Drug Bomb - Test 3 Flashcards
1
Q
Why is a drug given Topically
A
it is too toxic to give IV
1
Q
4 stages of a Grand Mal?
A
Aura, Tonic, Clonic, Sleep
2
Q
Buspirone
A
anxiolytic MOA- 5HT1a agonist - partial
2
Q
what is beta amyloid?
A
extracellular plaques
3
Q
Sevoflurane
A
Inhalable Anesthesia Tx: anesthesia, very potent, ropic onset and recovery Benefits: low airway irritation - very commonly used
3
Q
What drugs are given adjuvant to anesthetics?
A
benzodiazepine, barbiturates, anlagesics, scopolamine, antichhoingrgics, NMJ blocking agents
3
Q
Trihexyphenidyl
A
Anticholinergic TX: parkinson MOA: ++GABA SE: dry up - anticholinergic
3
Q
fentanyl
A
lipophilic opioid (TRANSDERMAL PATCH long acting ), 100xs stronger than morphine, sufentanyl is 5xs stronger than fentanyl
3
Q
nalorphine
A
opioid
4
Q
Chloroprocaine
A
Local Ester Anesthetic TX: epidural agent for labor (lower risk of toxcity than bupivacaine)
4
Q
Effects of estrogen in Alzheimers disease
A
women over 75 years old that have been on estrogen replacement therapy have seen a 4X decrease in alzheimers
5
Q
what is huntingtons protein?
A
intranuclear protein
5
Q
butorphanol
A
opioid
6
Q
Name this seizure: rapidly recurring seizures, need acute treatment
A
status epilepticus
6
Q
What are EPS
A
Extrapyramidal Syndrome, sx’s include: parkinson like, akathesia (muscle restlessness), dystonia, tardive dyskinesia (irreversible movt of face and mouth, seen more in the elderly)
6
Q
metabolism of opioids
A
through the liver, large 1st pass effect, heroin and codein are metabolized to morphine
6
Q
dextromethorphan
A
COUGH SUPRRESSANT (as well as codeine)
7
Q
Inclusions that we see in parkinsons and ALS?
A
lewy bodies
7
Q
what is the date rape drug
A
flunitrazepam, a benzodiazepine
8
Q
Caffeine
A
Methylxanthine TX: apnea of prematurity, resotre alertness MOA: –CNS Suppression via A1 antagonism
8
Q
Theophylline
A
Methylxanthine TX: COPD, Asthma MOA: –CNS Suppression via A1 antagonism
9
Q
barbiturate are long acting except for
A
thiopental
11
Q
Venlafaxine
A
SNRI MOA: – SERT and NET TX severe depression
11
Q
Carbidopa
A
–Dopa decarboxylase in the periphery = ++Ldopa to cross BBB
12
What are the 4 main anxiolytic/hypnotic drugs
Benzodiazepine, Barbituates, Melatonin agonists, 5HT agonists
12
what are the main uses of sedative hypnotics
TX of anxiety, insomnia, balanced anesthesia, epilepsy, withdrawal, muscle relaxation
13
haloperidol
typical antipsychotic, most potent
13
MOA of huntingtons dis
loss of dopaminergic neurons in the basal ganglia
13
effects of DA and Ach on GABA?
DA cause -- GABA,, Ach ++GABA
14
How does disulfiram work?
--ALDH (aldehyde dehydrogenase) and causes an unpleasant reaction to alcohol ingestion
15
levorphanol
opioid
16
Ethanol
Alcohol CNS Depressant MOA: has a linear slope of action (more likely to cause death)
17
Name for this seizure: no losss of consciusness, minimal spread, localized?
simple partial seizure
18
Lamotrigine
TX: all seizures SE: Stevens Johnson syndrom MOA: --Na, and Ca2+ channels
18
orlistat
--GI fat absorption
19
Amphetamine salts (Adderall)
Tx: ADAD, narcolepsy Amphetamine Schedule 2 controlled substance
20
Most common forms of ADHD
Combined\>Predominantly inattentive\>predominantly hyperactivity
20
clonidine
alpha 2 agonists TX: ADHD
22
Mirtazapine
MOA++5HT and NE, while --presynaptic alpha2 receptors TX: antidepressant SE: antiemetic (--5HT), sedation and weight gain (--H1)
22
What are false beliefs?
delusions
23
Midazolam
Benzodiazepine for Adjuvant to Anesthesia Tx: sedation, amnesia, anxiolytic, sedation for painful procedures, high risk pt's
24
What drug treats spasticity?
