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LECOM pharmacology notecards > chapter 14- serotonergic and central adrenergic neurotransmission > Flashcards

chapter 14- serotonergic and central adrenergic neurotransmission Flashcards

1
Q

what is the clinical application of modafinil

A

atypical depression, narcolepsy, observe sleep apnea

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2
Q

what is the clinical application of dextroamphetamine

A

ADHD, narcolepsy

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3
Q

what is the clinical application of lisdexamfetamine

A

ADHD

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4
Q

what is the clinical application of iproniazid, phenelzine, isocarboxazid

A

depression

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5
Q

what is the mechanism of action of modafinil, dextroaphetamine, lisdexamfetamine

A

inihbit serotonin storage; interfere with ability of synaptic vesicles to store monoamines

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6
Q

what are some adverse reactions seen with modafinil

A

cardiac arrhythmia; HTN; rhinitis, agitation

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7
Q

who is specifically susceptible to psychosis induced by modafinil

A

those with bipolar disorder

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8
Q

what are some adverse reactions seen with dextroamphetamine

A

sudden death, CNS stimulation, xerostomia, restlessness

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9
Q

what inhibitor of serotonin storage has the most significant potential for substance abuse

A

dextroamphetamine

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10
Q

what inhibitor of serotonin syndrome has an adverse effect of Gilles de la tourette syndrome

A

lisdexamfetamine

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11
Q

what is a common adverse effect of all inhibitors of serotonin degradation

A

systemic tyramine toxicity

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12
Q

what are the irreversible, nonselective MAOIs

A

iproniazid, phenelzineu, isocarboxazid

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13
Q

what is the clinical application of moclobemide, befloxatone, brofaromine

A

depression

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14
Q

what is the clinical application of selegiline

A

depression

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15
Q

what is the clinical application of tricyclic antidepressants

A

depression, pain syndromes

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16
Q

what is a specific clinical application of the tricyclic antidepressant imipramine

A

nocturnal enuresis

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17
Q

what is a specific clinical application of tricyclic antidepressant clomipramine

A

OCD

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18
Q

what is the mechanism of action of tricyclic antidepressants

A

inhibit reuptake of 5-HT and NE from the synaptic cleft by respectively block 5-HT and NE reuptake transporters, thereby causing enhancement of postsynaptic responses

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19
Q

what are some common adverse reactions seen with tricyclic antidepressants

A

heart block, cardiac arrhythmia, agranulocytosis, jaundice

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20
Q

what is a significant adverse effect of tricyclic antidepressants in the elderly

A

orthostatic hypotension

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21
Q

what are the clinical applications of SSRIs

A

depression, anxiety, OCD, PTSD, pain syndromes

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22
Q

what are the SSRIs

A

citalopram, fluoxetine, fluvoxamine, paroxetine, sertraline

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23
Q

what is serotonin syndrome characterized by

A

hyperthermia, muscle rigidity, myoclonus, and rapid fluctuations in mental status and vital signs

