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Neuro - Unit 4 > Drugs > Flashcards

Drugs Flashcards

1
Q

Chlorpromazine

  • Drug class?
  • Mechanism?
  • Administration?
  • Absorption?
  • Excretion?
  • AR? (2)
A
  • First generation antipsychotic (>D2/5HT2A) = good against + symptoms
  • Block D2 receptors
  • Oral, IM, IM suspension
  • Incompletely; highly lipid soluble to pass into CNS; CROSS PLACENTA
  • CYP450; excreted via kidney and excreted in BREAST MILK
  • ANS (dry mouth, tachy, constipation, ortho hypo)
    Sedation via musc and hist block
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2
Q

Haloperidol

  • Drug class?
  • Mechanism?
  • Administration?
  • Absorption?
  • Excretion?
  • AR?
A
  • First generation antipsychotic (>D2/5HT2A) = good against + symptoms
  • Block D2 receptors
  • Oral, IM, IM suspension
  • Incompletely; highly lipid soluble to pass into CNS; CROSS PLACENTA
  • CYP450; excreted via kidney and excreted in BREAST MILK
  • EPSE; Dystonia (treat with anti musc.); Akathisia (reduce dose); pseudoparkinsonian (add anti chol or amantidine); tarditive dyskinesia (prevention)
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3
Q

Aripiprazole

  • Drug class?
  • Mechanism?
  • Administration?
  • Absorption?
  • Excretion?
  • AR? (2)
A
  • Second generation antipsychotic (>5HT2A/D2) = good against - symptoms
  • Block D2/5HT2A receptors
  • Oral, IM, IM suspension
  • Incompletely; highly lipid soluble to pass into CNS; CROSS PLACENTA
  • CYP450; excreted via kidney and excreted in BREAST MILK
  • Weight gain, seizures, QT prolongation, photosensitivity, altered thermoreg, neuroleptic malignant syndrome
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4
Q

Clozapine

  • Drug class?
  • Mechanism?
  • Administration?
  • Absorption?
  • Excretion?
  • AR? (2)
A
  • Second generation antipsychotic (>5HT2A/D2) = good against - symptoms
  • Block D2/5HT2A receptors
  • Oral, IM, IM suspension
  • Incompletely; highly lipid soluble to pass into CNS; CROSS PLACENTA
  • CYP450; excreted via kidney and excreted in BREAST MILK
  • AGRANULOCYTOSIS!!! Weight gain, seizures, QT prolongation, photosensitivity, altered thermoreg, neuroleptic malignant syndrome
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5
Q

Olanzapine

  • Drug class?
  • Mechanism?
  • Administration?
  • Absorption?
  • Excretion?
  • AR? (2)
A
  • Second generation antipsychotic (>5HT2A/D2) = good against - symptoms
  • Block D2/5HT2A receptors
  • Oral, IM, IM suspension
  • Incompletely; highly lipid soluble to pass into CNS; CROSS PLACENTA
  • CYP450; excreted via kidney and excreted in BREAST MILK
  • Weight gain, seizures, QT prolongation, photosensitivity, altered thermoreg, neuroleptic malignant syndrome
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6
Q

Quetiapine

  • Drug class?
  • Mechanism?
  • Administration?
  • Absorption?
  • Excretion?
  • AR? (2)
A
  • Second generation antipsychotic (>5HT2A/D2) = good against - symptoms
  • Block D2/5HT2A receptors
  • Oral, IM, IM suspension
  • Incompletely; highly lipid soluble to pass into CNS; CROSS PLACENTA
  • CYP450; excreted via kidney and excreted in BREAST MILK
  • Weight gain, seizures, QT prolongation, photosensitivity, altered thermoreg, neuroleptic malignant syndrome
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7
Q

Risperidone

  • Drug class?
  • Mechanism?
  • Administration?
  • Absorption?
  • Excretion?
  • AR? (2)
A
  • Second generation antipsychotic (>5HT2A/D2) = good against - symptoms
  • Block D2/5HT2A receptors
  • Oral, IM, IM suspension
  • Incompletely; highly lipid soluble to pass into CNS; CROSS PLACENTA
  • CYP450; excreted via kidney and excreted in BREAST MILK
  • Weight gain, seizures, QT prolongation, photosensitivity, altered thermoreg, neuroleptic malignant syndrome
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8
Q

