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Pharmacology > Pharmacology: Psych/Neuro > Flashcards

Pharmacology: Psych/Neuro Flashcards

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1
Q

Methyphenidate

A

CNS stimulant

- Increase catecholamines in the synaptic cleft

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2
Q

Dextroamphetamine

A

CNS stimulant

- Increase catecholamines in the synaptic cleft

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3
Q

Mixed amphetamine salts

A

CNS stimulant

- Increase catecholamines in the synaptic cleft

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4
Q

Haloperidol

A

High potency, first generation antipsychotic

  • Block DA2 receptors, incr cAMP
  • Increased EPS: restlessness, involuntary mvmts, uncontrollable speech
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5
Q

Trifluoperazine

A

High potency, first generation antipsychotic

  • Block DA2 receptors, incr cAMP
  • Increased EPS: restlessness, involuntary mvmts, uncontrollable speech
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6
Q

Fluphenazine

A

High potency, first generation antipsychotic

  • Block DA2 receptors, incr cAMP
  • Increased EPS: restlessness, involuntary mvmts, uncontrollable speech
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7
Q

Chlorpromazine

A

Low potency, first generation antipsychotic

  • Less EPS SEs
  • More antiACh, antiH, anti-alpha SEs: dry mouth, sedating, hypotension
  • CORNEAL deposits!
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8
Q

Thioridazine

A

Low potency, first generation antipsychotic

  • Less EPS SEs
  • More antiACh, antiH, anti-alpha SEs: dry mouth, sedating, hypotension
  • reTinal deposits!
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9
Q

Eye effects of chlorpormazine vs. thioridazine

A

C: Corneal deposits
T: reTinal deposits (e.g. retinitis pigmentosa)

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10
Q

Dantrolene

A

Muscle relaxant
- Abolishes excitation-contraction coupling in muscle cells, probably by action on RyR
Tx: NMS (for muscle rigidity), malignant hyperthermia

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11
Q

Bromocriptine

A

D2 agonist

Tx: NMS

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12
Q 
Order these EPS side effects in order of appearance:
Akathisia
Akinesia
Acute dystonia
Tardive dyskinesia
A
  1. Acute dystonia - 4 hrs
  2. Akinesia (parkinsonian sx) - 4 days
  3. Akathisia (restlessness/out of body feeling) - 4 wks
  4. Tardive dyskinesia (involuntary repetitive body movements) - 4 mos
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13
Q

Olanzapine

A

Atypical antipsychotic
- Various 5HT2, DA, alpha, H1 effects
Tx: Schizophrenia; Olanz also for OCD, anxiety, depression, mania, Tourette’s
SE: weight gain! (like clozapine)

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14
Q

Clozapine

A

Atypical antipsychotic
- Various 5HT2, DA, alpha, H1 effects
Tx: Schizophrenia
SE: weight gain (like olanzapine), seizures! agranulocytosis!

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15
Q

Quetiapine

A

Atypical antipsychotic
- Various 5HT2, DA, alpha, H1 effects
Tx: Schizophrenia

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16
Q

Risperidone

A

Atypical antipsychotic
- Various 5HT2, DA, alpha, H1 effects
Tx: Schizophrenia

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17
Q

Aripiprazole

A

Atypical antipsychotic
- Various 5HT2, DA, alpha, H1 effects
Tx: Schizophrenia

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18
Q

Ziprasidone

A

Atypical antipsychotic
- Various 5HT2, DA, alpha, H1 effects
Tx: Schizophrenia
SE: Prolong QT!

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19
Q

Which drugs have these SEs?

  1. Restlessness, involuntary mvmts, incontrollable speech
  2. Dry mouth, constipation, sedation, hypotension
  3. Weight gain
  4. Agranulocytosis
  5. Prolonged QT
A
  1. Typical, high potency antipsychs: haloperidol, trifluoperazine, fluphenazine
  2. Typical, low potency antipsychs: chlorpromazine (corneal), thioridazine (retinal)
  3. clozapine, olanzapine
  4. clozapine
  5. ziprasidone
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20
Q

Lithium

A

Mood stabilizer
- Unk MOA
Tx: BPD (blocks relapse and acute manic events), SIADH
SEs: MNOP
- Movement (tremor)
- Nephrogenic DI (ADH antagonist) resulting in polyuria
- hypOthyroid
- Pregnancy problems: Ebstein’s anomaly, malformation of the great vessels

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21
Q

Buspirone

A

Serotonin agonist

  • Stimulates 5-HT1A receptors
  • No sedation, addiction, tolerance
  • No interaction with EtOH (unlike BZDs, barbs)
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22
Q

