15: Antidepressants, Antipsychotics Flashcards
Drugs with a high therapeutic index:
Slight changes in drug dosage are unlikely to produce toxicity
Slight changes in drug concentration are likely to produce toxicity
Slight changes in drug concentration are unlikely to produce toxicity
Need frequent therapeutic drug monitoring
Large changes in drug dosage are likely to produce toxicity
Slight changes in drug dosage are unlikely to produce toxicity
First drug used to treat seizure:
Phenobarbital
Much of this drug’s pharmacological activity is derived from its two active metabolites, PEMA and phenobarbital:
Primidone
A Novel Psychoactive Substance and the metabolite of trazodone:
mCPP
Major drawback of clozapine treatment:
Agranulocytosis
Metabolism of SSRIs
Extensively metabolized to mostly inactive metabolites
Considered to be the most toxic complication of neuroleptic use:
Neuroleptic Malignant Syndrome
For the SSRIs, the major metabolite route for the production of active metabolites:
Demethylation
Associated with high-potency antipsychotic medication and is dose-related:
Parkinsonism
Drug-induced movement disorders:
Extrapyramidal Effects
Used to treat absence seizures; not effective in the treatment of motor seizures:
Ethosuximide
An abnormal, excessive firing of neurons in the gray matter of the brain:
Seizures
What class of drugs is Fluoxetine?
SSRIs
Prone to postmortem redistribution:
TCAs
Late elution time on a 5% phenyl-methyl silicone column:
Trazodone
These drugs have a three-ring structure common to all members of this group:
TCAs
Serotonin Syndrome usually occurs in this time frame following taking a new drug:
Hours
This is an antidepressant and tobacco-addiction medication:
Bupropion
Although taking just one drug that increases serotonin levels can cause serotonin syndrome, this condition occurs most often when:
Medications are combined
Fluorometry is a not a specific method for measuring some neuroleptic drugs because:
Interferences from metabolites
Death following barbiturate intoxication is often due to:
Respiratory Failure
True/False:
In general, plasma concentrations of neuroleptic agents do not correlate well with clinical signs and symptoms.
True
Has become the drug of choice for the treatment of myoclonic seizures and generalized absence seizures:
Valproic Acid
This drug was derived from clozapine:
Olanzapine
Atypical antipsychotic agents reach steady-state plasma concentrations within:
2 - 10 days
A weakly acidic drug is:
Readily absorbed from the stomach into the blood
Readily absorbed from the intestine into the blood
Absorbed equally from the stomach and intestine into the blood
All of the above
None of the above
Readily absorbed from the stomach into the blood
Dystonia, Tardive Dyskinesia and Akathisia are examples of what?
Extrapyramidal effects
Number of Subtypes of Generalized Seizures
7
Used as an adjunct therapy for partial seizures and used to treat neuropathic pain in adults:
Gabapentin
When used to treat seizures, the therapeutic range is:
15-40 mcg/mL
Type of seizures that involve both hemispheres of the brain:
Generalized seizures
A naturally occurring mono-saccharide derived from D-fructose:
Topiramate
The most common side effect associated with this anticonvulsant is a rash:
Lamotrigine
AED has structural similarities to GABA:
Gabapentin
Tue/False: There is considerable first-pass metabolism with most of the antidepressants.
True
One significant toxic effect of this drug is aplastic anemia:
Carbamazepine
Immunoassay and/or chromatography can assay virtually all drugs that require TDM with the exception of this one notable exception:
Lithium
Used to treat generalized tonic-clonic and partial seizures:
Carbamazepine
A prodrug used to treat generalized tonic-clonic and partial seizures:
Oxcarbazepine
Its main metabolite is HPPH, which is inactive:
Phenytoin
Inhibition of the reuptake of _____ or _____ is regarded as an important action for the antidepressant drugs.
5-HT or NE
For major psychoses, daily doses may range up to 2400 mg.
Chlorpromazine
Loxapine metabolite
Amoxapine
Antidepressants:
Organic bases with low pKa
Organic bases with high pKa
Organic bases with moderate pKa
Acidic drugs with low pKa
Acidic drugs with low pKa
Organic bases with moderate pKa
Its mechanism of action is to inhibit GABA transferase:
Vigabatrin
Most common type of antidepressant
Selective serotonin reuptake inhibitors (SSRIs)
Increase serotonin in brain
Sertraline, Fluoxetine, Citalopram
Type of antidepressant that increases serotonin and norepinephrine in the brain
Serotonin and norepinephrine reuptake inhibitors (SNRIs)
Desvenlafaxine, duloxteine, venlafaxine
An older class of antidepressants that increase serotonin and norepinephrine levels in the brain. These are often reserved for treatment-resistant depression and anxiety.
TCAs
Clomipramine, Protriptyline, TCA confirm drugs
The oldest antidepressants; target the brain enzyme monoamine oxidase, which helps break down neurotransmitters such as serotonin; typically used as a last resort if other types haven’t worked.
MAOIs
Selegiline, Moclobemide, Tranylcypromine, Isocarboxazid,
Phenelzine
Atypical Antidepressants
Bupropion
Mirtazapine
Agomelatine
