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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
Q

vilazodone (Viibryd) AE

A

n/d headache

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26
Q

vortioxetine (Trintellix) MOA

A

unclear
likely inhibits 5-HT reuptake
causes increased NE, ACh, and DA activity in prefrontal cortex

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27
Q

common AEs

A

nausea and sexual dysfunction

28
Q

tricyclic antidepressants indication

A

depression

less commonly used bc of safety

29
Q

tricyclic antidepressants MOA

A

inhibits 5-HT and NE reuptake

other receptor blockage contributes to AE

30
Q

tricyclic antidepressants common AE

A 
weight gain
sexual dysfunction
sedation (histamine)
antichoningic effects (muscarinic)
hypotension and dizziness (alpha)
31
Q

tricyclic antidepressants serious AE

A

overdose!!

cardiac conduction abnormalities due to blocking cardiac Na channels

32
Q

tricyclic antidepressants other uses

A

neuropathic pain
migraine prevention
insomnia

33
Q

MAO inhibitors indication

A

depression

typically last line option

34
Q

MAO inhibitors MOA

A

increase 5-HT, NE and dopamine by inhibiting MAO enzyme

35
Q

MAO inhibitors common AE

A

OH
weight gain
sexual dysfunction

36
Q

MAO inhibitors serious AEs

A

HIGH risk of serotonin syndrome (so must separate from other antidepressants by several weeks if changing treatment)

risk of hypertensive crisis

37
Q

first line anxiety treatment

A

SSRI and SNRI

38
Q

when is propranolol used in anxiety

A

long term panic attacks and prn for phobias

reduces sympathetic stimulation related to palpitations and tremors

39
Q

when are benzodiazepines used in anxiety

A

only for acute treatment

40
Q

when is buspirone used in anxiety

A

maintenance in generalized anxiety

41
Q

benzodiazepines drugs

A

alpazolam (Xanax)

42
Q

benzodiazepines MOA

A

binds BZD receptors on GABA channels to enhance GABA inhibitory effects

43
Q

benzodiazepines dosing

A

avoid as maintenance therapy due to psychotic and physiologic dependence

  • taper off if long term use
44
Q

benzodiazepines common AE

A

sedation
ataxia
memory problems

45
Q

benzodiazepines less common AEs

A

paradoxical excitement or anxiety

46
Q

benzodiazepines contraindications

A

caution in elderly due to build up of metabolites

47
Q

buspirone (Buspar) MOA

A

unclear

known to bind to 5-HT and dopamine recepors

48
Q

buspirone (Buspar) advantages

A

no abuse risk

limits motor, memory, concentration impairments

49
Q

buspirone (Buspar) disadvantages

A

dizziness
3 weeks to see impact
possibly less effective in severe anxiety
metabolized by CYP - DDI

50
Q

FGA indication

A

schizophrenia

2nd line treatment due to AE

51
Q

FGA - general

A

aka conventional or typical
marketed before 1990
previously called “neuroleptics”

52
Q

SGA - general

A

aka novel or atypical
marketed after 1990
less EPS and TD
more likely 1st line

53
Q

FGA MOA

A

block d2 receptors where excess DA may contribute to positive sx

54
Q

FGA AEs

A

EPS is acute or delayed

55
Q

SGA indication

A

schizophrenia

1st lines treatment

56
Q

SGA drugs

A

quetiapine (Seroquel)

57
Q

SGA MOA

A

block d2 receptors (more affinity for 5- HT tho)

58
Q

SGA AE

A

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
Q

primary treatment for acute depressive episodes (bipolar)

A

SSRI

bupropion

60
Q

primary treatment for acute manic episodes (bipolar)

A

lithium

61
Q

primary treatment for maintenance treatment in bipolar

A

lithium

62
Q

lithium indication

A

bipolar disorder

  • management of episode
  • used combo bc takes 5-10 days for response
  • prevention of further mani and depressive episodes
63
Q

lithium AE

A 
GI (n/v/d, abdominal cramps)
weight gain
polydipsia and uria
CNS
fine hand tremor
fatigue
muscle weakness

LITHIUM TOXICITY

64
Q

valproic acid (VPA) indication

A

acute manic bipolar episodes

boxed warning: hepatoxicity usually within first 6 months

65
Q

carbamazepine indication

A

used in manic and mixed episodes and for maintenance of bipolar

boxed warning: SJS and toxic epidermal necrolysis

66
Q

lamotrigine indication

A

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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