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cns Flashcards

1
Q

bind GABA-A receptor subunits to increase frequency of chloride channel opening which causes membrane hyperpolarization

A

benzodiazepines (TOPNOTCH)

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2
Q

SE: anterograde amnesia, decreased psychomotor skills, unwanted daytime sedation, tolerance, dependence liability and rebound insomnia or anxiety

A

benzodiazepines (TOPNOTCH)

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3
Q

BZD that can be used for seizure disorders, Bipolar disorder and infantile spasm

A

Clonazepam (TOPNOTCH)

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4
Q

Why is Lorazepam preferred over Diazepam in status epilepticus

A

due to its long distribution halflife (TOPNOTCH)

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5
Q

date-rape drug

A

Flunitrazepam (TOPNOTCH)

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6
Q

BZD used for alcohol withdrawal

A

Diazepam and Chlordiazepoxide (TOPNOTCH)

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7
Q

antagonist at benzodiazepine sites on GABA-A receptor

A

Flumazenil (TOPNOTCH)

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8
Q

bind to GABA-A receptor sites to increase duration of chloride channel opening, block glutamic acid neurotransmission

A

barbiturates (TOPNOTCH)

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9
Q

which has greater dependence liability: barbiturates or benzodiazepine

A

barbiturates (TOPNOTCH)

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10
Q

Barbiturate with the highest lipid solubility

A

Thiopental (TOPNOTCH)

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11
Q

barbiturate for status epilepticus

A

Phenobarbital (TOPNOTCH)

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12
Q

SE: acute intermittent porphyria

A

barbiturates (TOPNOTCH)

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13
Q

High dose BZD and Barbs may suppress seizure but at the expenses of marked sedation EXCEPT for

A

Clonazepam and Phenobarbital (TOPNOTCH)

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14
Q

only interact with GABA-A receptors with alpha-1 subunit; For insomnia and sleep disorder esp when sleep onset is delayed

A

Zolpidem, Zaleplon, Eszopiclone (TOPNOTCH)

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15
Q

dependence liability and withdrawal symptoms is less than that of benzodiazepines

A

Zolpidem, Zaleplon, Eszopiclone (TOPNOTCH)

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16
Q

lack anti-convulsant, anti-anxiety and muscle relaxant effects, effects are reversed with Flumazenil, very rapid onset of action, may dec REM sleep

A

Zolpidem, Zaleplon, Eszopiclone (TOPNOTCH)

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17
Q

increasing use due to rapid onset with minimal effects on the sleep pattern and cause less daytime cognitive impairment as compared to BZD

A

Zolpidem, Zaleplon, Eszopiclone (TOPNOTCH)

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18
Q

partial agonist at 5-HT1A receptors and possibly D2 receptors, used For generalized anxiety disorders

A

Buspirone (TOPNOTCH)

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19
Q

slow onset of action (more than 1week), metabolized by CYP3A4, safe for pregnant patients

A

Buspirone (TOPNOTCH)

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20
Q

activates melatonin receptors (MT1 and MT2 receptors) in the suprachiasmatic nuclei in the CNS leading to dec latency of sleep onset

A

Ramelteon (TOPNOTCH)

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21
Q

block voltage-gated Na channel; DOC for generalized tonic-clonic seizures, DOC for partial seizures, can be used for migraine

A

Phenytoin, Fosyphenytoin, Mephenytoin, Ethotoin (TOPNOTCH)

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22
Q

SE: nystagmus, diplopia, sedation, gingival hyperplasia, hirsutism, anemias, peripheral neuropathy (absent DTRs), osteoporosis, fetal hydantoin syndrome, abnormalities in Vit D metabolism

A

Phenytoin, Fosyphenytoin, Mephenytoin, Ethotoin (TOPNOTCH)

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23
Q

preferred in prolonged therapy for status epilepticus because it is less sedating

A

phenytoin (TOPNOTCH)

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24
Q

block voltage-gated Na channels and decreases glutamate release; DOC for trigeminal neuralgia, DOC for generalized tonic-clonic seizures, DOC for partial seizures, for bipolar disorders

A

Carbamazepine, Oxcarbazepine (TOPNOTCH)

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25
Q

SE: diplopia, cognitive dysfunction, drowsiness, ataxia, blood dyscrasias, Stevens-Johnson syndrome, erythematous rash, teratogen (spina bifida and craniofacial anomalies), hyponatremia