Amitriptyline

A

Tertiary TCA
- Blocks 5HT > NE reuptake
Tx: MDD, fibromyalgia
SE: more antiACh than secondary TCAs (tachycardia–M2 decr HR, urinary retention, more confusion and hallucinations in elderly –like AD), sedation
Toxicity: Convulsions! Coma! Cardiotoxicity! Resp depression, hyperpyrexia

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23
Q

Imipramine

A 
Tertiary TCA
- Blocks 5HT > NE reuptake
Tx: MDD, fibromyalgia, BEDWETTING
SE: antiACh effects, sedation
Toxicity: Convulsions! Coma! Cardiotoxicity!  Resp depression, hyperpyrexia
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24
Q

Clompramine

A 
Tertiary TCA
- Blocks 5HT > NE reuptake
Tx: MDD, fibromyalgia, OCD
SE: antiACh effects, sedation
Toxicity: Convulsions! Coma! Cardiotoxicity!  Resp depression, hyperpyrexia
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25
Doxepin
``` Tertiary TCA - Blocks 5HT > NE reuptake Tx: MDD, fibromyalgia SE: antiACh effects, sedation Toxicity: Convulsions! Coma! Cardiotoxicity! Resp depression, hyperpyrexia ```
26
Tertiary vs. Secondary TCAs
Tertiary: 5HT > NE, more antiACh effects - urinary retention, tachy, dry mouth - confusion and hallucination in elderly Secondary: NE > 5HT
27
Nortriptyline
Secondary TCA - Blocks NE > 5HT reuptake Tx: MDD, fibromyalgia Better for elderly! Less anti-Ach effects (confusion, hallucinations)
28
Desipramine
Secondary TCA - Blocks NE > 5HT reuptake Tx: MDD, fibromyalgia LEAST sedating! But lower sz threshold
29
Amoxapine
Secondary TCA - Blocks NE > 5HT reuptake Tx: MDD, fibromyalgia
30
NaHCO3
antidote for TCA toxicity
31
Fluoxetine
SSRI
32
Paroxetine
SSRI
33
Sertraline
SSRI
34
Citalopram
SSRI
35
Cyproheptadine
5-HT2 receptor antagonist | - treats Serotonin Syndrome (hyperthermia, myoclonus, CV collapse, flushing, diarrhea, seizures)
36
Venlafaxine
SNRI | Depression, GAD
37
Duloxetine
SNRI Depression, diabetic peripheral neuropathy Great effect on NE than venlafaxine
38
Tranylcypromine
MAOI - incr NE. 5HT, DA Atypical depression (hypersomnia, overeating, mood reactivity, weight gain, sensitivity to rejection); anxiety, hypochondriasis SEs: Hypertensive crisis with Tyr ingestion and beta agonists; CNS stimulation **Don't give with SSRIs or meperidine (opioid) to prevent serotonin syndrome!!
39
Phenelzine
MAOI - incr NE. 5HT, DA Atypical depression; anxiety; hypochondriasis SEs: Hypertensive crisis with Tyr ingestion and beta agonists; CNS stimulation **Don't give with SSRIs or meperidine (opioid) to prevent serotonin syndrome!!
40
Isocarboxazid
MAOI - incr NE. 5HT, DA Tx: Atypical depression; anxiety; hypochondriasis SEs: Hypertensive crisis with Tyr ingestion and beta agonists; CNS stimulation **Don't give with SSRIs or meperidine (opioid) to prevent serotonin syndrome!!
41
Selegiline
MAO-I (MAOB selective, which is more location specific - neurons, astroglia, plts) - incr NE. 5HT, DA Tx: Parkinson's; atypical depression; anxiety; hypochondriasis SEs: Hypertensive crisis with Tyr ingestion and beta agonists; CNS stimulation **Don't give with SSRIs or meperidine (opioid) to prevent serotonin syndrome!!
42
Buproprion
``` Atypical antidepressant - Incr NE and DA (unk MOA) Tx: depression, smoking cessation **Sz in bulimic pts! No sexual SE ```
43
Mirtazapine
Atypical antidepressant - alpha2 antagonist, incr release of NE and 5HT via decr neg feedback - potent 5HT2 and 5HT3 antagonist SE: incr appetite! sedation, weight gain, dry mouth
44
Maprotiline
Atypical antidepressant - Blocks NE reuptake SE: sedation, orthostatic hypotension
45
Trazodone
Atypical antidepressant - Main action is to inhibit 5HT reuptake Tx: insomnia SEs: PRIAPISM, postural hypotension, sedation, nausea
46
Epinephrine
Alpha-agonist - Decrease aqueous humor due to vasconstriction SE: mydrasis (do not use in closed-angle glaucoma!); stinging
47
Brimondine
Alpha-agonist - Decrease aqueous humor due to vasconstriction SE: no pupillary or vision changes
48
Timolol
