. Flashcards
Antipsychotic agents exert both therapeutic actions and side effects as a result of dopaminergic receptor blocking activities in various brain regions. Appetite increase, weight gain and diabetes are common side effects of antipsychotic use that result from block of dopamine receptors at which site?
Mesolimbic system + s/s Nigrostriatal pathway -pp Mesocortical system- cognitive Hypothalamus- appetite Locus ceruleus- Pituitary- hyperprolactin
Low potency typical antipsychotic agents like chlorpromazine can have significant alpha-adrenergic receptor blocking activity. Therefore, if a patient taking chlorpromazine for schizophrenia is given epinephrine to increase blood pressure following anaphylactic shock in the clinic, one is likely to observe
****A paradoxical decrease in BP due to EPI reversal **
rx: phenylephrine selective a1
Agranulocytosis (low white blood cell count) can predispose patients to infections. Which of the following agents used in the pharmacotherapy of mental illnesses is associated with the highest incidence of agranulocytosis as a side effect?
*****Chlorpromazine
Agranulocytosis (low white blood cell count) can predispose patients to infections. Which of the following agents used in the pharmacotherapy of mental illnesses is associated with the highest incidence of agranulocytosis as a side effect?
Amitriptyline (Elavil) Chlorpromazine (Thorazine) Clozapine (Clozaril)* Fluoxetine (Prozac) Haloperidol (Haldol)
THIS IS ON THE EXAM IN SOME WAY
Which of the following therapeutic actions or side effects of antipsychotic agents does NOT result from blockade of dopamine receptors?
Anti-emetic action
Xerostomia
Hyperprolactinemia
Parkinson-like rigidity
Alleviation of hallucinations and delusions
Poikilothermia (interference with hypothalamic temperature regulation)
Orthostatic hypotension
Anti-emetic action
Xerostomia- BLOCK M
Hyperprolactinemia- D2
Parkinson-like rigidity- D2
Alleviation of hallucinations and delusions- D2
Poikilothermia (interference with hypothalamic temperature regulation)- D2
Orthostatic hypotension- a1
–NON DOPA BLOCK–
THIS IS ON THE TEST
Benzodiazepines and barbiturates share which of the following pharmacologic properties?
Augment GABA action at the GABA receptor-chloride channel complex at low doses
Ability to maintain surgical anesthesia (stage III) when administered intravenously
Inhibition of GABA neurotransmission
Efficacy in the treatment of seizure disorders
High therapeutic index
Agonist action at benzodiazepine receptors
Augment GABA action at the GABA receptor-chloride channel complex at low doses— TRUE**
Ability to maintain surgical anesthesia (stage III) when administered intravenously– NO
Inhibition of GABA neurotransmission– Augment not inhibit
Efficacy in the treatment of seizure disorders- BOTH GOOD AT SZ TRUE**
High therapeutic index–
Agonist action at benzodiazepine receptors– benzo binding
Which of the following properties is shared by both inhalational general anesthetics and oral benzodiazepine anti-anxiety agents?
Maintenance of Stage III surgical anesthesia
Potentiation of GABAA receptor activity
Low margin of safety
Relatively low potency
Inhibition of excitatory synaptic transmission
Maintenance of Stage III surgical anesthesia– NO
Potentiation of GABAA receptor activity– BOTH
Low margin of safety–
Relatively low potency–
Inhibition of excitatory synaptic transmission– general alone
????
Administration of flumazenil (Romazicon) will reverse the toxicities associated with an overdose of: Alcohol Barbiturates Benzodiazepines Morphine All of the above A, B, and C only
Alcohol- support. Barbiturates- can reverse TRUE ONLY Benzodiazepines Morphine- naloxone/ narcan All of the above- no A, B, and C only- no
Benzodiazepines and barbiturates share which of the following pharmacologic properties?
Augment GABA action at the GABA receptor-chloride channel complex at low doses
Ability to maintain surgical anesthesia (stage III) when administered intravenously
Inhibition of GABA neurotransmission
Efficacy in the treatment of seizure disorders
High therapeutic index
Agonist action at benzodiazepine receptors
Addiction potential with prolonged use
Augment GABA action at the GABA receptor-chloride channel complex at low doses- true????
Ability to maintain surgical anesthesia (stage III) when administered intravenously
Inhibition of GABA neurotransmission
Efficacy in the treatment of seizure disorders
High therapeutic index
Agonist action at benzodiazepine receptors
Addiction potential with prolonged use
The primary route of elimination for benzodiazepines is hepatic metabolism. If metabolism is impaired due to liver disease or advancing age benzodiazepines may accumulate in plasma and tissues and their potential for adverse reactions will increase. Glucuronidation metabolic pathways are affected least by aging or liver disease, thus benzodiazepines eliminated entirely by this pathway are preferred in these patients. Such benzodiazepines include: Alprazolam (Xanax) Chlordiazepoxide (Librium) Diazepam (Valium) Flurazepam (Dalmane) Oxazepam (Serax ) Triazolam (Halcion)
Alprazolam (Xanax) Chlordiazepoxide (Librium) Diazepam (Valium) Flurazepam (Dalmane) Oxazepam (Serax )*** TRUE Triazolam (Halcion)
Os and L
Side effects associated with the use of benzodiazepines in treatment of anxiety disorders could include all of the following EXCEPT:
Development of physical dependence Development of psychologic dependence Ataxia and risk of falls in the elderly Retrograde amnesia Excessive daytime drowsiness Impaired judgment Exacerbation of porphyria Could include all of the above
Development of physical dependence Development of psychologic dependence Ataxia and risk of falls in the elderly Retrograde amnesia Excessive daytime drowsiness Impaired judgment Exacerbation of porphyria Could include all of the above
Benzodiazepines are preferred over barbiturates when use of a sedative-hypnotic agent is needed in sedation procedures. Reasons for this preference include:
Barbiturates have a much lower therapeutic index than benzodiazepines.
Barbiturates (Schedule II) have a higher abuse potential than benzodiazepines (Schedule IV).
Barbiturates are classic inducers of cytochrome P450 enzymes with a greater potential for drug-drug interactions.
Barbiturate overdose is more likely to result in death by respiratory depression than is benzodiazepine overdose.
All of the above
Barbiturates have a much lower therapeutic index than benzodiazepines.
Barbiturates (Schedule II) have a higher abuse potential than benzodiazepines (Schedule IV).
Barbiturates are classic inducers of cytochrome P450 enzymes with a greater potential for drug-drug interactions.
Barbiturate overdose is more likely to result in death by respiratory depression than is benzodiazepine overdose.
All of the above
