Exam 4 drug names Flashcards
what is the mnemonic for MAOIs?
“TRAN, SELEna IS in the RASA porPHEN”
what should be avoided when taking MAOIs?
tyramine-rich foods
-pramine
-triptyline
tricyclic antidepressants
what are the kind of side effects for tricyclic antidepressants?
anticholinergic
what is the mnemonic for SSRI’s?
“LEXA LUV ZOLO bc he’s a PRO and has PAX”
lexapro
luvox
zoloft
prozac
paxil
what is the mnemonic for the SNRI’s?
“SER CYMBA is EFFEctive”
serzone
cymbalta
effexor
what medication is used for post-partum depression?
Brexanolone
what is the MOA for bupropion?
blocks NE and DA reuptake
major ADR for bupropion
seizures
what is the MOA for trazodone and nefazodone?
inhibits serotonin reuptake
what are the 4 atypical antidepressants?
buproprion
trazodone/nefazodone
brexanolone
ketamine
what part of the brain plays a role in depression and antidepressant efficacy?
hippocampus
schizophrenic symptoms that appear to reflect an addition to or an excess of normal functions
for example, hallucinations, delusions, and disorganized thinking
positive symptoms
schizophrenic symptoms that are absent from normal behavior.
for example, flat affect, anhedonia, and social withdrawal
negative symptoms
schizophrenic symptoms that is altered thinking, concentration, and memory
cognitive symptoms
what is the MOA for phenothiazines (typical antipsychotics used to treat schizophrenia?
blocks dopamine D2R
-idol
-zine
phenothiazines (typical antipsychotics)
what is the oldest hypotheses of schizophrenia?
increase in dopamine
dopamine pathway that regulates emotion and pleasure, and its hyperactivity is thought to underlie positive symptoms
mesolimbic pathway
dopamine pathway that regulates cognitive function due to cortical dopamine
mesocortical pathway
dopamine pathway that controls movements and will cause symptoms of parkinson’s disease
nigrostriatal pathway
dopamine pathway that inhibits prolactin release, and D2 blockade using anti-psychotic drugs will lead to hyperprolactinemia
tuberoinfundibular pathway
neurological emergency that resembles a very severe form of parkinsonism, leading to increases in serum CK and myoglobin, and can persist for weeks following discontinuance of anti-psychotic drugs
neuroleptic malignant syndrome
what can be administered for neuroleptic malignant syndrome? (2)
dopamine agonist - bromocroptine
muscle relaxant - dantrolene
-zapine
atypical antipsychotics
what is the MOA of typical antipsychotics?
block dopamine 2 receptor
what is the MOA of atypical antipsychotics?
block dopamine 2 receptor AND serotonin in nigrostriatal pathway
-pam
-lam
benzodiazepines
MOA for BZ
increase Cl channel openings
what is the mnemonic for benzodiazepines that are anxiolytics?
“CLOAD”
Clonazepam
Lorazepam
Oxazepam
Alprazolam
Diazepam
what is the mnemonic for benzodiazepines that are hypnotic?
“FETT”
Flurazepam
Estazolam
Temazepam
Triazolam
which BZ is more lipophilic, leading to a more rapid onset of action? about 20 mins
diazepam
which BZ is less lipophilic, leading to a slower onset of action? about 3 hours
oxazepam
why are BZ better choices for patients with impaired liver function?
do not have active metabolites and don’t rely on liver enzymes for activation
the sedation effect of BZ can be revered with which medication, that acts as a BZ antagonist?
flumazenil
for which patients are BZs contraindicated for?
patients taking opioid analgesics
sedation from BZs is less likely to occur in patients with history of? (3)
Alcohol use
barbiturate use
smoking
allergic reaction from BZs is more likely to occur in which patients? (3)
elderly
smokers
women on oral contraceptives
what part of the brain plays an important role in emotional processing, particularly with regard to fear and anxiety?
amygdala
which SSRI is used to treat OCD and PD?
Prozac
which SSRI is used to treat only PD?
Citalopram
which SSRI is used to treat GAD?
Ecitalopram
which SSRI is used to treat GAD, and anxiety associated with PTSD?
Buspar
what is the MOA of monoamine uptake inhibitors and monoamine releasers?
indirect agonists of DA, NE, and 5-HT
what are monoamine uptake inhibitors known as?
methylphenidates (psychomotor stimulants)
what is the mnemonic for monoamine uptake inhibitors (methylphenidates)?
RITA is a DAY nurse that likes CONCERTs for a METADATE and RITA is an LA FOCA”
ritalin
daytrana
concerta
metadate
ritalin la
focalin
what are the monoamine releasers known as? (2)
amphetamines
methamphetamines
what are the drugs for amphetamines of monoamine releasers?
aderall
aderall XR
dexedrine
dexedrine XR
vyvance
what is the drug for methamphetamines of monoamine releasers?
desoxyn
which 2 monoamine releasers are used for ADHD and obesity?
vyvance
desoxyn
what are 2 alternative CNS stimulants for ADHD?
strattera
guanfacine XR
what is the MOA of strattera?
NE reuptake inhibitor
what should not be given with strattera?
