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Systemic Pharmacology_Dr. McNaughton > 2. Neuromodulators > Flashcards

2. Neuromodulators Flashcards

1
Q

What is the most common drug we use to treat ADHD and Narcolepsy?

A

Amphetamine [Adderall]. 5-40mg/day

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2
Q

What is the mechanism of action of Amphetamine?

A

It stimulates CNS through a sympathomimetic mechanism involving the enhanced release and reduced reuptake of norepinephrine and dopamine.

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3
Q

What are the different neuromodulator drug classes?

A 
Psychomotor Stimulants
Antidepressants
Antipsychotics/Neuroleptics
Neurodegenerative Therapies
Anxiolytics & Hypnotics
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4
Q

What are the different neuromodulator drug classes?

A 
Psychomotor Stimulants
Antidepressants
Antipsychotics/Neuroleptics
Neurodegenerative Therapies
Anxiolytics & Hypnotics
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5
Q

What happens if you give a patient opthalmic beta blockers & alpha 2 agonists in the presence of Amphetamine?

A

Hypertensive crisis. DO NOT do this.

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6
Q

What happens if you give a patient carbonic anhydrase inhibitors in the presence of Amphetamine?

A

renal excretion decreased in alkaline urine

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7
Q

What happens if you give a patient NSAIDs or Decongestants in the presence of Amphetamine?

A

Additive effect. NSAIDs is a caffeine base drugs.

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8
Q

Why is Amphetamine contraindicated with glaucoma patients?

A

Normally glaucoma is treated with sympathetic activity drugs (beta blockers and alpha 2 agonists) but Amphetamine is the opposite.

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9
Q

Why is Amphetamine contraindicated with glaucoma patients?

A

Normally glaucoma is treated with a drug (beta blockers and alpha 2 agonists) but Amphetamine is the opposite.

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10
Q

The different classes of antidepressant drugs.

A
  1. Selective serotonin reuptake inhibitor (SSRIs),
  2. Selevtive serotonin/norepinephrine reuptake inhibitor (SNRIs)
  3. Tricyclic antidepressant (TCADs)
  4. Atypical
  5. MAOIs
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11
Q

The most common SSRI antidepressant is?

A

Escitalopram [Lexapro]

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12
Q

The most common SSRI antidepressant is?

A

Escitalopram [Lexapro]

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13
Q

What is the indicator for Escitalopram?

A

major depressive disorder and generalized anxiety disorder

10-20mg qd

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14
Q

Your patient comes in with a subconjunctival hemorrhage, which combination of drugs give you that?

A

Escitalopram with NSAIDs and Omega 3 FA Or Duloxetine with NSAIDs and Omega 3 FA.

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15
Q

What is the effect of Escitalopram (SSRI) or Duloxetine (SNRI) on Beta blockers metabolism?

A

it will reduce it, which increases beta blockers concentration in the blood. Beware of glaucoma patients who are taking this.

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16
Q

Which SNRI drug is the the most commonly prescribed?

A

Duloxetine [Cymbalta]

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17
Q

What is the indication for Duloxetine (SNRI)?

A

Depression, anxiety, neuropathic pain (DM), Fibromyalgia

Dosing: 60mg qd

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18
Q

What effect does Opiods give in the presence of Duloxetine?

A

it’s an additive

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19
Q

Which antidepressant drug can cause angle closure glaucoma and bleeding risk?

A

Duloxetine (SNRI) because this drug is an stimulant for catecholamines, which naturally will produce a dilation.

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20
Q

The different classes of antidepressant drugs.

A
  1. Selective serotonin reuptake inhibitor (SSRIs),
  2. Selevtive serotonin/norepinephrine reuptake inhibitor (SNRIs)
  3. Tricyclic antidepressant (TCADs)
  4. Atypical
  5. MAOIs
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21
Q

Which drug is the most commonly prescribed Tricyclic antidepressants?

A

Imipramine [Tofranil]

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22
Q

Which drug is the most commonly prescribed Atypical antidepressants?

A

Trazadone [Desyrel]

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23
Q

What is the indication for taking Trazodone (atypical antidepressant)

A

Major depressive disorder (50-100mg bid - tid)

Insomnia (25-50mg qhs)

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24
Q

The mechanism of action of Trazodone is to block _______ and serotonin subtypes ______ and ______.

A

adrenergic alpha 1, 2A, 2C

25
Q

Which Antidepressant has ocular irritation adverse effect?

A

Trazodone

26
Q

What is the drug interactions of cyclosporine, macrolides and azoles in the presence of Trazodone?

A

QT prolongation & impaired hepatic metabolism.

27
Q

What is the drug interactions of NSAIDs in the presence of Trazodone?

A

Hemorrhage

28
Q

The most common antipsychotics/neuroleptics is?

A

Quetiapin [Seroquel]

29
Q

Which receptors do Quetiapine (antipsychotics) blocked?