Amitriptyline

  • Drug class?
  • Mechanism?
  • Line?
  • Blood levels?
  • AR?
  • High levels?
A
  • TCAD; Antidepressant
  • Block NET and SERT to prevent reuptake of NE and 5HT
  • Second line
  • Easily monitored
  • Anticholinergic effects (can’t see…), hypotension, weight gain, sexual side effects, sedaton
  • Lethal (arrhythmias and seizures)
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9
Q

Imipramine

  • Drug class?
  • Mechanism?
  • Line?
  • Blood levels?
  • AR?
  • High levels?
A
  • TCAD; Antidepressant
  • Block NET and SERT to prevent reuptake of NE and 5HT
  • Second line
  • Easily monitored
  • Anticholinergic effects (can’t see…), hypotension, weight gain, sexual side effects, sedaton
  • Lethal (arrhythmias and seizures)
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10
Q

Desipramine

  • Drug class?
  • Mechanism?
  • Line?
  • Blood levels?
  • AR?
  • High levels?
A
  • TCAD; Antidepressant
  • Block NET and SERT to prevent reuptake of NE and 5HT
  • Second line
  • Easily monitored
  • Anticholinergic effects (can’t see…), hypotension, weight gain, sexual side effects, sedaton
  • Lethal (arrhythmias and seizures)
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11
Q

Fluoxetine

  • Drug class?
  • Mechanism?
  • Indications?
  • AR: Acute?
  • Delayed? Wtihdrawal?
  • Dangerous mix?
A
  • SSRI’s; Antidepressant
  • Block SERT
  • Many; Anxiety, panic, OCD, PTSD, PDD, GAD
  • P450 inhibition; diarrhea, dry mouth, jitters nausea
  • Cognitive blunting; sexual SE, weight gain
  • SSRI’s and MAOI!!! (hyperthermia, rigid, HTN)
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12
Q

Paroxetine

  • Drug class?
  • Mechanism?
  • Indications?
  • AR: Acute?
  • Delayed? Wtihdrawal?
  • Dangerous mix?
A
  • SSRI’s; Antidepressant
  • Block SERT
  • Many; Anxiety, panic, OCD, PTSD, PDD, GAD
  • P450 inhibition; diarrhea, dry mouth, jitters nausea
  • Cognitive blunting; sexual SE, weight gain
  • SSRI’s and MAOI!!! (hyperthermia, rigid, HTN)
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13
Q

Sertraline

  • Drug class?
  • Mechanism?
  • Indications?
  • AR: Acute?
  • Delayed? Wtihdrawal?
  • Dangerous mix?
A
  • SSRI’s; Antidepressant
  • Block SERT
  • Many; Anxiety, panic, OCD, PTSD, PDD, GAD
  • P450 inhibition; diarrhea, dry mouth, jitters nausea
  • Cognitive blunting; sexual SE, weight gain
  • SSRI’s and MAOI!!! (hyperthermia, rigid, HTN)
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14
Q

Trazodone

  • Drug class?
  • Mechanism?
  • AR?
A
  • Mixed; Antidepressant
  • Complex 5HT mechanism
  • Drowsiness (helps with insomnia)
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15
Q

Mirtazapine

  • Drug class?
  • Mechanism?
  • Advantages? (3)
  • AR? (2)
A
  • Mixed; Antidepressant
  • a2 block to increase NE
  • No insomnia or Sexual SE; rapid anti anxiety
  • Weight gain, daytime somnelence
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16
Q

Bupropion

  • Drug class?
  • Mechanism?
  • Advantages? (2)
  • AR? (4)
  • Contra in?
A
  • Mixed; Antidepressant
  • weak NE-DA reuptake inhibitor
  • No sexual SE; weight neutral
  • Anxiety, ineffective with panic, high seizure risk, insomnia, CONTRA in ANNORHEXICs
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17
Q

