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RU PA Pharm > CNS 1 Pharm > Flashcards

CNS 1 Pharm Flashcards

1
Q

methylphenidate

A 
ADHD tx
DA and NE reuptake inhibitor
-short acting 2-4 h
-SANS side effects
-possible effect on growth(controversial)
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2
Q

Adderall

A

ADHD
-amphetamine
only advantage over methylphenidate that it’s longer acting ( 12-14 h)
-

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3
Q

Atomexetine

A

ADHD
preferentially NE action, so no dependence potential, more effective on attention
potentially may replace methylphenidate as a drug of choice for ADHD

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4
Q

Pemoline

A

ADHD
long acting DA agonist
less efficacious and risk of fulminant hepatatis

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5
Q

Pramipexole

A

direct DA agonist

  • effective as levodopa in early disease, but not in late stage
  • Neuroprotective
  • SE: sleep attacks,risk of OCD
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6
Q

Ethanol

A

antitremor

-effective for essential tremor

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7
Q

Ropinirole

A

Direct acting DA agonist

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8
Q

propranolol

A

antitremor

-effective for essential tremor

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9
Q

Benztropine

A

antimuscarinic and DA reuptake inhibitor (takes advantage of DA/AcH balance theory)
tx of parkinsonism effects of antipsychotics

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10
Q

Aripiprazole

A 
atypical antipsychotic(Abilify)
MOA: partial antagonist of D2 receptors (80% selective)
very low risk of EPSA
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11
Q

Quetiapine

A 
2nd geniration antipsychotic (Seroquel)
MOA: partial 5HT 1A agonist
DA antagonist (Not much D2)
serotonin antagonist
antihistamine

Low EPSA +tardive Dyskinesia
high weight gain
high sedating
high orthostasis

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12
Q

Dystonia drugs

A

antimuscarinics
benzodiazepines
botox

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13
Q

Trihexyphenidyl

A

ANTIMUSCARINIC, almost no effect on DAT

used to tx parkinsonism signs of antipsychotics

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14
Q

Ziprasidone

A

atypical antipsychotic
MOA: D2, D3, 5HT antagonist
Also 5HT1A agonist-may alleviate anxiety and depression

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15
Q

OLANZAPINE

A

2nd generation antipsychotic, atypical
MOA: D4 anatgonist, little D2(reason for atypica?)
Potent antimuscarinic

Low EPSE 
low TD
low orthostasis
high weight gain
high sedating
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16
Q

risperidone

A

2nd generation antipsychotic, atypical
MOA: some DA anatgonist, potent 5HT antagonist
-Atypical ONLY at LOWER doses

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17
Q

Clozapine

A

atypical antipsychotic
MOA: D4 antagonist w/little striatal D2 anatagonist (reason for Atypical)
potent antimuscarinic
-very effective for psychosis/hallucination associated with PD meds
-very effective for negative symptoms, i=unlike other atypicals

  • paradoxical wet pillow-excessive drooling
  • risk of agranulocytosis
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18
Q

diazepam(valium)

A

BENZODIAZEPINES (prototypical)
96 h half life
long acting used for anxiety and problems staying asleep, as well as managemnt of seizures from alcohol withdrawal

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19
Q

triazolam

A

benzodiazepine,
for troubles falling asleep
short-acting 3-8 h.
more associated with anterograde amnesia

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20
Q

lorazepam(ativan)

A 
benzodiazepine
intermediate acting (10-20 h)
FDA approved an antianxiety
-used for status epilepticus
safe for people with compromised liver function because conjugated outside liver
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21
Q

estazolam

A

benzodiazepine
intermediate acting
for longer sedation and trouble staying asleep

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22
Q

flumazenil

A

direct acting competitive benzodiazepine antagonist

-used to reverse BZD/alcohol inuced coma

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23
Q

pentobarbital

A

barbiturate

-used to induce coma in status epilepticus

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24
Q

phenobarbital

A

barbiturate
autoinducer
1/day dose, long half life
-used to manage generalized seisures

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25
Q

zolpidem (Ambien)

A

-benzodiazepine-like

does not suppress REM, little musle relaxant, little rebound insomnia

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26
Q

Meprobromate

A

anti-anxiety

greater potential for tox in overdose; SE: hypotension, respiratory arrest

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27
Q

Eszopiclone(Lunesta)

A

-benzodiazepine-like, safe for chronic use because low tolerance

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28
Q

Remelteon

A

-new type of sedative hypnotic

melatonin agonist, no adverse events but not as agood a sedative

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29
Q

Zeleplon

A

short duration sedative hypnotic for troubles falling asleep, but NOT staying asleep

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30
Q

Buspirone

A

selective anxyolytic, 5HT-1A partial agonist, small anti DA
effective for generalized anxirty, but not panic attacks
no dependence, no sedation, no anti-epileptic

31
Q

Propranolol

A

selective anxiolytic

stage freight

32
Q

baclofen

A

anti-spastic
GABA-B specific (only in spinal cord)
reduces afferent reflexes mediating spasticity
less sedating than BDZ in anti-spastic doses, but withdrawal effects are severe hyper-spasticity and seizures- higher doses delivered intrathecally are used

