Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pharmacology III > CNS Drugs: Interactions & Withdrawal > Flashcards

CNS Drugs: Interactions & Withdrawal Flashcards

1
Q

This alcohol tolerance occurs with CYP2E1 induction… it leads to increased EtOH metabolism

A

pharmacokinetic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

The downregulation of GABA receptors and upregulation of NMDA receptors results in what two things?

A

pharmacodynamic tolerance and withdrawal sxs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Anterograde amnesia occurs with blockade of…

A

NMDA receptors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What 2 drugs can be administered if seizures due to acute alcohol toxicity?

A

lorazepam, phenytoin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Chornic alcohol abuse can lead to Wernicke-Koraskoff Syndrome, which is due to a deficiency of…

A

Thiamine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Which pharmacologic tx for EtOH abuse can be used with liver disease?

A

acamprosate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What two BZs can be used to prevent seizures in EtOH withdrawal?

A

diazepam, chlordiazepoxide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what type of tolerance?

increased metabolism

A

pharmacokinetic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what type of tolerance?

receptor downregulation

A

pharmacodynamic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

the opposite of tolerance is _______, it is increased responsiveness after repeated use. The dose/response curve is shifted ______

A

sensitization

left shift

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

does physiologic dependence mean addiction?

A

no

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

typically, abused drugs activate the ______

A

mesolimbic DA pathway (reward pathway)

VTA to NAc to PFC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

the below Class I drugs act on what target?

opioids
THC
GHB

A

GCPRs in VTA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

The below Class II drugs act on what target?

BZs
Nicotine
EtOH

A

Ion Channels in VTA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

the below Class III drugs work on what target?

cocaine
amphetamine
ecstasy

A

transporters in VTA, NAc

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Amphetamines can cause increased release of…

A

DA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

this drug reverses DA transport through the DAT

A

amphetamines

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Meth causes a decrease in ____

A

DA transporters

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

This drug inhibits DA reuptake leading to postsynaptic receptor downregulation and severe cravings, physical and psych dependence…

A

cocaine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

what differentiates crack cocaine from powder cocaine?

A

rapid onset

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

This drug reduces overall brain activity, can cause formications, severe withdrawal and has an intense physiologic dependence

A

cocaine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Three overdose/toxic effects of chronic cocaine use

A

arrhythmia
stroke/hemorrhage
seizures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

which drug can decrease craving for cocaine?

A

bromocriptine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

This drug blocks reuptake of 5HT and increases expression of 5HT receptors

A

MDMA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What three complications lead to MDMA fatality?

A

hyperthermia
dehydration
kidney failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

the intense, depression-like hangover from MDMA is due to…

A

decreased 5HT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

LSD, Mescaline, and psilocybin act on what receptors in the brain?

A

5HT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Do LSD, Mescaline, and psilocybin cause dependence? why?

A

no, don’t stimulate DA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

NMDA receptor antagonists…

A

PCP/ketamine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

weak GABA receptor agonist…

A

GHB

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

PCP psychosis can be treated with…

A

haloperidol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

chronic nitrous oxide use can cause…

A

peripheral neuropathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

inhalants general have what mechanism?

A

smooth muscle relaxant

34
Q

Phenytoin, carbamazepine and phenobarbital induce…

A

CYP450s

35
Q

_______ is an anticonvulsant metabolized by, induces and inhibits CYP450s

A

phenytoin

36
Q

______ increases the metabolism of anticonvulsants, haloperidol, and OCPs

A

carbamazepine (CYP450 inducer)

37
Q

Carbamazepine, phenytoin, phenobarbital metabolism is inhibited by…

A

valproic acid

38
Q

carbamazepine metabolism is increased by…

A

phenobarbital, phenytoin

39
Q

What increases the metabolism of lamotrigine?

A

CYP450 inducers (carbamazepine, phenytoin, phenobarbital)

40
Q

which drug doubles the half life of lamotrigine?