A

Carbamazepine, Oxcarbazepine (hyponatremia) (TOPNOTCH)

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26
Q

may be used for acute manic phase and as prophylaxis in the depressive phase

A

Carbamazepine, Oxcarbazepine (TOPNOTCH)

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27
Q

blocks high-frequency firing of neurons which modifies amino acid metabolism; DOC for bipolar disorder (acute mania), DOC for generalized tonic-clonic seizures and absence seizure, partial seizures, myoclonic seizures, also used for Bipolar disorders

A

Valproic acid (TOPNOTCH)

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28
Q

anti-manic that is CYP450 inhibitor

A

Valproic acid (TOPNOTCH)

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29
Q

for status epilepticus in children ; primary anticonvulsant in infants, children and pregnant patients

A

Phenobarbital (TOPNOTCH)

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30
Q

inhibit low threshold (T-type) Ca currents esp in thalamic neurons ; DOC for absence seizure

A

Ethosuximide, Phensuximide, Methsuximide (TOPNOTCH)

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31
Q

blocks Ca channels, increases GABA release ; For neuropathic pain such as postherpetic neuralgia, partial seizures, migraine

A

Gabapentin, Pregabalin (TOPNOTCH)

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32
Q

structural analogues of GABA but does not activate GABA receptor directly ; also have the same effect on Ca currents like Ethosuximide

A

Gabapentin, Pregabalin (TOPNOTCH)

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33
Q

blocks Na and Ca channels and decreases glutamate, used for acute manic phase and as prophylaxis in the depressive phase

A

Lamotrigine (TOPNOTCH)

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34
Q

primarily undergoes glucuronidation reaction ; SE: dizziness, ataxia, nausea, rash, SJS / TEN

A

Lamotrigine (TOPNOTCH)

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35
Q

Bind synaptic protein selectively inhibiting hypersynchronization of epileptiform burst firing ; For generalized tonic-clonic seizures, partial seizures

A

Levetiracetam (TOPNOTCH)

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36
Q

not metabolized by CYP450 enzymes, eliminated in the kidneys in their unchanged form

A

Levetiracetam (TOPNOTCH)

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37
Q

multiple actions on synaptic function, probably via actions on phosphorylation (Na, Ca, GABA, AMPA-glutamate, carbonic anhydrase)

A

Topiramate, Felbamate (TOPNOTCH)

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38
Q

also facilitate the inhibitory actions of GABA but its exact MOA is still unknown

A

Felbamate (TOPNOTCH)

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39
Q

Antiseizure drugs with the most number of MOA, undergo both hepatic and renal metabolism

A

Topiramate, Felbamate (TOPNOTCH)

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40
Q

Irreversibly inactivates GABA aminotransaminase (GABA-T) which terminates the action of GABA ; For GTC seizure

A

Vigabatrin (TOPNOTCH)

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41
Q

Inhibits GABA transporter (GAT-1) in neurons and glia thus inhibiting its reuptake, leading to prolongation of GABA effects ; For partial seizures

A

Tiagabine (TOPNOTCH)

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42
Q

SE: visual field defects

A

Vigabatrin (TOPNOTCH)

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43
Q

Facilitates GABA-mediated inhibition, block brain NMDA and Ach-N receptors

A

Inhalational anesthetics (TOPNOTCH)

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44
Q

SE: megaloblastic anemia on prolonged exposure; Euphoria (laughing gas), bronchodilation

A

Nitrous Oxide (TOPNOTCH)

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45
Q

Lowest Potency (highest MAC) and least cardiotoxic

A

Nitrous Oxide (TOPNOTCH)

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46
Q

all inhaled anesthetcis cause bronchodilation except

A

Desflurane (TOPNOTCH)

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47
Q

SE: catecholamine-induced arrhythmias, peripheral vasodilation, bronchodilation

A

Isoflurane (TOPNOTCH)

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48
Q

SE: spike-and-wave activity in EEG, muscle twitching, breath-holding, myocardial depression, renal insufficiency (due to Flourine release), dec cardiac output, bronchodilation

A

Enflurane (TOPNOTCH)

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49
Q

has pungent odor which limits its use

A

Enflurane (TOPNOTCH)

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50
Q

SE: catecholamine-induced arrhythmias, myocardial depression, post-operative hepatitis, dec cardiac output, bronchodilation

A

Halothane (TOPNOTCH)

