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M4: Pharmacology-Pharmacokinetics > CNS > Flashcards

CNS Flashcards

1
Q

What are the inhibitory neurotransmitter of the brain

A
  1. GABA (brain)
  2. Glycine (spinal cord)
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2
Q

What are the excitatory neurotransmitter of the brain

A
  1. Glutamate
  2. 5-HT (serotonin)
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3
Q

Primary neurotransmitter of the brain

A

GABA

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4
Q

Primary neurotransmitter of spinal cord

A

Glycine

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5
Q

What are the Target Actions of CNS Drugs

A
  1. PISO (cations)
  2. MICO (cations)
  3. PhIClo [anions]
  4. SuliBio [anions]
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6
Q

Depolarization
- stimulatory effects (+)
- (kapag positive sa loob)

A

DeCaNa
(Depolarization Calcium Sodium)

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7
Q

Hyperpolarization
- inhibitory effects (-)
- (kapag negative sa loob)

A

HyKCl
(Hyperpolarization Potassium Chloride)

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8
Q

What Disease is stated below:

▪️↑ Dopamine
▪️↑ 5-HT (Serotonin)
▪️↓ Glutamate

A

Schizophrenia

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9
Q

What is the goal for drugs of Antipsychotics/ Neuroleptics / Major Tranquilizers

A

Goal: ↓ DA, ↓ 5-HT

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10
Q

What drug is under of this:

▪️1st Gen/Classical/Traditional Antipsychotics
▪️MOA: Block D2 receptors
▪️Additional effects: Anti-HAM (Histamine (H1)- sedation, Alpha-1-vasodilation, ↓BP, Muscarinic 1&3- urinary retention
▪️Use: For Positive Symptoms

A
  1. Phenothiazine (-azine)
  2. Butyrophenones (-peridol)
  3. Thioxenthenes (-thix)
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11
Q

What drug is it:

▪️1st Gen/Classical/Traditional Antipsychotics
▪️For Manic Phase, Huntington Disease, Tourette Syndrome (TS)

A

Haloperidol and/or Droperidol

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12
Q

1st Gen/Classical/Traditional Antipsychotics

▪️↑ Potency = ↑ D2 affinity & ↓ HAM
▪️Mnemonics: BP PTA

A

Butyrophenones = Piperazines > Piperidines > Thioxanthines > Aliphatic

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13
Q

What drug is under of this:

▪️2nd Gen/Atypical Antipsychotics
▪️MOA: Block 5-HT > D4 receptors
▪️Use: For Negative Symptoms
▪️Advantage: NO EPS (extrapyramidal symptoms)

A

-zapine, -xapine, -peridone

  1. Clozapine
  2. Olanzapine
  3. Risperidone
  4. Loxapine
  5. Aripiprazole
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14
Q

What drug is it:

▪️2nd Gen/Atypical Antipsychotics
▪️Only antipsychotic that ↓ suicide risk
▪️Never given as 1st line bcoz. of SAM (seizures, agranulocytosis, myocarditis)
▪️No EPS
▪️↑ risk of seizure

A

Clozapine

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15
Q

What drug is it:

▪️2nd Gen/Atypical Antipsychotics
▪️Partial D2 Agonist
▪️Least Seadating

A

Aripiprazole

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16
Q

What drug is it:

▪️2nd Gen/Atypical Antipsychotics
▪️S/E: Weight gain
▪️ NOF: Overweight/Obesity, DM

A

Olanzapine

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17
Q

What drug is it:

▪️2nd Gen/Atypical Antipsychotics
▪️For intractable hiccups

A

Risperidone

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18
Q

What drug is it:

▪️2nd Gen/Atypical Antipsychotics
▪️ Used to induce sedation

A

Quetiapine

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19
Q

What is the Adverse Effects/SE for 1st & 2nd Gen Antipsychotics due to DA receptor blockade

A
  1. EPS (Extrapyramidal Syndrome)
  2. Hyperprolactinemia-↑ PRL
  3. Neuroleptic malignant syndrome
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20
Q

What is the 1st line tx for EPS

Goal: ↓Ach -> centrally acting anticholinergics (BBT)

A
  1. Biperiden
  2. Benztropine
  3. Trihexyphenidyl
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21
Q