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24
Q

what GI distress is sertraline most often associated with

A

diarrhea

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25
Q

what GI distress is paroxetine most often associated with

A

constipation

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26
Q

what are SSRIs used as first line treatment for

A

depression, anxiety, OCD

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27
Q

what do TCAs with secondary amines preferentially affect

A

NE system

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28
Q

what do TCAs with tertiary amines preferentially affect

A

5-HT system

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29
Q

what is the clinical application of venlafaxine, duloxetine

A

depression, anxiety, panic disorder with or without agoraphobia

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30
Q

what is the clinical application of dexveniafaxine

A

major depressive disorder

31
Q

what is the clinical application of milnacipran

A

fibromyalgia

32
Q

what is the clinical application of atomoxetine

A

ADHD

33
Q

what is the clinical application of bupropion

A

depression, smoking cessation

34
Q

what are the SNRIs

A

venlafaxine and duloxetine; desvenlafaxine; milnacipran

35
Q

how does venlafaxine act at low concentrations

A

SSRI by increasing serotonin levels

36
Q

how does venlafaxine act at high concentrations

A

also increases NE levels

37
Q

what does duloxetine inhibit

A

NE and 5-HT reuptake

38
Q

what is the active metabolite of venlafaxine

A

desvenlafaxine

39
Q

what does milnacipran inhibit

A

NE and 5-HT reuptake

40
Q

what SNRI can cause increased serum cholesterol and triglycerides

A

desvenlafaxine

41
Q

what is the mechanism of action of atomoxetine

A

selectively block NE transporter, leading to increased NE levels

42
Q

what are some adverse effects seen with atomoxetine

A

dysmenorrhea, MI, prolonged QT interval, seizures

43
Q

what is the mechanism of action of bupropion

A

aminoketone antidepressant that weakly inhibits neuronal uptake of 5-HT, dopamine and NE

44
Q

what is the mechanism of action of mertazapine

A

blocks 5-HT2a, 5-HT2c, and the alpha2-adrenergic auto receptor and presumably decreases neurotransmission at 5-HT2 synapses while increasing NE neurotransmission.

45
Q

what is the mechanism of action of nefazodone and trazodone

A

block postsynaptic 5-HT2 receptors

46
Q

what are some contraindications for bupropion use

A

seizures; electrolyte abnormalities; bulimia/anorexia

47
Q

what medication has the fewest sexual effects among antidepressant agents

A

bupropion

48
Q

what is the clinical application of mirtazapine

A

depression

49
Q

what is the clinical application of nefazodone

A

depression

50
Q

what is the clinical application of trazodone

A

insomnia, depression

51
Q

what is the clinical application of buspirone

A

anxiety

52
Q

what is the clinical application of “-triptan”

A

migraine headache

53
Q

what is the clinical application of ketanserin

A

glaucoma, HTN

54
Q

what is the clinical application of ondansetron

A

nausea

55
Q

what are some adverse rxns seen with mirtazapine

A

agranulocytosis, increased appetite, hyperlipidemia

56
Q

what is trazodone used principally as

A

somnorific

57
Q

what are some adverse rxns seen with buspirone

A

MI, stroke, blurred vision, hostile feeling/behavior, nervousness

58
Q

what are some adverse rxns seen with “-triptans”

A

coronary artery spasm, hypertensive crisis, chest pain, flushing

59
Q

what are some adverse rxns seen with ketanserin

A

orthostatic hypotension, ventricular tachycardia, flushing, fluid retention

60
Q

what is the mechanism of action of ketanserin

A

5-HT2a/2c antagonist

61
Q

what is ketanserin used primarily for

A

topically to reduce intraocular pressure in glaucoma

62
Q

what is the mechanism of action of ondansetron

A

5-HT3 antagonist

63
Q

what medication is a potent antiemetic that is frequently used as an adjunct to cancer chemotherapy or in cases of refractory nausea

A

ondansetron

64
Q

what are some adverse reactions seen with ondansetron

A

cardiac arrhythmia, bronchospasm, increased liver enzymes, fatigue

65
Q

what is the clinical application of tegaserod and prucalopride

A

irritable bowel syndrome with constipation predominance

66
Q

what is the clinical application of alosetron

A

irritable bowel syndrome with diarrhea predominance

67
Q

what is the clinical application of lithium

A

bipolar affective disorder

68
Q

what are some adverse reactions seen with tegaserod and prucalopride

A

hypotension, syncope; diarrhea, dizziness, haeche

69
Q

what is the mechanism of action of tegaserod and prucalopride

A

5-HT4 antagonist

70
Q

what are some adverse reactions seen with alosetron

A

severe constipation, acute ischemic colitis, abdominal pain, nausea, headache

71
Q

what is the mechanism of action of alosetron

A

5-HT3 antagonist; decreases serotonergic tone in intestinal cells, thus reducing intestinal motility

72
Q

what are some contraindications for lithium use

A

severe debilitation/dehydration/sodium depletion; significant CV disease; significant renal impairment; lactation

73
Q

what is the treatment for lithium intoxication

A

dialysis

LECOM pharmacology notecards (22 decks)

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