Phenelzine

  • Drug class?
  • Mechanism?
  • Effective in?
  • AR? (7)
A
  • MAOI; Antidepressant
  • Inhibit degradation of DA
  • Atypical depression
  • Hypertensive tyramine crises (sausage, wine, cheese), seizures, shock, postural hypo, weight gain, sexual SE, antichol. SE
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18
Q

Venlafaxine

  • Drug class?
  • Mechanism?
  • More effective than?
  • AR? (4)
  • Withdrawal?
A
  • SNRI; Antidepressant
  • Block NET and SERT preventing reuptake
  • TCADs
  • Htx, anxiety, Sexual SE, INCREASED DBP
  • RAPID; flu like electric shock!!!
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19
Q

Electroconvulsive therapy

- Mechanism?

A
  • Antidepressant; Increase tyrosine, tryptophan, tryptophan hydroxylases = more 5HT and NE
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20
Q

Lithium

  • Drug class?
  • Mechanism?
  • Takes how long to work?
  • Use dependent?
  • Also used for?
  • AR? (5)
  • Can increase plasma levels? (2)
A
  • Anti-manic
  • Interferes with recycling of phospho. which decreases action of GCPR’s; Inhibits DA/NE release; Enahnces 5HT release
  • 10-21 days
  • yes
  • preventive
  • Tremor, nausea, diabetes insipidus, hypothyroid, renal effects
  • Narrow therapeutic window
  • Diuretics and NSAIDs
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21
Q

Valproic acid

  • Drug class?
  • Mechanism?
  • AR?
A
  • Anti manic

- Inhibit VSSC

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22
Q

Carbamazepine

  • Drug class?
  • Mechanism?
  • AR?
A
  • Anti manic
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23
Q

Buspirone

  • Drug Class?
  • MOA?
  • Benefits? (2)
  • Absorption?
  • Distribution?
  • Effects order? (4)
  • AR? (3)
A
  • Anxiolytic
  • 5HT1A partial agonist/ some affinity for D2
  • No sedation or additive CNS effects
  • Rapid oral
  • Lipid soluble
  • Axiolysis (sleep and some psychomotor impairment; anticonvulsant; muscle relaxation; hypnosis
  • Amnesia, tolerance, dependence
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24
Q