What is the management for neuroleptic malignant syndrome

A
  1. Dantrolene (DOC)
  2. Bromocriptine (D2 Agonist)
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22
Q

What is common adverse effect/SE in 2nd Gen Antipsychotic

A

Weight gain

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23
Q

Drugs in 2nd Gen Antipsychotics that does not have a S/E of weight gain

Mnemonics: AMA

A
  1. Aripiprazole
  2. Molindone
  3. Amisulpride
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24
Q

Mood Regulation Neurotransmitters

A
  1. 5-HT
  2. NE
  3. DA
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25
Q

Biologic Theory for Mood Disorders

A

↓ Ne, 5-HT, DA

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26
Q

What is the Goal for Antidepressants

A

Goal: ↑ 5-HT, NE, DA

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27
Q

What drug is it:

▪️MOA: Block reuptake of NE > 5-HT
▪️Additional Effect: Anti-HAM
▪️Use: Mgt. of neuropathic pain, enuresis, anxiety attacks (panic attacks), OCD

A

-triptyline (Ami-, Nor-)
- pramine (Imi-, Desi-)
Doxepine

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28
Q

Antidepressant

Management of neuropathic pain

A

Amitriptyline

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29
Q

Antidepressant

Mgt. of enuresis

A

Imipramine (DOC)

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30
Q

Antidepressant

Mgt. of anxiety attacks (panic attacks)

A

Imipramine

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31
Q

Antidepressant

Mgt. of OCD

A

Clomipramine

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32
Q

Toxicities due to narrow TI in Antidepressant of Mood Disorder

A

Triads 3C’s
1. Cardiotoxicity
2. Convulsions
3. Coma

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33
Q

What are the Tetracyclic Antidepressants Drugs

Mnemonics: Ma Mia Amor

A

Maprotiline
Mianserin
Amoxapine

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34
Q

What are the Non-Selective MAOI that also use for Mood Disorder

Use: Mgt. of atypical depression (psychotic features, phobias)

A

Phenelzine
Isocarboxazid
Tranylcypromine (PT)

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35
Q

Drug-Food Interactions with MAOI

A

MAOI + Tyramine rich foods = HTNsive crisis

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36
Q

What drug is under of this:

▪️Selective 5-HT Reuptake Inh.
▪️MOA: Blocks 5-HT reuptake
▪️1st line w/ MDD
▪️ All are Category C except Paroxetine

A

Flu-Flu (Fluoxetine & Fluvoxamine)
Paro-Ser (Paroxetine & Sentraline)
Citalopram & Escitalopram

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37
Q

What is safer to use than TCAs & MAOIs

A

SSRI

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38
Q

SSRI

▪️Mgt. of OCD (Flu Flu)

A

Fluoxetine (laging piliin pag mang huhula)
Fluvoxamine

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39
Q

SSRI

▪️Mgt. of PDD (Premenstrual Dysphonic Disorder)

A

Fluoxetine
Fluvoxamine

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40
Q

SSRI

▪️Mgt. of bulimia nervosa
▪️Mgt. of OCD
▪️Mgt. of PDD

A

Fluoxetine

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41
Q

Black Box Warning: Fluoxetine (Prozac) - ↑ risk of (?)

A

↑ risk of suicidality

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42
Q

What is the Mgt. for Serotonin Syndrome

A

Cyproheptadine (5-HT Antagonist)

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43
Q

What is SNRI

A

Serotonin Norepinephrine Reuptake Inhibitor

44
Q

What drug is it:

▪️SNRI
▪️Use: Mgt. of depression in px. w/ back pain or muscle pain, chronic muscle pain

A

Duloxetine
Venlafaxine

45
Q

What drug is it:

▪️SNRI
▪️Hepatotoxic

A

Duloxetine

46
Q

What drug is it:

▪️SNRI
▪️Cardiotoxic

A

Venlafaxine

47
Q

▪️Drugs for Mood Disorder
▪️MOA: (-) presynaptic alpha-2 receptor
▪️Adv: Does not cause sexual dysfunction
▪️Ex. Mirtazapine (Remeron)

A

NASSA (Noradrenergic & Selective 5-HT Antagonist)

48
Q

What drug is it:

