All DRUGS

Question 1

Chlorpromazine

Answer 1

Use: SZ, Huntington’s
Class: Phenothiazines - typical neuroleptics
MoA: receptor antagonists, dirty drugs, block many sites: DA1, D2, D3, ACH, H1, 5-HT. Main activity through D2 block. Better at controlling positive symptoms
SE: motor disturbance-dystonias and TD (EPS SE), higher prolactin, anti-histamine, sedation, anti-muscarinic

Question 2

Haloperidol

Answer 2

Use: SZ
Class: Butyrohenonas- typical neuroleptics
MoA: receptor antagonists, dirty drugs, block many sites: DA1, D2, D3, ACH, H1, 5-HT. Main activity through D2 block. Better at controlling positive symptoms
SE: motor disturbance-dystonias and TD (EPS SE), higher prolactin, anti-histamine, sedation, anti-muscarinic

Question 3

Flupenthixol

Answer 3

Use: SZ
Class: Thioxanthines - typical neuroleptics
MoA: receptor antagonists, dirty drugs, block many sites: DA1, D2, D3, ACH, H1, 5-HT. Main activity through D2 block. Better at controlling positive symptoms
SE: motor disturbance-dystonias and TD (EPS SE), higher prolactin, anti-histamine, sedation, anti-muscarinic

Question 4

Clozapine

Answer 4

Use: SZ
Class: atypical neuroleptics, MARTAs
MoA: receptor antagonists, dirty drugs, block many sites: DA1, D2, D3, ACH, H1, 5-HT. Main activity through D2 block. More selective than typical neuroleptics. Better at controlling negative symptoms
SE: better side effect profiles, mainly due to greater selectivity, lower incidence of motor disturbances. Increased likelihood of compliance i.e. will continue to take drugs.

Question 5

Sulpiride

Answer 5

Use: SZ
Class: atypical neuroleptics
MoA: receptor antagonists, D2 receptor block. More selective than typical neuroleptics. Better at controlling negative symptoms
SE: better side effect profiles, mainly due to greater selectivity, lower incidence of motor disturbances. Increased likelihood of compliance i.e. will continue to take drugs.

Question 6

Risperidone

Answer 6

Use: SZ
Class: atypical neuroleptics
MoA: receptor antagonists, 5-HT and D2 receptor block. More selective than typical neuroleptics. Better at controlling negative symptoms
SE: better side effect profiles, mainly due to greater selectivity, lower incidence of motor disturbances. Increased likelihood of compliance i.e. will continue to take drugs.

Question 7

Selegiline

Answer 7

Use: Parkinson’s
MoA: MAOi
MAO breaks down DA

Question 8

Amantidine

Answer 8

Use: Parkinson’s

DA releaser

Question 9

mAchRs

Answer 9

Use: Parkinson’s

antagonists of Ach show some symptomatic relief

Question 10

Apomorphine

Answer 10

Advanted Parkinson’s

Question 11

Pramipexole

Answer 11

Uses: Parkinson’s

D2 agonist selective

Question 12

Bromocriptine

Answer 12

Use: Parkinson’s

DA agonist non selective

Question 13

Tetrabenazine

Answer 13

Use: Huntington’s

DA decrease in storage and release. VMAT inhibitor

Question 14

Baclofen

Answer 14

Uses: Huntington’s

GABA-B agonist

Question 15

Phenelzine

Answer 15

Use: Depression
MoA: MAOIs, inhibit MAO, increasing intra-terminal and intra-synaptic 5-HT (DA and NA?) conc.
Have immediate effect - euphoria and anti-depressive effect takes 4 weeks.
Long lasting effect.
SE: cheese reaction-enzyme metabolising cheese (tyramine) can displace NA from vesicles in sympathetic neurons, need to avoid foods, also have anti-muscarinic effects.
Not used too much as unpleasant SE.

Question 16

Moclobemide

Answer 16

Use: Depression
MoA: same but MAO-A selective so for 5-HT specific.
SE: cheese reaction-enzyme metabolising cheese (tyramine) can displace NA from vesicles in sympathetic neurons, need to avoid foods, also have anti-muscarinic effects.
Not used too much as unpleasant SE.

Question 17

Amitryptyline

Answer 17

Use: Depressoin
MoA: 5-HT/NA reuptake inhibition
Slow onset
SE: anti-muscarinic, sedative, overdose is dangerous

Question 18

Fluoxetine/prozac

Answer 18

Use: Depression
MoA: immediate increase in synaptic 5-HT by inhibiting re-uptake
SE: less side effects than TCAs and MAOIs

Question 19

Carbamazepine (CBZ)

Answer 19

Use: Epilepsy
MoA: affects membrane excitability by an action on v.g. sodium channels, shows use dependence block, bind preferentially to inactivated state neurons.
SE: dizziness, drowsiness, ataxia, accelerates hepatic enzymes so be careful with contraceptives.

Question 20

Phenytoin

Answer 20

Use: Epilepsy
MoA: affects membrane excitability by an action on v.g. sodium channels, shows use dependence block, bind preferentially to inactivated state neurons.
SE: Also interferes with hepatic enzymes. Narrow therapeutic range.

Question 21

Lamotrigine

Answer 21

Use: Epilepsy
MoA: affects membrane excitability by an action on v.g. sodium channels, shows use dependence block, bind preferentially to inactivated state neurons.

Question 22

Sodium valproate

Answer 22

MoA: inactivates GABA enzymes that break GABA down.
SE: hepatotoxicity, potent teratogen

Question 23

Ethosuximide

Answer 23

Use: Epilepsy
MoA:Inhibit calcium channels

Question 24

Benzos

Answer 24

Use: Epilepsy
MoA: diazepam rectally in acute seizures and intravenously in status epilepticus

Question 25

3 main ways epileptic drugs work?

Answer 25

Enhance GABA action
Inhibit Na channel function
Inhibit Ca channel function