MAOI - would lead to too much NE
what is the MOA of guanfacine XR?
alpha adrenergic receptor agonist
what medication is a used for ADHD and is a good alternative to psychomotor stimulants and tricyclic antidepressants?
guanfacine XR
prodrug for amphetamine and methamphetamine approved for short-term treatment of obesity
didrex (benzphetamine)
prodrug from phenmetrazine that releases DA, approved for short-term treatment of obesity
adipost (phendimetrazine)
drug that releases NE, approved for short-term treatment of obesity
adipex-p
what medication is adipex-p currently marked to be used in combination?
topiramate
MATE
medication that decreases hunger and activity of the brain reward system to attenuate craving - used to treat obesity
contrave
sudden loss of muscle tone, momentary paralysis triggered by a sudden emotion
cataplexy
CNS stimulants that are used for sleep disorders and have high risk of abuse (2)
amphetamines
methylphenidates
2 CNS stimulants that are atypical/weak DA transporter inhibitors, used for sleep disorders AND enhance cognition (study aid)
modafinil
armodafinil
what are the severe adverse effects of armodafinil, used as a CNS stimulant for sleep disorders?
angioedema
multi-organ hypersensitivity reactions
CNS stimulant that is a NE/DA transporter inhibitor used to treat excessive daytime sleepiness associated with narcolepsy or OSA
sunosi
non-stimulant used for narcolepsy
gamma hydroxybutyrate
which medication used for sleep disorders is the notorious date rate drug?
gamma hydroxybutyrate
H3 histamine receptor antagonist / inverse agonist that increases histamine in the CNS to promote wakefulness
Wakix
CNS stimulant for infantile apnea that eliminates episodes > 20 secs and reduces # of episodes that are < 20 secs
theophylline
why does theophylline require monitoring of plasma concentrations and adjustment of dose schedules?
has off-target effects, leading to toxicity, seizures, and sudden death
CNS stimulant for infantile apnea that is administered via IV once daily
can cause feeding intolerance, irritability, and cardiovascular problems
caffeine
what is the half-life of caffeine in adults?
3-7 hours
what is the half-life of caffeine in infants?
65-100 hours
the 6 high efficacy mu opioid receptor agonists
heroin
morphine
methadone
meperidine
fentanyl
remifentanil
which high efficacy mu opioid receptor agonist has good oral bioavailability, a long half-life, and is a sub therapy for opioid use disorder?
methadone
which high efficacy mu opioid receptor agonist is a synthetic opioid and has anticholinergic activity? (mydriasis, tachycardia)
meperidine
which high efficacy mu opioid receptor agonist is metabolized by plasma esterases, has a short half-life, and is used for operative pain control?
remifentanil
the 3 moderate efficacy mu opioid receptor agonists
codeine
hydrocodone
oxycodone
which moderate efficacy mu opioid receptor agonist is plant-derived and is used in acetaminophen and ibuprofen?
codeine
which moderate efficacy mu opioid receptor agonist is semi-synthetic and is used in acetaminophen and ibuprofen?
hydrocodone
which moderate efficacy mu opioid receptor agonist is a slow releasing formulation that should not be crushed, cut or chewed?
oxycodone
4 partial/low efficacy mu opioid receptor agonists
Talwin
Nubain
Bupranorphine
Buprenorphine + Naloxone
which partial/low efficacy mu opioid receptor agonists is used for moderate-severe pain?
Talwin
which partial/low efficacy mu opioid receptor agonists is only used by IV and is not scheduled?
Nubain
which partial/low efficacy mu opioid receptor agonists can be used by IV or SL, and is abused via IV?
buprenorphine
which partial/low efficacy mu opioid receptor agonists is used for opioid use disorder?
buprenorphine + naloxone
nal-
mu opioid receptor antagonists
which mu opioid receptor antagonist blocks all opioid receptors and is the drug of choice to reverse opioid overdose?
naloxone (narcan)
which mu opioid receptor antagonist blocks all opioid receptors and is used to treat alcoholism (PO) and opioid use disorder (IM)
naltrexone
which mu opioid receptor antagonist blocks only mu receptors and is used to reverse opioid effects
nalmefene
what is the primary cause of death in adverse effects of opioid analgesics?
respiratory suppression
what does the withdrawal syndrome of chronic opioid use resemble?
flu-like symptoms
detoxification after opioid dependence can be followed by long-term maintenance on opioid antagonist _____
naltrexone
what is used as the most common approach to treating opioid abuse, due to long half-life? (2)
methadone
buprenorphine
one “i”
esters
two “i’s”
amides
what are esters degraded by?
plasma esterases
what are amides degraded by?
hepatic enzymes
what is the MOA of esters and amides as local anesthetics?
block Na conductance in sensory nerve fibers
effectiveness of local anesthetics are reduced by what, that favor resting state?
high extracellular Ca
effectiveness of local anesthetics are enhanced by what, that favor active/inactivated state?
high intracellular K+
large doses of local anesthetics can cause convulsions. What can be given to treat convulsions?
diazepam
involuntary hyper-excitability of a normal reflex
spasticity
involuntary tonic increase in muscle tone
muscle spasm
spasticity treatment that increases K+ conductance - used for MS and trauma
baclofen
spasticity treatment that increases Cl conductance - used for MS, trauma, cerebral palsy, and supraspinal levels
diazepam
spasticity treatment that is an alpha adrenergic agonist that increases K+ conductance - used for ALL spasticity
Zanaflex
spasticity treatment that is a ryanodine receptor antagonist that inhibits Ca release - used for ALL spasticity
dantrolene
what is important to remember about dantrolene?
it will affect ALL muscles in the body
what are 3 DDI with dantrolene?
