FA Neuro & Psych Drugs Flashcards
1
Q
MoA: dec aqueous humor synthesis
Use: glaucoma
A
alpha-agonists
2
Q
alpha-agonist used for glaucoma
ADRs: mydriasis, stinging; C/I in closed-angle
A
Epinephrine
3
Q
alpha-agonist used for glaucoma
[ADRs: no pupillary/vision changes]
A
Brimonidine
4
Q
MoA: dec aqueous humor secretion
Use: glaucoma
[ADRs: no pupillary/vision changes]
A
beta-blockers
5
Q
beta-blocker used for glaucoma
A
Timolol
6
Q
beta-blocker used for glaucoma
A
Betaxolol
7
Q
beta-blocker used for glaucoma
A
Carteolol
8
Q
MoA: dec aqueous humor secretion (dec bicarb)
Use: glaucoma
[ADRs: no pupillary/vision changes]
A
Acetazolamide
9
Q
MoA: inc aqueous humor outflow by contracting ciliary muscle & opening trabecular meshwork
ADRs: miosis, cyclospasm
A
Cholinomimetics
10
Q
Direct cholinomimetic used in glaucoma
Use: glaucoma emergencies (v. effective)
A
Pilocarpine
11
Q
Direct cholinomimetic used in glaucoma
A
Carbachol
12
Q
Indirect cholinomimetic used in glaucoma
A
Physostigmine
13
Q
Indirect cholinomimetic used in glaucoma
A
Echothiphate
14
Q
MoA: PGF_2alpha, inc outflow of aqueous humor
Use: glaucoma
ADRs: darkens iris color (browining)
A
Latanoprost
15
Q
MoA: agonist at opioid-R (esp mu) –> open K+ channels & close Ca2+ channels to dec synaptic transmission & inhibit release of ACh, NE, 5-HT, glutamate, & substance P
Use: pain
ADRs: Respiratory depression, pinpoint pupils, additive CNS depression, addiction, constipation (no tolerance to miosis & constipation)
A
Opioid Analgesics
16
Q
Opioid-R antagonist
Use: opioid OD
A
Naloxone
17
Q
Opioid-R antagonist
Use: opioid OD
A
Naltrexone
18
Q
Opioid analgesic
Use: general anesthesia (w/ other CNS depressants); acute pul edema for relief of anxiety (not 1st line)
A
Morphine
19
Q
Opioid analgesic
Use: general anesthesia (w/ other CNS depressants)
A
Fentanyl
20
Q
Opioid analgesic
A
Codeine
21
Q
Opioid analgesic
A
Heroin
22
Q
Opioid analgesic
Use: maintenance programs for addicts
A
Methadone
23
Q
Opioid analgesic
A
Meperidine
24
Q
Opioid analgesic
Use: cough suppression
A
Dextromethorphan
25
Opioid analgesic
| Use: diarrhea
Dipheoxylate
26
Opioid analgesic
| Use: diarrhea
Loperamide
27
MoA: partial opioid mu-R agonist, agonist at opioid kappa-R
Use: pain
ADRs: less respiratory depression than nl opioids; withdrawal if on full opioid agonist
Butorphanol
28
MoA: weak opioid agonist; inhibits 5-HT & NE reuptake
Use: chronic pain
ADRs: like opioid; dec seizure threshold
Tramadol
29
Carbamazepine
DOC for simple partial seizures
30
Carbamazepine
DOC for complex partial seizures
31
Carbamazepine, phenytoin, valproic acid
DOC for tonic-clonic generalized seizures
32
Ethosuximide
DOC for absence generalized seizures
33
Prophylaxis: phenytoin
Acute: benzodiazepines (diazepam/lorazepam)
DOC for status epilepticus
34
Carbamazepine
DOC for trigeminal neuralgia
35
Phenobarbital
DOC for seizures in pregnant women & children
36
1st line: MgSO4
| 2nd line: benzodiazepines (diazepam/lorazepam)
DOC for seizures of eclampsia
37
MoA: inc Na+ channel inactivation (use-dependent) --> inhibits glutamate release from pre-synaptic neuron
Use: partial & tonic-clonic seizures (1st line for TC), status epilepticus prophylaxis (1st line); also class 1B anti-arrythmic
ADRs: nystagmus, ataxia, diplopia, sedation, drug-induced lupus, teratogenic; chronically --> gingival hyperplasia in children, peripheral neuropathy, hirsutism, megaloblastic anemia
PK: fosphenytoin --> parenteral; induces P450
Phenytoin
38
