pharmacology Flashcards

(36 cards)

1
Q

what type of drugs best cross the blood brain barrier?

A

Hydrophobic drugs

The BBB is made of fat and so is hydrophobic meaning it is easiest for hydrophobic drugs to pass through

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2
Q

which one of these neurotransmitters is not a monoamine:

  1. dopamine
  2. glutamate
    3.noradrenaline
  3. 5- Hydroxytryptophan (5-HT, serotonin)
A
  1. Glutamate

(the rest are monoamines)

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3
Q

examples of monoamines

A

dopamine

noradrenaline

5- Hydroxytryptophan (5-HT, serotonin)

Imipramine

Phenelzine

Fluoxetine

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4
Q

which nuclei is involved in the serotonin projection pathway

A

Rostral nucleus and then projects all over the cortex

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5
Q

what is the caudal raphe nuclei involved in?

A

analgesia

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6
Q

what is the locus coreuleus involved in?

A

-arousal, emotion

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7
Q

examples of monoamine oxidase inhibitors

A

-phenelzine (irreversible inhibitor)
-moclobemide (reversible inhibitor)

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8
Q

MOA: monoamine oxidase inhibitors

A

Irreversible (phenelzine) or reversible (Moclobemide) inhibitors of MAO-A and B

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9
Q

SE: monoamine oxidase inhibitors

A

-Hypertensive crisis if patient eats cheese, gravy, yoghurt and any other foods with dopamine and high tyrine

-Increases effects of other drugs (e.g. barbiturates) by decreasing their metabolism

-Insomnia

-Postural hypotension

-Peripheral oedema

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10
Q

Examples of triyclic antidepressants

A

-Imipramine (most commonly)
-Dosulepin
-Amitriptyline
-Lofepramine

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11
Q

MOA: triyclic antidepressants

A

Block the reuptake of monoamines (mainly noradrenaline and 5-HT) into presynaptic terminals

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12
Q

SE: triyclic antidepressants

A

Anticholinergic: (inhibits parasympathetic, rest and digest)
-Blurred vision
-Dry mouth
-Constipation
-Urinary retention
-Sedation
-Weight gain
-Postural hypotension
-Tachycardia
-Arrythmias
-Cardiotoxic overdose

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13
Q

depression is a result of a deficit in what type of neurotransmitters?

A

depression is a result of a deficit in MONOAMINE transmitters

in particular:
-serotonin (5-HT)
-noradrenaline

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14
Q

what drugs can induce low mood?

A

-drugs that deplete stores of monoamines (e.g. reserpine)

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15
Q

how long does it take for most antidepressants to work?

A

several weeks (they have a delayed reaction)

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16
Q

to antidepressants work better for those with more mild or severe depression?

17
Q

example of SSRIs?

A

-fluoxetine
-Citalopram/ Escitalopram
-Sertraline
-Paroxetine

18
Q

MofA: SSRIs

A

-selectively inhibit reuptake of serotonin (5-HT) from the synaptic cleft

19
Q

SE: SSRIs

A
  • Nausea (an decrease appetite and lose weight as SE)
  • Headache
  • Transient increase in self harm/ suicidal ideation in < 25 years
  • Sweating/ vivid dreams
  • Sexual dysfunction
  • Hyponatraemia (in elderly)
  • Discontinuation effects

Paroxetine stopped suddenly can give very bad mental and physical affects

20
Q

advantage of using SSRIs over tricyclics?

A

-SSRIs are more selective than tricyclics and so have less anticholinergic side effects

21
Q

example of fual reuptake inhibitors/ SNRIs ?

A

-duloxetine
-venlafaxine

22
Q

MofA of SNRIs?

A

-block the reuptake of monoamines (noradrenaline and 5-HT) into presynaptic terminals

-increase both serotonin and norepinephrine levels

23
Q

SE: SNRIs?

A

Similar to SSRIs:
* Nausea (an decrease appetite and lose weight as SE)
* Headache
* Transient increase in self harm/ suicidal ideation in < 25 years
* Sweating/ vivid dreams
* Sexual dysfunction
* Hyponatraemia (in elderly)
Discontinuation effects

24
Q

MofA: Mirtazapine?

A

-blocks a2, 5-HT2 & 5-HT3

25
SE: Mirtazapine?
-weight gain -sedation
26
how is lithium normally given?
-as lithium carbonate
27
MofA of lithium
-may block phophatidylinositol pathway (second messanger system) OR -inhibit Glycogen synthase Kinase 3-beta OR -modulate NO signalling
28
what are the side effects of lithium?
SE: -dry mouth/strange taste -polydipsia + poliuria -tremor -hypothyroidism -long term reduced renal function -nephrogenic diabetes insipidus -weight gain TOXIC EFFECTS: -vomiting -diarrheoa -ataxia/ coarse tremor -drowsiness/altered conscious level -convulsions -coma
29
exmaples of anticonvulsants given for bipolar?
-Valproic acid -Lamotrigine -Carbamazepine
30
MofA: anticonvulsants
-very unclear -perhaps potentiate GABA transmission and therefore block overactive pathways (kindling model of bipolar disorder)
31
SE: Valproate (anticonvulsant)
-Drowsiness -Ataxia -CVD effects -Induces liver enzymes -tetragenicity (neural tube defect)
32
SE: carbamasepine
-drowsiness -ataxia -CVD effects -induces liver enzymes
33
SE: lamotrigine
-very small risk of Stevens Johnson syndrome
34
examples of antipsychotics
-quetiapine -atripiprazole -olanzapine -lurasidone
35
MofA: antipsychotics
-dopamine antagonism and 5-HT antagonism
36
SE: antipsychotics
-sedation -weight gain -metabolic syndrome Atripiprazole= extra pyramidal side effects