Pharm Neuro IV Flashcards Preview

Neuro IV pharm > Pharm Neuro IV > Flashcards

Flashcards in Pharm Neuro IV Deck (100)
Loading flashcards...
1

Chlorpromazine

Typical antipsychotic D2 antagonist low potency Schizophrenia (+ symp.) psychosis, acute mania, Tourette syndrome Side effects: ANS (dry mouth), sedation, hypotension

2

Haloperidol

Typical antipsychotics D2 antagonist High potency Schizophrenia (+ symp.), Huntington's Side effects: EPS tardive dyskinesia Neuroleptic malignant syndrome

3

Clozapine

Atypical antipsychotics D2/5HT2A antagonist (low ratio) Schizophrenia (- symp) SE: weight gain, *agranulocytosis*, seizures, prolonged QT

4

Olanzapine

Atypical antipsychotics D2/5HT2A antagonist (low ratio) Schizophrenia (- symp) SE: weight gain, prolonged QT

5

Quetiapine

Atypical antipsychotics D2/5HT2A antagonist (low ratio) Schizophrenia: (- symp) SE: weight gain, prolonged QT, some sedation

6

Risperidone

Atypical antipsychotics D2/5HT2A antagonist (low ratio) Schizophrenia (- symp) SE: increased prolactin (lactation and gynecomastia) irregular menstruation and fertility issues, DM type II, prolonged QT

7

Aripiprazole

Atypical antipsychotics D2 and 5HT1A Partial agonist, 5HT2A antagonist high potency Schizophrenia (- symp) SE: weight gain, headache, anxiety, insomnia, nausea, constipation, lightheadedness

8

Ziprasidone

Atypical antipsychotics D2/5HT2A antagonist (low ratio)

9

Paroxetine

SSRI Block SERT SE: sedation, constipation, weight gain, dry mouth, serotonin syndrome, SIADH, sexual dysfunction, withdrawal symptoms (

10

Sertraline

SSRI Block SERT SE: *GI distress*, activation insomnia, constipation, dry mouth, weight gain, serotonin syndrome, SIADH, sexual dysfunction, withdraw symptoms (

11

Citalopram

SSRI Block SERT SE: fewest of the SSRIs

12

Escitralopram

SSRI Block SERT SE: fewest of the SSRIs

13

Bupropion

NE DA reuptake inhibitor (NDRI) Depression (Wellbutrin), smoking cessation (Zyban) SE: insomnia/agitation, stimulant effects, headache, *seizures at high dose* no sedation, no addiction, no tolerance and no sexual SE no interaction with EtOH

14

Venlafaxine

SNRI SERT and NET blocker Depression, anxeity, panic, PTSD SE: Hypertension, anxeity, nausea, withdrawal symptoms, sexual dys., sedation

15

Duloxetine

SNRI SERT and NET blocker Depression, Diabetic peripheral neuropathy SE: Hypertension, anxeity, nausea, withdrawal symptoms, sexual dys., sedation

16

Trazodone

Mixed serotonin receptor and alpha 1 receptor blocker Insomnia, High doses for depression SE: sedation, nausea, priapism (trazo*bone*), postural hypotension

17

Mirtazapine

Alpha-2 adrenergic antagonist increase release of NE and 5HT 5HT2 and 3 receptor antagonist depression, insomnia SE: sedation, increase appetite, weight gain, dry mouth

18

Amitriptyline

TCADs NET/SERT reuptake block Major depression, peripheral neuropathy, chronic pain, migraine prophylaxis SE: Sedation, antimuscarinic (Amitriptyline >Desipramine), orthostatic hypotension, Convulsions, Coma, Cardiotoxicity (arrhythmias), respiratory depression

19

Nortriptyline

TCADs NET/SERT reuptake block Major depression, peripheral neuropathy, chronic pain, migraine prophylaxis SE: Sedation, antimuscarinic, orthostatic hypotension, Convulsions, Coma, Cardiotoxicity (arrhythmias), respiratory depression

20

Imipramine

TCADs NET/SERT reuptake block Major depression, enuresis SE: Sedation, antimuscarinic, orthostatic hypotension, Convulsions, Coma, Cardiotoxicity (arrhythmias), respiratory depression

21

Desipramine

TCADs NET reuptake block Major depression, peripheral neuropathy, chronic pain, migraine prophylaxis SE: Sedation, antimuscarinic (Amitriptyline >Desipramine), orthostatic hypotension, Convulsions, Coma, Cardiotoxicity (arrhythmias), respiratory depression

22

Clomipramine

TCADs (NET)/SERT reuptake block Major depression, OCD, peripheral neuropathy, chronic pain, migraine prophylaxis SE: *Sedation*, antimuscarinic , orthostatic hypotension, Convulsions, Coma, Cardiotoxicity (arrhythmias), respiratory depression

23

Phenelzine

MAOI Atypical depression, anxeity SE: Hypertensive crisis (tyramine), CNS stimulation, Serotonin syndrome

24

Fluoxetine

SSRI Block SERT SE: Hypertension, anxeity, nausea, withdrawal symptoms (lower risk with fluox), sexual dys., sedation