Baclophen (++GABAb agonist)
25
Morphine, Codeine, Heroin, Oxycodone
Opioids RR addiction 4 Highly euphoric
26
what treats tonic clonic seizures?
carbamazepine, phenytoin, valproic Acid
27
name this seizure: tonic spasms, convulsion, LOC
Tonic-Clonic or grand mal
28
Sedatives or Hypnotics cause calming effects mainly?
sedative anxionlytics. Hypnotics cause sleep.
28
Cardinal Sx of parkinsons?
Bradykinesia, muscular rigidity, resting tremor, postural instability
29
loperamide
opioid, antidiarrheal
30
MOA for alzheimers tx?
increase Ach, --AchE, --ButyrylchE (converts Ach to choline and acetate)
30
what does opium mean?
coming from poppy seeds - morphine and codeine
30
Analeptic that is an analgesic
caffeine (excedrine)
31
excitalopram
SSRI
31
ascending pain pathway
opioid receptors on presynaptic nerve causes -- in excitability. Post synaptically, opening of K+ channels
32
Thioridazine
typical antipsychotic, middle potent
33
Lithium
TX: manic depression - maintanence (bipolar) MOA: unsure but it is mood stabilizing SE: Tremor, hypothyroidism, Nephrogenic DI, skin reactions CI: Thiazides (NCCI) and Loop diuretics (NKCCI)
33
what three areas of the brain are affected in ADHD
dorsolateral prefrontal cortex, dorsal anterior cingulate cortex and the caudate/putamen
34
What are the three MOA for anticonvulsants?
--Na+ and Ca2+ voltage gated ion channels, ++GABA or it's effects
36
what treats before and after medical procedures?
midazolam, diazepam, lorazepam
36
Alchohol abuse
sedative, hypnotic, RR adiction is 3 mild euphoria, reducing inhibitions completely absorbed in the stomach fetal alcohol concentration is the same as the mothers metabolized by ADH in the liver (some in lungs and kidney) follows 0 order kinetics (enzyme limited - only 1 cup per hour) MOA: ++GABA at GABAa receptors, --NMDA (NMDA is used in learning, cognition, etc) Low doses: slurred speech, ataxia High dose: amnesia, blackouts, respiratory distress CONTRAINDICATED:BARBITURATES, BENZODIAZEPINES, MARIJUANA, COCAINE (LIVER MAKES COCAETHYLENE) SE: wernicke korsakoff syndrome (--Vit B1 thiamin) wet brain; Fetal alcohol syndrome (up to 50%, mental retardation, hyperactivity, antisocial behavior); alcoholic fatty liver syndrome = cirrhosis = liver failure
37
Duloxetine
SNRI MOA: -- SERT and NET TX: Chronic pain (better than TCA's)
38
what barbiturate causes a medically induced coma?
pentobarbital
38
Name this seizure: sudden onset, abrupt cessation, brief LOC
Absence seizure, or petit mal
38
what is an opiate (meaning)?
extracted from poppy seeds
39
Mu2
receptor for opioids - brainstem and spinal cord
40
Valproic acid, carbamazepine
TX: MDD acute sx's of mania
41
adding a benzodiazepine with what drugs could cause additive CNS depression
ethanol, opioids, anticonvulsants, phenothizine, antihistamine, TCA's
42
Amphetamines (meth, dexamphetamine, methylphenidate, cocaine, modafinil)
Sympathomimetic Amides Metabolized by liver, avoid MAOI and SSRI Duration of action is usually short MOA: ++ synaptic monoamines by --DAT; --VMAT = more DA to be released from presynaptic neuron
43
paroxetine
SSRI Short half life - see SE with sudden discontinuation
44
Whats is used more, atypical or typical antiphsychotic agents?
