Additonal Stuff Pt 3 Flashcards
Wad is the metabolite of
1) risperidone
2) Imipramine
1) Paliperidone
2) Desmipramine
Buspirone belongs to the chemical class
How about flupenthixol
How any thioridazine
4) bupropion?
Azasipirones
Thioxanthene
3) piperdine derivatives
4) aminoketone
Wad are the secondary amine for tricyclics
Name 3
Nortriplyine , Amoxapine, desmiprasine
Major transquilisters are known to be wadtype
Antipsychotics
Who use valproate in Mania
Bowden (1994)
Who is Janssen
Create haloperidol and dropidol
What is minacipran
SNRI
Zimeldine was wad and why it was withdrawn
The first SSRI
Withdrawn due to hypersensitivity syndrome and demyelination get disease
Rivatigmine is a wad type of drug
Reversible non competitive inhibitor of AchEs
Non Selective oso
Name two reversible MAOI
Moclobemide and brofaromine
What drug would best be used to trade mixed affective states?
Sodium valproate
Acamprosate is a wad
Synthetic taurine analogue
Act centrally glutamate and GABA neurotransmitter system .
First antidepressant is
Iproniazid
A MAO inhibitor
Wad does Kuhn does
Create imipramine
OCC can be affected by wad drugs name 4
Carbamazepine, St. John , topimarate, phenytoin, phenobarbitone
VALPROATE DOES NOT affect it
What is affected in old ppl and How
Name 4
1) total body fat increase
2) gastric pH increase, acidity drops
3) reduced renal clearance
4) decrease in plasma protein binding
5) decreased number of acetylene choline postsynaptic receptors
Comment on tricyclic’s
1) lipid solubility
2) protein binding
1) good, can pass easily
2) very binding
Half life of quietiapine?
6 hours
Fluoxetine drug effect
Can be seen for wad and wad does it do
1) propranolol
2) haloperidol
3) carbamazepine
4) oral anticoagulant
5) phenytoin
1) enchance
2) increases
3) increases
4) enchance
5) increases
Half life of nitrazepam
15-38 hours
Smoking is an enzyme inducer of inhibitor
How abt caffeine
Smoking : inducer
Caffeine: inhibitor
What kind of drugs follow zero order kinetics
1) depot antipsychotics
2) control realise drug
3) phenytoin
4) alcohol
Wad drug will be affected by moist air
Sodium valproate
Which SSRI shows the most autoinhibition
Paroxetine
Valproate can affect which drug
How carbameziene affect valproate
It can increase lamotrigibe, clomipramine, phenobarbitone by competitive inhibition of their metabolism
It is decreased by carbamazepine
Donepezil has efficacy in what domain
efficacy against the three major domains of Alzheimer’s disease symptoms, namely functional ability, behavior, and cognition.
What drugs are associated with bruxism
Stimulants
Wad drug is good to be added with MAOI
Amitriptyline, as it potentiates action of TCA
Wad antidementia drug acts on nicotinine receptors as well
Galatamine
Acamprosate is a wad
Glutamate antagonism
Sodium valproate does
GABA potentiation 5
What is the most sedative for TCA
Trimipramine
Endogenous substrate for MAO included
epinephrine, dopamine and serotonin
Chronic use of antidepressant can show
Downregulation of beta-adrenergic receptors
Which antipsychotics are better in reducing epse
Quetiapine
Barbiturates mechanism of actions
Increasing duration of chloride channel opening
Act on GABA
Clozapine hypersalivation is due to
How to treat (4)
Alpha 2 antagonism,
M4 agonism
Amitriptyline Hyoscine Benzhexol Pirenzepine (M1,M4 antagonist) Terazoxin
Trazodone is wad class
SARI
Serotonin antagonist and reuptake inhibitor
Which TCA has a stimulant effect
Desmiprasine
Cyproheptadine is mechanism of action
Histamine h1 receptor blockage
Tyramine inters persona-tic neuron via what and release stored catecholamine via wad
Amine uptake pumps
Via Catecholamines reuptake channels
Which EPSE reacts best with anticholinergic
Dystonia
Drugs that are useful in tardive dyskinesia
Clonazepam, vitamins e, licensed is tetrabenazine (also can treat HD/tics, hemiballismus)
Which benzodiazepine is most toxic?
