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Pharmacology > Exam 3 Neuro Part 4 Drugs > Flashcards

Exam 3 Neuro Part 4 Drugs Flashcards

1
Q

anti depressive therapy - general

A

2 weeks to see improvement in physical sx

6-8 weeks to see emotional sx improvement

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2
Q

SSRI indication

A

depression

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3
Q

SSRI MOA

A

inhibit reuptake of 5-HT in CNS

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4
Q

SSRI drugs

A

citalopram (Celexa)

escitalopram (Lexapro)

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5
Q

first line depression med

A

SSRI due to efficacy and tolerability

OR

SNRI esp if concomitant neuropathic pain or fibromyalgia

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6
Q

SSRI common AEs

A

less anticholinergic and cvd effects than other classes

HA, n/v/d, insomnia, sexual side effects

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7
Q

SSRI less common AEs

A

hyponatremia

bleeding (impaired platelet aggregation

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8
Q

SSRI other uses

A 
eating disorder
PTSD
anxiety 
OCD
bipolar disorder
vasomotor menopausal sx
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9
Q

SNRI MOA

A

inhibit reuptake of 5-HT and NE in CNS

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10
Q

SNRI indication

A

depression

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11
Q

SNRI common AE

A

ha, nausea, dry mouth, sweating, sexual dysfunction, insomnia

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12
Q

SNRI other uses

A

tons

fibromyalgia, migraine prevention

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13
Q

SNRI drugs

A

venlafaxine (Effexor)

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14
Q

bupropion (Wellbutrin) class

A

DA/NE reuptake inhibitor

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15
Q

bupropion (Wellbutrin) indication

A

often adjunct to reduce sexual dysfunction in depression

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16
Q

bupropion (Wellbutrin) MOA

A

inhibits NE and DA uptake

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17
Q

bupropion (Wellbutrin) common AE

A

ha, nausea, insomnia, tremor, dry mouth, decrease appetite

seizure risk

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18
Q

bupropion (Wellbutrin) other uses

A

ADHD, smoking cessation , weight loss

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19
Q

mirtazapine (Remeron) class

A

a2 antagonist

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20
Q

mirtazapine (Remeron) indication

A

used as adjunct therapy in depression

less common

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21
Q

mirtazapine (Remeron) MOA

A

stops inhibition of 5-HT and NE so increases release

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22
Q

mirtazapine (Remeron) common AEs

A

sedation
increase appetite (weight gain)
dry mouth
constipation

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23
Q

vilazodone (Viibryd) indication

A

depression

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24
Q

vilazodone (Viibryd) MOA

A

inhibits NE reuptake but also acts as a 5-HT receptor agonist

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25
vilazodone (Viibryd) AE
n/d headache
26
vortioxetine (Trintellix) MOA
unclear likely inhibits 5-HT reuptake causes increased NE, ACh, and DA activity in prefrontal cortex
27
common AEs
nausea and sexual dysfunction
28
tricyclic antidepressants indication
depression less commonly used bc of safety
29
tricyclic antidepressants MOA
inhibits 5-HT and NE reuptake other receptor blockage contributes to AE
30
tricyclic antidepressants common AE
``` weight gain sexual dysfunction sedation (histamine) antichoningic effects (muscarinic) hypotension and dizziness (alpha) ```
31
tricyclic antidepressants serious AE
overdose!! | cardiac conduction abnormalities due to blocking cardiac Na channels
32
tricyclic antidepressants other uses
neuropathic pain migraine prevention insomnia
33
MAO inhibitors indication
depression typically last line option
34
MAO inhibitors MOA
increase 5-HT, NE and dopamine by inhibiting MAO enzyme
35
MAO inhibitors common AE
OH weight gain sexual dysfunction
36
MAO inhibitors serious AEs
HIGH risk of serotonin syndrome (so must separate from other antidepressants by several weeks if changing treatment) risk of hypertensive crisis
37
first line anxiety treatment
SSRI and SNRI
38
when is propranolol used in anxiety
long term panic attacks and prn for phobias reduces sympathetic stimulation related to palpitations and tremors
39
when are benzodiazepines used in anxiety
only for acute treatment
40
when is buspirone used in anxiety
maintenance in generalized anxiety
41
benzodiazepines drugs
alpazolam (Xanax)
42
benzodiazepines MOA
binds BZD receptors on GABA channels to enhance GABA inhibitory effects
43
benzodiazepines dosing
avoid as maintenance therapy due to psychotic and physiologic dependence - taper off if long term use
44
benzodiazepines common AE
sedation ataxia memory problems
45
benzodiazepines less common AEs
paradoxical excitement or anxiety
46
benzodiazepines contraindications
caution in elderly due to build up of metabolites
47
buspirone (Buspar) MOA
unclear | known to bind to 5-HT and dopamine recepors
48
buspirone (Buspar) advantages
no abuse risk | limits motor, memory, concentration impairments
49
buspirone (Buspar) disadvantages
dizziness 3 weeks to see impact possibly less effective in severe anxiety metabolized by CYP - DDI
50
FGA indication
schizophrenia | 2nd line treatment due to AE
51
FGA - general
aka conventional or typical marketed before 1990 previously called "neuroleptics"
52
SGA - general
aka novel or atypical marketed after 1990 less EPS and TD more likely 1st line
53
FGA MOA
block d2 receptors where excess DA may contribute to positive sx
54
FGA AEs
EPS is acute or delayed
55
SGA indication
schizophrenia 1st lines treatment
56
SGA drugs
quetiapine (Seroquel)
57
SGA MOA
block d2 receptors (more affinity for 5- HT tho)
58
SGA AE
variable bc variable effect on histamine, muscarinic and alpha receptor less frequent EPS high risk for metabolic dysfunction - glucose and lipid abnormalities - weight gain monitor for dyslipidemia and diabetes
59
primary treatment for acute depressive episodes (bipolar)
SSRI | bupropion
60
primary treatment for acute manic episodes (bipolar)
lithium
61
primary treatment for maintenance treatment in bipolar
lithium
62
lithium indication
bipolar disorder - management of episode - used combo bc takes 5-10 days for response - prevention of further mani and depressive episodes
63
lithium AE
``` GI (n/v/d, abdominal cramps) weight gain polydipsia and uria CNS fine hand tremor fatigue muscle weakness ``` LITHIUM TOXICITY
64
valproic acid (VPA) indication
acute manic bipolar episodes boxed warning: hepatoxicity usually within first 6 months
65
carbamazepine indication
used in manic and mixed episodes and for maintenance of bipolar boxed warning: SJS and toxic epidermal necrolysis
66
lamotrigine indication
alternative to lithium for bipolar depressive episodes boxed warning: serious skin rash, can be life threatening, more common in kids

Pharmacology (11 decks)

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