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Pharm Unit 3 Drugs > CNS 1 and 2 > Flashcards

CNS 1 and 2 Flashcards

1
Q

Levodopa (L-DOPA) (Dopar) Class

A

Dopamine precursor

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2
Q

Levadopa (L-DOPA) MOA

A

Oral, absorbed in small bowel

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3
Q

Levadopa (L-DOPA) Therapeutics

A

Given with carbidopa; first-line treatment for Parkinson’s unless patient is young (want to delay as long as possible)

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4
Q

Levadopa (L-DOPA) Important SE

A

Hallucinations, dyskinesias; on-off phenomenon, neuroleptic malignant syndrome (NMS)*, psychosis possible with chronic use

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5
Q

Levadopa other SE

A

Nausea/GI distress, hypotension, dizziness

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6
Q

Levadopa Misc

A

Given with carbidopa; may accelerate PD progression; relatively short half-life (3 hours)

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7
Q

Carbidopa (Lodosyn) Class

A

Aromatic amino acid decarboxylase inhibitor

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8
Q

Carbidopa (Lodosyn) MOA

A

Inhibits peripheral conversion of L-DOPA to dopamine; does not cross BBB

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9
Q

Bromocriptine (Parlodel) Class

A

Ergot Derivative

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10
Q

Rasagiline (Azilect) Class

A

MAO-b inhibitor

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11
Q

Deep Brain Stimulation Misc

A

Patients must still be sensitive to levodopa therapy (or they aren’t a candidate)

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12
Q

Haloperidol (Haldol) Class

A

First-generation antipsychotics (phenothiazine)

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13
Q

Haloperidol (Haldol) Therapeutics

A

Schizophrenia (hallucinations, delusions), movement disorder in Huntingtons

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14
Q

Haloperidol (Haldol) Misc

A

Little effect on negative symptoms

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15
Q

Carbidopa (Lodosyn) Therapeutics

A

Parkinson’s (given with Levadopa)

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16
Q

Carbidopa (Lodosyn) Important SE

A

Dyskinesias, on-off phenomenon, neuroleptic malignant syndrome (NMS), psychosis possible with chronic use

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17
Q

Carbidopa (Lodosyn) Misc

A

MAO-A inhibitors are contraindicated (except MAO-B, which only hits DA)

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18
Q

Bromocriptine (Parlodel) MOA

A

D2 agonist, D1 antagonist

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19
Q

Bromocriptine (Parlodel) Therapeutics

A

Mild Parkinson’s; DA agonism in NMS; hyperprolactinemia

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20
Q

Bromocriptine (Parlodel) SE

A
  1. Pleural effusions, cough, shortness of breath, pulmonary fibrosis
  2. Peripheral DA-like effects
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21
Q

Bromocriptine (Parlodel) Misc

A

Must be titrated slowly due to hypotension

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22
Q

Pramipexole (Mirapex) Class

A

Non-ergot DA

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23
Q

Pramipexole (Mirapex) MOA

A

Selective D2 agonist

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24
Q

Pramipexole (Mirapex) Therapeutics

A

Mild Parkinson’s (first-line); to delay L-dopa treatment, usually in combination with ropinorole

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25
Q

Pramipexole (Mirapex) SE

A
  1. More acute: psychosis, nausea/GI, edema, compulsive behavior (nucleus accumbens, D3)
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26
Q

Pramipexole (Mirapex) Misc.

A

Less effective with motor symptoms of PD

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27
Q

Apomorphine (Apokyn) Class

A

Non-ergot DA

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28
Q

Apomorphine (Apokyn) Therapeutics

A

Rescue therapy for ‘off’ periods (immobility)

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29
Q

Apomorphine (Apokyn) SE

A
  1. Psychosis, drowsiness, hypersexuality (increase in erections); emesis (pre-administer trimethobenzamide or domiperidone); hypotension with serotonin receptor antagonists
  2. Peripheral DA effects
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30
Q

Apomorphine Misc

A

Injectable only; serotonin receptor antagonists contraindicated (e.g., ondansetron)

