Exam 1 pharm

Question 1

Acetylcholine fxns

Answer 1

Movement, memory

- Def: Alzheimer’s

Question 2

Dopamine

Answer 2

Movement, reward center
Def-< parkinsonism
Surplus-> schizophrenia and addictive behaviors

Question 3

Ne

Answer 3

Alertness, arousal

Def-> Depressive disorders

Question 4

Serotonin 5 HT

Answer 4

Mood, evidence of sleep

Def-> depression, OCD, ED

Question 5

GABA

Answer 5

Awake arousal and regulates anxiety levels
Def-> Anxiety disorders, seizures/tremors,
imnsomnia

Question 6

Gutamate

Answer 6

Fxn-> memeory and learning

Surplus-> schizoprhenia, seizures, migranes

Question 7

Endirphins

Answer 7

-imitate opiate receptors and pain relief

Question 8

Dopaminergic/ psychotic/ RF s and SE

Answer 8

• TARDIVE DYSKENSIA!! usually from 1st gen Clozapine *Clozaril)
• This is why 2nd gen are often used to less SE risk

Question 9

consideration for mergency meds

For IM meds->
Haloperidol (Haldol)
Ziprasidone (Geodone)
Olazapine (Zyprexa)

Answer 9

• For IM olanzapine do not give with lorazepam and be given at least 1 hour apart!!
• Less risk associated with EPS with olanzapine and ziprasidone
• When given IM Zyprexa’s serum is 5x more concentrated and potent

Question 10

First gen Antipsychotics

Answer 10

D2 antagonist

• Higher rates of EPS/ Tardive dyskinesia
• symptoms -> may be debiliting and affect walking, breathing, eating and talking
• Elderly are at higher risk
• AIMS tetsing and monitotring

Question 11

2nd gen antipsychotics

Answer 11

• 5HT2A/ D2 antagomsists
• lower rates of EPS
• Higher ratesof metabolic SE
  risk of DM, hyperchlosterimaia, BMI,body circumference
• Educaiton of diet

Question 12

Clozapin montiroing

Answer 12

• associated with risk for agranulocytosis
• requires managment within a lab monitoring program
• weekly blood monitroing for 1st 6months
• Biweekly monitroing for next 6 months
• Tx w/o hematological problems can be performed monthly
• Also leads to high risk of seizures

Question 13

Neuroliptic MAlignant syndrome

Answer 13

Symptoms: High fever, sweating, anxiety, Tachycardia, arrhythmia, alterations on blood pressure

• can lead to multi-organ failure, aspiration, hypoxia
• edcuate on switching meds carefully

Question 14

Serotonin is the pricipal NT in what

Answer 14

in Stress, anxiety, depression

Question 15

SSRIs

Answer 15

• Fluoxetine, citalopram, escitalopram, paroxetine, setraline
• SE: Nausea, Insomnia, anxiety, tremors, sexual dysfunciton

Question 16

SNRIs

Answer 16

Duleoxetine, Venlafaxine, desvenlafaxine

- Nausea, Tired, fatigue, dry mouth

Question 17

TCAs

Answer 17

SE-> Drowsiness,arrthymia, QTc alteractions, blurry viision, seizures
- clomipramine, amytrypiline, nortripyline,doxepin, impramine

Question 18

MAOIs

Answer 18

Selgiline

- Dietary restictions -> cancause increased tyramine levels and HTN crisis

Question 19

SARIs

Answer 19

trazodone, vortioxwtine, vilazoone

- decrease serotinin related SE

Question 20

mirtazapine

Answer 20

Noradenergic antagonist blcoks epi recpetors

Question 21

Symbax

Answer 21

Combo drug og prozac and Zyprexa

- tx of bipolar disorder depression

Question 22

Wellbutrin

Answer 22

Dopamine reuptake inhibitor. Tx of depression, SAD, smoking

SE: Dizziness, dry mouth. N/v, blurry vision, wt gain, sex dysfunction

Question 23

Serotinin Syndrome

Answer 23

• AMS, autonomic hyperactivity, neuromuscular abnormalities

- stop meds, procide supportive therapy, tx symptoms

Question 24

Durgs for mania

Answer 24

• atypical antipsychotics are gold stanadar for mania

Question 25

Lithium levels

Answer 25

0.6-1.2 toxic is over 1.5 monitor for sedation, cognitive impairment, tremor, wt gain, rash Long term-> alteartion in thyroid level

Question 26

drugs for anxiety

Answer 26

SSRI-> risk for transient anxiety at first Setraline, citalopram, paroxetine-> may be used in high anxiety disorder patinets Buspirone-> can be good as PRN but takes 2-3 weeks to beocme evident venlafaxine-> Effective in trating insomnia, poor concetration, restlessness, irritability, and excessive muscle tension associated with GAD Benzos-> use with caution, watch for sedatin, respiratory depression, advise against driving TCAs-> impriminenine Antihistamines-> hydroxyzine - sedation but lesser extent B- adnergic antagonists -> propranolol Tx duration-> 6-12 months

Question 27

Benzos onset

Answer 27

very rapid high risk of adiction and short life | - do not stop rapidly

Question 28

ADHD pharma

Answer 28

- Psychostimulants are the 1st line and cornerstone Methlyphenidate and amphetamine salts SE-> worsended sleep, decreased apetite, psychisis, increased dopamine - can decrease anxiety - zombie- Look think about restriction esp in children

Question 29

Non stimulant ADHD

Answer 29

- Stattera atmoxetine - noradernergic agent reuptake inhibitor - decreased risks in some populations espcially psychotic symptomatology - SE-> liver injury monitor

Question 30

Alpha-2 no stimulant

Answer 30

- > can improve cognitive fxn and improve HTN | - > more receptive to NE