Beta-blocker - Decrease aqueous humor due to vasconstriction SE: no pupillary or vision changes
49
Betaxolol
Beta-blocker - Decrease aqueous humor due to vasconstriction SE: no pupillary or vision changes
50
Carteolol
Beta-blocker - Decrease aqueous humor due to vasconstriction SE: no pupillary or vision changes
51
Acetazolamide
Diuretic, inh CA - Decrease aqueous humor due to decr HCO3- SE: no pupillary or vision changes
52
Pilocarpine
Direct cholinomimetic - incr aqueous humor outflow, contract ciliary muscle and open trabecular meshwork SE: miosis, cyclospasm (contraction of the ciliary muscle in the eye) **Pilocarpine good for emergencies! Good for opening meshwork into canal of Schlemm
53
Carbachol
Direct cholinomimetic - incr aqueous humor outflow, contract ciliary muscle and open trabecular meshwork SE: miosis, cyclospasm (contraction of the ciliary muscle in the eye)
54
Physostigmine
Indirect cholinomimetic - incr aqueous humor outflow, contract ciliary muscle and open trabecular meshwork SE: miosis, cyclospasm (contraction of the ciliary muscle in the eye)
55
Echothiopate
Indirect cholinomimetic - incr aqueous humor outflow, contract ciliary muscle and open trabecular meshwork SE: miosis, cyclospasm (contraction of the ciliary muscle in the eye)
56
Latanoprost
Prostaglandin (PGF2alpha) - Increase outflow of aqueous humor SE: darkens iris (browning)
57
Morphine
Opioid analgesic
58
Fentanyl
Opioid analgesic
59
Codeine
Opioid analgesic
60
Heroin
Opioid analgesic
61
Methadone
Opioid analgesic
62
Detromethorphan
Opioid analgesic | - Cough suppr
63
Deiphenoxylate
Opioid analgesic | - For diarrhea
64
Loperamide
Opioid analgesic | - For diarrhea
65
Opioid tolerance does NOT develop to...
1. miosis | 2. constipation
66
Butorphanol
Partial agonist at mu opiod receptors, agonist at kappa receptors - Causes w/d if on full opioid agonist
67
Tramadol
Very weak opioid agonist, also inhibits 5HT and NE | - Decreases sz threshold
68
Phenytoin
Na channel inactivation 1st line: GTC, Status PPX (vs BZD for acute) Also: Simple- and complex-partial
69
Fosphenytoin (IV form)
Na channel inactivation 1st line: GTC, Status Also: Simple- and complex-partial
70
Carbamazepine
Na channel inactivation | 1st line: Trigeminal neuralgia, GTC, simple- and complex-partial
71
Lamotrigine
Na channel inactivation
72
Gabapentin
GABA analog, but inhibits Ca2+ channels | Peripheral neuropathy, BPD
73
VPA
Na channel inactivation, incr GABA | 1st line: GTCs, myoclonic seizures
74
Topiramate
Na channel inactivation, incr GABA
75
Phenobarbital
Barbiturate, incr GABA via incr DURATION of Cl- channel opening (vs. BZD incr freq) 1st line: pregnant women and children - incr P450
76
Ethosuximde
Blocks T type Ca channels 1st line: Absence SJS
77
Diazepam
Lond acting BZD, incr GABA action by incr FREQ of Cl- channel opening 1st line: acute status
78
Lorazepam
Intermediate BZD, incr GABA action by incr FREQ of Cl- channel opening 1st line: acute status
79
Tigabine
Inh GABA reuptake
80
Vigabatrin
Incr GABA via irrev inhibition of GABA transaminase
81
Levetriacetam
Unk MOA, may modulate GABA and Glu release
82
Pentobarbital
Barbiturate, incr GABA via incr DURATION of Cl- channel opening (vs. BZD incr freq) 1st line: pregnant women and children - incr P450
83
Thiopental
Barbiturate, incr GABA via incr DURATION of Cl- channel opening (vs. BZD incr freq) * 1st line: pregnant women and children * Anesthesia induction (high lipid solubility, high potency) - incr P450 - DECR cerebral BF (may incr cerebral metabolic demand?)
84
Secobarbital
Barbiturate, incr GABA via incr DURATION of Cl- channel opening (vs. BZD incr freq) 1st line: pregnant women and children - incr P450
85
Triazolam
Short acting BZD
86
Alprazolam
Short acting BZD
87
Oxazepam
Short acting BZD
88
Midazolam
Short acting BZD
89
Estrazolam
Intermediate acting BZD (along with lorazepam and temazepam)
90
Temazepam
Intermediate acting BZD (along with lorazepam and estrazolam)
91
Flurazepam
Long acting BZD (along with diazepam, chlordiazepoxide, clorazepate)
