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PANCE > Clinical Therapeutics > Flashcards

Clinical Therapeutics Flashcards

1
Q

What is the Mechanism of Action of Aspirin
What is it used for
Side Effects

A

COX inhibitor, which impairs transformation of arachidonic acid which decreases prostaglandins, decreases thromboxane A2 and finally DECREASES PLATELET AGGREGATION (Irreversible!)

Used for Analgesia, Prophylaxis for AMI/TIA/CVA, Acute Coronary Syndrome

SE: Dyspepsia, GI Bleed, Reye’s Syndrome (kids with viral infection), Ringing of ears (SNHL), Bronchospasms in asthma

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2
Q

What is the Mechanism of Action of Clopidogrel
What is it used for
Side Effects

A

Irreversible Platelet Binding
Used for Cardiac Stents, TIA
SE: Brusing/Bleeding, TTP

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3
Q

What is the Mechanism of Action of Warfarin
What is it used for
What are things to be careful with use of Warfarin
Side Effects

A

Inhibits Vitamin K, which is needed for clotting cascade (Factors 2, 7, 9 and 10, Protein C and S)

Used to prevent and treat Thrombosis, Embolisms (DVT, A.Fib)

Need to measure INR (INR>10 leads to non-life threatening hemorrhage)
Reversible with administration of IV Vitamin K plus FFP
Careful with use with Antibiotics, as many interfere

SE: Bleeding/Hemorrhage, Purple Toe Syndrome, Skin Necrosis, Teratogenic

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4
Q

What is the Mechanism of Action of Unfractionated Heparin
What is it used for
What are things to be careful with use of UF
Side Effects

A

Indirect Thrombin Inhibitor

Need to monitor platelets, aPTT
Reversible by lowering dose or stopping Heparin
If need fast reversal give Protamine

Used for DVT prophylaxis, Systemic Anticoagulation

SE: Bleeding/Hemorrhage, Heparin-Induced Thrombocytopenia

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5
Q

What are examples of Low Molecular Weight Heparin
What is the Mechanism of Action of Low Molecular Weight Heparin
What is it used for
What are things to be careful with use of LMWH
Side Effects

A

Enoxaparin, Dalteparin
Inactivates Factor 10

No need to measure PT/PTT
If need fast reversible give Protamine

Used for DVT Prophylaxis and DVT/PE treatment, Acute Coronary Syndrome

SE: Pain at injection site, Hemorrhage (less so than with Heparin), Thrombocytopenia (less so than with Heparin)

Enoxaparin is Category B in pregnancy - so ok to use!

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6
Q

What are examples of HMG-COA Reductase Inhibitors
What is the MOA
What is it used for
What are side Effects

A

STATINS! Atorvastatin, Simvastatin

Inhibit HMG-COA Reducate which in turn leads to DECREASED SERUM LDL

Used for High LDL (usually >190), pts at risk like DM, AMI

SE: Myalgias that can lead to Myopathy, Hepatotoxicity, Increased blood glucose

CATEGORY X IN PREGNANCY

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7
Q

What are examples of Fibrates
What is the MOA
What is it used for
What are side Effects

A

Gemfibrozil, Fenofibrate

Used for high Triglycerides

SE: Hepatotoxicity, Myopathy

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8
Q

What are examples of Niacin
What is the MOA
What is it used for
What are side Effects

A

Nicotinic Acid, Nicotinamide

Used to lower LDL, increases HDL, lowers TRG

SE: Flushing, Hepatotoxic,

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9
Q

What are important interactions to watch for with Anti-Arrhythmics

A

Avoid other QT prolongators like Macrolides
Metabolized by CYP3A4 or 2D6
Careful with drugs that cause hyopkalemia/hypomagnesemia