▪️Drug for Mood Disorder
▪️under Norepinephrine Dopamine Reuptake Inh.
▪️Use: for smoking cessation
▪️Does not cause sexual dysfunction

A

Bupropion

49
Q

What drug is it:

Reversible Inh. of MAO-A

A

Moclobemide

50
Q

Drugs for Bipolar Disorder (4)

A
  1. Lithium Carbonate (Eskalith)
  2. Valproic Acid
  3. Carbamazepine
  4. 2nd Gen Antipsychotics
51
Q

What drug is it:

▪️MOA: (-) phosphoinositides recycling
▪️Use: 1 mgt of Mania & Hypomania

A

Lithium Carbonate (Eskalith)

52
Q

What drug is it

▪️Drugs for Bipolar Disorder
▪️Better than Li for rapid recycles

A

Valproic Acid

53
Q

What drug is it

▪️Drugs for Bipolar Disorder
▪️Prophylaxis or tx. of mania

A

Carbamazepine

54
Q

Biological Theory for Anxiety

A

Biological Theory:
- ↓GABA, ↑ EPI, ↑ Cortisol

55
Q

Drugs for Anxiety/ Anxiolytics/ Minor Tranquilizer

A
  1. Benzodiazepines (-zepam, -zolam)
  2. Barbiturates (-barbital, -bital)
56
Q

Short-Acting BZDS [MT-zolam]
- use for initiation & maintenance of sleep

A

Midazolam
Triazolam

57
Q

Intermediate-Acting BZDS [LTO-zepam, A-zolam]
- use for seizures and insomnia

A

Lorazepam
Temazepam
Oxazepam
Alprazolam

58
Q

Long-Acting BZDS

A

Diazepam -> N-desmethyldiazepam

59
Q

What are the Ultra Short Acting Barbiturates (sulfur containing)

“TTM”

A
  1. Thiopental
  2. Thiamylal
  3. Methohexital
60
Q

What class of Barbiturates is stated below:

▪️Very lipophilic
▪️Rapid onset of action, short duration
▪️USE: For induction of anesthesia

A

Ultra short acting

61
Q

What are the Short Acting Barbiturates

“5-6-7 barbital”

A
  1. Pentobarbital
  2. Hexobarbital
  3. Secobarbital
62
Q

What class of Barbiturates is stated below:

▪️USE: Sedatives

A

Short Acting Barbiturates

63
Q

What are the Intermediate Acting Barbiturates

” AmoButa”

A
  1. Amobarbital
  2. Butabarbital
64
Q

What class of Barbiturates is stated below:

▪️USE: Hypnotic

A

Intermediate Acting Barbiturates

65
Q

What are the Long Acting Barbiturates

A
  1. Phentobarbital
66
Q

What class of Barbiturates is stated below:

▪️USE: Anticonvulsant, insomnia, migraine relief

A

Long Acting Barbiturates

67
Q

What do we called to- transient loss of memory after administration of high doses of BZDs

A

Anterograde amnesia

68
Q

What drug is it:

▪️Basis for date-rape drug
▪️Acceptable use: During surgery/procedure

A

Flunitrazepam (Rohypnol) “roofies”

69
Q

What drug is it:

Management of spasticity states (Cerebral Palsy)

A

Diazepam

70
Q

What drug is it:

Mgt. of seizures

CD-zepam & P-bital

A
  1. Clonazepam
  2. Diazepam
  3. Pino-barbital
71
Q

What drug is it:

Mgt. of Neonatal Hyperbilirubinemia

A

Phenobarbital

72
Q

What type of seizure is stated below:

▪️Involves 1 hemisphere
▪️Aka: Jacksonian Seizure
▪️Remains conscious/ No loss of consciousness

A

Simple Focal Seizure (Partial)

73
Q

What type of seizure is stated below:

▪️Involves 1 hemisphere
▪️Aka: Psychomotor Seizure
▪️Loss consciousness
▪️(+) altered sensorium

A

Complex Focal Seizure (Partial)

74
Q

DOC/ 1st line: Focal Partial Seizure

A

Phenytoin
Carbamazepine

75
Q

What type of seizure is stated below:

▪️Both hemisphere
▪️Impaired consciousness
▪️Tonic-Clonic Seizure (Grand Mal)