33
Q

CNS depressants

A

anesthetics, alcohol, BDZs, barbiturates

34
Q

codeine

A

opioid analgesic, full agonist
-converted to morphine
-less sedating and analgesic, but more antitussive (affinity for Glu receptors)
-adverse affects similar to morphine but less severe
HIGH constipation

35
Q

morphine

A

opioid analgesic

“morphine flush”

36
Q

heroine

A

opioid analgesic, full agonist
converted to morphine and produces “morphine flush”
-greater dependence risk than morphine because enters the brain quicker(more lipid soluble)

37
Q

hydromorphone(dilaudid)

A

opioid analgesic, full agonist

38
Q

hydrocodone (vicodin)

A

opioid analgesic, full agonist
-used in combinations with acetominophen and ibuprofen
analgesic and antitussive potency»codeine

39
Q

oxycodone

A

opioid analgesic, full agonist
SUSTASINED RELEASE
often abused

40
Q

meperidine(demerol)

A
  • opioid analgesic, full agonist
  • 1/10 morphine potency
  • metabolite non-peredine can cause CNS excitation in patients with renal disease or in high doses
  • in combination with MAOI-serotonin syndrome, because inhibits seratonin transporter
41
Q

fentanyl

A

opioid analgesic, full agonist
80 times > morphine
NEVER to non-tolerant patients due to respiratory depression risk

42
Q

methadone

A

opioid analgesic, full agonist
cross linking with morphine, but long acting, great oral availability, easier to withdraw from
-tx of narcotic abstinence syndrom and methadone program

43
Q

propoxyphene

A

opioid analgesic, full agonist

44
Q

pentazocine

A

prototypical partial opioid agonist

  • respiratory depression ceiling effect
  • minor withdrawal symptoms when swithced from full agonist
  • psychotomimetic effect in high doses
45
Q

buprenorphine

A

partial mu opioid agonist

similar to varenicline in smoking sessation used to treat opiod abstinence patients

46
Q

naloxone

A

opioid antagonist

  • used to treat opioid overdose(coma, miosis, respiratory depression); very short 1/2 life so pt. has to be monitored not to slip back into coma
  • always IV
  • can trigger withdrawal in addicts and reduce pain threshold in normal people
47
Q

naltrexone

A

opioid antagonist

effects similar to naloxone, but used less frequently and available in ORAL form

48
Q

Tramadol(ultram)

A

partial opioid mu agonist(analgesic)-effects not as pronounces (e.g respiratory depression
NE and 5HT reuptake inhibitor-potentiate opiod actions

49
Q

dextromethorphan

A

non- narcotic centrally acting antitussive, Glu antagonist

antitussiv effect similar to codeine but no analgesic, euphoric or respiratory deprssion side effects

50
Q

diphenoxylate with atropine

A

opioid like, tx of diarrhea

atropin( antimuscarinic-constipation+ unpleasant side effects when large doses)

51
Q

loperamide(imodium)

A

opiod like; tx of diarrhea

doesn’t cross BBB, but if used with greapfruit juice -morphine like effects

52
Q

Imipramine

A

tca

53
Q

amitriptyline

A

TCA

54
Q

trazodone

A

heterocyclic antidepressant, 5HT2 antagonist, Glu release, paradoxical

55
Q

fluoxetine

A

SSRI

  • very long half-life, so interaction with other antidepressants possible when switching meds, but skipped dose is not that important
  • high potential of CV and CNS drug interaction
56
Q

venlafaxine

A

5HT and NE reuptake inhibitor

57
Q

phenelzine

A

MAOI, suicide inhibition

58
Q

lithium carbonate

A

antimanic

59
Q

carbamazepine

A

antimanic

60
Q

valproate

A

antimanic

61
Q

bupropion

A

NE and DA reuptake inhibitor

62
Q

venlafaxin

A

SNRI

63
Q

Mertazapine

A

NE and serotonin specific reuptake inhibitor, alpha antagonist

64
Q

selegiline

A

Indirect DA tone agonist, selective MAO-B inhibitor
converted to amphetamine/methamphetamine-DA, NE, 5ht reuptake inhibitors that further increases DA
-tx PD symptoms and slows Clinical progression

65
Q

rasagiline

A

Indirect DA tone agonist, selective MAO-B inhibitor

DOESN’T convert to amphetamine

66
Q

tolcapone

A

Indirect DA agonist,peripheral and central COMT inhibitor
-cross BBB and increases levodopa availability and length of action in brain
T for TOTAL COMT inhibition and Liver TOXICITY

67
Q

entacapone

A

Indirect DA agonist, peripheral COMT inhibitor

-extends levodopa availability to brain, does not cross BBB

68
Q

ropinirole

A

direct DA agonist

  • effective as levodopa in early disease, but not in late stage
  • Neuroprotective
  • SE: sleep attacks, risk of OCD
69
Q

haloperidol

A

typical antipsychotic
highest therapeutic index
huntington’s and torret

70
Q

chlorpromazine

A

typical antipsychotic

71
Q

thioridazine

A

typical antipsychotic, but

doesn’t cause EPSEs due to its muscarinic activity

72
Q

fluphenazine

A

typical antipsychotic

73
Q

Apomorphine,

Syrup of epicac

A

Emetics,

Act on CTZ

74
Q

Prochlorperazine, ondansetron, metoclopramide

A

Antiemetic

Act on CTZ

RU PA Pharm (5 decks)

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