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31
Q

Entacapone (Comtan) Class

A

COMT Inhibitor

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32
Q

Entacapone (Comtan) MOA

A

Prevents breakdown of DA

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33
Q

Entacapone (Comtan) Therapeutics

A

Prolong half-life of levodopa, reduce ‘off’ time; primarily works peripherally

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34
Q

Entacapone (Comtan) SE

A
  1. Increase in dyskinesias, diarrhea, urine discoloration

2. DA SE

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35
Q

Entacapone Misc

A

Short-acting (2 hours)

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36
Q

Selegiline (Eldepryl) CLass

A

MAO-B inhibitor

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37
Q

Selegiline (Eldepryl) MOA

A

Prevents breakdown of DA

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38
Q

Selegiline (Eldepryl) Therapeutics

A

Mild early Parkinson’s (monotherapy); may delay onset of levodopa therapy

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39
Q

Selegiline (Eldepryl) SE

A
  1. Hypotension, GI distress, dyskinesia, psychosis

2. N/V

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40
Q

Selegiline (Eldepryl) Misc

A

Antidote to environmental toxins; contraindications: decongestants, dextromethorphan, St. John’s wort, analgesics, methadone, tramadol, propoxyphene; caution with SSRIs, MAO-A inhibitors

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41
Q

Rasagiline (Azilect) Class

A

MAO-b inhibitor

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42
Q

Rasagiline (Azilect) MOA

A

Prevents breakdown of DA

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43
Q

Rasagiline (Azilect) Therapeutics

A

Mild early Parkinson’s (monotherapy); may delay onset of levodopa therapy; also, as an adjunct with levodopa (reduces ‘off’ time)

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44
Q

Rasagiline (Azilect) SE

A
  1. Hypotension, GI distress, dyskinesia, psychosis

2. N/V

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45
Q

Rasagiline (Azilect) Misc.

A

Contraindications: decongestants, dextromethorphan, St. John’s wort, analgesics, methadone, tramadol, propoxyphene; caution with SSRIs, MAO-A inhibitors

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46
Q

Benztropine (Cogentin) Class

A

Anticholinergics

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47
Q

Benztropine (Cogentin) Therapeutics

A

Tremor and drooling in Parkinson’s, and really only used if drooling is a major problem (otherwise, very bad mental symptoms)

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48
Q

Benztropine (Cogentin) SE

A
  1. Confusion, impaired memory, hallucinations

2. Typical anticholinergic (dry mouth, etc)

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49
Q

Benztropine (Cogentin) Misc

A

Contraindicated in demented Parkinson’s; abrupt discontinuation exacerbates symptoms

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50
Q

Trihexyphenidyl (Artane) Class

A

Anticholinergics

51
Q

Trihexyphenidyl (Artane) Therapeutics

A

Tremor and drooling in Parkinson’s, and really only used if drooling is a major problem (otherwise, very bad mental symptoms)

52
Q

Trihexyphenidyl (Artane) SE

A
  1. Confusion, impaired memory, hallucinations

2. Typical anticholinergic (dry mouth, etc)

53
Q

Trihexyphenidyl (Artane) Misc.

A

Contraindicated in demented Parkinson’s; abrupt discontinuation causes exacerbation of symptoms

54
Q

Amantadine (Symmetrel) Class

A

Anti-viral

55
Q

Amantadine (Symmetrel) MOA

A

Dopaminergic, anticholinergic, anti-NMDA

56
Q

Amantadine (symmetrel) Therapeutics

A

Mild early Parkinson’s (2nd-line); best as an adjunct to levodopa/carbidopa for long-term treatment; movement disorders in Huntingtons; only adjunct that reduces dyskinesias

57
Q

Amantadine (Symmetrel) SE

A
  1. DA side effects, edema, psychosis, NMS upon withdrawal
58
Q

Amantadine (Symmetrel) Misc

A

Excreted unchanged in urine (renal dysfunction requires lower dose); contraindicated in elderly with dementia (anticholinergic effects)

59
Q

Deep Brain Stimulation Class

A

Surgery

60
Q

Deep Brain Stimulation MOA

A

Hits subthalamic nucleus

61
Q

Deep Brain stimulation Therapeutics

A

Treatment for motor fluctuations or dyskinesias refractory to other medications; reduces ‘off’ time, may reduce levodopa dosage

62
Q

Deep Brain Stimulation SE

A
  1. Fatal intracerebral hemorrhage, cognitive impairment
63
Q

Deep Brain Stimulation Misc

A

Patients must still be sensitive to levodopa therapy (or they aren’t a candidate)

