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Red-line Drugs Neuro IV Flashcards

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1
Q

Chlorpromazine

A

Typical antipsychotic D2 antagonist

low potency

Schizophrenia (+ symp.) psychosis, acute mania, Tourette syndrome

Side effects: ANS (dry mouth), sedation, hypotension

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2
Q

Haloperidol

A

Typical antipsychotics D2 antagonist

High potency

Schizophrenia (+ symp.), Huntington’s

Side effects: EPS tardive dyskinesia Neuroleptic malignant syndrome

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3
Q

Clozapine

A

Atypical antipsychotics

D2/5HT2A antagonist (low ratio)

Schizophrenia (- symp)

SE: weight gain, *agranulocytosis*, seizures, prolonged QT

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4
Q

Quetiapine

A

Atypical antipsychotics

D2/5HT2A antagonist (low ratio)

Schizophrenia: (- symp)

SE: weight gain, prolonged QT, some sedation

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5
Q

Paroxetine

A

SSRI Block SERT

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

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6
Q

Escitralopram

A

SSRI Block SERT

SE: fewest of the SSRIs

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7
Q

Bupropion

A

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

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8
Q

Venlafaxine

A

SNRI SERT and NET blocker

Depression, anxeity, panic, PTSD

SE: Hypertension, anxeity, nausea, withdrawal symptoms, sexual dys., sedation

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9
Q

Trazodone

A

Mixed serotonin receptor and alpha 1 receptor blocker

Insomnia, High doses for depression

SE: sedation, nausea, priapism (trazo*bone*), postural hypotension

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10
Q

Amitriptyline

A

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

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11
Q

Phenelzine

A

MAOI

Atypical depression, anxeity

SE: Hypertensive crisis (tyramine), CNS stimulation, Serotonin syndrome

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12
Q

Fluoxetine

A

SSRI

Block SERT

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

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13
Q

Selegiline

A

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

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14
Q

Lithium

A

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),

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15
Q

Alprazolam

A

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

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16
Q

Flurazepam

A

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

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17
Q

Diazepam

A

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), status epileticus

SE: Dependence, additive depressant effects w/ EtOH, anterograde amnesia, abuse

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18
Q

Oxazepam

A

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

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19
Q

Triazolam

A

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

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20
Q

Lorazepam

A

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, status epilepticus

SE: Dependence, additive depressant effects w/ EtOH, anterograde amnesia, abuse

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21
Q

Midazolam

A

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

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22
Q

Temazepam

A

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

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23
Q

Flumazenil

A

Benzodiazepine receptor ANTagonist used for OD of Benzo

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24
Q

Zolpidem

A

Non-BDZ Activate BZ1 subtype of GABA receptor

Insomnia

SE: Ataxia, headache, confusion less dependence risk, less amnesia

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25
Eszopiclone
Non-BDZ Activate BZ1 subtype of GABA receptor Insomnia SE: Ataxia, headache, confusion less dependence risk, less amnesia
26
Zaleplon
Non-BDZ Activate BZ1 subtype of GABA receptor (GABA Cl- channel) Insomnia SE: Ataxia, headache, confusion less dependence risk, less amnesia
27
Phenobarbital
Barbiturates increase \*duration\* of GABA CL- channel opening Anxiety, seizures, insomnia, anesthesia (thiopental) Seizures: partial and generalized tonic-clonic SE: Respiratory and CV depression! Sedation! CNS depression (worse w/ EtOH), dependence, DDI (P-450 inducer)