Alprazolam
3 mechanism of weight gain due to drugs
5ht2c antagonism
H1 antagonism
Hyperprolactinemia
Increased serum leptin
Risk of NMS
0.5 -1%
Wad atypical can increase prolactin
Name 3
Risperidone, Amisulpride and Zotepine
Tca potentiates 4 types of drug
alcohol, hypnotics, anxiolytics and antipsychotics n anticoagulant
Name 4 tat causes high effect on QTC
sertindole, thioridazine, pimozide and droperidol
Rare side effect of MAOI name 4
hepatocellular jaundice, Peripheral neuropathy, bone marrow suppression, and cardiac arrhythmia
Which SSRI has more problems of erectile dysfunction
Which has least
Paroxetine
Fluvoxamine
Which antidepressant can hav urinary hesitancy and how to treat
Reboxetine
Can use alpha 1 antagonist such as doxazosin or Tamsulosin
Wad antibiotic will cause serotonin syndrome if add with MAOI
Linezoid a oxazolidone family
Percentage of patient developing
1) tardive dyskinesia
2) Dystonia
3) Pseudoparkinsonism
4) akathesia
1) 2-5%
2) 2-10%
3) 20%
4) 25%
What can be used for self injurious behaviour of ID peeps
Naltrexone
Give three medication that can be sued to treat NMS
Bromocriptine, Dantrolene, amantadine
Who belongs to the seven transmembrane receptor
Dopamine
Mirtazapine mechanism
5HT2A antagonism
Alpha 2 antagonism
Antihistamine
Anti 5HT3
Agomelatine mechanism
Norepinephrine and dopamine neurotransmission through 5-HT2C antagonism
Direct agonist at melatonin receptors
How SSRI can cause tolerance to hallucinogic drug
Down regulation of 5HT 2A
Lower incidence of EPSEs of newer atypical antipsychotics is due to
5-HT2 receptor blockage
Who create the first benzodiazepine
What is it
chlordiazepoxide
Hugo sternbach
Lithium cannot be combine with which TCA because
Clomipramine
Serotonin syndrome
Wad can cause atropine psychosis
Amitriptyline
Serotonin syndrome is due to hyperstimulation of wad
5HT 1A/5HT 2A
Most common side effect of
1) amisulpride and clozapine
2) imipramine and chlorpromazine
1) hypersalivation
2) dry cough
Which antidementia drugs are non selective
Rivastigmine
Special side effect of topimarate
Word finding difficulty
Wight loss
Renal stone
Special side effect of galatamine
Bradycardia
Phencyclidine mechanism
Ketamine mechanism
Phencyclidine: competitive
Ketamine
Non competitive NMDA receptor s
Tell me three types if phenothiazine
1) aliphatic: chlorpromazine, trifluoperazine, promazine
Piperidine: thioridazine
Piperazine: trifluoperazine, perphenazine, fluphenazine
Sinadefil made by
Osterloh
Who made carbamazepine
Takezaki and Hanoka with okuma
To treat mania
How does sodium valproate react
Enhances GABAergic function and inhibits GABA aminotransferase, increase GABA binding
Lamotrigine
Neuronal membrane stabiliser and blocks voltage-dependent sodium channels hence reducing release of excitatory amino acid
Topimarate how does it function
enhances GABA and blocks glutamate at NMDA receptors
What is the first depot injection and is introduced byyyyyy
Fluphenazine
By G.R. Daniels
Irreversible retinal pigmentation is associated with
use of high dose thioridazine (above 1000 mg a day)
Which SSRI has weakly blocking reuptake of dopamine
Which SSRI stimulate 5-HT2C receptors
1) setraline so good for psychomotor reduction
2) Fluoxetine-hence does not cause weight gain
Which antidepressant has a safe cardiovascular profile
Ribose Tien
Wad ssri can have potent effect ion the pain receptors (which site)
How abt zopidem
Or zopiclone
Zaleplon
Fluvoxamine on sigma
Both z affect omega receptor-1 in GABA
All omega receptors in GABA
Why these drugs are withdrawn
1) sertindole
2) mianserin’
3) Thalidomide
4) Zimeldine
1) sudden cardiac death
2) blood dyscrasias
3) teratogenic effect of phocomelia
4) GB and hypersensitive reaction
Lithium might made wad cardiac issue even worse
Brugada
RBBB and ST elevation in right precordial leads
Wad blood stuff can sodium valproate do
Leukopenia, thrombocytopenia, red cell hypoplasia
Which antidepressent can cause dependence
Tranylcypromine cuz it has an amphetamine like structure
Antidepressant related QTC prolongation is
Trazodone
Which TCA has the least effect in cardiac arrhythmia
Lofepramide
Which antidementia drug has no hepatic involvement
Rivastigmine
Phenelzine has been shown to be superior to placebo in the treatment of
Social phobia
Which of the following medications used to treat depression can directly influence gene transcription via nuclear receptors
Tri-iodothyronine
GABApentin binds to
: Voltage-dependent calcium channel
Lithium tremors can be helped by
Smaller, more frequent dose, or/and propranolol
ST johns wort might do what two these two things
1) contraceptive pills
2) warfarin
1) decrease
2) inhibit
Which hypnotic has a unique side effect of metallic taste in the mouth
Zopiclone
disturbance in cerebral torque is proposed as the underlying pathological change in
Psychosis
Wad protein is involved in Motor neuron disease
Superoxide dismutase
Mifepristone is wad
glucocorticoid receptor antagonis
Can help in depression
Wad is the male to female ratio for FTD and how many % it is associated with MND
1:1
15%
ECG in Huntington can be
% will have abnormal ECG
Conduction abnormalities and bradycardia, QTC elevation
25%
Elfin facial feature is wad syndrome
Other symptoms include
Williams syndrome hoarse voice, premature wrinkling and sagging of the skin, LD, hypercalcemia, supravalvular aortic stenosis
Wad disease is due to lack of sphingomyelinase?