atypical are used more
44
Amantadine
Antiviral TX: parkinsons MOA: increase DA release, only works for 12 motnhs
46
intermediate druation benzodiazepines
Lorazepam
47
what treats narcolepsy
modafinil
48
Valproic acid
MOA: --T type Ca2+ channels, -- GABA transaminase Tx: petit mal (absence seizure) SE: hepatotoxic syndrome, teratogenic
49
Fluoxetine
SSRI Longest half life of the SSRI, --P450
49
what is cross tolerance
seen in opioid tolerance, tolerance to one drug is tolerance to many others
50
What drug treats spasms
Diazepam (by ++GABA)
51
Phenytoin, Fospenytoin
Class: cyclic ureides Dose dependent (zero order kinetics)- low dose = linear, high dose = non linear MOA: --Na channels (keeping in inactive state), -- release of Glutamate, ++GABA TX: -- Seizure propagation - Grand Mal, partial seizures, status epilepticus SE: nystagmus, ataxia, gingival hypertrophy, Fetal hydantoin syndrome (teratogenic) Fosphenytoin (more soluble, better for IV) ASA increase free phenytoin (causes protein dissociation)
52
surgical tx for parkinsons
Fetal DA grafts, deep brain stimulation, thalamtomy (--tremors)
53
tx seizures
diazepam, lorazepam, clonazepam, chlorazepate
54
L-Dopa
most common drug for Parkinsons, L-dopa can cross the BBB SE: dyskenesias - use with a drug holiday (helps --on-off phenomenon by stopping medication for a short time), GI, Cardio prx.
54
tramadol
TX: pain, opioid
55
propranolol (beta Blockers)
TX: sympomatic relief of anxiety (tremors, sweat)
56
Benzocaine
Local Ester anesthetic TX: topical only (great lipid solubility) SE: may induce methemoglobin
57
what is also affected in parkisnons beside motor?
cognition via the hippocampus and cerebral cortex
58
risperidone
atypical antipsychotic
59
Flumazenil
used as an antidote to benzodiazepine and newer hypnotics
59
What are two neurolytics
Ethyl alcohol and Phenol
59
Tiagabine
TX: anticonvulsant MOA --GABA reptake
60
quetiapine
atypical antipsychotic
61
Name this seizure: starts local but spreads to a generalized seizure
partial becoming generalized
62
Pramipexole
DA receptor agonist TX: Parkinson
62
naloxone
TX OPIOID OVERDOSE IMMEDIATELY
63
Modafinil
NOT FOR USE IN CHILDREN TX: ADHD
64
what treats myoclonic Seizures?
clonazepam, valproate
64
What is the worst drug interaction with opioid?
MAOI!!! causes htn, mostly with meperidine
65
meperidine
active metaboilte, opioid
66
MOA of schizophrenia
excessive mesolimbic/mescortical Dopamine
66
descending pain pathway
opioids block the inhibitory GABA neurons = --of nociceptive processin
67
Rivastigmine
Tx: alzheimers MOA: --AchE and BchE CAN HAVE TRANSDERMAL Patch
69
tx for panic attacks
alprazolam
70
do opioids experience sensitization?
yes
71
can antidepressants be used in tx of ADHD?
yes
72
what are lewy bodies?
intracellular alpha synuclein
73
Gabapentin, Pregabalin
GABA analog - but --presynaptic Ca2+ channels TX: grand mal (tonic clonic), partial seizures, Neuropathic pain
74
Codeine
Metabolized to morpine in the liver
75
SE of anticonvulsants:
Sedation, Diplopia, nystagmus, ataxia, GI upset, withdrawal, --oral contraceptive effectiveness, teratogenic (except phenobarbital)
76
SE of Stimulants
Euphoria, dysphoria, insomnia, irriability, tremor, loss of appetite, Cardio risks (MI and Stroke), Addiction, No long term affect on growth
77
benzodiazepine that treats bipolarism
clonazepam, lorazepam
78
what causes most of the SE of the antipsychotics?
the Dopamine antagonists
79
what drug interaction is bad with antiAlzheimers?
TCA, AVOID THEM, orthostatic hypotension
81
Alprazolam, Clorazepate, Diazepam, Lorazepam, Oxazepam
Anxiolytic, benzodiazepine, anxiolytic TX: anxiolytic, sedative, hypnotic
82
atomexetine
NE reuptake inhibitor TX: ADHD no abuse potential
83
what are the three pathologies of Alzheimers Disease
Brain atrophy, amyloid plaques, tau protein (neurofibrillary tangles)
84
Selegiline
MAOI Class, MAO B (just Dopamine) at lower dose, MAO A and B with higher dose Irreversible Low Dose TX: parkisons disease Higher dose TX: antidepressant via a patch (transdermal)
85
Diazepam, Lorazepam
Benzodiazepine TX: initial tx for Status epilepticus MOA: ++GABAa response Lorazepam\>diazepam SE: sedative, tolerance
85
aripiprazole
atypical antipsychotic
86
what atypical agent is has most EPS?