25

Selegiline

MAOI Parkinson's SE: Hypertensive crisis (tyramine), CNS stimulation, Serotonin syndrome

26

Lithium

mechanism unknown (inhibition of phosphoinositol cascade) Mood stabilizer for bipolar blocks relapse and acute manic events SE: narrow therapeutic index (monitoring) LMNOP Movement (tremor) Nephrogenic Diabetes Insipitus O-hypOthyroid Pregnancy problems (Ebstein anomaly) polyuria (diabetes insipitus),

27

Carbamazepine

Antimanic agent

28

Alprazolam

Benzodiazepine agonist intensify GABA effects (binding alpha 1 and 2-5) Increase freq. of Cl- channel opening short acting, high potency acute management of anxiety. (situational anxiety) ,SE: Dependence, additive depressant effects w/ EtOH, anterograde amnesia, abuse

29

Flurazepam

Benzodiazepine agonist intensify GABA effects (binding alpha 1 and 2-5) Increase freq. of Cl- channel opening Anxiety, spasticity, detox, night terrors, sleepwalking, general anesthetic (amnesia, muscle relaxant), insomnia SE: Dependence, additive depressant effects w/ EtOH, anterograde amnesia, abuse

30

Diazepam

Benzodiazepine agonist intensify GABA effects (binding alpha 1 and 2-5) Increase freq. of Cl- channel opening longer half life acute management of anxiety. (situational anxiety) SE: Dependence, additive depressant effects w/ EtOH, anterograde amnesia, abuse

31

Oxazepam

Benzodiazepine agonist intensify GABA effects (binding alpha 1 and 2-5) Increase freq. of Cl- channel opening; short acting anxiety, insomnia, withdraw from EtOH SE: Dependence, additive depressant effects w/ EtOH, anterograde amnesia, abuse

32

Triazolam

Benzodiazepine agonist intensify GABA effects (binding alpha 1 and 2-5) Increase freq. of Cl- channel opening; short acting Insomnia SE: Dependence, additive depressant effects w/ EtOH, anterograde amnesia, abuse

33

Lorazepam

Benzodiazepine agonist intensify GABA effects (binding alpha 1 and 2-5) Increase freq. of Cl- channel opening short half life, high potency acute management of anxiety. (situational anxiety) good for elderly SE: Dependence, additive depressant effects w/ EtOH, anterograde amnesia, abuse

34

Midazolam

Benzodiazepine agonist intensify GABA effects (binding alpha 1 and 2-5) Increase freq. of Cl- channel opening; short acting anesthesia (adjunct), anxiety, insomnia SE: Dependence, additive depressant effects w/ EtOH, anterograde amnesia, abuse

35

Temazepam

Benzodiazepine agonist intensify GABA effects (binding alpha 1 and 2-5) Increase freq. of Cl- channel opening insomnia, anxiolytic, anticonvulsant, muscle relaxant SE: Dependence, additive depressant effects w/ EtOH, anterograde amnesia, abuse

36

Flumazenil

Benzodiazepine receptor ANTagonist used for OD of Benzo

37

Zolpidem

Non-BDZ Activate BZ1 subtype of GABA receptor Insomnia SE: Ataxia, headache, confusion less dependence risk, less amnesia

38

Eszopiclone

Non-BDZ Activate BZ1 subtype of GABA receptor Insomnia SE: Ataxia, headache, confusion less dependence risk, less amnesia

39

Zaleplon

Non-BDZ Activate BZ1 subtype of GABA receptor (GABA Cl- channel) Insomnia SE: Ataxia, headache, confusion less dependence risk, less amnesia

40

Pentobarbital

Barbiturates increase *duration* of GABA CL- channel opening Anxiety, seizures, insomnia, anesthesia (thiopental) SE: Respiratory and CV depression! CNS depression (worse w/ EtOH), dependence, DDI (P-450 inducer)

41

Phenobarbital

Barbiturates increase *duration* of GABA CL- channel opening Anxiety, seizures, insomnia, anesthesia (thiopental) SE: Respiratory and CV depression! CNS depression (worse w/ EtOH), dependence, DDI (P-450 inducer)

42

Ramelteon

Melatonin Receptor Agonist

43

Buspirone

5HT1A partial agonist (D2 antagonist) Anxiety

44

Chloral hydrate

Enhance GABA receptor sedative-hyponitic class Short term insomnia treatment

45

Cocaine

DAT (+SERT, NET) Stimulant

46

Amphetamines

DAT (+SERT, NET) stimulant

47

MDMA

ecstasy SERT>DAT, NET stimulants

48

Nicotine

nicotinic receptor Stimulants

49

Stimulants

Nicotine Cocaine Meth MDMA (ecstasy)