Niemann Pick disease
sphingomyeline accumulate in liver, spleen, lungs, bone marrow and brain leading to neurological damage
Two types type 1 in infants, type b before teenager
Melatonin is secreted in
Pineal gland
Normal ration of CSF and serum glucose is
It is decreased due to
0.6 (CSF has 60%) seen in blood
Bacterial meningitis
Contraindication of disease in MAOI include
Phaeochromocytoma
Adrenal medulla tumors
Sigma receptors are associated with
Wad drugs might affect it (4)
Depression
Haloperidol, setraline, fluvoxamine, cocain, phenytoin
Methadone can cause wad cardiac problems
QTC prolongation, torsades de -pointes
Cleft palate is indicated in wad three drugs
Diazepam, lamotrigine, sodium valproate , and ?SSRI
Having clozapine will hav a cumulative risk of developing seizure by how much
10%
Atypical depression can usually use wad to treat
MAOI
Which 3 are potent inhibitors of CYP2D6
Parole Tien, fluoxetine and duloxetine
Wad antibiotic will cause an reaction with alcohol
Metronidazole
Acetylation
how many percent will b from Caucasian tat is slow
Wad drugs will be affected in slow acetylations
50%
IsonAzid, procainamide, nitrazepam
D2 are excitatory/inhibitory
Pre+post or just post
Inhibitory, pro+postsynaptic
Which serotonin receptor has auto-regulatory function in synaptosomes (5-HT terminals)
5-HT1B
What you can see in EEG in R.E.M.
Saw tooth
Wad u can see in EEG for delirium tremens
Low voltage fast wave
What drugs should be avoided in Organic disinhibition
Should use wad
Benzodiazepine
Can use SSRI and trazodone
What is the highest risk if developing NMS
Sudden withdrawal of antiparkinsonian medication
What should be monitor when starting agomelatonin.
Liver function test
Wad drugs should be given to SSRI induced hyponatremia
following treatment with antidepressants such as Fluoxetine. For those who develop hyponatraemia with an SSRI, consider Noradrenergic drugs such as Nortriptyline and Lofepramine, riboxetine or an MAOI such as Moclobemide
NMS is usually due to
Young male, use high potensive drugs, use high potency drugs, dopaminergic drugs on withdrawal
How do change TCA to most SSRI
Half TCA, add new drug then slow withdrawal
What will happen with pregnancy in terms of pharmacokinetic changes
Reduce gastric emptying Reduce motility Reduce plasma protein binding Some drugs have higher metabolism due to oestrogen and progesterone Increase renal elimination Increase volume of distribution
Which antidepressant has a Low predicate for a manic switch
Bupropion
What to give if someone js hypertensive crisis due to MAOI
name two
Phentolamine
Phenoxybenzamine
Common side effect of rivastigmine
Name 5
Nausea, vomiting, diarrhoea, high blood pressure, hallucination
Tricyclics that has the highest antihistamine is
Which tricyclics is the most toxic in overdose
Doxepine
Dosulepin and amitriptyline
Botox can be use to treat
Tardive dystonia
What can cause floppy baby syndrome
Benzodiazepine
Also can cause cleft palate
Difference between NMS and SEROTONIN syndrome
SS has myoclonus and hyperreflexia
Which ssri is good for cardiac ppl
Which ssri can be found in milk
Which ssri can cause virginismasmus
Setraline
Fluoxetine
Paroxetine
Toxic confusional stage in antipsychotic is likely due to
Muscarinic receptor blockage
Cholesterol check for antipsychotics every how many months on the first year
3 months
Wad drugs can cause ovarian cyst
Sodium valproate
What are the risk of tetratrogic for sodium valproate
And birth defect in general
Neural tube defect (1-2%)
Spina Bifida(10 fold increase), anencephaly , heart defect
Birth defect in general for valproate is 7 %
Normal range for phenytoin
10-20
What does ramelton do
How does atomoxetine works
Ramelton: MT1/MT2 receptor agonist promoted as hypnotic
Atomoxetine is a presynaptic norepinephrine inhibitor