MoA: inc Na+ channel inactivation
Use: partial & tonic-clonic seizures (1st line for all), trigenminal neuralgia
ADRs: diplopia, ataxia, agranulocytosis or aplastic anemia, liver tox, SIADH, Stevens-Johnson Syndrome, teratogenesis
PK: induces P450
Carbamazepine
39
MoA: blocks V-gated Na+ channels
Use: partial & tonic-clonic seizures
ADRs: Stevens-Johnson Syndrome
Lamotrigine
40
MoA: inhibits HVA Ca2+ channels, GABA analog
Use: partial & tonic-clonic seizures, peripheral neuropathy, bipolar disorder
ADRs: sedation, ataxia
Gabapentin
41
MoA: blocks Na+ channels, inc GABA action
Use: partial & tonic-clonic seizures
ADRs: mental dulling, sedation, kidney stones, weight loss
Topiramate
42
MoA: inc Na+ channel inactivation, inc GABA concentration
Use: partial, tonic-clonic, absence, & myoclonic seizures (1st line for TC)
ADRs: GI distress, neural tube defects in fetus (C/I in preg), tremor, wt gain, rare but fatal hepatotoxicity
Valproic acid
43
MoA: blocks thalamic T-type Ca2+ channels
Use: absence seizures (1st line)
ADRs: GI distress, fatigue, headache, urticaria, Stevens-Johnson Syndrome
Ethosuximide
44
MoA: inhibits GABA reuptake
Use: partial seizures
Tiagabine
45
MoA: irrev inhibits GABA transaminase --> inc GABA
Use: partial seizures
Vigabatrin
46
MoA: may modulate GABA/glutamate release
Use: partial & tonic-clonic seizures
Levetiracetam
47
MoA: inc freq of Cl- channel opening --> facilitate GABA action; dec REM sleep
Use: anxiety, spasticity, detoxification (esp delirium tremens ass'd w/ alcohol), night terrors, sleepwalking, general anesthetic, insomnia
ADRs: sedation, tolerance & dependence, additive CNS depression (w/ EtOH), less respiratory depression/coma risks
Benzodiazepines
48
MoA: competitive GABA BZD-R antatonist
Use: BZD overdose
Flumazenil
49
Benzodiazepine
Use: status epilepticus
PK: Long-acting (lower addictive potential)
Diazepam
50
Benzodiazepine
Use: status epilepticus
PK: Long-acting (lower addictive potential)
Lorazepam
51
Benzodiazepine
| PK: Short-acting (higher addictive potential)
Triazolam
52
Benzodiazepine
| PK: Long-acting (lower addictive potential)
Temazepam
53
Benzodiazepine
| PK: Short-acting (higher addictive potential)
Oxazepam
54
Benzodiazepine
Use: IV anesthetic for endoscopy (w/ inhaled anesthetics & narcotics
ADRs: severe post-op resp depression, dec BP, amnesia
PK: Short-acting (higher addictive potential)
Midazolam
55
Benzodiazepine
| PK: Long-acting (lower addictive potential)
Chlordiazepoxide
56
Benzodiazepine
| PK: Long-acting (lower addictive potential)
Alprazolam
57
MoA: inc GABA action by inc duration of Cl channel opeining --> dec neuron firint
Use: (sedative) anxiety, seizures, insomnia
ADRs: sedation, tolerance, dependence, additive CNS depression (w/ alcohol), resp/CV depression
OD Tx: symptom management (respiration, inc BP)
PK: induces P450
Barbituates
58
Barbituate
| Use: partial & tonic-clonic seizures, esp in pregnancy
Phenobarbital
59
Barbituate
Pentobarbital
60
Barbituate
Use: induction of anesthesia, short surgical procedures
PK: high potency (high lipid solubility), rapid CNS entry; dec cerebral blood flow; Fx terminated by redistribution into tissue/fat
Thiopental
61
Barbituate
Secobarbital
62
MoA: act at BZ1-R subtype; reversible by flumazenil
Use: insomnia
ADRs: ataxia, headaches, confusion; lower dependence risk than BZDs, only modest day-after psychomotor depression, few amnestic Fx (short duration)
Non-BZD hypnotic
63
Non-BZD hypnotic
Zolpidem
64
Non-BZD hypnotic
Zaleplon
65
Non-BZD hypnotic