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10
Q

What are important side effects with Anti-Arrhythmics

A

QT Prolongation

Careful use in patients with bradycardia and heart blocks

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11
Q

What are Class I Anti-Arrhythmics

What do they do

A

Modulate or Block Sodium Channels

Quinidine, Procainamide, Lidocaine, Propafenone

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12
Q

What are Class II Anti-Arrhythmics

What do they do

A

Inhibit Sympathetic Activity

Beta-Blockers

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13
Q

What are Class III Anti-Arrhythmics
What do they do
Side Effects

A

Block Potassium Channels
Amiodarone
Side Effects: Bradycardia, AV Nodal Block, Thyroid Toxicity, Photosensitivity

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14
Q

What are Class IV Anti-Arrhythmics
What do they do
Side Effects

A

Block Calcium Channels
Verapamil, Diltiazem

SE: Hypotension, Bradycardia, Negative Ionotrope, Peripheral Edema, Headache, Constipation

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15
Q

What is Amiodarone used for

A

Life-Threatening Arrhythmias
Atrial Fibrilliation
Careful with use with other QT prolongating drugs

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16
Q

What id Diltiazem and Verapamil used for

A

Non-Dihydropyridine CALCIUM CHANNEL BLOCKERS

Used for SVT, A.Fib, HTN (especially in AA)

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17
Q

What is Digoxin

Side Effects

A

Rate Control in A.Fib
Used for Heart Failure Sx

SE: Rhythm distrubances (PVC), Yellow/Green or blurred vision

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18
Q 
How do Loop Diuretics Work
What is an example
What are they used for
Caution with
SE
A

Furosemide
Interferes with Na/K exchange in ASCENDING Loop of Henle by inhibiting Na/K-ATPase

Used for Heart Failure or Acute Hypercalcemia

Caution with Hypotension or other anti-HTN, Digoxin and Lithium Toxicity

SE: Hypokaelmia, Orthostatic Hypotension, Glucose Intolerance, Hyperuricemia

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19
Q 
How do Thiazides work
What is an example
What are they used for
Caution with
SE
A

Hydrochlorothiazide
Interferes with Na/K exchange in DISTAL Convoluted Tube by inhibiting Na/K-ATPase

Used for Essential HTN

Caution with Hypotension or other anti-HTN, Digoxin and Lithium Toxicity

SE: Hypokaelmia, Orthostatic Hypotension, Glucose Intolerance, Hyperuricemia

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20
Q 
How do Potassium Sparing Diuretics work
What is an example
What are they used for
Caution with
SE
A

Spironolactone, Eplerenone, Amiloride

Used for Mineralcorticoid Excess (Primary Aldosteronism), HF, Hepatic Cirrhosis, Nephrotic Syndrome

Careful with use with drugs that retain Potassium like ACE/ARB

SE: Hyperkalemia, Teratogenic, Painful Gynecomastia, Decreased Libido

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21
Q 
How do ACE-Inhibitors work
What is an example
What are they used for
Caution with
SE
A

Lisinopril, Enalapril
Vasodilates efferent nodules, which decreases glomerular pressure

Used for HTN, Systolic HF, DM and Chronic Kidney Disease

Careful with other meds that retain Potassium

SE: Cough, Hyperkaelmia, Angioedema, Birth Defects
DONT USE IN PREGNANCY

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22
Q 
How do Angiotensin-II Receptor Blockers work
What is an example
What are they used for
Caution with
SE
A

Losartan, Valsartan

Used for HTN, Systolic HF, DM, and Chronic Kidney Disease

Careful with other meds that retain Potassium

SE: NO COUGH, Hyperkalemia, Angioedema, Birth Defects

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23
Q 
How do Alpha-Adrenergic Blockers Work
What is an example
What are they used for
Caution with
SE
A

Prazosin, Terazosin, Doxazosin
Selective Alpha1 Blockers which leads to decreased arterial pressure by vasodilation

Used in HTN, BPH

Careful with hypotension and other vasodilating agents (nitrates)

SE: Postural Hypotension (titrate the drug), Sedation/Fatigue, Nasal Congestion

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24
Q 
How do Beta-Blockers Work
What is an example
What are they used for
Caution with
SE
A