64
Q

Chlorpromazine (Thorazine) Class

A

First-generation antipsychotics (phenothiazine)

65
Q

Chlorpromazine (Thorazine) MOA

A

Catalepsy (trance, muscle rigidity, lack of voluntary movement)

66
Q

Chlorpromazine (Thorazine) Therapeutics

A

Schizophrenia (hallucinations, delusions), movement disorder in Huntingtons

67
Q

Chlorpromazine (Thorazine) SE

A
  1. NMS
  2. Extrapyramidal, tardive dyskinesia; sedation, postural hypotension, weight gain, anticholinergic effects; sexual dysfunction, hyperprolactinemia
68
Q

Chlorpromazine (Thorazine) Misc.

A

Little effect on negative symptoms

69
Q

Fluphenazine (Prolixin) Class

A

First-generation antipsychotics (phenothiazine)

70
Q

Trifluoperazine (Stelazine) Class

A

First-generation antipsychotics (phenothiazine)

71
Q

Perphenazine (Trilafon) Class

A

First-generation antipsychotics (phenothiazine)

72
Q

Thioridazine (Mellaril) Class

A

First-generation antipsychotics (phenothiazine)

73
Q

Haloperidol (Haldol) Class

A

First-generation antipsychotics (phenothiazine)

74
Q

Fluphenazine (Prolixin) MOA

A

Catalepsy (trance, muscle rigidity, lack of voluntary movement)

75
Q

Trifluoperazine (Stelazine) MOA

A

Catalepsy (trance, muscle rigidity, lack of voluntary movement)

76
Q

Perphenazine (Trilafon) MOA

A

Catalepsy (trance, muscle rigidity, lack of voluntary movement)

77
Q

Thioridazine (Mellaril) MOA

A

Catalepsy (trance, muscle rigidity, lack of voluntary movement)

78
Q

Haloperidol (Haldol) MOA

A

Catalepsy (trance, muscle rigidity, lack of voluntary movement)

79
Q

Fluphenazine (Prolixin) Therapeutics

A

Schizophrenia (hallucinations, delusions), movement disorder in Huntingtons

80
Q

Trifluoperazine (Stelazine) Therapeutics

A

Schizophrenia (hallucinations, delusions), movement disorder in Huntingtons

81
Q

Perphenazine (Trilafon) Therapeutics

A

Schizophrenia (hallucinations, delusions), movement disorder in Huntingtons

82
Q

Thioridazine (Mellaril) Therapeutics

A

Schizophrenia (hallucinations, delusions), movement disorder in Huntingtons

83
Q

Haloperidol (Haldol) Therapeutics

A

Schizophrenia (hallucinations, delusions), movement disorder in Huntingtons

84
Q

Fluphenazine (Prolixin) SE

A
  1. NMS
  2. Extrapyramidal (more than chlorpromazine), tardive dyskinesia; sedation (less than chlorpromazine), hypotension, anticholinergic effects; sexual dysfunction, hyperprolactinemia
85
Q

Fluphenazine (Prolixin) Misc

A

Little effect on negative symptoms

86
Q

Trifluoperazine (Stelazine) SE

A
  1. NMS

2. Extrapyramidal, tardive dyskinesia; sexual dysfunction, hyperprolactinemia

87
Q

Trifluoperazine (Stelazine) Misc

A

Little effect on negative symptoms

88
Q

Perphenazine (Trilafon) SE

A
  1. NMS
  2. Extrapyramidal (less than chlorpromazine), tardive dyskinesia; sedation (less than chlorpromazine); sexual dysfunction, hyperprolactinemia
89
Q

Perphenazine (Trilafon) Misc

A

Little effect on negative symptoms

90
Q

Thioridazine (Mellaril) SE

A
  1. NMS

2. Extrapyramidal, tardive dyskinesia; sexual dysfunction, hyperprolactinemia

91
Q

Thioridazine (Mellaril) Misc

A

Little effect on negative symptoms

92
Q

Haloperidol (Haldol) SE

A
  1. NMS
  2. Extrapyramidal (more than chlorpromazine), tardive dyskinesia; sedation (less than chlorpromazine), hypotension, anticholinergic effects; sexual dysfunction, hyperprolactinemia
93
Q