A

valproic acid (enzyme inhibitor)

41
Q

Ethosuximide metabolism is inhibited by…

A

valproic acid (CYP450 inhibitor)

42
Q

at low doses, valproic acid (induces/inhibits) its own metabolism

A

inhibits

43
Q

Withdrawal from anticonvulsants results in…

A

rebound seizures

44
Q

OD of anticonvulsant results in

A

non-fatal CNS depression

45
Q

The withdrawal from ____ can be severe… it includes the below sxs…

orthostatic hypotension
hyperactive reflexes
seizures
restlessness
anxiety
weakness
A

barbiturates

46
Q

BZs should be prescribed with caution in what population?

A

elderly

47
Q

which three BZs can be helpful to provide a tapered withdrawal from alcohol and barbiturates?

A

chlordiazepoxide, diazepam, lorazepam

48
Q

abrupt discontinuation of BZs and Z drugs can result in ______, therefore they should be tapered slowly

A

rebound insomnia, anxiety

49
Q

Ramelteon when combined with _____ has an additive effect

A

etoh, sedatives

50
Q

which spasmolytic is similar to barbiturates and therefore should be used with caution in addicts?

A

carisoprodol (soma)

51
Q

TCA metabolism by _____ makes drug interactions common

A

CYP2D6

52
Q

tolerance to what three TCA effects can occur

A

sedation
hypotension
anticholinergic effects

53
Q

Major issue with TCA toxicity

A

Torsades/cardiotoxic

54
Q

TCAs + _____ can cause serotonin syndrome

A

MAOIs

55
Q

severe CNS toxicity presented as hyperpyrexia, convulsions, coma

A

serotonin syndrome

56
Q

TCAs compete with _____ which can lead to toxicity

A

SSRIs

57
Q

TCAs can cause HTN when combined with…

A

amphetamine

58
Q

TCAs potentiate the effects of.. (2)

A

depressants, anticholinergics

59
Q

SSRIs (induce/inhibit) CYP450 meaning they have many drug interactions

A

inhibit

60
Q

SSRIs + MAOIs can cause…

A

serotonin syndrome

61
Q

CYP450 inhibition means increased toxicity of what three drugs?

A

TCAs, phenytoin, carbamazepine

62
Q

fluoxetine inhibits conversion of this prodrug to active form…

A

codeine

63
Q

SSRIs + Meperidine =

A

serotonin syndrome

64
Q

SSRIs + tramadol =

A

seizure risk

65
Q

MAOIs +

TCAs
Meperidine
DXM
SSRIs

A

serotonin syndrome (hyperpyrexia)

66
Q

MAOIs + sympathomimetics (ephedrine, amphetamines)

A

HTN

67
Q

MAOIs inhibit ______ which effects SSRI, CCB metabolism

A

CYP2D6

68
Q

St. John’s wort + antidepressants =

A

serotonin syndrome

69
Q

What drug class should be avoided with…

anticholinergics

sedative hypnotics (supraadditive)

TCAs (seizures, cardiotoxic)

CYP450 inducers (tobb, carbamazepine)

antihypertensives

A

antipsychotics

70
Q

Can lithium/antipsychotics be taken with BZs?

A

yes

71
Q

lithium + NSAIDs =

A

increased toxicity

72
Q

tolerance is not developed for what three effects of opioids

A

miosis, constipation, seizures

73
Q

opioid withdrawal can be reduced by use of… (2)

A

clonidine or methadone

74
Q

morphine, hydrocodone (prodrug), oxycodone, codeine (prodrug) are metabolized by…

A

CYP2D6

75
Q

fentanyl is metabolized by ____ making drug interactions likely

A

CYP3A4

76
Q

Tramadol + MAOIs, TCAs, SSRIs =

A

serotonin syndrome, seizures

77
Q

L-dopa + MAOI-As =

A

HTN

78
Q

L-Dopa + pyridoxine =

A

increased peripheral metabolism

79
Q

Apomorphine + odansetron =

A

HTN

80
Q

AChE Inhibitors are metabolized by…

A

CYP450

81
Q

Memantine cannot be taken with what two drugs?

A

meperidine, DXM

Pharmacology III (15 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions