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NMSP > Exam 3 Pharm > Flashcards

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
Q

Levomilnacipran MOA

A

SNRI (block SERT and NET)

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26
Q

Mirtazapine MOA

A

SARA (block 5-HT receptor and a2 receptor)

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27
Q

Trazodone, Nefazodone MOA

A

SARA (block 5-HT receptor and a1 receptor)

a1 block can cause hypotension

nefazodone off market bc liver tox

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28
Q

Bupropion MOA

A

NDRI (NE and DA reuptake inhibitor)

also used for smoking cessartion
can cause seizures in at risk pts

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29
Q

Isocarboxazid MOA

A

MAOi

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30
Q

Phenylzine MOA

A

MAOi

can cause sedation

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31
Q

Tranylcypromide MOA

A

MAOi

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32
Q

Selegiline MOA

A

MAOi (Selective MAO-B inhibitor)

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33
Q

Esketamine MOA

A

NMDA-R antagonist

used for treatment resistant depression w/ ongoing antidepressant tx

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34
Q

Brexanolone MOA

A

GABA-A Positive allosteric modulator

used for postpartum depression

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35
Q

Lithium MOA in mood disorders

A

myoinositol depletion, prevents intracellular signaling cascades

anti-manic effects by blocking PKC and MARCKS
neuroprotective CREB expression

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36
Q

Mood stabilizers for maintenance of BPD

A

Lithium
Valproic acid/Divalproex,
Carbamazapine,
Lamotrigine

all can be used for acute mania EXCEPT Lamotrigine

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37
Q

Which antidepressant can be used for nicotine withdrawal?

A

Bupropion

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38
Q

Which antidepressant can be used for enuresis?

A

Imipramine

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39
Q

Which antidepressant can be used for chronic pain, peripheral neuropathy, FMS or stress incontinence?

A

Duloxetine

40
Q

Patient with agitation, hyperthermia, tremor/clonus that is on many antidepressant drugs is likely suffering from

A

Serotonin syndrome

41
Q

Patient with flu-like sxs, insomnia, N/V, lightheadedness, and sensory disturbances, who is prescribed antidepressants may be suffering from

A

antidepressant withdrawal syndrome

42
Q

All antidepressants can increase risk of suicide

A

facts

43
Q

Which SSRI is a classic CYP450 inhibitor?

A

Fluoxetine

44
Q

Classic TCA side effects due to blocking multiple other receptors (H1, M, a1)

A

H1: sedation, fatigue
M: anticholinergic (dry mouth, hot, urine retention)
a1: tachycardia, hypotension

45
Q

Patient with hypertensive crisis after eating meat, cheese and wine most likely caused by

A

MAOi (isocarboxazid, phenylzine, tranylcypromide)

due to MAO-A being required for metabolism of dietary tyramine

46
Q

Which antipsychotic can be used to treat recurrent suicidal behavior?

A

Clozapine

47
Q

What antipsychotic can be used to treat hallucinations/delusions associated with Parkinson Disease psychosis?

A

Pimavanserin

48
Q

-azine drug MOA

Chlorpromazine, Fluphenazine, Perphenazine, Thioridazine, Trifluoperazine

A

FGA

primary D2 blockade (>5-HT)

49
Q

Haloperidol MOA

A

FGA

primary D2 blockade (>5-HT)

50
Q

Loxapine MOA

A

FGA

primary D2 blockade (>5-HT)

51
Q

Molindone MOA

A

FGA

primary D2 blockade (>5-HT)

52
Q

Pimozide MOA

A

FGA

primary D2 blockade (>5-HT)

53
Q

Thiothixene MOA

A

FGA

primary D2 blockade (>5-HT)

54
Q

FGA are more commonly associated with what side effect?