risperidone
87
Desflurane
Inhalable Halogenated Tx: anesthesia, very rapid onset and recovery, good minute to minute SE: more irritable to Respiratory system
88
Cause of ADHD
DA deficit
91
What treats Partial Seizures
Carbamazepine, Phenytoin, Valproic Acid
92
In what disease do we see and ++ in alzheimers disease
Trisomy 21
93
heroin
no medical use
94
what cell do we see an accumulation of near the plaques in alzheimers?
microglial - cns macrophages
95
pharmacokinetic tolerance
increased drug metabolism
97
Cocaine
Local Ester anesthetic TX: ENT procedures SE: abuse, CNS excitation, HTN
98
Imipramine
TCA Class, Anticholinergic. TX: enuresis MOA: --5HT and NE reuptake
98
MOA of benzodiazepine
potentiate effects of GABA --\> ++frequency of Cl- channel opening --\> cause hyperpolarization --\> inhibition
99
What is the VTA?
part of the mesolimbic/mesocortical area, effects behavior and psychosis, is the Ventral Tegmental Area, projects to the nucleus accumbens (DA1 receptors)
100
hydrocodone
opioid, used in combo with acetaminophen, nsaids, etc.
101
oxymorphone
opioid
102
What two general anesthetics are pungent?
enflurane and isoflurane
103
what antipsychotics especially cause weight gain?
clozapine and olanzapine
105
Topiramate
Tx: anticonvulsant, anorexia
105
sx's of Alzheimers
Loss of short term memory, aphasia (difficulty with words), apraxia (--motor use), agnosia(--recognition of objects), disorientation
107
negative signs of schizophrenia
no emotions, no socialness, no attentiveness
107
another name for emotional dependance
addiction
108
what treats agitation
lorazepam and diazepam
109
Narcotic meaning?
any drug that causes sedative and stuporous effects
110
Bupivacaine
Local Amide Anesthetic TX: epidural infusion for labor, excellent spinal anesthetic
111
MOA of parkinson
loss of dopaminergic neurons in the basal ganglia that project into striatum
113
hydromorphone
10xs stronger than morphine
114
what receptor is more important in antipsychotics?
5HT\>\>D2, less EPS toxic than if D2\>\>5HT
114
Benztropine
Anticholinergic TX: parkinson MOA: ++GABA SE: dry up - anticholinergic
116
fluphenazine/prochlorperazine
typical antipsychotic, highly potent
116
nalbuphine
opioid
118
What is a nuerolytic's tx?
to permanently decrease nerve conduction
119
pentazocine
opioid
121
eszopiclone, zolpidem
new hypnotics Tx: insomnia MOA: binds and activates GABAa channel ------\>-----\> hyperpolarization
122
what happens if the SE of opioids are too severe?
change opioids
124
Phenelzine Tranylcypromine
MAOI Class Irreversable and Non selective (Both MAO A and B) (NE, 5HT, Dopa, tyramine) Bad Side effects
125
what are three natural opioids?
morphine, codeine
126
THC - marijuana, dronabinol
RR addiction 2 MOA: disinhibition of DA neurons in VTA
128
what classes of drugs have a non linear slope
benzodiazepines and newer hypnotics -exzopiclone and zopidem (safer- less likely to cause OD)
129
tx of Parkinsons D?
work with DA. Increase DA, decrease degradation of DA, agonist of DA, Anticholingergic
129
Apomorphine
DA receptor agonist TX: Parkinson
130
long lasting benzodiazepien
Diazepam
131
morphine
prototype Mu agonist, opioid, tx severe pain
133
What sleep aid do we not see dependance?
ramelteon (melatonin agonist)
135
Propofol
Milk of Amnesia, Intravenous Anesthetic Tx: most used IV anesthetic, rapid induction, rapid recovery with little hangover
136
what drug is used to tx alcohol addiction?
Disulfiram
137
Cocaine
Stimulant, topical anesthetic, appetite suppressant Affects reward center (VTA), ++libido and energy Schedule 2 controlled substance MOA: --DAT transporter = ++ DA in synapse RR addtiction is 5 (strongest of any drug) When mixed with alcohol = cocaethylene
138
what is the grading of abused drugs
Schedules 1 (highly addictive, no clinical use) to 5 (high clinical use, low addiction rate)
139
methadone
TX: OPIATE ADDICTION, long acting = less withdrawal
140
effects of opioids?
respiration depresssion, miosis, --cough, analgesia, euphoria, sedation, Emesis, GI constipation, urinary retention, --uterus contraction, cause PANS effect on Heart, and Histamine release
141
meth abuse
Lasts much longer than cocaine SE: sympathomimetic effects, RR addiction = 5
142
what treats status epilepticus?
Lorazepam\>Diazepam, Phenytoin/Fosphenytoin
143
What general anesthetic is an irritant
Desflurane
144
Felbamate
TX: anticonvulsant adjunct, aplastic anemia
145
What is cardinal sign of ADHD
Inattention (but a total of 6 sx's have to be present)
147
Trazodone
5HT2 Antagonist MOA: --5HT receptor post synaptically TX: unlabeled for hypnotic, SE: Priapism (long lasting boner), Sedation (block H1)
149
Desipramine
TCA Class MOA: --NE reptake\>5HT Tx: neuropathic pain
150
Nicotine Abuse
mesolimbic reward pathway, highly abused substance, MOA: ++Nicotinic Ach receptors in VTA Tx addiction iwth burpropion and verenicline (chantix)
151
best drug to treat ADHD
Methylphenidate
153
Amitriptyline
TCA Class Anticholingergic TX: sedative effects
154
Do benzodiazepines experience dependence?
yes, can be minimized via long acting (diazepam) drug, or tapering
155
When do I not give benzodiazepines to?
pregnant women, elderly individuals (only after dose changing)
156
Thiopental
Intravenous Anesthetic Barbiturate Tx: induction, not maintainence SE: hyperalgesic
158
what is tau protein
intracellular neurofibrillary tangles, affects the microtubules, from hyperphosphorylated tau protein
160
How are the benzodiazepines metabolized
metabolised via: liver, CYP3A4. Varying length of activity.
161
dextroamphetamine
TX:ADHD
163
what treats acute alcohol withdawal
diazepam and oxazepam
165
Positive sx of Schizophrenia
delusions, hallucinations, agitation, paranoia, intrusion of thoughts
166
Bupropion
MOA: --NE and Dopa reuptake TX: smoking cesation, MDD
166
what classes of drugs have a linear dosing slope
barbiturates and ethanol (deadlier, more likely from an OD)
167
loss of what neurotransmitter is correlated with progression of Alzheimers disease
Ach
169
Entacapone
COMTI (catechol o methyltranserase inhibitor) Tx; parkinsons MOA: Peripheral COMT I - no CNS
170
Nitrous Oxide
Inhalable (Laughing Gas), Systemic Anesthetic Good analgesics- rapid onset and recovery Never used by itself (Low potency)- helps the potency of others
171
codeine
tx moderate pain, opioid, used in combo with acetaminophen (ANIT-TUSSANT, along with dextromethorphan) less addictive than morphine
172
Inclusions that we see in Alzheimers?
beta amyloid and tau protein
173
what drug causes Stevens Johnson Syndrome (Severe allergic reaction, red patchy skin)?
lamotrigine
175
Flurazepam, Temazepam, Triazelam, Midazolam, Flunitrazepam
benzodiazepine, sedative/hypnotic Tx: anxiolytic and sedative, hypnotic
176
Why is a drug given IV
it isn't too lipophilic to cross skin
177
what is an opioid (meaning)?
anything that binds to opioid receptors
178
what is the antibenzodiazepine?
flumazenil --the benzodiazepine receptor
179
what drugs reduce Ca2+ influx
valproate and ethosuximide (effective in petit mal seizures)
180
what receptors are targeted with antipsychotics?
D2 is the most used receptor (antagonized), cna use 5HT2a as well (antagonized)
181
Do benzodiazepines experience tolerance?
yes
183
Name this seizure: starts local but spreads quickly, altered conscousness
complex partial seizure
184
what is required for the benzodiazepines to have sedative hypnotic activity?
a negative on the number 7 position
185
ramelteon
melatonin agonist, CNS Depressant Tx: insomnia MOA: MT1-sleep onset, MT2-circadian rhythm
186
naltrexone
TX OPIOID AND ALCOHOL ADDICTION/OVERDOSE - MAINTANENCE
187
LSD (lysergic acid diethylamide), psilocybin
Hallucinogen RR addiction =1 severly altered judgement = harm others and yourself MOA: 5HT2a (Gq) = ++Ca2+ = ++Glutamate in cortex
188
buprenorphine
opioid
189
What treats absence seizures?
ethosuximide, valproic acid (by reducing Ca2+ influx)
190
What is EMLA and give an example
Eutectic Micture of Local Anesthetics Lidocaine and prilocaine
191
fluvoxamine
SSRI
192
TCA SE
orthostatic hypotension - hip breakers (alpha 1), weight gain (H1), anti cholinergic effects, 3 C's = convulsions (CNS), Coma (CNS), Cardiac arrhythmias (Cardiac)
193
What are the thre states of Na channel
Resting, open, inactive
194
What are 3 underlying causes of Seizures?
CNS injury, Congenityal Prx, Genetics Prx
196
MAOI Class SE
orthostatic hypotension, weight gain, Tyramine interaction (too ++mono amines, cheese and wine)
198
SE of benzodiazepines
drowsiness, ataxia, respiratory depression (lethal if combo with other Depressant), date rape (anterograde amnesia - flunitrazepam)
199
ziprasidone
atypical antipsychotic
200
Fentanyl
100x's more potent than morphine
201
SSRI SE
Seratonin syndrome (if not titrated off one med before starting another SSRI= lethargy, confusion, diaphoresis, tremor)
203
Carbamazepine, oxacarbazapine
TCA TX: grand mal, partial seizures, trigeminal neuralgia (drug of choice) MOA: --Na channels, potent inducer of P450s and it's own metabolism SE: SIADH (sx of Inapropriate ADH secretion, Teratogenic Oxacarbaxepine has longer duration and fewer drug interactions
205
Spasticity vs Spasm
Spasticity is CNS injury, spasm is local Muskuloskeletal injury
206
What drug interacts with L-dopa, never give with it
Pyridoxine - Vit B6 - causes ++decarboxylation of L Dopa
207
psychosis that is heritable and includes lots of delusions
Schizophrenia
209
What two things do we need to have on hand in case of a bad reaction to a local anesthetic?
antihistamine and epinephrine
210
Galantamine
similar to Donepezil
211
Phenobarbital, Primidone
Class: cyclic ureides, barbiturate MOA: ++GABAa recptor response TX: status epilepticus Primidone is metabolized by MES (liver P450) into phenobarbital
212
Ketamine and Phencyclidine (PCP, angel dust)
Hallucinogen dissociative anesthesia/analgesic MOA: block NMDA glutamate receptors = --CNS cortex and limbic system
213
diphenoxylate
opioid, antidiarrheal
215
what barbiturate is an anticonvulsant
phenobarbital
216
ethosuximide
Class: cyclic ureides TX: petit mal (absence seizure) MOA: --T type Ca2+ channels
217
What does the dorsal anterior cingulate cortex affect
attention
219
how many patients don't respond to antiepileptic meds?
20%
221
inclusions that we see in huntingtons dis?
huntingtons protein
222
What is TAC and when it is used?
Tetracaine, Adrenalin and Cocaine used in Pediatric Emergency Rooms
223
methylphenidate (ritalin)
TX: ADHD
225
Chlorpromazine
typical antipsychotic, least potent
226
Fomepizole
TX: antifreeze ingestion via --ADH
227
what is different about the MOA of cocaine and amphetemine?
Cocaine is blocker of DA reuptake, Amphetamines also block NET, cause ++ release of DA and NE,
229
Roinirole
DA receptor agonist TX: Parkinson
231
What drugs do you never combine
MAOI, TCA, SSRI
232
are amphetamines appetite supressants?
yes
233
What is the abuse pathway of benzodiazepines and barbiturates?