Competitive Inhibitors of Catecholamines at Beta-Receptors

Non-Beta1 Selective: Propranolol (can cause bronchospasms so careful with use in asthma, COPD)
Beta1-Selective: Metoprolol, Atenolol
Beta and Alpha Blockers: Cavedilol
Used for HTN, Angina, AMI, HF, A.Fib

Careful with use with CCB (additive effect)

SE: Bradycardia, Bronchospasms, Erectile Dysfunction, Exercise Intolerance

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25
Q 
How do Calcium Channel Blockers Work
What is an example
What are they used for
Caution with
SE
A

Nifedipine, Amlodipine
Inhibit L-Type Calcium Channel which leads to Vasodilation

Used in HTN, Angina, Raynaud’s Phenomenon

Careful with hypotension and other anti-hypertensives and vasodilators

SE: Headache, Dizziness, Peripheral Edema
GINGIVAL HYPERPALSIA WITH NIFEDIPINE

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26
Q

What are examples of Short Acting Beta2-Agonists, how do they work
What are they used for
Side Effects

A

Albuterol, Levalbuterol
Used for asthma and COPD, they bronchodilate

SE: Tachycardia, Palpitations, Tremor

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27
Q

What are examples of Long Acting Beta2-Agonists, how do they work
What are they used for
Side Effects

A

Salmeterol, Formoterol
Maintenance meds for Asthma and COPD, they bronchodilate

Contraindicated as solo therapy in asthma
SE: Tachycardia, Palpitations, Tremor

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28
Q

What are examples of Short Acting Inhaled Anticholinergics and how do they work
What are they used for
Side Effects

A

Ipratropium (-ium drugs)
Used for COPD

SE: Dry mouth, Pharyngeal Irritation, urinary retenion, Increased Intraocular Pressure
Caution use in patients with Glaucoma and BPH

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29
Q

What are examples of Long Acting Inhaled Anticholinergics
What are they used for
Side Effects

A

Tiotropium (Spiriva), Aclindinium
Used for Bronchospasms associated with COPD

SE: Dry mouth, Pharyngeal Irritation, urinary retenion, Increased Intraocular Pressure
Caution use in patients with Glaucoma and BPH

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30
Q

What are examples of Inhaled Corticosteroids, how do they work
What are they used for
Side Effects

A

Fluticasone, Budesonide
1st line for persistent asthma

SE: Dyphonia, Thrush, Growth deceleration in kids

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31
Q

What are examples of Leukotriene Modifiers, how do they work
What are they used for
Side Effects

A

Zilueton, Montelukast

Used as adjunct or alternative to ICS in persistent asthma

SE: Neuropsychiatric effects with Montelukast (insomnia, agitation, anxiety, depression)

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32
Q

What is an example of Methylxanithines
What are they used for
Side Effects

A

Theophylline
Used for asthma and COPD but less so because of SE

SE: Many CYP interactions, Need to monitor levels

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33
Q

What is Acetaminophen
What is it used for
Side Effects

A

Analgesia, Antipyresis, Mild-to-moderate Pain

SE: Well Tolerated, Hepatotoxicity

34
Q

What are examples of NSAIDS
What are they used for
Side Effects

A

ASA, Ibuprofen and Naproxen, Piroxicam and Meloxicam, Indomethacin, Diclofenac, Ketorolac

They inhibit COX1 and COX2 (depending which one you use)
COX1: Housekeeping enzyme, expressed in most tissues, regulates normal cell processes
COX2: Inflammation Enzyme, expressed during times of inflammation

Used for Analgesia, Antipyretic, Anti-Inflammatory

Caution use with CVD, Chronic Kidney Disease, Asthma, PUD, Pregnancy

It interferes with antiplatelet effect of ASA, so stop all NSAIDS in AMI patients (except ASA)

SE: Dyspepsia, Gastritis, Ulcers, Nephrotoxic

35
Q

What are examples of Opioids
What are they used for
Side Effects

A

Mild-to Moderate: Codeine, Hydrocodone, Diphenoxylate, Loperamide
Strong: Morphine, Oxycodone, Oxymorphone, Hydromorphone, Methadone, Fentanyl, Meperidine