50

Depressants

Alcohol Barbiturates Benzodiazepines

51

Barbiturates

increase GABA-A, decrease NMDA

52

Benzos

Increase GABA-A only antagonist: flumazenil

53

Dissociative Anesthetics

Phencyclidine (PCP) Ketamine

54

Phencyclidine

NMDA receptor antagonist

55

Ketamine

NMDA receptor antagonist

56

Opioid analgesics

Morphine heroin fentanyl meperidine

57

Morphine

Mu-opioid receptor (Gi/o) agonist treat w/ naloxone

58

Heroin

Mu-opioid receptor (Gi/o) agonist treat w/ naloxone

59

Fentanyl

Mu-opioid receptor (Gi/o) agonist treat w/ naloxone

60

Meperidine

Mu-opioid receptor (Gi/o) agonist treat w/ naloxone

61

Cannabinoids

CB-1 receptor (Gi/o) agonist

62

Hallucinogens

Lysergic acid diethyl amide (LSD) Mescaline (peyote)

63

LSD

5HT-2A receptor (Gq) partial agonist

64

Methadone

Treat opioid dependence binds Mu receptor agonist and NMDA antagonist

65

Buprenorphine

partial mu agonist (avoid respiratory depression) Treat opioid addiction

66

Nicotine

Help stop smoking Nicotinic receptors

67

Varenicline

treat nicotine addiction agonist of nicotinic receptors

68

Clonidine

Alpha 2 agonist treat withdrawal from EtOH, Opioids, smoking

69

Disulfiram

Antabuse blocks enzyme acetaldehyde dehydrogenase treat alcoholism SE: metallic taste, headache, drowsiness, optic neuritis, peripheral neuropathy, hepatitis Contraindications: Risk MI, CVA, pregnant or if cognitively

70

Naltrexone

antagonists at μ-opioid receptor, the κ-opioid receptor (KOR) to a lesser extent reverses effects of opioids and EtOH SE: Nausea, Headaches, anxiety, sedation If on opiates or heroin will go into withdrawal

71

d-Amphetamine

Adderall Inhibits or reverses the transporter proteins for the monoamine Increases releases of monoamines Inhibits breakdown of monoamines

72

Methylphenidate

Ritalin Blocks the dopamine transporter and norepinephrine transporter more remains in synaptic cleft

73

-ipramine

TCA

74

-etine

SSRI

75

-triptyline

TCA

76

-zepam

Benzo

77

-zolam

Benzo

78

-barbital

Barbiturate

79

-azine

Typical antipsychotics

80

Nitrous Oxide

Gaseous anesthetics low potency, good analgesic paired with barbiturates or opioids rapid onset and recovery Problems: Concentration effect (faster uptake) Diffusion hypoxia (not enough O2) Second gas effect (more of paired GA)

81

Volatile anesthetics

Desflurane Enflurane Halothane Isoflurane Sevoflurane

82

Desflurane

Volatile anesthetics induce and maintain surgical anesthesia low blood and fatty tissue solubility (fast onset and recovery) Con: smells bad Do NOT use with pts w/ Family history of malignant hyperthermia

83

Enflurane

Volatile anesthetics Maintenance of GA in adults Good analgesic and muscle relaxant fast induction and recovery Con: can trigger seizures

84

Halothane

Volatile anesthetics mod to high potency; poor analgesic Three issues: -Respiratory and CV failure -Hepatotoxicity (metabolized in liver) -Malignant Hyperthermia

85

Isoflurane

Volatile anesthetics most widely used Pros: more potent, less hepatotoxicity, less risk of seizure, good muscle relaxant Con: bad odor can lead to coughing

86

Sevoflurane

Volatile anesthetics pleasant odor used for induction Con: releases fluoride ions-->renal toxicity

87

IV anesthetics

Propofol Etomidate Thiopental

88

Propofol

IV anesthetic Potentiates GABA-A receptor activity rapid onset, faster recovery than thiopental less nausea post-op

89

Etomidate

IV anesthetic non-barbiturate hypnotic potentiates GABA-A no analgesia minimal depression of CV and respiratory function (larger safety margin) Con: can cause involuntary movements, lots of nausea and vomiting and pain on injection.

90

Thiopental

Barbiturate (short acting) Potentiates GABA-A IV anesthetic Induction and short surgical procedures High potency, high lipid solubility, rapid entry into brain

91

IV adjuncts for GA

Diazepam Ondansteron (anti-emetic) Fentanyl (analgesic) Glycopyrrolate (Anticholinergic) Ketamine (NMDA antagonist) Morphine Neuromuscular blocking agents Dantrolene (Ca2+ channel blocker)

92

Diazepam

Valium Benzo--potentiates GABA-A used pre-op for induction and *sedative* purposes

93

Ondansteron

5-HT3 receptor antagonist Anti-emetic reduces post-op nausea and vomiting

94

Fentanyl

Mu receptor agonist Analgesics

95

Glycopyrrolate

Anticholinergic drug reduce GA-induced hypotension, bradycardia, and excess salivations (prevent choking)

96

Ketamine

NMDA receptor antagonist IV anesthetic--produces dissociative anesthesia (catatonia, amnesia, analgesia)

97

Morphine

Mu receptor agonist Analgesics

98

Neuromuscular blocking agents

Vecuronium Relax skeletal muscle (esp for abdominal surgeries)

99

Dantrolene

prevents release of Ca2+ from sarcoplasmic reticulum of skeletal muscle Malignant hyperthermia and neuroleptic malignant syndrome

100

Phenytonin

Grand mal