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Flashcards in Red-line Drugs Neuro IV Deck (72)
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1

Chlorpromazine

Typical antipsychotic D2 antagonist

low potency

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

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

2

Haloperidol

Typical antipsychotics D2 antagonist

High potency

Schizophrenia (+ symp.), Huntington's

Side effects: EPS tardive dyskinesia Neuroleptic malignant syndrome

3

Clozapine

Atypical antipsychotics

D2/5HT2A antagonist (low ratio)

Schizophrenia (- symp)

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

4

Quetiapine

Atypical antipsychotics

D2/5HT2A antagonist (low ratio)

Schizophrenia: (- symp)

SE: weight gain, prolonged QT, some sedation

5

Paroxetine

SSRI Block SERT

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

6

Escitralopram

SSRI Block SERT

SE: fewest of the SSRIs

7

Bupropion

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

8

Venlafaxine

SNRI SERT and NET blocker

Depression, anxeity, panic, PTSD

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

9

Trazodone

Mixed serotonin receptor and alpha 1 receptor blocker

Insomnia, High doses for depression

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

10

Amitriptyline

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

11

Phenelzine

MAOI

Atypical depression, anxeity

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

12

Fluoxetine

SSRI

Block SERT

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

13

Selegiline

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

14

Lithium

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),

15

Alprazolam

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

16

Flurazepam

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

17

Diazepam

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

18

Oxazepam

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

19

Triazolam

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

20

Lorazepam

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

21

Midazolam

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

22

Temazepam

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

23

Flumazenil

Benzodiazepine receptor ANTagonist used for OD of Benzo

24

Zolpidem

Non-BDZ Activate BZ1 subtype of GABA receptor

Insomnia

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

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]) (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

69

Phenobarbital

Increase GABA-A action 

CYP450 inducer (many DDI)

Partial seizures and generalized tonic-clonic 

excessive sedation limits use 

SE: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