Exam I Drugs Flashcards
donepezil (aricept)
- acetyl cholinesterase inhibitor
- increases ACh
- alzheimers disease
phenelzine
- MAOI
- mood disorders
- autonomic side effects
tramadol (ultram)
- non-opioid analgesic
- neuropathic pain
methyltrexate
- anti-inflammatory
- multiple sclerosis
tamsulosin (flomax)
- alpha 1 antagonist
- multiple sclerosis - bladder dysfunction
indomethacin
- COX-1 and COX-2 inhibitor
- potent with many side effects, rarely used
- rheumatoid arthritis and gout
modafinil
- considered a non-stimulant, but is actually a minor stimulant
- multiple sclerosis - fatigue
- ADHD and ADD, also narcolepsy
meperidine (demerol)
- opioid
- moderate pain
entacapone
- COMT inhibitor
- increases DA, NE, and Epi
- parkinson’s disease
trihexyphenidyl
- anticholinergic
- used to control sialorrhea
- parkinson’s disease
benztropine
- anticholinergic
- used to control sialorrhea
- parkinson’s disease
- side effect: xerostomia
metamucil (psyllium)
- multiple sclerosis - bowel dysfunction
pramipexole
- D2 agonist
- parkinson’s disease
- used early in disease (before L-DOPA)
meloxicam
- COX-2 > COX-1
- less GI effects, but more CV effects
- pain
buprenerphine
- opioid - mixed agonist/antagonist
- treat opioid abuse
hydromorphone
- opioid
- 1.5mg
selegiline
- MAOI
- increases DA, NE, 5HT
- parkinson’s disease, mood disorders (depression)
- side effect: bruxism
ketoprofen
- more potent form of ibuprofen
- 50mg
morphine
- opioid narcotic
- 10mg
ibuprofen
- COX-1 and COX-2 inhibitor
- pain - 400mg
- inflammation - 800mg
- CV side effects
naloxone
- “narcan”
- µ opioid antagonist
- treat opioid overdose, fast acting
methadone
- opioid
- moderate/severe pain
- treats opioid dependence
prednisone
- steroid, anti-inflammatory
- multiple sclerosis
nortryptyline
- antidepressant - block NE uptake
- 1st line tx for neuropathic pain
fentanyl
- opioid (most potent)
- 0.1mg
oxycodone
- opioid
- 20mg
- percodan = 20mg aspirin + oxycodone
naprosyn/naproxen
- aleve
- longer lasting, slower acting form of ibuprofen
celecoxib (celebrex)
- COX-2 selective inhibitor
- lacks GI and antiplatelet effects
- CV warning
codeine
- opioid
- 200mg
gabapentin (“lyrica” or “neurontin”)
- ASD, neuropathic pain, affects GABA systems
- multiple sclerosis, epilepsy, pain, fibromyalgia
oxymorphone
- opioid
- 1.0mg
salicylates (aspirin)
- COX-1 and COX-2 inhibitor
- pain - 600mg
- inflammation - 1000mg
- anti-clotting/anti-platelet effects
- side effects - GI irritation, tinnitus, respiratory alkalosis, reye syndrome
interferon
- anti-inflammatory
- multiple sclerosis
L-DOPA + carbidopa
- precursor to DA
- parkinson’s disease
- side effects: xerostomia, glossitis, pigmentation, bruxism, can develop dyskinesias
hydrocodone + acetaminophen
- “lortab” or “vicodin”
- opioid
- 30mg
clonazepam
- benzodiazepine, classic ASD
- multiple sclerosis - tremors; sedative
duloxetine (cymbalta)
- antidepressant - mixed NE/5HT transport blocker
- neuropathic pain, mood disorders (depression)
piroxican (feldene)
- ibuprofen-like
desipramine
- tricyclic antidepressant
- mood disorders
- side effects: anticholinergic effects
fluoxetine (prozac)
- SSRI - antidepressant
- mood disorders, multiple sclerosis, eating disorders (anorexia nervosa and bulimia)
phenothiazines
- ex. chlorpromazine, thioridizine
- typical antipsychotic - D2 antagonist
- schizophrenia, psychosis
- side effects: orthostatic hypotension, sedation, xerostomia, extrapyramidal effects (less than butyrophenones)
quetiapine
- atypical antipsychotic - D2 antagonist, 5HT2A antagonist
- shizophrenia
- fewer side effects
pentazocine (talwin)
- opioid - mixed agonist/antagonist
- moderate pain
amytriptyline
- tricyclic antidepressant
- mood disorders
- side effects: anticholinergic effects, drowsiness
olanzapine
- atypical antipsychotic - block 5HT2A presynaptic receptors to alter DA synthesis
