Pharmacology Flashcards
(44 cards)
1
Q
Ethosuxamide
- MOA
- Use
- ADRs
A
- blocks T-type Ca channels
- Absence seizures
- GI, fatigue, HA, itchiness, SJS (EFGHIJ)
2
Q
BDZ’S
- MOA
- Use
- ADRs
A
- Increase GABAa
- SE
- Tolerance and dependence!
- Sedation, tolerance, dependence, cardiorespiratory depression
3
Q
Phenobarbital
- MOA
- Use
- ADRs
A
- Increases GABA a action
- simple, complex, tonic clonic, 1st line in neonates
- Similar to BDZ’s, also induces cyp P450
4
Q
Phenytoin, fosphenytoin
- MOA
- Use
- ADRs (neuro, derm, MSK, heme, repro, other)
A
- Blocks Na+ channels, zero-order kinetics
- everything but absence
- Neuro: nystagmus, diplopia, ataxia, sedation
- Derm: hair, SJS, gingival hyperplasia, DRESS syndrome
- MSK: osteopenia, SLE-like syndrome
- HEME: megaloblastic anemia
- REPRO: fetal hydantoin syndrome
- other: cyp inducer
5
Q
Carbamazepine
- MOA
- Use
- ADRs
A
- Blocks Na channels
- everything but absence, trigeminal neuralgia
- diplopia, ataxia, blood dycrasias (agranulocytosis, aplastic anemia), liver too, cyp inducer, SJS, SIADH, teratogen
6
Q
Valproic Acid
- MOA
- Use
- ADRs
A
- Increases Na channel inactivation, increases GABA concentration by inhibiting GABA transaminase
- everything (including absence), also for myoclonus, bipolar, migraine PPx
- GI, hepatotoxicity, pancreatitis, neural tube defects, tremor, weight gain
7
Q
Vigabatrin
- MOA
- Use
A
- Increases GABA by inhibiting GABA transaminase
- simple, complex
8
Q
Gabapentin
- MOA
- Use
- ADRs
A
- Inhibits high voltage activated Ca channels, GABA analog
- simple, complex, peripheral neuropathy, postherpetic neuralgia
- Sedation, ataxia
9
Q
Topiramate
- MOA
- Use
- ADRs
A
- Blocks Na channels, increases GABA action
- everything but absence, migraine PPx
- Sedation, mental dulling, kidney stones, weight los
10
Q
Lamotrigine
- MOA
- Use
- ADRs
A
- Blocks voltage gated Na channels
- everything including absence seizures
- SJS!!!
11
Q
Levetiracetam
- MOA
- Use
- ADRs
A
- Unknown, GABA and glutamate??
- everything but absence
12
Q
Tigabine
- MOA
- Use
- ADRs
A
- increase GABA by inhibiting reuptake
- simple, complex
13
Q
Baclofen
- MOA
- Use
A
- Activated GABAb receptors at spinal level, inducing skeletal mm relaxation
- Muscle spasms
14
Q
Cyclobenzaprine
- MOA
- Use
- ADRs
A
- entrally acting mm relaxants, similar to TCAs, similar anticholinergic ADRs
- mm spasms
15
Q
Triptans
- MOA
- Use
- ADRs
A
- 5HT-1b/d agonists, inhibit trigeminal activation (pain), prevent vasoactive peptide release, induce vasoconstriction
- acute migraine, cluster headaches
- coronary vasospasm, mild paresthesia
16
Q
Methylphenidate, dextroamphetamine, methamphetamine
- MOA
- Use
A
- Increased catecholamines in the synaptic cleft (NE and DA)
- ADHD, narcolepsy, appetite control
17
Q
Name the typical antipsychotics
(haloperidol plus the -azines)
-which are high potency?
-which are low?
A
Haloperidol-high
trifluoperazine-high fluphezanizine-high thioridazine-low
chlorpromazine-low
18
Q
Name the atypical antipsychotics
AACILOPQRZ
A
Aripiprazole, asenapine, clozapine, iloperidone, lurasidone, olanzapine, paliperidone, quetiapine, risperidone, ziprasidone
19
Q
LITHIUM
- MOA
- Use
- ADRs
A
- Unknown, probably phosphoinositol cascade
- Bipolar disorder
- tremor, nephrogenic diabetes insipidus, hypothyroidism, abstain anomaly
20
Q
Buspirone
- MOA
- Use
A
- 5HT1a receptor agonist
- Second line for GAD
- no sedation, addiction, or tolerance
21
Q
SSRI’s (FPSC)
- MOA
- Use
- ADRs
A
Fluoxetine, paroxetine, sertraline, citaloprma
- 5-HT reuptake inhibition
- depression, GAD, OCD, bulimia, social anxiety, PTSD, premature ejaculation, premenstrual dysphoria
- GI distress, SIADH, sexual dysfunction
22
Q
SNRIs (VDLDM)
- MOA
- US
- ADRs
A
Vegans don’t like dairy or meat: venlafaxine, desvenlafaxine, levomilnacipran, duloxetine, milnacipran
- inhibit 5-HT and NE reuptake
- depression, GAD, diabetic neuropathy, venlafaxine for social anxiety, panic, PTSD, OCD
- Increased BP, stimulant, sedation, nausea
23
Q
TCAs (ANIDCDA)
- MOA
- USE
- ADRs
A
amitriptyline, nortirptyline, imipramine, desipramine, clomipramin, doxepin, amoxapine
- block reuptake up 5-HT and NE
- depression, OCD, peripheral neuropathy, chronic pain, migraine PPx
24
Q
TCA ADRs:
A
- convulsions, coma, cardiotoxicity
- Rx of arrhythmia: NAHCO3
25
MAOi's
- Increase levels of what?