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51
Q

Highest potency and lowest MAC (very slow onset and recovery)

A

Methoxyflurane (TOPNOTCH)

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52
Q

a usual adjunct with inhalational anesthetics and IV opioids, has a slow onset but longer DOA

A

Midazolam (TOPNOTCH)

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53
Q

Blocks excitation by glutamate at NMDA receptors; For dissociative anesthesia (analgesia, amnesia and catatonia but with retained consciousness)

A

Ketamine (TOPNOTCH)

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54
Q

congener of Phencyclidine / angel dust

A

Ketamine (TOPNOTCH)

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55
Q

For general anesthesia to patients with limited cardiac or respiratory reserve

A

Etomidate (TOPNOTCH)

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56
Q

Interacts with mu, sigma, kappa receptors for endogenous opioid peptides ; For high risk patients who might not survive general anesthesia

A

Opioid analgesics: Fentanyl, morphine, alfentanil, remifentanil (TOPNOTCH)

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57
Q

SE: respiratory depression, chest wall rigidity (which may cause impaired ventilation) and constipation

A

Opioid analgesics: Fentanyl, morphine, alfentanil, remifentanil (TOPNOTCH)

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58
Q

Antidote is Naloxone / Naltrexone

A

Opioid toxicity (TOPNOTCH)

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59
Q

milk of anesthesia

A

Propofol, Fospropofol (TOPNOTCH)

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60
Q

Potentiates GABA-A receptors, blocks Na channels; For prolonged sedation esp in ICU patients and also in OPD surgeries

A

Propofol, Fospropofol (TOPNOTCH)

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61
Q

Blockade of Na channels slows which prevents axon potential propagation

A

Local Anesthetics (TOPNOTCH)

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62
Q

Shortest half-life among local anesthetics

A

Procaine (TOPNOTCH)

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63
Q

For local anesthesia, topical anesthesia

A

Benzocaine, Cocaine, Tetracaine (TOPNOTCH)

64
Q

Use cautiously in sunburns, Topical only

A

Benzocaine (TOPNOTCH)

65
Q

with intrinsic sympathomimetic activity so it does not need an alpha agonist (like epinephrine) to limit its systemic absorption

A

Cocaine (TOPNOTCH)

66
Q

All local anesthetics are vasodilators EXCEPT

A

Cocaine (TOPNOTCH)

67
Q

SE: light-headedness, sedation, restlessness, nystagmus, seizures, respiratory, CV depression, abuse liability, severe hypertension, cerebral hemorrhage, cardiac arrhythmia, MI

A

Cocaine (TOPNOTCH)

68
Q

For local anesthesia, spinal anesthesia, epidural anesthesia, topical ophthalmic anesthesia

A

Tetracaine (TOPNOTCH)

69
Q

Blockade of Na channels slows which prevents axon potential propagation; For local anesthesia, antiarrythmia (group 1B activity), used for post-MI and for digitalis toxicity

A

Lidocaine (TOPNOTCH)

70
Q

For local anesthesia, dental anesthesia

A

Prilocaine (TOPNOTCH)

71
Q

local anesthetic that can cause methemoglobinemia

A

Prilocaine (TOPNOTCH)

72
Q

For local anesthesia, epidural anesthesia, intrathecal anesthesia

A

Bupivacaine (TOPNOTCH)

73
Q

Use with caution in pregnant women and patients with cardiac disease (may cause heartblock, arrhyhtmia and hypotension)

A

Bupivacaine (TOPNOTCH)

74
Q

Longest half-life among local anesthesia

A

Ropivacaine (TOPNOTCH)

75
Q

Depolarizing Neuromuscular Blocker

A

Succinylcholine (TOPNOTCH)

76
Q

Agonist at Ach-N receptors causing initial twitch then persistent depolarization

A

Succinylcholine (TOPNOTCH)

77
Q

SE: muscle pain, hyperkalemia, increased intragastric pressure leading to regurgitation (aspiration), increased intraocular pressure, malignant hyperthermia

A

Succinylcholine (TOPNOTCH)

78
Q

Metabolized by pseudocholinesterase ; may cause malignant hyperthermia if given together with inhaled anesthetics

A

Succinylcholine (TOPNOTCH)

79
Q

a common SE for this group is Histamine release

A

Non-Depolarizing Neuromuscular Blocker (TOPNOTCH)

80
Q

Undergoes Hoffman elimination (rapid spontaneous breakdown)