A

Quetiapine is a 2nd generation antipsychotics. It blocks D2 and 5-HT2 receptors. It also has ancillary effects that come from blocking of H1 (histamine) and alpha 1 (vasoconstrictor) receptors.

30
Q

What is the drug interactions of NSAIDs in the presence of Trazodone?

A

Hemorrhage

31
Q

Which receptors do Quetiapine (antipsychotics) blocked?

A

Quetiapine is a 2nd generation antipsychotics. It blocks D2 and 5-HT2 receptors. It also has ancillary effects that come from blocking of H1 (histamine) and alpha 1 (vasoconstrictor) receptors.

32
Q

Which anti-psychotic drugs can cause cataracts?

A

Quetiapine. BPH uses to treat hypertension also causes cataracts.

33
Q

What is the drug interactions of Macrolides, Azoles, CsA in the presence of Quetiapine (anti-psychotic)?

A

Prolonged QT segment

34
Q

What is the drug interactions of Classic Anti-histamine in the presence of Quetiapine (anti-psychotic)?

A

Additive CNS depression because Quetiapine has sedative effect and classic 1st generation anti-histamines have that as well.

35
Q

What is the drug interactions of Classic Anti-histamine in the presence of Quetiapine (anti-psychotic)?

A

Additive CNS depression because Quetiapine has sedative effect and classic 1st generation anti-histamines have that as well.

36
Q

Patients with Alzheimer disease have a significant loss of _______ in the temporal lobe and entorhinal cortex. Most of the drugs available to treat the disease are __________.

A

cholinergic neurons, acetylcholinesterase inhibitors

37
Q

Which is the most commonly prescribed alzheimer therapy drug?

A

Donepezil [Aricept]

dosing: 1 tabs qhs (bed time) [5/10/23] mg

38
Q

Is Donepezil a neural protected drug?

A

No. It has indirect acting; reversibly binds to and inactivates acetylcholinesterase.

39
Q

Is Donepezil a neural protected drug?

A

No. It has indirect acting; reversibly binds to and inactivates acetylcholinesterase.

40
Q

What is the most commonly prescribed Anti-parkinson therapies drug?

A

Carbidopa (10-25 mg) and Levodopa (100-250 mg)

[Sinemet]

41
Q

Which Sinemet drug component (Carbidopa and Levodopa) crosses the blood brain barrier (BBB)?

A

Levodopa crosses the BBB to enhance dopamine synthesis in the substantia nigra.

42
Q

What is the function of Carbidopa in Sinemet?

A

It inhibits dopa decarboxylase. It also degrades levodopa to dopamine, which it can’t enter the BBB.

43
Q

What is the drug interactions of Sinemet?

A

NONE. It’s a safe drug to take with other drugs!!

44
Q

Which receptor in the CNS does Anxiolytics & Hypnotics drugs act on?

A

GABAa

45
Q

What are the Anxiolytic & hypnotic drug classes?

A

BENZODIAZEPINES (BZD)
NON-BENZODIAZEPINES
BARBITURATES

46
Q

Which of the Anxiolytic & hypnotic drug class is the most toxic?

A

Barbiturates

47
Q

Which is the first Benzodiazepine being produced?

A

Librium has a distinct generic name and is recognized as the first BZD, produced in 1955

48
Q

Which is the most commonly abused Benzodiazepine?

A

Temazepam’s pharmacokinetic properties render it the most commonly abused BZD

49
Q

Which is the most commonly prescribed Benzodiazepine?

A

Alprazolam [Xanax]

Dosing: [1/4, 1/2, 1, 2mg]_ 1 tab tid

50
Q

Which Benzodiazepine drug can cause anterograde amnesia?

A

Alprazolam [Xanax]

51
Q

What happens if you prescribe Cyclosporine, Azoles, and Erythromycins in the presence of Alprazolam [Xanax]?

A

Reduce Alprazolam metabolism

52
Q

What happens if you prescribe Chlorpheniramine (anti-histamines) or Diphenhydramine (anti-histamines) or Opioids in the presence of Alprazolam (anxiolytic)?

A

Additive effect in sedation

53
Q

T/F Alprazolam causes disregulated muscle tone.

A

True. Diplopia. Unstable Myasthenia Gravis

54
Q

T/F Alprazolam causes disregulated muscle tone.

A

True. Diplopia. Unstable Myasthenia Gravis

55
Q

What is the most common Non-Benzodiazepines?

A

Zolpidem [Ambien]

Dosing: [5/10mg] 1 tab ghs (bed time)

56
Q

Zolpidem [ambien] treats _______.

A

Insomnia

57
Q

T/F Zopidem is a long term therapy drug.

A

False. Only 7-10 days. Relatively safe to take because of that.

58
Q

Mechanism of action of Zopidem.

A

Selective agonist of GABAa-BZD-1 receptor

Systemic Pharmacology_Dr. McNaughton (12 decks)

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