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Pharmacology III > CNS Drugs: Unique Features > Flashcards

CNS Drugs: Unique Features Flashcards

1
Q

inhibits aldehyde dehydrogenase…

A

disulfiram

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2
Q

inhibits alcohol dehydrogenase…

A

fomepizole

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3
Q

Which has a ceiling effect? BZs or Barbs?

A

BZs

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4
Q

Describe the dose response curve of barbiturates and what this means…

A

steep, low margin of safety

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5
Q

Duration of action?

Diazepam
flurazepam
temazepam
chlordiazepoxide

A

Long acting

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6
Q

Duration of action?

alprazolam
lorazepam
oxazepam

A

Intermediate acting

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7
Q

Duration of Action?

midazolam
triazolam

A

very short acting

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8
Q

do BZs depend on GABA binding the receptor?

A

yes

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9
Q

Flumazenil has what C/I?

A

hx of seizure

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10
Q

Describe the margin of safety for Z drugs…

A

high margin of safety

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11
Q

Which Z drug is unique in that it has a long half-life and is used in long-term treatment?

A

eszopiclone

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12
Q

What type of psychotic sxs?

hallucination, delusion
catatonic behavior
disorganized speech/thoughts

A

positive sxs

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13
Q

overactive limbic system DA pathways describes…

A

positive mesolimbic symptoms

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14
Q

underactive DA pathway in PFC describes

A

Negative mesocortical sxs

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15
Q

What type of psychotic sxs?

Affective behavior
Apathy
Withdrawal
Anti-social
Lack of motivation
depression
A

negative sxs

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16
Q

How long for antipsychotic onset?

A

6 weeks

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17
Q

The below mechanism describes what type of psychotic sxs?

DA receptor blockade in nigrostriatal pathway

Imbalance of striatal DA and ACh → Parkinson’s like sxs

A

extrapyramidal sxs

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18
Q

Choreic, uncontrolled jerky movements of face and limbs

S/E of long-term tx, often irreversible

A

tardive dyskinesia

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19
Q

which two antipsychotics are least likely to cause tardive dyskinesia

A

clozapine

olanzapine

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20
Q

what is the tx for EPS?

A

benztropine (anticholinergic)

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21
Q

which antipsychotic class is more likely to cause EPS?

A

classic antipsychotics

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22
Q

** LIFE THREATENING **

Block of Striatal and Hypothalamic DA D2 receptors → Muscle Rigidity, Hyperpyrexia

A

neuroleptic malignant syndrome

23
Q

neuroleptic malignant syndrome can be treated with what two drugs?

A

1st line: dantrolene (muscle relaxant for hyperthermia, rigidity)
2nd line: bromocriptine (DA agonist)

24
Q

The below antipsychotics have increased risk of…

Lurasidone
clozapine

A

agranulocytosis

25
Q

describe the metabolism of lithium

A

no metabolism

26
Q

The below have what major S/E?

Carbamazepine
phenytoin
phenobarbital
lamotrigine
valproate
A

SJS

27
Q

What type of seizure?

Begin in focused cortical area, then may spread

A

partial

28
Q

What type of seizure?

No LOC, 20-90s

Grimacing

Focal clonic jerking of extremity

A

simple partial

29
Q

what type of seizure?

AMS or LOC, Hallucination, < 120s

Temporal lobe

Automatic movements

A

Simple complex

30
Q

What type of seizure?

LOC
Muscle contractions alternating w. relaxation

A

Partial w. Secondary Generalized Tonic-Clonic

31
Q

What type of seizure?

15-30s tonic rigidity → tremor → clonic jerking

LOC, AMS (stupor, confusion)

Arise from reciprocal firing of thalamus and cortex

A

Generalized tonic-clonic

32
Q

What type of seizure?

sudden onset, 15-30s, no LOC
Loss of Awareness

A

Generalized absence

33
Q

What type of seizure

brief spasm/rigidity, seconds long

secondary to other seizure d/o

A

Generalized myoclonic

34
Q

What type of seizure?

sudden loss of postural tone
patient falls down

A

Generalized atonic

35
Q

The below drugs have what benefit?

ethosuximide
vigabatrin
levetiracetam
topiramate
TCAs
A

safe in pregnancy/non-teratogenic

36
Q

Describe the kinetics of phenytoin at therapeutic doses?

A

zero order

37
Q

topiramate can increase the metabolism of what other meds?

A

OCPs

38
Q

what prolongs the absorption of valproate?

A

food

39
Q

seizures and sedation are more common in what class of TCAs?

A

Tertiary Amines (amitriptyline, imipramine)

40
Q

What increases the metabolism of…

OCPs
digoxin
protease inhibitor
warfarin

A

st. john’s wort

41
Q

schizophrenia occurs with progressive loss of…

A

grey matter

42
Q

sxs of parkinson’s occur due to…

A

loss of DA in substantia nigra

43
Q

This is an aggregation of alpha-synuclein/proteins in the nigrostriatal system

A

lewy body

44
Q

sxs of parkinson’s appear when there is ___% of DA neurons

A

70-80%

45
Q

The decreased DA production from substantia nigra in parkinson’s leads to a change in the ratio of…

A

DA:ACh

46
Q

Alzheimer’s is a function of accumulating…

A

beta amyloid plaques

tau protein tangles

47
Q

What causes the decreased memory/cognition in alzheimers?

A

degeneratio of cholinergic neurons in the nucleus of meynert

48
Q

Alcohol is metabolized by and induces CYP ____

A

CYP2E1

49
Q

The primary pathway for alcohol metabolism is thru…

A

EtOH to acetaldehyde via ADH

and acetaldehyde to acetate via ALDH

50
Q

the ADH pathway of alcohol metabolism via oxidation requires which cofactor, which can be diminished in chronic users?

A

NAD+

51
Q

The minor metabolic pathway of alcohol is _____

A

Microsomal-ethanol oxidizing system via CYP2E1

52
Q

CYP2E1 increases toxicity of…

A

acetaminophen

53
Q

these BZs are useful for the person who has trouble staying asleep

A

flurazepam, temazepam

Pharmacology III (15 decks)

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