-GABA Action Agonist at melatonin MT1 (induce sleepiness) and MT2 receptors (regulation of circadian rhythms) in suprachiasmatic nucleus of hypothalamus. Decreases mean latency to sleep. ADVERSE: Dizziness, somnolence, fatigue, nausea; 5% incidence or less.
28
Diphenhydramine
Antihistamines H1 histamine and muscarinic antagonist May be effective in short term treatment of insomnia Heavily advertised but NOT recommended Antimuscarinic effects can be troublesome in elderly
29
Cocaine
Stimulant DAT (+SERT, NET) Toxicity=sympathetic sx (high BP, high temp, sweating) Treat with supportive measures (ventilation, lavage, etc) Treat seizures with Diazepam Treat high BP (DBP>120) with phentolamine  DON’T use beta-blockers (unopposed alpha-stimulation) Treat psychosis with haloperidol Withdrawal is generally mild (mostly craving, depression, sleepy). Treat with TCADs, bupropion
30
Amphetamine
1. Stimulant (think cocaine) DAT (+SERT, NET) Can stimulate psychosis Amphetamine salts = Adderall = ADHD tx 2. "ampehtamine-like" Hallucinogen 5HT-2A receptor (Gq) partial agonist
31
Methamphetamine
Stimulant DAT (+SERT, NET) Toxicity=sympathetic sx (high BP, high temp, sweating) Treat with supportive measures (ventilation, lavage, etc) Treat seizures with Diazepam Treat high BP (DBP>120) with phentolamine  DON’T use beta-blockers (unopposed alpha-stimulation) Treat psychosis with haloperidol Withdrawal is mild (craving, depression, sleepy)
32
Nicotine
Stimulant Nicotinic Receptor Toxicity usually due to accidental ingestion (i.e. of tobacco products (kids), of nicotine insecticides) Toxicity=nausea, vomiting, stomach pain, salivation, diarrhea, headacheprogress to hypotension, convulsions, resp failure Treat with supportive measures (ventilation, lavage, etc) Individual with impaired nicotine metabolism=protection=less likely to become addicted to cigarettes Increased use in anxiety, VERY common in Schizophrenia Withdrawal: irritable, anxiety, depression, restless, increased appetite. Treat with nicotine replacement therapy like bupropion
33
Alcohol
CNS depressant Increase GABA-A, decrease NMDA Withdrawal: Increased DTR (deep tendon reflex), BP and pulse Seizures (1-2 days) Delirium Tremors (2-5 days) Treatment Meds: Disulfiram (inhibits acetaldehyde dehydrogenase) Naltrexone: opioid antagonist Acamprosate (GABA antagonist) NADH is produced via ETOH metabolism, which depletes the NAD required for oxidative reactions Leads to increased blood lactate (acidosis), increased Mg excretion (convulsions), decreased uric acid excretion (gout attack), increase acetyl CoA (inc fatty acid synthesis and decrease fat breakdown= fatty liver), decrease krebs=decreased gluconeogenesis (hypoglycemia) Increased use in anxiety 3rd leading cause of death
34
Barbiturates
CNS Depressant Increase GABA-A, decrease NMDA Act via prolonging GABA channel chloride effect even in absence of GABA (at high concentrations) and decreasing Glutamate Toxicity: respiratory depression, hypotension, coma, death *High tolerance* Withdrawal carries significant risk of morbidity/mortality: treat with reduced dose or substitution therapy and monitor for seizures **Classic inducers of CYP450** Uses: Not often used in anxiety anymore, Insomnia,
35
Benzodiazepines
CNS Depressant Increase GABA-A only Bind alpha 1 AND alpha 2/5 GABA receptors >> sleep AND anxiolysis Facilitate process of GABA opening, but does NOT initiate chloride current Toxicity: respiratory depression, hypotension, coma, death Benzo antagonist: flumazenil Withdrawal carries significant risk of morbidity/mortality: treat with reduced dose or substitution therapy and monitor for seizures. Delirium Tremors. Increased DTR, BP and Pulse Uses: Panic Disorder, GAD, Social Phobia, Anxiolytic agent, Insomnia medication, Absence seizures
36
Heroin
Mu-opioid receptor (Gi/o) agonists Acute toxicity= coma, respiratory depression, pin-point pupils Tolerance develops to most opioids (not equally for all systems i.e. develop little tolerance to constipation) Dependence develops rapidly; withdrawal sx can be intense but are not medically dangerous Withdrawal treatment: clonidine (for symp sx); methadone (to alleviate sx), buprenophine (partial agonist)
37
Marijuana
B-1 receptor (Gi/o) agonist Intoxication: Slowed time, decreased coordination, euphoria. Toxicity: severe overdose is rare, but can have paranoia, memory impairment, tremors, high HR, dec. strength and coordination>> should not drive Can exacerbate sx of existing psychotic illness Treat with supportive measures ADVERSE: Long-term use can cause cognitive impairment, “amotivational syndrome,” pulm problems (COPD, laryngitis, pharyngitis) Tolerance develops and disappears rapidly; high potential for dependence Mild withdrawal=sleep issues, anorexia, irritability, cravings
38
Methadone
Opiod Mu-opioid receptor (Gi/o) agonists Use in opiod withdrawal to alleviate sx Acute toxicity= coma, respiratory depression, pin-point pupils Treat toxicity with naloxone
39
Buprenorphrine
Treatment for Opiod addiction Partial agonist at mu opioid receptors that produces minimal withdrawal symptoms, has a low potential for overdose toxicity, a long duration of action, and will block the acute reinforcing effects of heroin. Do not experience the ups and downs of heroin and drug craving diminishes and may disappear
40
Clonidine
Alpha Agonists Uses: * ADHD treatment * Opiod withdrawal * Alcohol withdrawal In treating withdrawal: will alleviate symptoms of sympathetic nervous system overactivity (nausea /vomiting, cramps, sweating, tachycardia, and increased blood pressure) that occur during acute withdrawal
41
Disulfiram
Inhibits acetaldehyde dehydrogenase Results in 5-10 fold increase in acetaldehyde levels (nausea/vomiting, respiratory and cardiovascular collapse, convulsions) EtOH sensitizing drug Alcohol addiction treatment
42
Naltrexone
Opioid antagonist Medication for Alcohol and Opiod addiction Alcohol: Shown to reduce alcohol craving, consumption, and relapse rates when used in combination with psychotherapy Opiods: block reinforcing actions of heroin but has no effect on craving or the PWS
43
d-Ampethamine
x
44
Methylphenidate
Stimulant Aka Ritalin Treatment for ADHD Block reuptake pump and/or increase release of norepinephrine, but these drugs also block dopamine reuptake and/or increase dopamine release, leading to high abuse potential
45
Nitrous oxide
Volatile Anesthetics Only true gas (other are volatile liquids); MAC is 105% so can’t be sued as a sole anesthetic (combine with barb+opioid) Concentration effect: because of high inspired %, uptake rate is faster than predicted Diffusion hypoxia: when admin is terminated, large volume of nitrous oxide leaves blood and expands lungsdiutes alveolar O2 >> hypoxia Second gas effect: if combined with another gas, the huge uptake of rate of nitrous oxide also pulls second gas, so second gas has faster uptake than expected
46
Halothane
Volatile Anesthetics fluorinated hydrocarbon Highly potent, poor analgesic (used to be widely used, not so much anymore) ``` ADVERSE: Respiratory and cardiovascular failure (arrhythmias), Hepatotoxic (1/10,000 have fever/anorexia/nausea 2-5 days later and 50% of these patients die; repeated exposure significantly increases risk) Malignant hyperthermia (occurs with most volatile GAs): muscle rigidity and fever (due to mutation in RyR) ```
47
Dantrolene
Causes relaxation by blocking Ca2+ release via the ryanodine receptor Treatment for malignant hypothermia (plus an ice bath)
48
Phenytoin
Inhibit VSSC (Na channel) in use-dependent manner; suppress repetitive APs For partial seizures and gen tonic-clonic Fosphenytoin (water soluble pro drug) for active seizures NO LONGER FIRST LINE b/c of variable kinetics and availability of better drugs ADVERSE: Strong P450 inducer! Nystagmus, diplopia, ataxia, sedation, rash, gingival hyperplasia. Long term=osteomalacia/peripheral neuropath
49
Carbamazepine
Inhibit VSSC (Na channel) in use-dependent manner; suppress repetitive APs Drug of choice for partial seizures Often tried first for generalized tonic-clonic ADVERSE: P450 inducer. Can cause Diplopia, ataxia, nausea/vomiting, drowiness, occasionally Hypnatremia, Risk of Steven-Johnson syndrome
50
Levetiracetam
Treats tonic-clonic seizures, Atypical Absence seizures, Atonic or Myoclonic seizures Binds to and inhibits function of synaptic vesicle protein SV2A in Ca++- mediated neurotransmitter release. Relation to antiseizure action is uncertain
51
Valproate
Treats tonic-clonic seizures and Atypical Absence seizures Blocks VSCC Increases levels of other anti-seizure drug, Lamotrigine Risk of birth defects; mothers need to take higher doses of folic acid
52
Divalproex
Anti-maniac, Anti-seizures Mechanism of Action: Unclear, but probably involves some potentiation of GABA function (weak effect on GABA-transaminase) and effects on membrane excitability (similar to phenytoin). Limits activity of Ttype Ca++-channels. ADVERSE: Not proven as preventative agent, weight gain, sedation, “perming effect”—hair gets frizzy and/or falls out
53
Ethosuximide
Anti-seizure Drug Inhibit low-threshold T-type Ca channel Complete oral absorption CYP3A4 metabolized Drug of choice for ABSENCE SEIZURES ``` ADVERSE: CYP3A4 inducing/inhibiting DDIs GI upset (dose-dependent); some HA, dizziness ```
54
Treatment efficacy for bipolar depression
quetiapine> lamotrigine> olanzapine+fluoxetine>lithium

Pharm list for Neuro Exam 4 (2 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions