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pharmacology Flashcards

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1
Q

all atypical anti-psychotics are antagonists for D2 receptors

A

false, aripiprazole is partial agonist

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2
Q

what are the extrapyramidal side effects associated with anti-psychotic drugs

A

1) parkinsonism, bradykinesia
2) acute dystonia
3) akathisia

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3
Q

what is tardive dyskinesia

A
  • Affect on the CNS:
    1) orthostatic hypotension, impotence and failure in ejaculation
    2) anti-cholinergic effects
  • Affects on the endocrine
    1) hyperprolactinemia which can cause ammoniuria, galactorrhea, infertility and impotence
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4
Q

which drugs should not be used with antipsychotics?

A

anti-Parkinson’s drugs , because they potentiate the extra-pyramidal side effects

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5
Q

read slide 12 of anti-psychotic drugs

A

ok

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6
Q

what are the 3 classes of phenothiazine

A

1) fluphenazine, perphenazine(piperazine)
2) chlorpromazine(aliphatic chain)
3) thioridazine(piperidine)

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7
Q

which side chain anti-psychotic drugs are the most potent?

A

piperazine (fluphenazine ,perphenazine)

however they have the highest incidence of extra pyramidal side effects

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8
Q

typical antipsychotics alleviate what type of symptoms in schizophrenia

A

positive, ex: hallucinations and delusions

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9
Q

chlorpromazine is the drug of choice in?

A

intractable hiccups

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10
Q

which anti-psychotic agent is the least potent?

A

thioridazine, it has has the least severe extrapyramidal side effects

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11
Q

which drug is used for borderline personality disorder

A

thiothixene (thioxanthene)

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12
Q

which drugs are used for the initial stabilization of a psychotic patient?

A

butyrophenones( haloperidol)

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13
Q

what is the function of pimozide

A

1) prevents acute exacerbations in chronic schizophrenia

2) suppresses motor and vocal tics in Tourette syndrome

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14
Q

what is the function of loxapine ?

A

treatment of schizoaffective disorders, because it major metabolite is an antidepressant ; amoxapine

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15
Q

clozapine is reserved for the treatment of what ?

A

it is reserved for the treatment of refractory severe psychosis

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16
Q

atypical antipsychotics are used for the treatment of ?

A

1) psychotic disorders 2)mania 3)bipolar disorders

4) autism

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17
Q

true or false

atypical anti-psychotics are used to alleviate only positive and negative symptoms of schizophrenia

A

false, also cognitive

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18
Q

what are the side effects of atypical agents

A

less extrapyramidal and anticholinergic side effects. however, more weight gain leading to type II diabetes and can cause cardiac QT interval prolongation leading to cardiac arrhythmias

note: Clozapine can cause agranulocytosis

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19
Q

true or false

levodopa is pharmacologically inert

A

true

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20
Q

true or false

levodopa doesn’t relieve dementia, causes postural hypotension , and it inhibits the release of prolactin

A

true

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21
Q

what is the effect of levodopa on the urine and on the and the dip stick test for ketoacidosis ?

A

the urine is red and turns black on exposure to air or alkali
it gives a false positive test

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22
Q

what drugs are contraindicated with levodopa

A

1)vit b6 pyridoxine
2)reserpine
3)anticholinergics
4)anti psychotics
5)MAO-I ;can cause hypertensive crisis
and hyperpyrexia

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23
Q

what is the side effect caused by tolcapone

A

acute liver failure

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24
Q

when is amantadine used ?

A

in early Parkinson’s or as an adjunct to levodopa

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25
uses of Bromocriptine, Pramipexole, and Ropinirole
restless leg syndrome | Parkinson's
26
which of the anti-Parkinson's drugs is More effective in relieving tremor than either rigidity or bradykinesia
MOA-I, levodopa is the opposite | note: MOA-I causes cycloplegia
27
is COX1 or COX2 responsible for the anti pyritic , anti-inflammatory and anti- analgestic effect of NSAIDs ?
COX-2
28
what are the side effects of NSAIDS?
1) acute renal failure 2) skin rash or hypersensitivity 3) gastric distress, worsened by ethanol and SSRI 4) bronchospasm in NSAID -sensitive asthmatics note: they are also contraindicated in 1) pregnancy;3rd trimester 2) in influenza like diseases; causes Reyes syndrome 3) alcohol use and peptic ulcers 4) bleeding disorders
29
in asthmatics you should use --------- to relieve pain ?
acetaminophen
30
true or false the major difference between NSAIDs is not in the anti-inflammatory , anti pyretic and analgesic activity but in the pharmacokinetic activity
true
31
true or false | aspirin causes nephrotoxicity
false
32
Olsalazine, mesalamine ,Sulfasalazine are used for
ulcerative colitis, crohn disease, RA | note: they are reversible inhibitors and they do not inhibit platelet aggregation
33
indomethacin is used for ?
1) gout | 2) closure of patent ductus arteriosus
34
the most frequent side effect of indomethacin is ?
severe frontal headache
35
contraindications of indomethacin
1) peptic ulcer | 2) should be used with caution with elderly, epileptic patients and patients with psychosis or Parkinson's
36
COX-2 selective inhibitors ?
they cause a prothrombic state but they do not cause GI irritation
37
true or false acetaminophen is an anti inflammatory, anti pyretic, analgesic drug
false, it doesn't have an anti-inflammatory action not: it is a weak inhibitor of cyclooxygenases
38
uses of acetaminophen
1) when aspirin is contraindicated | 2) it is the drug of choice in pregnancy
39
overdose of acetaminophen can lead to
hepatotoxicity(due to accumulation of NAPQI which can be aggravated by ethanol, it is treated with acetylcysteine
40
for mild to moderate nociceptive pain it is better to use
NSAIDs
41
neuropathic pain responds best to
anticonvulsants, tricyclic antidepressants, or serotonin/norepinephrine reuptake inhibitors
42
can opioids cause orthostatic hypotension
yes
43
what are the actions of opioids which act on the mu receptor ?
supra spinal analgesia euphoria dependence respiratory depression
44
what are the actions of opioids which act on the kappa receptor ?
spinal analgesia miosis sedation
45
what are the actions of opioids which act on the delta receptor ?
involved in affective behaviors
46
which opioid drugs are used to treat diarrhea and cough
diarrhea: loperamide cough: codeine and Dextromethorphan (morphine doesn't work)
47
Morphine and related compounds act at all opiate receptors, but with the highest affinity at
u receptors
48
morphine is metabolized by:
glucuronide conjugation
49
true or false | opioids decrease biliary pressure
false, they increase biliary pressure
50
opioids are contraindicated in patients with
1) patients with head injury | 2) patients with lung diseases as it causes respiratory depression
51
opioid action is potentiated by ?
phenothiazines MOA-I tricyclic antidepressants
52
what are the analogues of meperidine ?
Fentanyl Sufentanil at toxin levels they can cause CNS excitement (unlike morphine)
53
describe meperidine
1) higher bioavailability (doesn't undergo first pass metabolism ) 2) postural hypotension 3) spasmogenic like morphine, but less intense in relation to its analgesia 4) respiratory depression 5) no anti tussive and constipation action note: meperidine reacts with MOA-I causing excitation, delirium, hyperpyrexia, convulsions, and severe respiratory depression.
54
what metabolite accumulates in meperidine
normeperidine , which causes CNS excitation
55
methadone and LAAM uses
used for 1)analgesia 2)used to treat opioid withdrawal symptoms note: they cause constipation and biliary spasm
56
pentazocine ?
is a μ-receptor antagonist and a δ- and κreceptor agonist. note: May block the analgesia produced by morphine note: can cause Tolerance, dependence, and withdrawal