Disinhibition of the VTA = activation of the mesolimbir reward pathway
234
what is an analeptic?
restores the CNS - stimulant
235
Hydroxyzine, Diphenhydramine
antihistamine CNS Depressant agent (off label) = sedative action
236
olanzapine
atypical antipsychotic
237
Rasagiline/Selegiline
MAOI-B TX: adjunct to L Dopa in parkinsons MOA: --MAOB and ++ DA (at higher doses also --MAOA) SE: serotonins Syndrome
238
clozapine
atypical antipsychotic
239
Mu1
receptor for opioids - supraspinal analgesia
240
what are opioid used for
relief of pain, moderate to severe pain
241
barbiturates abuse
Sedative, hypnotic, RR adiction is 3
242
another name for physical dependance
withdrawal
244
pentobarbital, phenobarbital, thiopental
CNS depressant, barbiturate MOA: linear slope (can cause death more easily), metabolites have NO activity, acts on GABA channels and keeps them open --\> hyperpolarization
245
what anxiolytic wont induce sleep or drowsiness
buspirone
246
short duration benzodiazepines
midazolam, triazolam
247
Donepezil
Long half life - 3days, once a day dosing, increase compliance TX: alzheimers mild, moderate and severe MOA: --AchE
248
tolcapone
COMTI (catechol o methyltranserase inhibitor) Tx; parkinsons MOA: Central and Peripheral COMTI SE: hepatotoxic
249
Articiane
Amide Anesthitic TX: dental procedures local anesthetic
250
Doxapram
Analeptic Respiratory stimulant TX: post anesthesia MOA: increase tidal volume and RR via --GABAa
251
Enflurane
Inhalable Halogenated Tx anesthesia SE: CNS stimulation (jerking, twitching) and Pungent odor
252
gama hydroxy butyric acid (GHB)
sedative, hypnotic, RR adiction is 3 can be used as date rape drug, cause amnesia, reward pathway activation
253
What are some general SE to general anesthesia?
low blood pressure, low cardiac output, arrhythmias
254
sertraline
SSRI Short half life - see SE with sudden disncontinuation
255
what drug is an antispasmodic
Diazepam
256
Isoflurane
Inhalable Halogenated Tx: maintanence of anesthesia Low toxcitiy high pungency
257
memantine
TX: moderate to severe Alzheimers Disease MOA: --NMDA receptor (glutamate receptor), = --Ca2+ influx = --glutamate toxicity
258
MDMA (ecstasy)
designer drug MOA: Causes ++release of 5HT via SERT SE: 5HT depletion following the next 24 hours, acutely: hyperthermia and dehydration
259
SE of DA receptor agonist?
GI N/V/C
260
how much of poputlation does alzheimers affect?
10% over 65, 50% over 85
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metabolism of antipsychotics
metabolized by liver, cyp450, metabolized into active metabolites
262
Antipsychotics can treat what dieseases?
schizophrenia, psychotic behavior, mania, emesis, coughing
263
3 MOA for analgesics
1) inhibition of adenylyl cyclase (--cAMP) 2) --Ca2+ influx = -- release of Neurotransmitter 3) opening post synaptic K+ channels = loss of intracellular K+ = hyperpolarization
265
Acetazolamide
TX: anticonvulsant MOA: -- Carbonic Anhydrase
266
what are the effects of Dopaminergic antagonists?
cognitive fxn, EPS, antiemetic, ++prolactin, weight gain
267
What seizure is often found in children?
Atonic - wear helmet
268
Halothane
Halogenated Inhalables tx: maintancence of anethesia prototype drug for this class
269
tx for depression (that is a benzodiazapine)
alprazolam
271
signs and sx's of ADHD
Inattention, impulsivity, hyperactivity, aggression
273
if pts with alzheimers are treated and see psychotic sx's, what next?
give an atypical antipsychotic, SSRI if we see depression (sertraline and citalopram)
274
oxycodone
opioid, used for postsurgical pain
275
what atypical agent has least EPS?
clozapine and quetiapine
276
Benzodiazepines abuse
Sedative, hypnotic, RR adiction is 3 diazepam and alprazolam are the most abused
277
pharmacodynamic tolerance
receptor downregulation, desensitization
278
Lidocaine
Local Amide Anesthetic Reference Standard TX: pain MOA: topically or injection (not too toxic and still lipophilic) SE: Transient neurologic symptoms with high dose
279
Name for recurring seizures?
epilepsy
280
Ketamine
IV anesthetic MOA: non competitiveglutamate NMDA receptor antagonist Tx: analgesia and amnesia SE: emergence phenomenon - zombie stuff
281
citalopram
SSRI Safest for adeverse interactions
282
Most common seizures?
Complex Partial\>tonic clonic\> the rest