- huntington’s disease, schizophrenia (negative symptoms)
- side effects: orthostatic hypotension, sedation, xerostomia, extrapyramidal effects
haldol (haloperidol)
- butyrphenones - D2 antagonist (antipsychotic)
- huntington’s disease, schizophrenia
- side effects: tardive dyskinesia, parkinsonism, extrapyramidal effects
- lacks anticholinergic effects
diflunisal
- related to salicylates
- good for bone pain
venalafaxine
- mixed NE/5HT uptake blocker
- mood disorders
doxepine
- tricyclic antidepressant
- mood disorders
- side effects: anticholinergic effects
sertraline (zoloft)
- SSRI
- mood disorders, phobia disorders
lithium carbonate
- alters 2nd messenger systems
- bipolar disorder
- side effects: weight gain, edema, kidney damage, tremors
clozapine
- atypical antipsychotic - blocks 5HT2A receptors in addition to D2 antagonism
- schizophrenia
- side effects: serous agranulocytosis
ether
- volatile compound
- low vapor pressure, high boiling point
- general anesthesia - provides hypnosis, amnesia, immobility (not any others)
nitrous oxide
- volatile compound
- low vapor pressure, high boiling point
- low blood:gas partition coefficient
- not very soluble in blood
- need higher concentration for effects
- rapid induction and recovery
- incomplete anesthesia
halothane
enflurane
isoflurane
- volatile compound
- low vapor pressure, high boiling point
- high blood:gas partition coefficient
- soluble in blood
- requires lower concentration
- moderate induction and recovery phases
- complete anesthesia
flumazenil
- benzodiazepine antagonist
- reverses effects of benzodiazepines for emergency or quick recovery after a procedure
benzodiazepines used in anesthesia
- diazepam
- lorazepam (ativan)
- midazolam (versed)
- mid-long acting (10-30hrs)
- inhibits polysynaptic reflexes and skeletal neuromuscular junction at high doses
- good amnestic and anxiolytic, not good analgesic (on its own)
- side effects: synergizes with other sedatives
phenobarbital
- barbiturate - enhances GABA
- long-acting
- treats seizures
propofol
- replaced barbiturates
- increases GABA activity
- hypnotic, not analgesia, so must be given with other substances for GA
- general anesthesia
buspirone
- anxiolytic - some NE agonist action
- non-sedating, low abuse potential
paxil
- SSRI
- panic attacks
venlafaxin
- antidepressant
- panic attacks
adderal
- amphetamine - stimulant
- ADHD and ADD
ritalin
- methylphenidate - stimulant
- ADHD and ADD
atomoxetine (straterra)
- NE uptake inhibitor - non-stimulant
- ADHD and ADD
what is the treatment of autism spectrum disorders?
- atypical antipsychotics and SSRIs
- behavioral management
triazolam (halcion)
- benzodiazepine
- hypnotic - shorter acting
- chronic, moderately severe anxiety
lorazepam (ativan)
- benzodiazepine
- hypnotic - shorter acting
- chronic, moderately severe anxiety
diazepam (valium)
- benzodiazepine
- sedative - longer acting
- chronic, moderately severe anxiety
alprazolam (xanax)
- benzodiazepine
- sedative - longer acting
- chronic, moderately severe anxiety
zolpidem (ambien)
- benzodiazepine-like
- sleep aid
pentothal
- barbiturate - short acting
- enhances GABA
- anesthesia induction
M1 agonists
ACh, bethanechol, pilocarpine
M1 angatonists
atropine, scopolamine
M2 agonists
ACh, bethanechol, pilocarpine
M2 antagonist
atropine, scopolamine
M3 agonists
ACh, bethanechol, pilocarpine
M3 antagonists
atropine, scopolamine
Nm agonists
ACh
Nm antagonist
succinylcholine, d-tubocurarine
Nn agonist
ACh
Nn antagonist
mecamylamine, trimethaphan
alpha1 agonists
Epi > NE
phenylephrine, methoxamine
alpha1 antagonist
prazosin, terazosin
alpha2 agonist
Epi > NE
clonidine, guanfacine
alpha2 antagonist
yohimbine
beta1 agonist
Epi = NE
isoproterenol, dobutamine
beta1 antagonist
propanolol, atenolol, metoprolol
beta2 agonist
Epi >> NE