A

Grand Mal Seizure

76
Q

What type of seizure is stated below:

▪️Both hemisphere
▪️Blank stares, lip smacking
▪️Common in children

A

Absent Seizure (Petit Mal)

77
Q

DOC/ 1st Line: Generalized Seizure/Grand-Mal

A

Valproic Acid

78
Q

DOC/ 1st Line: Absence Seizure (Petit Mal)

A

Ethosuximide

79
Q

DOC/ 1st line: Atonic Seizure [loss of muscle tone]

A

Clonazepam

80
Q

DOC/ 1st Line: Acute Seizure

A

Diazepam

81
Q

What type of seizure is stated below:

▪️medical emergency
▪️ 5 minutes or more of continuous seizure
▪️ recurrent seizures without recovery

A

Status Epilepticus

82
Q

New DOC for Status Epilepticus

A

Lorazepam

83
Q

Old DOC for Status Epilepticus

A

Diazepam

84
Q

Drugs: Anticonvulsants

What drug is it:
▪️Na channel blocker (2)

A
  1. Carbamazepine
  2. Phenytoin
85
Q

Drugs: Anticonvulsants

What drug is it:
▪️Na, Ca channel blockade
▪️↑ GABA
▪️Broadest spectrum

A

Valproic Acid

86
Q

Drugs: Anticonvulsants

What drug is it:
▪️T-type
▪️Ca channel blockade

A

Ethosuximide

87
Q

Drugs: Anticonvulsants

What drug is it:
▪️GABA-mimetics

A

Phenobarbital
Diazepam

88
Q

Neurodegenerative Disorder

A

Parkinson’s Disease

89
Q

Manifestation of Parkinson’s Disease

“TRAPS”

A

Tremors
Rigidity
Akinesia/ Bradykinesia
Postural instability
Shuffling gait

90
Q

Drugs for Anti-Parkinsonism

What drug is it
▪️MOA: Precursor of DA
▪️It can pass through BBB

A

Levodopa

91
Q

Drugs for Anti-Parkinsonism

What drug is it:
▪️Antiviral
▪️Used primarily in the mgt. of Influenza A

A

Amantadine

92
Q

DOC for Parkinson’s Disease

A

Levodopa

93
Q

What type of Anesthesia is stated below:

A state characterized by unconsciousness and loss of reflexes-through IV or inhalational

A

General Anesthesia

94
Q

What type of Anesthesia is stated below:

Loss of sensation in a limited region of the body

A

Local Anesthesia

95
Q

What Inhaled Anesthetics is stated below:

▪️aka: laughing gas
▪️non-volatile gas
▪️weakest anesthetic; potent analgesic

A

Nitrous oxide (N2O)

96
Q

What Inhaled Anesthetics is stated below:

▪️ popular anesthetic for outpatient procedure

A

Desflurane

97
Q

What Inhaled Anesthetics is stated below:

▪️For children-sweet & less pungent

A

Sevoflurane

98
Q

What Inhaled Anesthetics is stated below:

▪️For asthmatic px.

A

Enflurane

99
Q

What Inhaled Anesthetics is stated below:

▪️For children also but most hepatotoxic

A

Halothane

100
Q

What Inhaled Anesthetics is stated below:

▪️Used: During labor
▪️Potent anesthetic; weak analgesic

A

Methoxyflurane

101
Q

Intravenous Anesthetic

What drug is it:
▪️milk emulsion (milk of anesthesia)
▪️ most commonly used for induction

A

Propofol

102
Q

Intravenous Anesthetic

What drug is it:
▪️MOA: (-) NMDA receptors
▪️Similar to Phencyclidine aka: Angel Dust
▪️Use: For dissociative anesthesia

A

Ketamine

103
Q

Intravenous Anesthetic

What opioid analgesics is for General Anesthesia

A

Morphine
Fentanyl
Sulfentanyl

104
Q

What Local Anesthetics is stated below: -MOA: Na channel blocker

  1. Ester Type: 1i
  2. Amide Type: 2ii
A
  1. Procaine, Cocaine
  2. Lidocaine, Bupivacaine (most cardiotoxic), Prilocaine
105
Q

BN of Lidocaine + Prilocaine

A

EMLA

M4: Pharmacology-Pharmacokinetics (50 decks)

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