Haloperidol (Haldol) Misc

A

Little effect on negative symptoms

94
Q

Tetrabenazine (Xenazine) MOA

A

Dopamine-depleting, VMAT2 inhibitor

95
Q

Tetrabenazine (Xenazine) Therapeutics

A

Movement disorder in Huntingtons; tardive dyskinesia

96
Q

Tetrabenazine (Xenazine) SE

A

NMS

97
Q

Dantrolene (Dantrium) Therapeutics

A

Malignant hyperthermia (associated with NMS)

98
Q

Dantrolene (Dantrium) MOA

A

Muscle relaxant

99
Q

Clozapine (Clozaril) Class

A

Second-Generation Antipsychotics (tricyclic)

100
Q

Clozapine (Clozaril) MOA

A

D2 receptor antagonist, 5HT2 receptor antagonist

101
Q

Clozapine (Clozaril) Therapeutics

A

Treatment-resistant psychoses (including schizophrenia); decreases risk of suicide; can be used in pregnancy

102
Q

Clozapine (Clozaril) SE

A
  1. Agranulocytosis; weight gain, type II DM, seizure risk, hyperlipidemia
  2. Akathesia (rare, at high doses); GI hypomotility; myocarditis
103
Q

Clozapine (Clozaril) Misc

A

No catalepsy, no EPS, no TD

104
Q

Olanzapine (Zyprexa) Class

A

Second-Generation Antipsychotics (tricyclic)

105
Q

Olanzaprine (Zyprexa) MOA

A

D2 receptor antagonist, 5HT2 receptor antagonist

106
Q

Olanzaprine (Zyprexa) Therapeutics

A

Schizophrenia (effective against positive symptoms, modest effect on negative); severe bilpolar

107
Q

Olanzapine (Zyprexa) SE

A
  1. Metabolic complications (weight gain, hyperglycemia, type 2 DM, hyperlipidemia)
  2. Somnolence, dizziness, increased serum hepatic transaminases, postural hypotension, constipation; EPS, hyperprolactinemia, akathesia may occur
108
Q

Quetiapine (Seroquel) Class

A

Second-Generation Antipsychotics (tricyclic)

109
Q

Quetiapine (Seroquel) MOA

A

D2 receptor antagonist, 5HT2 receptor antagonist

110
Q

Quetiapine (Seroquel) Therapeutics

A

Schizophrenia (effective against positive symptoms, modest effect on negative)

111
Q

Quetiapine (Seroquel) SE

A
  1. Weight gain, hyperglycemia, postural hypotension, constipation, somnolence, dizziness
112
Q

Risperidone (Risperdal) Class

A

Second-Generation Antipsychotics (non-tricyclic)

113
Q

Risperidone (Risperdal) MOA

A

D2 receptor antagonist, 5HT2 receptor antagonist

114
Q

Risperidone (Risperdal) Therapeutics

A

Schizophrenia (effective against positive symptoms, modest effect on negative); severe bilpolar

115
Q

Risperidone (Risperdal) SE

A
  1. Weight gain, hyperglycemia, postural hypotension, constipation, insomnia, dizziness, hyperprolactinemia; EPS at greater doses
116
Q

Risperidone (Risperdal) Misc

A

Less metabolic complications

117
Q

Ziprazidone (Geodon) Class

A

Second-Generation Antipsychotics (non-tricyclic)

118
Q

Ziprazidone (Geodon) MOA

A

D2 receptor antagonist, 5HT2 receptor antagonist

119
Q

Ziprazidone (Geodon) Therapeutics

A

Schizophrenia (effective against positive symptoms, modest effect on negative)

120
Q

Ziprazidone (Geodon) SE

A
  1. Somnolence, cardiac arrhythmias (QTc prolongation); EPS in 5%Fewer metabolic comlications
121
Q

Ziprazidone (Geodone) Misc

A

Fewer metabolic complications

122
Q

Aripiprazole (Abilify) Class

A

Second-Generation Antipsychotics (non-tricyclic)

123
Q

Aripiprazole (Abilify) MOA

A

Partial D2 and D3 receptor agonist, partial 5HT1a agonist, 5HT2a antagonist

124
Q

Aripiprazole (Abilify) Therapeutics

A

Not as effective as other atypicals and typicals at treating schizophrenia; severe bipolar

Pharm Unit 3 Drugs (13 decks)

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