isoproterenol, albuterol, terbutaline
beta2 antagonist
propanolol
beta3 agonist
NE > Epi
physostigmine
- cholinesterase inhibitor
- glaucoma, antidote for atropine poisoning
sarin
- cholinesterase inhibitor
- nerve gas
mechanism of succinylcholine
desensitizes the NM endplate by depolarizing it, so more ACh doesn’t do anything
mechanism of tubocurarine
- competitive, so it prevents access of ACh to receptor, so the endplate doesn’t depolarize
- skeletal muscle relaxant (Nm antagonist)
mechanism of botox
blocks the release of ACh at NM juntion
cevimelin
- cholinergic agonist
- xerostomia in sjogren’s patients
pilocarpine
- cholinergic agonist
- xerostomia after radiation therapy
phenytoin
- classic ASD
- partial seizures (simple, complex, secondarily generalized, tonic-clonic)
- side effect: gingival hyperplasia, hirsuitism, rare hepatitis
carbamazepine
- classic ASD
- partial seizures (simple, complex, secondarily generalized, tonic-clonic)
- side effects: rare hepatitis
ethosuximide
- classic ASD
- uncomplicated absence seizures
valproic acid (valproate)
- classic ASD
- partial seizures (simple, complex, secondarily generalized, tonic-clonic), generalized onset tonic-clonic, absence + tonic-clonic
- side effects: rare hepatitis, alopecia
diazepam
- ASD
- status epilepticus
topiramate
- newer ASD
- partial seizures (simple, complex, secondarily generalized, tonic-clonic), generalized onset tonic-clonic
prostigmine
- acetylcholinesterase inhibitor
- myasthenia gravis
neostigmine
- acetylcholinesterase inhibitor
- myasthenia gravis
treatment of guillain-barre syndrome?
plasma exchange and/or steroids
thiopental/methohexital
- barbiturate - short acting
- no analgesia
- avoid intermittent porphyria (red blood cell disease - porphyrin accumulation in brain)
- thiopental - antiseizure
- methohexital - used in electro-convulsive therapy
ketamine
- NMDA antagonist (some DAT inhibition)
- dissociative analgesic - eyes remain open in a stare
- antidepressant effects
- side effects: hallucinations, abused
spasmolytics
- relieve spasmotic involuntary action of muscles
- back spasms
- diazepam-BDZ receptors
- baclofen - GABAB receptors (less sedation than BDZs)
- botulinum toxin
rocuronium
- skeletal muscle relaxant
- competitive antagonist - prevents access of ACh to receptor
- immobility
sugammadex
reverses rocuronium (acts as a scavenger)
disulfiram (antabuse)
- inhibits ALDH with resulting increase in acetaldehyde
- treats alcoholism
naltrexone
- µ opioid receptor antagonist
- treats alcoholism
- thought to decrease feelings of reward associated with drinking alcohol
acamprosate (campral)
- weak NMDA antagonist
- activates GABAA receptors which may decrease feeling of a need for alcohol
- treats alcoholism
phenylephrine
alpha 1 agonist
pseudoephedrine
alpha 1 agonist
prazosin
alpha 1 antagonist
terazosin
alpha 1 antagonist
phenoxybenzamine
alpha 1 antagonist
alpha 2 antagonist
phentolamine
alpha 1 antagonist
alpha 2 antagonist
clonidine
alpha 2 agonist
guanfacine
alpha 2 agonist
yohimbine
alpha 2 antagonist
isoproterenol
beta 1 agonist
beta 2 agonist
dobutamine
beta 1 agonist
propranolol
beta 1 antagonist
beta 2 antagonist
atenolol
beta 1 antagonist
metoprolol
beta 1 antagonist
albuterol
beta 2 agonist
terbutaline
beta 2 agonist
pilocarpine
muscarinic agonist
cevimeline
muscarinic agonist
bethanechol
muscarinic agonist
carbachol
muscarinic agonist
atropine
muscarinic antagonist
scopolamine
muscarinic antagonist
propantheline (probanthine)
muscarinic antagonist
trihexyphenidyl
muscarinic antagonist
succinylcholine
nicotinic antagonist
d-turbocurarine
nicotinic antagonist
mecamylamine
nicotinic antagonist
(ganglion blocker)
sarin
acetyl cholinesterase inhibitor
physostigmine
acetyl cholinesterase inhibitor
donepezil
acetyl cholinesterase inhibitor
edrophonium
acetyl cholinesterase inhibitor