Diazepam

  • Drug Class?
  • MOA?
  • Usage?
  • Absorption?
  • Distribution?
  • Metabolism?
  • Effects order? (4)
  • AR? (5)
A
  • Anxiolytic BDZ
  • Intensify GABA channel chloride current ONLY if GABA is available on gamma subunit
  • Declining due to abuse potential; more for accute
  • Rapid oral
  • Lipid soluble
  • CYP450 1–>2 then renal
  • Axiolysis (sleep and some psychomotor impairment; anticonvulsant; muscle relaxation; hypnosis
  • Amnesia, tolerance, dependence; additive CNS effects; daytime sedation due to active phase 1 metabolites
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25
Alprazolam - Drug Class? - MOA? - Usage? - Absorption? - Distribution? - Metabolism? - Effects order? (4) - AR? (5)
- Anxiolytic BDZ - Intensify GABA channel chloride current ONLY if GABA is available on gamma subunit - Declining due to abuse potential; more for accute - Rapid oral - Lipid soluble - CYP450 1-->2 then renal - Axiolysis (sleep and some psychomotor impairment; anticonvulsant; muscle relaxation; hypnosis - Amnesia, tolerance, dependence; additive CNS effects; daytime sedation due to active phase 1 metabolites
26
Lorazepam - Drug Class? - MOA? - Usage? - Absorption? - Distribution? - Metabolism? - Effects order? (4) - AR? (5)
- Anxiolytic BDZ - Intensify GABA channel chloride current ONLY if GABA is available on gamma subunit - Declining due to abuse potential; more for accute - Reliable IM - Lipid soluble - NOT CYP450!!! Good for elderly - Axiolysis (sleep and some psychomotor impairment; anticonvulsant; muscle relaxation; hypnosis - Amnesia, tolerance, dependence; additive CNS effects; daytime sedation due to active phase 1 metabolites
27
Oxazepam - Drug Class? - MOA? - Usage? - Absorption? - Distribution? - Metabolism? - Effects order? (4) - AR? (5)
- Anxiolytic BDZ - Intensify GABA channel chloride current ONLY if GABA is available on gamma subunit - Declining due to abuse potential; more for accute - Rapid oral - Lipid soluble - Not CYP450!!! Good for elderly - Axiolysis (sleep and some psychomotor impairment; anticonvulsant; muscle relaxation; hypnosis - Amnesia, tolerance, dependence; additive CNS effects; daytime sedation due to active phase 1 metabolites
28
Flumazenil - Drug Class? - MOA? - Usage? - Absorption? - Distribution? - Metabolism? - Effects order? (4) - AR? (5)
- Anxiolytic BDZ - Intensify GABA channel chloride current ONLY if GABA is available on gamma subunit - Declining due to abuse potential; more for accute - Rapid oral - Lipid soluble - CYP450 1-->2 then renal - Axiolysis (sleep and some psychomotor impairment; anticonvulsant; muscle relaxation; hypnosis - Amnesia, tolerance, dependence; additive CNS effects; daytime sedation due to active phase 1 metabolites
29
Midazolam - Drug Class? - MOA? - Usage? - Absorption? - Distribution? - Metabolism? - Effects order? (4) - AR? (5)
- Anxiolytic BDZ - Intensify GABA channel chloride current ONLY if GABA is available on gamma subunit - Declining due to abuse potential; more for accute - Rapid oral - Lipid soluble - CYP450 1-->2 then renal - Axiolysis (sleep and some psychomotor impairment; anticonvulsant; muscle relaxation; hypnosis - Amnesia, tolerance, dependence; additive CNS effects; daytime sedation due to active phase 1 metabolites
30
Pentobarbital - Drug Class? - MOA? - Usage? - Absorption? - Distribution? - Metabolism? - Effects order? (4) - AR? (5)
- Anxiolytic Barbituate - Prolong GABA channel even in absence of GABA and decreasing Glu so some anesthetic properties - HIGH abuse potential; not really used - Rapid oral - Lipid soluble - CYP450 - Axiolysis (sleep and some psychomotor impairment; anticonvulsant; muscle relaxation; hypnosis; ANESTHESIA!!! - Amnesia, tolerance, dependence; additive CNS effects; CLASSIC CYP450 INDUCER!!!!!
31
Phenobarbital - Drug Class? - MOA? - Usage? - Absorption? - Distribution? - Metabolism? - Effects order? (4) - AR? (5)