28
Ramelteon
Melatonin Receptor Agonist
29
Buspirone
5HT1A partial agonist (D2 antagonist) Anxiety
30
Cocaine
DAT (+SERT, NET) Stimulant
31
Amphetamines
DAT (+SERT, NET) stimulant
32
Nicotine
nicotinic receptor Stimulants
33
Stimulants
Nicotine Cocaine Meth MDMA (ecstasy)
34
Depressants
Alcohol Barbiturates Benzodiazepines
35
Barbiturates
increase GABA-A, decrease NMDA
36
Benzos
Increase GABA-A only antagonist: flumazenil
37
Dissociative Anesthetics
Phencyclidine (PCP) Ketamine
38
Opioid analgesics
Morphine heroin fentanyl meperidine
39
Heroin
Mu-opioid receptor (Gi/o) agonist treat w/ naloxone
40
Cannabinoids
CB-1 receptor (Gi/o) agonist
41
Hallucinogens
Lysergic acid diethyl amide (LSD) Mescaline (peyote)
42
Methadone
Treat opioid dependence binds Mu receptor agonist and NMDA antagonist
43
Buprenorphine
partial mu agonist (avoid respiratory depression) Treat opioid addiction
44
Clonidine
Alpha 2 agonist treat withdrawal from EtOH, Opioids, smoking
45
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
46
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
47
d-Amphetamine
Adderall Inhibits or reverses the transporter proteins for the monoamine Increases releases of monoamines Inhibits breakdown of monoamines
48
Methylphenidate
Ritalin Blocks the dopamine transporter and norepinephrine transporter more remains in synaptic cleft
49
-ipramine
TCA
50
-etine
SSRI
51
-triptyline
TCA
52
-zepam
Benzo
53
-zolam
Benzo
54
-barbital
Barbiturate
55
-azine
Typical antipsychotics
56
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)
57
Volatile anesthetics
Desflurane Enflurane Halothane Isoflurane Sevoflurane
58
Halothane
Volatile anesthetics mod to high potency; poor analgesic Three issues: -Respiratory and CV failure -Hepatotoxicity (metabolized in liver) -Malignant Hyperthermia
59
IV anesthetics
Propofol Etomidate Thiopental
60
IV adjuncts for GA
Diazepam Ondansteron (anti-emetic) Fentanyl (analgesic) Glycopyrrolate (Anticholinergic) Ketamine (NMDA antagonist) Morphine Neuromuscular blocking agents Dantrolene (Ca2+ channel blocker)
61
Dantrolene
prevents release of Ca2+ from sarcoplasmic reticulum of skeletal muscle Malignant hyperthermia and neuroleptic malignant syndrome
62
Ethosuximide
Blocks thalamic T-type Ca2+ channels Absence seizures SE: EFGHIJ Ethosuximide causes Fatigue GI distress Headache Itching steven-Johnson syndrome
63
Diazepam
Benzodiazepime Increased GABA-A action--increased frequency of Cl- channel opening Status Epliepticus SE:Sedation, tolerance dependence, respiratory depression
64
Lorazepam
Benzodiazepime Increased GABA-A action--increased frequency of Cl- channel opening Status Epliepticus SE:Sedation, tolerance dependence, respiratory depression
65
Midazolam
Benzodiazepime Increased GABA-A action--increased frequency of Cl- channel opening Status Epliepticus SE:Sedation, tolerance dependence, respiratory depression
66
Phenytoin
increase Na+ channel inactivation zero order kinetics, Induction of P450 Not as popular anymore but used for Partial seizures and generalized tonic-clonic seizures Prophylaxis for status epilepticus SE: Nystagmus, diplopia, ataxia, sedation (high dose), rash, gingival hyperplasia, hirsutism, megaloblastic anemia, peripheral neuropathy
67
Carbamazepine
Increase Na+ channel inactivation First line for Partial and Tonic clonic (also trigeminal neuralgia) SE: diplopia, ataxia, blood dyscrasias (agranuloctosis and aplastic anemia), teratogenesis Induction of P450 SIADH, Steven-Johnson syndrome
68
Valproic Acid
Inhibits GABA transminase (increasing [GABA]) (I*ncreases Na+ channel inactivation)* Use: first line in Generalized Tonic-Clonic also for absance and partial SE: GI destress, possible hepatotoxicity, neural tube defects, tremor, weight gain, bad for pregnancy DDI: alcohol/CNS depressants, anticonvulsants, aspirin/warfarin
69
Phenobarbital
Increase GABA-A action CYP450 inducer (many DDI) Partial seizures and generalized tonic-clonic * excessive sedation limits use* * S*E:sedation, tolerance, dependence, cardiorespiratory depression
70
Levetiracetam
unknown MOA First line for Tonic-clonic SE: somnolence, dizziness, fatigue NO P450 effect
71
Lamotrigine
Blocks VSSC partial, generalized and absance SE: dizziness, ataxia, diplopia, sedation, rashes, nausea (less than phenytoin)
72
Divalproex
Inhibits GABA transminase (increasing [GABA]) (Increases Na+ channel inactivation) Use: first line in Generalized Tonic-Clonic also for absance and partial SE: GI destress, possible hepatotoxicity, neural tube defects, tremor, weight gain, bad for pregnancy DDI: alcohol/CNS depressants, anticonvulsants, aspirin/warfarin

Neuro IV pharm (3 decks)

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