A

EPS (dystonia, akathesia, parkinsonism, TD)

55
Q

Low potency FGA

A

Chlorpeomazine, Thioridazine

more sedation/hypotension/tachycardia/ECG changes

56
Q

High potency FGA

A

Haloperidol, Fluphenazine

more associated with EPS

57
Q

EPS treatments:

Dystonia

A

Benztropine (anticholinergics)

58
Q

EPS treatments:

Akathisia

A

B-blocker, Benzo, Benztropine

the 3 B’s

59
Q

EPS treatments:

Parkinsonism

A

Benztropine, Amantadine

60
Q

EPS treatments:

Tardive dyskinesia

A

Valbenazine, Deutetrabenazine (VMAT2 inhibitors)

61
Q

-idone drug MOA

Iloperidone, Lurasidone, Palperidone, Respiridone, Ziprasidone

A

SGA

5-HT/DA receptor antagonists

62
Q

-piprazole drug MOA

Aripiprazole, Brexpiprazole

A

SGA

5-HT/DA antagonists +5-HT/DA agonists

*also Cariprazine

63
Q

Cariprazine MOA

A

SGA

5-HT/DA antagonists + 5-HT/DA agonists +D3 agonist

*also -piprazole’s

64
Q

-apine drug MOA

Asenapine, Clozapine, Olanzapine, Quetiapine

A

SGA

Multi-acting receptor-target agents

*also Lumateperone

65
Q

Lumateperone MOA

A

SGA

Multi-acting receptor-target agents

*also -apine’s

66
Q

Pimavanserin MOA

A

selective serotonin inverse agonist

*only for parkinson psychosis

67
Q

Class warning for all antipsychotics in elderly patient with dimentia

A

Stroke

68
Q

What SGA’s are most associated with weight gain and metabolic effects?

A

Clozapine, Olanzapine

69
Q

What SGA’s are most associated with QT prolongation/ECG changes?

A

Ziprasidone

70
Q

Recommended metabolic monitoring for antipsychotics (4)

A

BMI, sugars, lipids, BP

71
Q

Antipsychotic monitoring for general assessment of SE’s

A

GASS

72
Q

Antipsychotic monitoring for involuntary movement

A

AIMS

73
Q

Antipsychotic monitoring for akathisia

A

BARS

74
Q

Antipsychotic monitoring for extrapyramidal symptoms

A

ESRS

75
Q

SGA associated with agranulocytosis and seizures

A

Clozapine, monitor WBC

76
Q

SGA associated with DRESS syndrome (drug HSR associated with skin eruption, hemotologic abn, LAD)

A

Olanzapine

77
Q

Patient antipsychotic presenting with altered mental status, then muscle rigidity, hyperthermia, and dehydration. Dx and Tx

A

Neuroleptic Malignant Syndrome

Tx with Dantrolene, Diazepam

78
Q

Injectable antipsychotics for acute agitation (4)

A

Haloperidol, Ziprasidone, Olanzapine, Aripiprazole

79
Q

SGA used for multi-drug resistant disease

A

Clozapine

works well but awful side effects

80
Q

Long acting injectable agents for adherence to antipsychotic tx

A

Risperidone, Olanzapine, Aripiprazole, Palperidone

soap ROAP

81
Q

mu opioid receptors have highest affinity for

A

endorphins

82
Q

delta opioid receptors have highest affinity for

A

enkephalins

83
Q

kappa opioid receptors have highest affinity for

A

dynorphins

84
Q

Codeine, Hydrocodone, Morphine, Fentanyl MOA and indication

A

opioid agonists for pain management

85
Q

Opioid agonist used for tx of opioid use disorder

A

Methadone

86
Q

Partial opioid agonist used for severe pain refractory to other tx

A

Pentazocine

87
Q

Opioid agonist used for pre/postop pain that is highly addictive and may be abused by anesthesiologists

A

Meperidine

88
Q

Partial opioid agonist used for treatment of pain as well as opioid dependence

A

Bupenorphine

89
Q

Disulfiram MOA

A

Inhibits aldehyde dehydrogenase

tx of alcoholism, drinking causes hangover-like rxn

90
Q

Acomprosate MOA

A

NMDA-R antagonist, GABA-A R antagonist

decreases desire to drink

91
Q

IR amphetamine based formulations

A

tab, cap, liquid

92
Q

ER amphetamine based formulations

A

cap, liquid

Adzenys XR-ODT = chewable tab

93
Q

IR methylphenidate based formulations

A

tab, liquid

94
Q

SR methylphenidate based formulation

A

tab

95
Q

ER methylphenidate based formulation

A

cap, tab, liquid, patch and chewable

*most likely test Q

96
Q

Atomoxetine MOA

A

NET inhibitor, non-stimulant for ADHD

assoc w suicidal thoughts

97
Q

Clonidine and Guanfacine MOA

A

a2 agonists, non-stims for ADHD

NMSP (1 decks)

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