- Anxiolytic Barbituate - Prolong GABA channel even in absence of GABA and decreasing Glu so some anesthetic properties - HIGH abuse potential; not really used - Rapid oral - Lipid soluble - CYP450 - Axiolysis (sleep and some psychomotor impairment; anticonvulsant; muscle relaxation; hypnosis; ANESTHESIA!!! - Amnesia, tolerance, dependence; additive CNS effects; CLASSIC CYP450 INDUCER!!!!!
32
Xenon | Type of drug?
- Volatile Anesthetic
33
Nitrous oxide - Type of drug? (2) - Type of substance? - MAC? So? - 3 related concepts? - Use?
- Volatile Anesthetic; Inorganic gas - Only true gas (others = volatile liquids) - 105%; can't be used as sole anasthetic (combine with barb/opioid) - Conc. effect; diffusion hypoxia; second gas effect - Balanced anasthesia
34
Diethyl ether | Type of drug?
- Volatile Anesthetic
35
Cyclopropane | Type of drug? (2)
- Volatile Anesthetic; hyrdocarbon
36
Chloroform | Type of drug? (2)
- Volatile Anesthetic; chlorinated hydrocarbon
37
Halothane (Fluothane®) - Type of drug? (2) - Potency? Alagesic? Use? - Side effects? (4)
- Volatile Anesthetic; fluorinated hydrocarbon - High; poor; not anymore - Resp. supression; CV arrhythmias; liver failure; malignant hyperthermia with RyR mutation --> treat with Dantrolene
38
Enflurane (Ethrane®) | Type of drug? (2)
- Volatile Anesthetic; fluorinated ether
39
Isoflurane (Forane®) - Type of drug? - Use? - Advantages? (4) - Induction? - Muscle relaxant? - Odor? Triggers? Overcome how?
- Volatile Anesthetic - Most widely used - More potent; less hepatotoxicity; little seizure propensity; spares heart - Rapid/smooth - Good - Bad; Coughing; IV agents
40
Desflurane (Suprane®) | Type of drug?
- Volatile Anesthetic
41
Sevoflurane (Ultane®) - Type of drug? - Odor? Used for? - Drawback? (2)
- Volatile Anesthetic - Good; Induction - Chemically unstable; release of fluoride ions may be renal toxic
42
Thiopental(Pentathal®) | Type of drug? (2)
- IV anesthetics; Barbituate
43
Propofol (Diprivan®) | Type of drug?
- IV anesthetics
44
Etomidate (Amidate®) | Type of drug?
- IV anesthetics
45
Ketamine (Ketalar®) | Type of drug? (2)
- Intravenous adjuncts anesthetics; glu receptor agent
46
D-tubocurarine | Type of drug? (2)
- Intravenous adjuncts anesthetics; NM antagonist
47
Morphine (MS-Contin®) | Type of drug? (2)
- Intravenous adjuncts anesthetics; opoid analgesic
48
Fentanyl (Sublimaze®) | Type of drug?
- Intravenous adjuncts anesthetics
49
Diazepam (Valium®) | Type of drug? (2)
- Intravenous adjuncts anesthetics; BDZ
50
Ondansetron (Zorfan®) | Type of drug?
- Intravenous adjuncts anesthetics
51
Glycopyrrolate (Robinul®) | Type of drug?
- Intravenous adjuncts anesthetics
52
Zolpidem - Type of drug? - MOA? - Absorption? - Half life? - Side effects? (4) - Rebound? Psychomotor? - Effect on sleep? (2) - Generic? Safety? - Withdrawal/ dependence? - Common? - Line?
- "Z" drug for insomnia - Bind gamma subunit of ALPHA1!!! (sleep without anxiolysis); facilitates GABA opening - Rapid - 2-2.5 hours; duration 6-8 - Drowsy, amnesia, HA; strange sleep behavior - No rebound insomnia; no psychomotor impairment - ↑ total sleep time; minimal effect on sleep stages III/IV/REM - Generic available; good safety profile - Withdrawal and dependence possible - Most widely prescribed - First
53
Zaleplon - Type of drug? - MOA? - Absorption? - Half life? - Side effects? (4) - Rebound? Psychomotor? - Effect on sleep? (2) - Used for?
- "Z" drug for insomnia - Bind gamma subunit of ALPHA1!!! (sleep without anxiolysis); facilitates GABA opening - Rapid absorption - 1 hour half life - HA, dizziness, somnolence; strange sleep behavior - No rebound insomnia, No psychomotor impairment - ↑ total sleep time; minimal effect on sleep stages III/IV/REM - Best sleep aid for middle of night awakenings - First
54
Eszoplicone - Type of drug? - MOA? - Absorption? - Half life? - Side effects? (4) - Rebound? Psychomotor? - Effect on sleep? (2) - Line?
