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Exam 3 Pharm Flashcards

1
Q

Benzodiazepine MOA

Diazepam, Alprazolam, Clonazepam, Lorazepam, Temazepam, Midazolam

A

GABA-A Receptor Agonists

*increase Cl- channel opening FREQUENCY

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2
Q

What benzo is can be used as a muscle relaxant or for benzo withdrawal/tapering?

A

Diazepam

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3
Q

What benzo is can be used for preoperative sedation, anxiolysis and amnesia?

A

Midazolam

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4
Q

What benzo is can be used for insomnia?

A

Temazepam

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5
Q

Flumazenil MOA

A

GABA-A Receptor Antagonist

*used for Benzo/Zolpidem OD or reversal of sedation

use sparingly due to seizure risk

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6
Q

Eszoplicone MOA

A

BZ1 agonist

used for insomnia

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7
Q

Zolpidem MOA

A

BZ1 agonist

used for insomnia, NO other benzo-like effects, SAFE in pregnancy

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8
Q

Zolpidem formulation used for sleep onset

A

IR

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9
Q

Zolpidem formulation used for sleep onset or maintenance

A

ER

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10
Q

Barbiturate MOA

Phenobarbital, Pentobarbital, Thiopental

A

GABA-A Receptor Agonist

*increase Cl- channel opening DURATION

Classic CYP3A4 inducers

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11
Q

Ranks the barbs from long to short acting:

Phenobarbital, Pentobarbital, Thiopental

A

thats the order bruh

Phenobarbital > Pentobarbital > Thiopental

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12
Q

Buspirone MOA

A

partial 5-HT agonist

used for anxiety with partial antidepressant response
NO tolerance, dependence or withdrawal

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13
Q

Ramelton MOA

A

MT1 and MT2 Agonists at suprachiasmatic nuclei

used for insomnia (mostly sleep onset)

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14
Q

Suvorexant MOA

A

OX1, OX2 (orexin) Receptor Antagonist

used for insomnia, sleep onset and duration

orexins cause wakefulness, blocking causes sleepy

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15
Q

Doxepin MOA

A

H1 Receptor Antagonist

used for insomnia (sleep maintenance only)

Also a TCA/SNRI

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16
Q

Citalopram, Escitalopram MOA

A

SSRI, block SERT

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17
Q

Fluoxetine, Paroxetine MOA

A

SSRI, block SERT

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18
Q

Sertraline MOA

A

SSRI, block SERT

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19
Q

Vilazodone, Vortioxetine MOA

A

SSRI + 5-HT agonist

the “V” sign requires 2 fingers, so 2 MOA

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20
Q

Amitriptyline, Nortriptyline, Protriptyline MOA

A

TCA’s (SNRI, block SERT and NET)

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21
Q

Imipramine, Desipramine, Clomipramine, Trimipramine MOA

A

TCA’s (SNRI, block SERT and NET)

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22
Q

Amoxapine MOA

A

TCA, SNRI (block SERT and NET) + DA antagonist

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23
Q

Venlafaxine, Desvenlafaxine MOA

A

SNRI (block SERT and NET)

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24
Q

Duloxetine MOA

A

SNRI (block SERT and NET)