Agonist for Mu receptor which modulates analgesia, euphoria, respiratory depression, and physical dependency properties

Used for analgesia, cough (codeine), diarrhea (loperamide)

Reversable with Naloxone

SE: Euphoria, Sedation, Respiratory Depression, Miosis, Constipation, Urinary Retention, Flushing, “allergy”

36
Q

What is Allopurinol
What is it used for
Side Effects

A

Xanthine Oxidase Inhibitor
Used for Gout
Titrate low and slow

SE: Paradoxical gout Flare, Simple Rash, SJS/TEN

37
Q

What are examples of DMARDS

A

Methotrexate, Hydroxychloroquine, Infliximab, Etanercept (these last 2 are TNF inhibitors)

38
Q

What is Methotrexate used for

Side Effects

A

Rheumatoid Arthritis

SE: Myelosuppresion, Liver and Lung Inflammation which can lead to fibrosis, Teratogenic and Abortifacient

39
Q

What is Hydroxychloroquine used for

Side Effects

A

RA

SE: Irreversible Retinopathy, Hemolysis with G6PD deficiency

40
Q

What are TNF Inhibitors
How doe they work
What are they used for
Side Effects

A

Infliximab, Etancercept
Tumor Necrosis Factor is a pro-inflammatory Cytokine, it binds TNF and blocks its activity

Used for Moderate to Severe RA, Psoriatic Arthritis, IBD

Monitor TST and CXR before treatment, appropriate vaccinations and cancer screening

SE: Injection site pain, increased risk of infection and mlaignancy

41
Q

What are examples of H2-Receptor Antagonists
How do they work
What are they used for
Side Effects

A

Cimetidine and Ranitidine
Famotidine and Nizatidine

Inhibit gastric secretions by blocking Histamine Receptors on Parietal Cells

Used for Dyspepsia, GERD, PUD

Careful as these interact with iron absorption, digoxin, they need an acidic environment to be absorbed

SE: Acid Rebound, Confusion, Dementia, Drug Fever, Erectile Dysfunction, Gynecomastia

42
Q

What is an example of a Proton Pump Inhibitor
How do they work
What are they used for
Side Effects

A

Omeprazole, Iansoprazole

Inhibits parietal cell H/K ATP pump
Should be administered 30-60 minutes before a meal

Used for GERD, PUD, Zollinger-Ellison Syndrome, H.Pylori Infection

SE: Anemia, Fractures, C.Diff Infections

43
Q

What are 4 neurotransmiiter receptor sites important for vomiting reflex

A

M1 (Muscarinic): Inner Ear
H1 (Histamine): Inner Ear
D2 (Dopamine): Systemic
5-HT (Serotonin): Systemic

44
Q

What are examples of M1 Receptor Antagonists
What are they used for
Side Effects

A

Scopolamine
Prophylaxis for motion sickness, patch behind ear

SE: Anticholinergic: Xerostomia, Sedation, Dilated Pupils

45
Q

What are examples of H1 Receptor Antagonists
What are they used for
Side Effects

A

Dimenhydrinate (Dramamine)
Used for Motion Sickness

Meclizine (Antivert)
Used for Vertigo Management

SE: Anticholinergic: Xerostomia, Sedation, Dilated Pupuils

46
Q

What are examples of H1 AND D2 Receptor Antagonists
What are they used for
Side Effects

A

Promethazine (Phenergan)
Used for Antiemetic, Pain Management Adjunct (migraines)

May interact with Levodopa, QT Prolongation Meds

SE: Extrapyramidal Symtpoms, Cardiac Conduction

47
Q

What are examples of D2 Receptor Antagonists
What are they used for
Side Effects

A

Prochlorperazine (Compazine)
Used for Antiemetic, Pain Management Adjunct
SE: Extrapyramidal Sx, Cardiac Conduction

Metoclopramide (Reglan)
Used to prevent and tx Chemo induced emesis, Post-Op N/V
SE: Acute Dystonia, Black Box Warning