A

Atracurium (TOPNOTCH)

81
Q

converted to Laudanosine which can cause seizures

A

Atracurium (TOPNOTCH)

82
Q

short-acting Non-Depolarizing Neuromuscular Blocker

A

Mivacurium (TOPNOTCH)

83
Q

intermediate-acting Non-Depolarizing Neuromuscular Blocker ; Undergoes elimination in bile

A

Vecuronium (TOPNOTCH)

84
Q

Suggamadex is a novel reversal agent for

A

Rocuronium (TOPNOTCH)

85
Q

Competitive antagonists at skeletal muscle nicotinic acetylcholine receptors; For skeletal muscle relaxation during intubation and general anesthesia

A

Non-Depolarizing Neuromuscular Blocker (TOPNOTCH)

86
Q

long-acting Non-Depolarizing Neuromuscular Blocker; may cause heart block

A

Pancuronium (TOPNOTCH)

87
Q

Relatively contraindicated in myocardial ischemia; reverse effects with neostigmine

A

Tubocurarine (TOPNOTCH)

88
Q

a dopamine precursor

A

Levodopa (TOPNOTCH)

89
Q

inhibits peripheral metabolism via dopa decarboxylase

A

carbidopa (TOPNOTCH)

90
Q

SE: GI upset (emesis), dyskinesia (choreoathetosis), behavioural changes (anxiety, agitation, confusion, delusion), on-off phenomena, wearing-off phenomena, postural hypotension, tachycardia

A

Levodopa-carbidopa (TOPNOTCH)

91
Q

Partial agonist at dopamine D2 receptors in brain

A

Bromocriptine, Pergolide (TOPNOTCH)

92
Q

For Parkinson’s disease which is levodopa intolerance, hyperprolactinemia

A

Bromocriptine, Pergolide (TOPNOTCH)

93
Q

SE: anorexia, n/v, dyskinesia, postural hypotension, behavioural changes, erythromelalgia, pulmonary infiltrate

A

Bromocriptine (TOPNOTCH)

94
Q

Partial agonist at dopamine D3 receptors in brain

A

Pramipexole (TOPNOTCH)

95
Q

SE: Contraindicated for patients with active peptic ulcer disease, psychotic illnesss or recent MI

A

Pramipexole, Ropinirole (TOPNOTCH)

96
Q

Partial agonist at dopamine D3 receptors, antagonist at 5-HT and alpha adrenoceptors

A

Apomorphine (TOPNOTCH)

97
Q

For off-periods of Parkinson’s disease, alcoholism, opiate addiction, erectile dysfunction, alzheimer’s disease

A

Apomorphine (TOPNOTCH)

98
Q

Selective inhibitors of MAO type B leading to decreased degradation of dopamine, increases response to levodopa/carbidopa

A

Selegiline, Rasagiline (TOPNOTCH)

99
Q

Block L-dopa metabolism by inhibiting catechol-O-methyltransferase in periphery and CNS, prolongs response to levodopa

A

Entacapone, Tolcapone (TOPNOTCH)

100
Q

T or F: Entacapone only acts in the periphery while Tolcapone acts both in the periphery and CNS

A

TRUE (TOPNOTCH)

101
Q

enhances dopaminergic transmission by unknown mechanism, maybe by influencing the synthesis, release or reuptake of dopamine

A

Amantadine (TOPNOTCH)

102
Q

SE: behavioral changes (restlessness, agitation, insomnia, hallucination, psychosis), livedo reticularis, GI disturbances, urinary retention, postural hypotension, peripheral edema

A

Amantadine (TOPNOTCH)

103
Q

Decrease the excitatory actions of cholinergic neurons on cells in the striatum by blocking muscarinic receptors

A

Benztropine, Biperiden, Trihexyphenidyl, Orphenadrine (TOPNOTCH)

104
Q

as adjunct for parkinson’s disease and extrapyramidal symptoms caused by antipsychotics

A

Benztropine, Biperiden, Trihexyphenidyl, Orphenadrine (TOPNOTCH)

105
Q

Blocks D2 receptos more than 5-HT2 receptors

A

Typical Antipsyhotics (TOPNOTCH)

106
Q

Typical Antipsychotic, SE: retinal deposits and arryhthmias

A

Thioridazine (TOPNOTCH)

107
Q

has the Strongest autonomic effects; only antipsychotic with fatal overdose

A

Thioridazine (TOPNOTCH)