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25
Levomilnacipran MOA
SNRI (block SERT and NET)
26
Mirtazapine MOA
SARA (block 5-HT receptor and a2 receptor)
27
Trazodone, Nefazodone MOA
SARA (block 5-HT receptor and a1 receptor) a1 block can cause hypotension nefazodone off market bc liver tox
28
Bupropion MOA
NDRI (NE and DA reuptake inhibitor) also used for smoking cessartion can cause seizures in at risk pts
29
Isocarboxazid MOA
MAOi
30
Phenylzine MOA
MAOi can cause sedation
31
Tranylcypromide MOA
MAOi
32
Selegiline MOA
MAOi (Selective MAO-B inhibitor)
33
Esketamine MOA
NMDA-R antagonist used for treatment resistant depression w/ ongoing antidepressant tx
34
Brexanolone MOA
GABA-A Positive allosteric modulator used for postpartum depression
35
Lithium MOA in mood disorders
myoinositol depletion, prevents intracellular signaling cascades anti-manic effects by blocking PKC and MARCKS neuroprotective CREB expression
36
Mood stabilizers for maintenance of BPD
Lithium Valproic acid/Divalproex, Carbamazapine, Lamotrigine all can be used for acute mania EXCEPT Lamotrigine
37
Which antidepressant can be used for nicotine withdrawal?
Bupropion
38
Which antidepressant can be used for enuresis?
Imipramine
39
Which antidepressant can be used for chronic pain, peripheral neuropathy, FMS or stress incontinence?
Duloxetine
40
Patient with agitation, hyperthermia, tremor/clonus that is on many antidepressant drugs is likely suffering from
Serotonin syndrome
41
Patient with flu-like sxs, insomnia, N/V, lightheadedness, and sensory disturbances, who is prescribed antidepressants may be suffering from
antidepressant withdrawal syndrome
42
All antidepressants can increase risk of suicide
facts
43
Which SSRI is a classic CYP450 inhibitor?
Fluoxetine
44
Classic TCA side effects due to blocking multiple other receptors (H1, M, a1)
H1: sedation, fatigue M: anticholinergic (dry mouth, hot, urine retention) a1: tachycardia, hypotension
45
Patient with hypertensive crisis after eating meat, cheese and wine most likely caused by
MAOi (isocarboxazid, phenylzine, tranylcypromide) due to MAO-A being required for metabolism of dietary tyramine
46
Which antipsychotic can be used to treat recurrent suicidal behavior?
Clozapine
47
What antipsychotic can be used to treat hallucinations/delusions associated with Parkinson Disease psychosis?
Pimavanserin
48
-azine drug MOA Chlorpromazine, Fluphenazine, Perphenazine, Thioridazine, Trifluoperazine
FGA primary D2 blockade (>5-HT)
49
Haloperidol MOA
FGA primary D2 blockade (>5-HT)
50
Loxapine MOA
FGA primary D2 blockade (>5-HT)
51
Molindone MOA
FGA primary D2 blockade (>5-HT)
52
Pimozide MOA
FGA primary D2 blockade (>5-HT)
53
Thiothixene MOA
FGA primary D2 blockade (>5-HT)
54
FGA are more commonly associated with what side effect?
EPS (dystonia, akathesia, parkinsonism, TD)
55
Low potency FGA
Chlorpeomazine, Thioridazine more sedation/hypotension/tachycardia/ECG changes
56
High potency FGA
Haloperidol, Fluphenazine more associated with EPS
57
EPS treatments: Dystonia
Benztropine (anticholinergics)
58
EPS treatments: Akathisia
B-blocker, Benzo, Benztropine | the 3 B's
59
EPS treatments: Parkinsonism
Benztropine, Amantadine
60
EPS treatments: Tardive dyskinesia
Valbenazine, Deutetrabenazine (VMAT2 inhibitors)
61
-idone drug MOA Iloperidone, Lurasidone, Palperidone, Respiridone, Ziprasidone
SGA 5-HT/DA receptor antagonists
62
-piprazole drug MOA Aripiprazole, Brexpiprazole
SGA 5-HT/DA antagonists +5-HT/DA agonists *also Cariprazine
63
Cariprazine MOA
SGA 5-HT/DA antagonists + 5-HT/DA agonists +D3 agonist *also -piprazole's
64
-apine drug MOA Asenapine, Clozapine, Olanzapine, Quetiapine
SGA Multi-acting receptor-target agents *also Lumateperone
65
Lumateperone MOA
SGA Multi-acting receptor-target agents *also -apine's
66
Pimavanserin MOA
selective serotonin inverse agonist *only for parkinson psychosis
67
Class warning for all antipsychotics in elderly patient with dimentia
Stroke
68
What SGA's are most associated with weight gain and metabolic effects?
Clozapine, Olanzapine
69
What SGA's are most associated with QT prolongation/ECG changes?
Ziprasidone
70
Recommended metabolic monitoring for antipsychotics (4)
BMI, sugars, lipids, BP
71
Antipsychotic monitoring for general assessment of SE's
GASS
72
Antipsychotic monitoring for involuntary movement
AIMS
73
Antipsychotic monitoring for akathisia
BARS
74
Antipsychotic monitoring for extrapyramidal symptoms
ESRS
75
SGA associated with agranulocytosis and seizures
Clozapine, monitor WBC
76
SGA associated with DRESS syndrome (drug HSR associated with skin eruption, hemotologic abn, LAD)
Olanzapine
77
Patient antipsychotic presenting with altered mental status, then muscle rigidity, hyperthermia, and dehydration. Dx and Tx
Neuroleptic Malignant Syndrome Tx with Dantrolene, Diazepam
78
Injectable antipsychotics for acute agitation (4)
Haloperidol, Ziprasidone, Olanzapine, Aripiprazole
79
SGA used for multi-drug resistant disease
Clozapine works well but awful side effects
80
Long acting injectable agents for adherence to antipsychotic tx
Risperidone, Olanzapine, Aripiprazole, Palperidone soap ROAP
81
mu opioid receptors have highest affinity for
endorphins
82
delta opioid receptors have highest affinity for
enkephalins
83
kappa opioid receptors have highest affinity for
dynorphins
84
Codeine, Hydrocodone, Morphine, Fentanyl MOA and indication
opioid agonists for pain management
85
Opioid agonist used for tx of opioid use disorder
Methadone
86
Partial opioid agonist used for severe pain refractory to other tx
Pentazocine
87
Opioid agonist used for pre/postop pain that is highly addictive and may be abused by anesthesiologists
Meperidine
88
Partial opioid agonist used for treatment of pain as well as opioid dependence
Bupenorphine
89
Disulfiram MOA
Inhibits aldehyde dehydrogenase tx of alcoholism, drinking causes hangover-like rxn
90
Acomprosate MOA
NMDA-R antagonist, GABA-A R antagonist decreases desire to drink
91
IR amphetamine based formulations
tab, cap, liquid
92
ER amphetamine based formulations
cap, liquid Adzenys XR-ODT = chewable tab
93
IR methylphenidate based formulations
tab, liquid
94
SR methylphenidate based formulation
tab
95
ER methylphenidate based formulation
cap, tab, liquid, patch and chewable *most likely test Q
96
Atomoxetine MOA
NET inhibitor, non-stimulant for ADHD assoc w suicidal thoughts
97
Clonidine and Guanfacine MOA
a2 agonists, non-stims for ADHD

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