92
Chlordiazepoxide
Long acting BZD (along with diazepam, flurazepam, clorazepate)
93
Clorazepate
Long acting BZD (along with diazepam, chlordiazepoxide, flurazepam)
94
Zolpedim
aka Ambien | Non-BZD hypnotic
95
Zaleplon
Non-BZD hypnotic
96
Eszopiclone
Non-BZD hypnotic
97
Flumazenil
Competitive antagonist at GABA BZD receptor site | - OD of BZD or non-BZD hypnotics
98
Halothane
Inhaled anesthetic | - Hepatotoxicity
99
Enflurane
Inhaled anesthetic | - Proconvulsant
100
Isoflurane
Inhaled anesthetic
101
Sevoflurane
Inhaled anesthetic
102
Methoxyflurane
Inhaled anesthetic | - Nephrotoxicity
103
NO
Inhaled anesthetic | SE: expansion of trapped gas
104
Arylcyclohexylamines (Ketamine)
Dissociative anesthetic - Blocks NMDA receptor - Incr cerebral BF (decr cerebral metabolic demand) SE: CV stimulation
105
Propofol
Potentiates GABA | - Rapid anesthesia induction and short procedures
106
Procaine
Ester local anesthetic | - block Na ch
107
Cocaine
Ester local anesthetic - block Na ch SE: HTN, hypotension, arrhythmia
108
Tetracaine
Ester local anesthetic | - block Na ch
109
Lidocaine
Amide local anesthetic (give if ester allergic) | - block Na ch
110
Mepivacaine
Amide local anesthetic (give if ester allergic) | - block Na ch
111
Bupivacaine
Amide local anesthetic (give if ester allergic) - block Na ch SE: Severe CV tox!
112
Succinylcholine
Depolarizing NM blocking agent - Phase I (prolonged depol): no antidote, potentiated by AChE-I - Phase II (repol but not blocked): give AChE-I e.g. neostigmine as antidote
113
Tubocurarine
Non-depolarizing NM blocking agent - Competitive ACh R antagonist Rev blockade with AChE-I (neostigmine, edrophonium)
114
Atracurium
Non-depolarizing NM blocking agent - Competitive ACh R antagonist Rev blockade with AChE-I (neostigmine, edrophonium)
115
Mivacurium
Non-depolarizing NM blocking agent - Competitive ACh R antagonist Rev blockade with AChE-I (neostigmine, edrophonium)
116
Pancuronium
Non-depolarizing NM blocking agent - Competitive ACh R antagonist Rev blockade with AChE-I (neostigmine, edrophonium)
117
Vecuronium
Non-depolarizing NM blocking agent - Competitive ACh R antagonist Rev blockade with AChE-I (neostigmine, edrophonium)
118
Rocuronium
Non-depolarizing NM blocking agent - Competitive ACh R antagonist Rev blockade with AChE-I (neostigmine, edrophonium)
119
Dantrolene
Prevents release of Ca from SR of skeletal muscle - Malignant hyperthermia - NMS
120
Bromocriptine
DA agonist | ergot (not preferred)
121
Pramipexole
DA agonist
122
Ropinirole
DA agonist | non-ergot (preferred)
123
Amantadine
Incr DA release, blocks viral uncoating (M2 protein)
124
L-dopa/carbidopa
Incr DA in CNS - Carbidopa inh periph decarboxylase SE: ARRHYTHMIAS from peripheral conversion of DA
125
Selegiline
selective MAOB inh (MAOB prefers to metabolize DA) | - Prevent L-dopa degradation
126
Entacapone
COMT inh | - Prevent L-dopa degradation
127
Tolcapone
COMT inh | - Prevent L-dopa degradation
128
Benztropine
Antimuscarinic, improves tremor and rigidity but little effect on bradykinesia
129
Baclofen
GABA derivative, GABA-B agonist | For spasticity and alcoholism
130
Memantine
NMDA R antagonist - prevent excitotoxicity mediated by Ca Alzheimers
131
Donepezil
AchE inhibitor | Alzheimers
132
Galantamine
AchE inhibitor | Alzheimers
133
Rivastigmine
AchE inhibitor | Alzheimers
134
Vit E
Antioxidant
135
Reserpine
blocks the vesicular monoamine transporter (VMAT), prevent NT packaging into vesicles and release (they then get degraded by MAO and COMT) - Huntington's (hyperkinetic mvmnt)
136
Tetrabenazine
blocks the vesicular monoamine transporter (VMAT), prevent NT packaging into vesicles and release (they then get degraded by MAO and COMT) - Huntington's (hyperkinetic mvmnt)
137
Sumatriptan
5-HT1B/1D agonist - Vasocontriction, inh trigeminal activation and Vasoactive peptide relsease Tx: acute migraine, cluster Ha SE: coronary vasospasm!

Pharmacology (15 decks)

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