108
Q

For schizophrenia and other psychotic disorders, huntington’s disease and tourette’s syndrome

A

Haloperidol, Droperidol (TOPNOTCH)

109
Q

SE: extrapyramidal dysfunction, tardive dyskinesia, hyperprolactinemia, neuroleptic malignant syndrome

A

Haloperidol, Droperidol (TOPNOTCH)

110
Q

Only antipsychotic that reduces the risk of suicide

A

Clozapine (TOPNOTCH)

111
Q

For schizophrenia (refractory, suicidal) and other psychotic disorders

A

Clozapine (TOPNOTCH)

112
Q

Blocks 5-HT2 receptors more than D2 receptors

A

Atypical Antipsychotics (TOPNOTCH)

113
Q

SE: Extrapyramidal dysfunction (less), hyperprolactinemia (less), postural hypotension, weight gain, hyperglycemia, hyperlipidemia, myocarditis, agranulocytosis, seizures, ileus, hypersalivation (sialotthea)

A

Clozapine (TOPNOTCH)

114
Q

weight gain and hyperglycemia is prominent, safe in pregnancy

A

Olanzapine (TOPNOTCH)

115
Q

SE: Extrapyramidal dysfunction (less), hyperprolactinemia (less), postural hypotension, weight gain, somnolence, fatigue, sleep paralysis, hypnagogic hallucinations, cataracts, priapism, QT prolongation (TDP) ; safe in pregnancy

A

Quetiapine (TOPNOTCH)

116
Q

Only antipsychotic approved for schizophrenia in the youth

A

Risperidone (TOPNOTCH)

117
Q

Increased mortality in elderly patients with dementia-related psychosis ; can cause TDP

A

Ziprasidone (TOPNOTCH)

118
Q

Least sedating atypical antipsychotics

A

Aripiprazole (TOPNOTCH)

119
Q

Uncertain MOA but the proposed MOA is by inhibiting the enzyme involved in the recycling of neuronal membrane phosphoinositides which causes depletion of phosphatidylinositol bisphosphate, thus consequently decreasing IP3 and DAG leading to decreased neurotransmission

A

Lithium (TOPNOTCH)

120
Q

SE: Tremor, sedation, ataxia, aphasia, thyroid enlargement, hypothyroidism, reversible nephrogenic diabetes insipidus, edema, acneiform skin eruption, leukocytosis, teratogen (ebstein’s anomaly), bradycardia

A

Lithium (TOPNOTCH)

121
Q

Block NE and 5-HT transporters leading to potentiation of NT action at postsynaptic receptors

A

Tricyclic Antidepressants (TOPNOTCH)

122
Q

Tricyclic Antidepressants

A

Imipramine, Clomipramine, Desipramine, Amitryptyline, Nortryptiline (TOPNOTCH)

123
Q

For MDD (most effective), bipolar disorder, acute panic attacks, ADHD, chronic pain states, as sleeping aid, OCD ; this group is very useful for patients with psychomotor retardation, sleep disturbance, poor appetite and weight loss

A

Imipramine, Clomipramine, Desipramine, Amitryptyline, Nortryptiline (TOPNOTCH)

124
Q

3Cs of TCA overdose

A

Coma, Cardiotoxicity, Convulsions (TOPNOTCH)

125
Q

longterm use may lead to down-regulation of Beta receptors leading to a decrease in BP and depression of cardiac conduction

A

Tricyclic Antidepressants (TOPNOTCH)

126
Q

Inhibits neuronal reuptake of serotonin by inhibiting Serotonin Transporter (SERT)

A

SSRI (TOPNOTCH)

127
Q

SSRIs

A

Fluoxetine, Paroxetine, Citalopram, Escitalopram, Sertraline, Fluvoxamine (TOPNOTCH)

128
Q

DOC for OCD, for MDD, anxiety, panic attacks, phobias, PTSD, GAD, bulimia, premenstrual dysphoric disorder, alcohol dependence

A

Fluoxetine, Paroxetine, Citalopram, Escitalopram, Sertraline, Fluvoxamine (TOPNOTCH)

129
Q

This antidepressant group can decrease appetite leading to weight loss

A

SSRI (TOPNOTCH)

130
Q

Inhibits neuronal reuptake of serotonin and norepinephrine by binding to transporters for both 5HT and NE