- use
Tranylcypromine, Phenelzine, Isocarboxazid, Selegeline
- NE, DA, 5-HT
- atypical depression, anxiety
26
MAOi's ADRs
- HTN crisis
- Washout period
- Not used with SSRIs, TCAs, St. John's wort, meperidine, dexgromethorphan
27
Bupropion
- MOA
- Uses
- ADRs
- Which patient populations should you avoid this drug with?
- Increases NE and DA
- Smoking cessation, second line antidepressant
- NE and DA-->stimulant: tachycardia, insomnia
- HAs, seizures in anorexic/bulimic its due to low potassium
28
Mirtazapine
- MOA
- USE
- ADRs
- Alpha2 antagonist, increase NE and 5-HT release, also Antagonist of 5-HT2 5-HT3, and H1
- Second line antidepressant
- Sedation, increased appetite, with gain, dry mouth
29
Trazadone
Blocks 5-ht2, alpha 1, and H1 receptors
- Insomnia ,high doses for depression
- Sedation, nausea, priapism, postural hypotension
30
Varenicline
Nicotinic ACh partial agonist
- Smoking cessation
- Causes sleep disturbance
31
MOA of opioid analgesics
Agonists at opioid receptors
- Open K+ channels, close Ca++ channels, decreases synaptic transmission
- Inhibit release of ACh, NE, 5-HT, glutamate, substance P
32
Pentazocine
Kappa agonist and mu antagonist
- analgesia for mod to severe pain
- can cause withdrawal if also taking full opiod antagonist
33
Butorphanol
Kappa agonist and my partial agonist
- analgesia for severe pain (migraine, labor)
- Withdrawal with full opioid agonist
34
Tramadol
Weak opioid agonist, inhibits 5-HT and NE reuptake
- Chronic pain
- Opioid ADRs, decreases seizure threshold, serotonin syndrome
35
Thiopental
- MOA
- Use
- Increases duration of GABAa opening
| - induction of anesthesia
36
BDZ's
- Use
- MOA
- anxiety, spasticity, SE, eclampsia, etOH detox, night terrors, sleepwalking, anesthesia, sleep aid
- Increase frequency of GABAa channel opening
37
BDZ's (ATOM)
alprazolam, triazolam, oxazepam, midazolam
38
Barbiturates (PPTS)
phenobarbital, pentobarbital, thiopental, secobarbital
39
Inhaled anesthetics (MDHESIN)
My dentist hates everything, so inhale nitrous
| methoxyflurane, desflurane, halothane, enflurane, sevoflurane, isoflurane, N2O
40
IV anesthetics (TMKPO)
the mighty king proposes foolishly to oprah
| thiopental, midazolam, ketamine, propofol, opioids
41
Neuroleptics
- MOA
- Uses
- ADRs
- -extrapyramidal
- -ENDO
- -alpha 1
- -muscarinic
- -histamine
- -CV
- Block D2 receptors increasing cAMP
- schizophrenia, huntington disease, OCD
- Lipid soluble, stay in body fat, extrapyramidal ADRs,
- ENDO: high PRL-->galactorrhea, oligomenorrhea, gynecomastia
- -dry mouth, constipation
- -orthostatic hypotension
- -sedation
- -QT prolongation
- -NMS
- -Tardive dyskinesia
42
Rx of NMS
| -sxs of NMS
- dantrolene and bromocriptine
| - FEVER: fever, encephalopathy, vitals unstable, enzymes up, rigidity
43
atypical antipsychotics
- Not understood, D2 antagonists, aripiprazole partial D2 agonist, varied D, alpha, H-1, and 5-HT effects
- Shizo, bipolar, OCD, anxiety, depression, mania, tourette
- prolong QT
- metabolic syndrome with pines
- risperidone-->hyperprolactinemia
44
Chlordiazepoxide
- Delirium tremens
| - Works like a BDZ