48
Q

What are examples of 5-HT Receptor Antagonists
What are they used for
Side Effects

A

Ondansetron, Dolasetron

Used to prevent chemo induced emesis, Nausea related to irradiation, Post-Op N/V

Careful with use with QT drugs

SE: Headaches, QT Prolongation

49
Q

What is an example of an Intranasal Steroid
What is it used for
Side Effects

A

Fluticasone, Mometasone
Used for allergic rhinitis

SE: Epistaxis, Stinging/Burning, Nasal Dryness

50
Q

What are examples of Antihistamines
What are they used for
Side Effects

A

Diphenhydramine
Used for Allergic Rhinitis
SE: Anticholinergic Effects (Xerostomia (dry mouth), Sedation)

Fexofenadine, Loratadine, Cetirizine
Used for Allergic Rhinitis
SE: Headache, Sedation

51
Q

What is a GLP-1 Receptor Agonists
What is ti used for
Side Effects

A

Exenatide (Byetta)
SQ Injection of synthetic exendin-4 analog of incretin hormone GLP-1

SE: Weight loss, Nausea, Hemorrhagic Pancreatitis

52
Q

What is a DDP-4 Inhibitor
What is it used for
Side Effects

A

Sitagliptin (Januvia)
DDP-4 is an enyzme that degrades incretin hormones, so taking this will leave incretin hormone around longer

SE: Hemorrhagic Pancreatitis

53
Q

What is a SGLT2 Inhibitor
What is it used for
Side Effects

A

Canagliflozin, Dapagliflozin, Empagliflozin

Increases urinary glucose excretion

SE: Diuretic effect, increased GU infections (bacterial UTI, Candida), Euglycemic DKA

54
Q

What is a Biguanide
How does it work
What it is used for
Side Effects

A

Metformin
Decreases hepatic glucose production, it needs insulin to work
Used for DM2

Don’t give in renal or liver failure

SE: Metallic taste, N/V/D, No weight gain, Lactic Acidosis

55
Q

What is Sulfonylureas
How does it work
What is it used for
Side Effects

A

Tolazamide, Chlorpopamide, Glimepiride, Glipizide

Binds ATP-Dependent Potassium channels in pancreatic Beta-Cells, which stimulates insulin secretion

Used for DM2

SE: Weight gain, Hypoglycemia

56
Q

What is Thiazolidinediones
How does it work
What is it used for
Side Effects

A

Pioglitazone, Rosiglitazone
Increases insulin sensitivity by acting on adipose and muscle and liver to increase glucose use and decrease glucose production, it needs insulin to work

SE: Fluid Retention, Weight Gain, Contraindicated in HF NYHA III or IV, Increased risk of AMI, Bladder CA

57
Q

How does Levothyroxine work
What is it used for
Side Effects

A

Active compound is T3

Used for Congenital or Acquired Hypothyroidism

Resolution of sx is about 2-3 weeks after starting drug
Need to monitor TSH and T3/T4 every week, then 4-6 weeks after dose adjustments, then every 6-12 months

SE: Cardiac arrhythmias, Angina, AMI, Decreased bone mineral density

58
Q

What is Propylthiouriacil and Methimazole
What it is used for
Side Effects

A

Palliative treatment of hyperthyroidism as adjunct to ameliorate hyperthyroidism in preparation for surgery or RAI therapy

SE: ANCA-Positive vasculitis with acute kidney injury, arthritis, skin ulcerations, vasculitic rash, agranulocytosis

Methimazole is Teratogenic, so use PTU instead in pregnancy

59
Q

What are examples of Bisphosphonates
How doe they work
Side Effects

A

Alendronate, Risedronate
Drug binds bone, osteoclasts resorb bone with drug, promote apoptosis, leads to reduced bone resporption

Used to prevent and treat osteoporosis, Hypercalcemia

SE: Esophagitis, Esophageal Ulcer, Ostenecrosis of Jaw, Atypical Femur Fractures

60
Q

What are examples of Corticosteroids
How do they work
What are they used for
Side Effects