- "Z" drug for insomnia - Bind gamma subunit of ALPHA1!!! (sleep without anxiolysis); facilitates GABA opening - Rapid - 6 hours (longer for longer term use) - Drowsy, amnesia, HA; strange sleep behavior - No rebound insomnia; no psychomotor impairment - ↑ total sleep time; minimal effect on sleep stages III/IV/REM - First
55
Triazolam - Type of drug? - MOA? - Absorption? - Line? - Half life? - Dose reduction in? - Side effects? (6) - Treat toxicity with? - Effects on sleep? (4)
- BDZ for insomnia - Bind A1 and A2/5 = sleep and anxiolysis - Rapid - 2nd after Z drugs - Short; <5 hours - Elderly - Rebound insomnia, anterograde amnesia, confusion, hallucination, agitation, bizarre behaviors - Flumazenil - ↓ sleep latency; ↑ total sleep time; ↑ stage 2; ↓ REM, stage 3, 4
56
Temazepam - Type of drug? - MOA? - Line? - Half life? - Side effects? (2) - Treat toxicity with? - Effects on sleep?
- BDZ for insomnia - Bind A1 and A2/5 = sleep and anxiolysis - Slow - 2nd after Z drugs - Intermediate; 9-13 hours - Rebound insomnia, daytime sedation - Flumazenil - ↓ sleep latency; ↑ total sleep time; ↑ stage 2; ↓ REM, stage 3, 4
57
Flurazepam - Type of drug? - MOA? - Line? - Half life? - Metabolite? - Side effects? (2) - Treat toxicity with? - Effects on sleep?
- BDZ for insomnia - Bind A1 and A2/5 = sleep and anxiolysis - Slow - 2nd after Z drugs - Long; 75-90 hours - Active - Daytime sedation - Flumazenil - ↓ sleep latency; ↑ total sleep time; ↑ stage 2; ↓ REM, stage 3, 4
58
Ramelteon - Melatonin - Type of drug? - MOA? - Decreases latency of sleep? - Side effects? (4) - Effect on sleep?
- Non-GABA for insomnia - MT1/MT2 agonist - Yes - Dizziness; somnelence; fatigue; nausea - Decreases mean latency to sleep
59
Trazodone - Type of drug? (2) - MOA? - Good for what type of patients? Why? - Side effects? (3) - Effect on sleep?
- Non-GABA for insomnia (Antidepressant) - Complicated MOA; inhibits 5HT reupatake - Abuse/ addiction; Tolerance/addiction is low - Oversedation; orthostasis; priapism (constantly erect penis) - ↑ REM sleep
60
Diphenhydramine - Type of drug? - MOA? - Effective for? Advertised by not? - Side effects?
- Non-GABA for insomnia; Benadryl - H1/M antagonist - Short term insomnia; recommended - Antimuscarinic in older populations
61
Carbamazepine - Type of drug? - MOA? - Broken down by? - Use? - SE? (6)
- Anti seizure - Inhibits VSSC in use dependent fashion - P450 - Partial Siezures - Hepatotoxicity; Hyponatremia; Diplopia; Ataxia; Nausea/vomitting; Steven Johnson
62
Phenytoin - Type of drug? - MOA? - Broken down by? - Use? - SE? (5)
- Anti seizure - Inhibit VSSC in use dependent - P450 zero order kinetics - Partial - Nystagmus!, diplopia, rash!, gingival hyperplasia!, sedation
63
Lamotrigine - Type of drug? - MOA? - Use? - SE?
- Anti seizure - Unclear - Partial and tonic clonic - Levels increased by valproate, decreased by OC's
64
Ethosuximide - Type of drug? - MOA? - Broken down by? - Use? - SE? (3)
- Anti seizure - Inhibit low threshold T-type Ca channel - CYP3A4 - Absence Seizures - GI, HA, dizzy
65
Levetriacetam - Type of drug? - MOA? - Use? - SE?
- Anti seizure - Unknown - Partial and tonic clonic - Fatigue
66
Valproic Acid - Type of drug? - MOA? - Coated? - Use? - SE? (5)
- Anti seizure - Increases GABA function and limits T type Ca channels - Enteric coated - Tonic Clonic (Absence but hepatotoxicity bad) - Weight gain, hepatotoxicity, CONTRA in PREGNANCY, increases phenobarb levels, decreased plt aggregation
67
Diazepam - Type of drug? - MOA? - Use? - SE?
- Anti seizure - Ehance GABA - Status eppilecticus - Tolerance
68
Midazolam - Type of drug? - MOA? - Broken down by? - Use? - SE? (5)
- Anti seizure - Ehance GABA - Status eppilecticus - Tolerance
69
Lorazapam - Type of drug? - MOA? - Broken down by? - Use? - SE? (5)
- Anti seizure - Ehance GABA - Status eppilecticus - Tolerance
70
Phenobarbital - Type of drug? - MOA? - Broken down by? - Use? - SE? (3)
- Anti seizure - Enhance GABA, decrease GLU - CLASSIC CYP450 INDUCER - Neonatal status epilecticus - Sedation, irritability, interferes with learning

Neuro - Unit 4 (11 decks)

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