57
Buprenorphine?
is a partial agonist at μ receptors.
58
which opioid antagonist has the highest duration of action
nalmefene
59
which drugs are used to treat opioid poisoning
naloxone , nalmefene note: naltrexone is used to treat drug and alcohol addiction
60
tramadol is used for
neuropathic pain note: It is equal to or less effective than codeine plus aspirin or to codeine plus acetaminophen.
61
ziconotide is used for
severe chronic pain note: it has sever side effects described as drunken-like. also it is related to bacterial meningitis
62
true or false | It is possible for a person to exhibit signs of dependence following withdrawal of a drug, yet not crave the drug.
true
63
true or false | Tolerance develops more slowly to meperidine than morphine
true
64
true or false if I abused a short acting highly potent drug the withdrawal will be be more intense and for a short duration
true
65
which drugs are used for the treatment of heroin withdrawal
methadone and Buprenorphine
66
true or false | alcohol will cause hyperthermia
false, it will cause hypothermia note: diuresis will also occur due to decrease ADH release
67
liver cirrhosis caused by alcoholism can lead to
1) hypertension in liver BV 2) gastric and esophageal varices 3) ascites 4) hepatic encephalopathy
68
describe fetal alcohol syndrome
abnormal facial features, growth deficiencies, vision and hearing deficits mental disorders(difficulty in learning, memory problems, poor attention span, and poor communication skills).
69
true or false | Benzodiazepines are cross tolerant with alcohol and will alleviate withdrawal symptoms
true note: but they do not have the same stimulating effects on the central nervous system (CNS) as alcohol.
70
arrhythmias are treated with------ tremor are treated with --------- hallucinations and paranoia are treated with -------- Delirium tremens are treated with ---------
lidocaine propranolol phenothiazine or haloperidol diazepam
71
naltrexone's are contraindicated in ?
liver failure or acute hepatitis
72
methanol ingestion causes ?
Metabolic acidosis and organ damage Methanol can cause blindness by damaging the optic nerve. note: methanol is metabolized to formaldehyde then it is metabolized to formic acid
73
what are the withdrawal symptoms of Benzodiazepines
anxiety, insomnia, convulsion ( in severe withdrawal)
74
true or false — Tolerance develops to the sedative and hypnotic effects of barbiturates but No tolerance develops to the anticonvulsant actions of barbiturates.
true
75
true or false Chronic toxicity of cocaine and amphetamines produces anxiety and confusion, leading to paranoia and psychosis, which is indistinguishable from schizophrenia
true note: amphetamines are used to treat ADHD and narcolepsy
76
true or false | cocaine and amphetamines can cause hypopyrexia
false, they cause hyperpyrexia
77
drug used for intoxication of cocaine and amphetamines
chlorpromazine
78
true or false | tolerance develops to both cocaine and amphetamines
false, only for amphetamines
79
Synesthesia's and “flashbacks” are unique features of?
Psychedelic Hallucinogens
80
Marijuana and Hashish are used as
Antiemetic in cancer chemotherapy patients
81
true or false | Benzodiazepines have a higher therapeutic index compared to barbiturates
true note: but barbiturates do not only facilitate the GABA receptor but they also have an additional GABA agonist effect of their own
82
remember Diazepam has a direct muscle relaxant effect in addition to CNS actions. Alprazolam has an additional antidepressant effect. Triazolam may result in rebound anxiety following cessation of administration.
ok
83
The only peripheral effects of Benzodiazepines
coronary vasodilation after certain benzodiazepines are injected intravenously (IV) and neuromuscular block after very high doses
84
Flumazenil is used for
overdose or poisoning with benzodiazepines
85
Eszopiclone , Zaleplon, and Zolpidem are used for
They are used exclusively to treat insomnia.
86
barbiturates induce ?
cytochrome P-450 microsomal enzyme activity and δ-aminolaevulinic acid (δ-ALA) synthetase note: therefore barbiturates are contraindicated inpatients with acute intermittent porphyria, porphyria variegate, or a positive family history of these porphyria's.

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