A

Prednisone, Methylpredinisolone

SE: Topicals may cause skin atrophy
Systmics may cause Fat redristribution, Cataracts, Osteoporosis, Poor Wound Healing, Growth Suppression

61
Q

What are examples of Incontinence Drugs
How do they work
What are they used for
Side Effects

A

Tolterodine: M2 and M3 selective antagonists
Oxybutynin: M3 selective antagonists
Darifenacin: M3 selective antagonists

By Antagonizing the Muscarinic receptors, they increased bladder capacity, Decrease uninhibited contractions and delay desire to void, resulting in decreased IVS

Used for overactive bladder and Urge Incontinence

SE: Anti-Cholinergic Effects (Xerostomia)

62
Q

What are examples of BPH Drugs
How do they work
What are they used for
Side Effects

A

Alpha1-Adrenoreceptors

  • These are found in prostate and bladder neck
  • Stimulation leads to contraction, so antagonists relax them

Alpha-1B Adrenoreceptors

  • Found in peripheral vasculature
  • Stimulation leads to contraction, so antagonists lead to orthostasis and syncope
63
Q

What is Tamsulosin
What is it used for
Side Effects

A

Uroselective Alpha1-Antagonists
Antagonism leads to relaxation of smooth muscles of prostate and bladder neck without blocking vascular receptors

SE: Retrograde Ejaculation

64
Q

What are examples of PDE-5 Inhibitors
What are they used for
Side Effects

A

Sildenafil, Verdenafil, Avanafil, Tadalafil

Used for Erectile Dysfunction and Pulmonary Arterial HTN
Nitric Oxide leads to increased in cGMP, which leads to smooth muscle relaxation and inflow of blood, so PDE-4 Inhibitors degrade cGMP

SE: Priapism, Headache and Facial Flushing

65
Q

What are drugs used for Migraines
How do they work
Side Effects

A

Sumitriptan, Zolmitriptan, Rizatriptan
Selective agonist for serotinin receptors in cranial arteries that lead to vasoconstriction

Avoid using other vasoconstrictors
SE: AMI with vascular patients

66
Q

What are drugs used for Alzheimer’s
How do they work
Side Effects

A

Donepezil, Rivastigmine, Galantamine
Cholinesterase Inhibitors
Well Tolerated

67
Q

What are drugs for Parkinson’s Disease
How do they work
Side Effects

A

1st line is Levodopa PLUS Carbidopa
Dopamine Agonists
-After 5 years of use with, response is erratic and marked by motor fluctations

2nd line is Anticholinergics (Trihexyphenidyl), Selective MOA-B Inhibitors (Selegiline, Rasagiline), MNDA Antagonists (Amantidine)

Side Effects: N/V, Anorexia, Orthostatic Hypotension, Vivid Dreams, Hallucinations, Delusions, Confusion, Sleep Disturbances

68
Q

What is Phenytoin Used for

Side Effects

A

Prevention of seizures following head trauma/Neurosurgery
CYP inducer so careful with other drugs

SE: Gingival Hypertrophy, Teratogenic, Nystagmus

69
Q

What is Carbamazepine used for

Side Effects

A

Biopolar and Chronic Pain Syndromes (Trigeminal Neuralgia)

CYP Inducer so careful with other drugs

SE: Bone marrow suppression, Rash may range from subtle to SJS, Teratogenic

70
Q

What is Valproic Acid Used for

Side Effects

A

Mania associated with Bioplar
Migraine Prophylaxis

SE: Hepatotoxicity, Hepatic Failure, Teratogenic

71
Q

What is Gabapentin used for

Side Effects

A

Restless Leg Syndrome
Postherpetic Neuralgia

SE: Sedation

72
Q

What is Lamotrigine used for

Side Effects

A

Maintenance drug for Bioplar

SE: Rash that ranges from subtle to SJS

73
Q

What is Topiramate used for

Side Effects

A

Migraine Prophylaxis
Chronic Weight Management

SE: Weight loss, Reversible memory or concentration difficulties

74
Q

What are drugs that are SSRI’s
How do they work
What are they used for
Side Effects