BP meds
oral birth control
sedatives
what is the mnemonic for muscle relaxants that treat spasms?
“SOMA is FLEXin’ and reLAXIN’”
soma
flexeril
norflex
paraflex
skelaxin
robaxin
combining flexeril with an MAOI will result in what?
serotonin syndrome
paraflex should not be combined with ______; if combined, it will result in _____ _____
acetaminophen
liver toxicity
skelaxin should not be combined with _____; if combined, it will result in _____ _____
SSRIs
serotonin syndrome
where is H1 distributed?
throughout the body
where is H2 distributed?
cardio
gastric acid
where is H3 distributed?
CNS
where is H4 distributed?
blood cell production
-amine
1st generation H1 antihistamines
H1 receptor antagonists / inverse agonists that are first generation antihistamines use for allergic rhinitis (4)
+ half life
diphenhydramine - 9 hrs
doxylamine - 11 hrs
clemastine - 20 hrs
chlorpheniramine - 30 hrs
what is the underlying cause of narcolepsy?
deficiencies in orexin
what do we want less of to treat insomnia?
orexin
-exant
orexin receptor antagonists - treat insomnia
H1 receptor antagonists that are 2nd generation antihistamines that cause less sedation and anticholinergic effects (4)
+ half life
claritin - 8 hrs
allegra - 15 hrs
zyrtec - 24 hrs
clarinex - 27 hrs
intranasal mast cell stabilizer used for allergic rhinitis
cromolyn sodium
inhaler mast cell stabilizer used for asthma
nedocromil
eye drops mast cell stabilizer used for allergic conjunctivitis
cromolyn sodium
nedocromil
what is the first-line therapy for anaphylaxis?
epinephrine via IM
what are 3 second-line treatments for anaphylaxis?
antihistamines
corticosteroids
dopamine/NE
4 first-line treatments for n/v during pregnancy
doxylamine + vit B
doxylamine
diphenhydramine
metoclopramide
what is the last resort treatment for n/v in pregnancy?
ondansetron
what is the mnemonic for n/v in pregnancy?
“the D, D, D is the M, O”
-tidine
H2 inhibitors used to treat peptic ulcers
-prazole
proton pump inhibitors used to treat peptic ulcers
inhibitors used to treat mild, intermittent symptoms of peptic ulcers
H2 inhibitors
inhibitors used to treat moderate-severe, frequent symptoms of peptic ulcers
proton pump inhibitors
what is the ADR of H2 inhibitors?
headache
what is the ADR specific to cimetidine?
gynecomastia if used for over 1 month
ADR of proton pump inhibitors
headache
dizziness
abdominal signs
which serotonin receptor is specific for n/v?
5-HT3
5-HT 1B sit where?
vasculature
5-HT 1D sit where?
neurons
how long do migraines typically last?
2-72 hrs
how long do cluster headaches usually last?
15 mins - 3 hrs
what is effective in treating mild symptoms of migraines only, not cluster headaches? (2)
NSAIDs
Opioids
what reduces symptoms in 70% of patients, only for cluster headaches?
oxygen
what route is preferred for triptans?
SQ injection
what 2 routes is preferred for ergotamines?
injection
intranasal
what is an ADR of triptans?
recurrent migraine if used more than 10 days per month
triptans and ergotamines are CI in: (3)
cardiovascular disease
pregnancy
younger than 18 yrs
what drugs are CI with triptans and ergotamines?
SSRIs
SNRIs
MAOIs
what CYP 3A4 inhibitors should be avoided with triptans and ergotamines? (2)
grape fruit juice
ketoconazole
3 prophylactic treatments for migraines
depakote
topamax
propranolol
antiepileptic used for migraines with actions at Na channels and GABA
depakote
anticonvulsant used for migraines with actions at Na, Ca channels and GABA A
topamax
2 prophylactic treatments for cluster headaches
Verapamil
topamax
what should be avoided when taking topamax? (2)
alcohol
tobacco
-mab
CGRP monoclonal antibodies used to treat migraines (NEW TREATMENT)
how should CGRP monoclonal antibodies be administered?
injection d/t slow onset of action
-gepant
CGRP antagonists used to treat migraines (NEW TREATMENT)
how should CGRP antagonists be administered?
when are symptoms reduced?
orally - reduces symptoms within 2 hours
what is CI when taking CGRP Antagonists?
CYP 3A4 inhibitors
what is the most common adverse effect of ondansetron?
headache
what receptor does ondansetron act on?
5-HT3 (antagonist)