A

SNRI (TOPNOTCH)

131
Q

SNRIs

A

Venlafaxine, Duloxetine, Desvenlafaxine (TOPNOTCH)

132
Q

differ from TCA in lacking blockade of H1, M and alpha receptors ; Increased risk for suicide in children and adolescents

A

SNRIs (TOPNOTCH)

133
Q

Blocks 5-HT2A receptors, weak inhibitor of NE and 5HT transporters

A

Serotonin antagonist (TOPNOTCH)

134
Q

Antidepressant Serotonin antagonist

A

Trazodone, Nefazodone (TOPNOTCH)

135
Q

Strong norepinephrine reuptake inhibitor and weak serotonin reuptake inhibitor, blocks dopamine D2 receptors

A

Tetracyclics: Amoxapine (TOPNOTCH)

136
Q

Increases amine release from nerve endings by antagonism of presynaptic a2 adrenoceptors, also blocks serotonin 5-HT2A receptors

A

Tetracyclics: Mirtazapine (TOPNOTCH)

137
Q

Inhibits neuronal reuptake of dopamine and norepinephrine, increase dopamine and norepinephrine activity

A

Tetracyclics: Bupropion (TOPNOTCH)

138
Q

Inhibits MAO type A and type B, increases CNS levels of NE and serotonin

A

Phenelzine, tranylcypromine (TOPNOTCH)

139
Q

MAO-B selective inhibitor

A

Selegiline (TOPNOTCH)

140
Q

Triad of opioid overdose

A

miosis, coma, respiratory depression (TOPNOTCH)

141
Q

Strong agonist at u receptors; For severe pain, pain associated with acute MI, for pulmonary edema

A

Morphine (TOPNOTCH)

142
Q

morphine is metabolized in the body to _____ which has equal analgesic activity as morphine

A

morphine-6-glucuronide (TOPNOTCH)

143
Q

Strong agonist at u receptors; For severe pain, adjunct in anesthesia, chronic pain and breakthrough cancer pain

A

Fentanyl (TOPNOTCH)

144
Q

Strong agonist at u and k receptors, inhibits pain neurotransmission, muscarinic blocking actions; For moderate to severe pain, labor analgesia, spasmodic pain (biliary, renal), preoperative sedation

A

Meperidine (TOPNOTCH)

145
Q

Only opioid that does not cause miosis and biliary contraction

A

Meperidine (TOPNOTCH)

146
Q

opioid of choice for pain relief in pancreatitis

A

Meperidine (TOPNOTCH)

147
Q

metabolized to normeperidine which can cause _____ therefore contraindicated in patients with ______

A

seizure, seizure disorder (TOPNOTCH)

148
Q

full opioid agonist, Strong agonist at u receptors, inhibits pain neurotransmission, binds NMDA receptors and antagonizes the effects of glutamate; For moderate to severe pain, opioid dependence, opioid withdrawal

A

Methadone (TOPNOTCH)

149
Q

used as maintenance therapy for opioid dependence

A

Methadone (TOPNOTCH)

150
Q

Decreases sensitivity of cough receptors, depressing the medullary cough center through sigma receptors stimulation; For cough suppression

A

Dextrometorphan, codeine (TOPNOTCH)

151
Q

codeine is metabolized by CYP2D6 to ______

A

morphine (TOPNOTCH)

152
Q

SE: miosis, restlessness, respiratory depression, increased ICP, postural hypotension, urinary retention, pruritus, addiction liability

A

Opioid analgesics (TOPNOTCH)

153
Q

Mixed Agonist-Antagonist: Strong agonist at k receptors, weak antagonist activity at u receptors

A

Nalbuphine, buprenorphine, butorphanol, pentazocine (TOPNOTCH)

154
Q

Weak agonist at u receptors, inhibits pain neurotransmission; For mild to moderate pain, restless leg syndrome

A

Propoxyphene, levopropoxyphene, dextropropoxyphene (TOPNOTCH)

155
Q

Competitively blocks u, sigma and k receptors, rapidly reverses effects of opioid agonists; For opioid overdose, opioid and alcohol dependence

A

Naloxone, naltrexone, nalmefene (TOPNOTCH)

156
Q

Weak agonist at u receptors, inhibits neuronal reuptake of serotonin and norepinephrine; For moderate pain, chronic pain syndrome, neuropathic pain

A

Tramadol (TOPNOTCH)

pharma (8 decks)

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