A

Fluoxetine, Paroxetine, Sertraline, Citalopram/Escitalopram

Block presynpatic serotonin reuptake pump which increases the amount of synaptic serotonin

Used for Major Depressive Disorder, OCD, Panic Disorder, Bulimia, PMDD, Seasonal Affective Disorder, PTSD, GAD, Social Anxiety Disorder

SE: Delayed Ejaculation, Decreased Libido, Long QT Syndrome, Suicdal Ideation

Taper off when removing SSRI’s as they may cause N/V/D, headache, agitation, anxiety, anorexia

Serotonin Syndrome: Agitation, altered mental status, fever, resting tremor, myoclonic jerks, hyperreflexia, ataxia

75
Q

What are examples of SNRIs

A

Venlafaxine, Duloxetine

Similar to SSRI’s

76
Q

What are examples of Tricyclic Antidepressants (TCAs)
How do they work
What are they used for
Side Effects

A

Amitrtriptyline, Nortriptyline, Imipramine, Clomipramine, Doxepin

Used for Major Depressive Disorder that are intolerante to SSRIs, Migraine Prophylaxis

SE: Anti-Cholinergic effects, Quinidine-like Cardiac Effects, Taper off to avoid discontinuation syndrome

77
Q

What are examples of Monoamine Oxidase Inhibitors
How do they work
What are they used for
Side Effects

A

Phenelzine, Isocarboxazid

Careful with Tyramine rich foods as can lead to HTN crisis

SE: Dizziness, Orthostatic Hypotension, Xerostomia, Nausea, Headache

78
Q

What are examples of Benzodiazepines
How do they work
What are they used for
Side Effects

A

All end in -am

For insomnia
-Estazolam, Flurazepam
For Anxiety
-Alprazolam, Diazepam, Lorazepam
For Seizures
-Lorazepam, Diazepam
For Anesthesia
-Midazolam

Potentiates Inhibitory Neurotransmitter (GABA)
Can be reversed with Flumazenil
CNS depressant so careful with other drugs

SE: Sedation, dizziness, withdrawal sx

79
Q

What are Nonbenzodiazepine Benzodizaepine Receptor Agonists

Side Effects

A

Zolpidem, Zaleplon

Can lead to CNS depression

Side Effects: Warning for complex sleep-related behavior and severe allergic reactions

80
Q

What is the main treatment for Bipolar

Side Effects

A

Lithium
Need to monitor levels
Careful with ACE-I/ARBs, NSAIDS, as they increase Lithium levels

Side Effects: Severe tremor, Hypothyroidism (monitor thyroid function tests), Polyuria, Polydipsia, Weight Gain

81
Q 
What are 1st generation Antipsychotics
What are 2nd generation Antipsychotics
How do they work
What are they used for
Side Effects
A

1st Gen: Haloperidol, Chlorpromazine
2nd Gen: Risperidone, Olanzapine, Quetiapine, Clozapine, Ziprasidone, Aripiprazole

Used for Schizophrenia, Bioplar, Depression adjunct

SE: 1st Gen have Extrapyramidal Sx (Dystonia, Akathisia, Parkinsonism), Neuroleptic Malignant Syndrome, QT Prolongation, Increased Prolactin
2nd Gen have weight gain, Diabetes, Hyperlipidemia

82
Q

What is Isotretinoin
What is it used for
How does it work
Side Effects

A

Oral vitamin A Analogue, decreases sebaceous Gland activity
Used for Acne

Causes severe teratogenic effects, so much have 2 forms of contraception in women, monitor labs, need to be on registry

Careful with Alcohol use and Tetracycline (increased risk of pseudotumor cerebri)

SE: Pseudotumor Cerebri, Teratogenic, Alopecia, Hepatitis, Photosensitivity, Psychosis, Suicidal Ideation

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