Eszopiclone
66
MoA: unknown
Fx: myocardial & respiratory depression, N/V, inc cerebral blood flow
Inhaled anesthetics
67
Inhaled anesthetic
| ADR: hepatotoxicity
Halothane
68
Inhaled anesthetic
| ADR: proconvulsant
Enflurane
69
Inhaled anesthetic
Isoflurane
70
Inhaled anesthetic
Sevoflurane
71
Inhaled anesthetic
| ADR: nephrotoxicity
Methoxyflurane
72
Inhaled anesthetic
| ADR: expansion of trapped gas
Nitrous Oxide
73
MoA: PCP analogs --> block NMDA-R, inc cerebral bloodflow
Use: dissociative anesthetics
ADRs: cardiovascular stimulant, disorientation, hallucination, bad dreams
Arylcyclohexylamines
74
Arylcyclohexylamine
Ketamine
75
MoA: potentiates GABA
Use: rapid anesthesia induction, short procedures
ADRs: less post-op nausea than thiopental
Propofol
76
MoA: bind to intracellular portion of Na+ channels (penetrate = uncharged; bind = charged); use-dependent (prefer activated Na+ channels)
Use: minor surgical procedures, spinal anesthesia
PK: more needed in infected (acidic) tissue; usually given w/ vasoconstrictors (except cocaine)
ADRs: CNS excitation, HTN/hypotension
Local anesthetics
77
Ester local anesthetic
| ADRs: allergy (give amide)
Procaine
78
Ester local anesthetic
| ADRs: allergy (give amide), arrythmias
Cocaine
79
Ester local anesthetic
| ADRs: allergy (give amide)
Tetracaine
80
Amide local anesthetic
Lidocaine
81
Amide local anesthetic
Mepivacaine
82
Amide local anesthetic
| ADRs: severe CV tox (arrythmias, hypotension) if given IV
Bupivacaine
83
MoA: Compete w/ ACh for motor nicotinic receptor
Use: muscle paralysis in surgery or mechanical ventilation
Reverse blockade w/ cholinesterase inhibitors
Nondepolarizing neuromuscular blocking drugs
84
MoA: depolarizing neuromuscular blocking drug; Phase I = prolonged depolarization (no antidote), Phase II = repolarized but blocked (use cholinesterase-I)
Use: muscle paralysis in surgery or mechanical ventilation (quicker onset than non-depol)
ADRs: hypercalcemia, hyperkalemia
Succinylcholine
85
Nondepolarizing neuromuscular blocker
Tubocurarine
86
Nondepolarizing neuromuscular blocker
Atracurium
87
Nondepolarizing neuromuscular blocker
Mivacurium
88
Nondepolarizing neuromuscular blocker
Pancuronium
89
Nondepolarizing neuromuscular blocker
Vecuronium
90
Nondepolarizing neuromuscular blocker
Rocuronium
91
MoA: prevent Ca2+ release from skeletal muscle sarcoplasmic reticulum
Use: malignant hyperthermia (from inhalation anesthetics + succinylcholine), neuroleptic malignant syndrome (from antipsychotics)
Dantrolene
92
MoA: agonize Dopamine receptors
Use: Parkinson's disease
Dopamine agonists
93
Ergot Dopamine agonist
Bromocriptine
94
Non-ergot (preferred) Dopamine agonist
Pramipezole
95
Non-ergot (preferred) Dopamine agonist
Ropinirole
96
MoA: may inc dopamine release
Use: Parkinson's Disease, influenza A, rubella
ADRs: ataxia
Amantadine
97
MoA: inc dopamine in brain (L-dopa crosses BBB & is converted to dopamine)
Use: Parkinsonism
ADRs: N/V w/o constipation, arrhythmias (due to peripheral conversion); long-term: dyskinesia w/ admin, akinesia b/w doses; dec ADRs w/ carbidopa
L-dopa/carbidopa
98
MoA: selective MAO-B inhibitor --> inc dopamine availability
Use: Parkinson's disease (adjunctive Tx), depression, anxiety, hypochondriasis
ADRs: may enhance L-dopa ADRs; hypertensive crisis (w/ tyramine or beta-agonists), CNS stimulation, C/I w/ SSRIs/meperidine
Selegiline
99
MoA: prevent L-dopa degradation --> inc dopamine
Use: Parkinson's disease
COMT inhibitors
100
MoA: anti-muscarinic
Use: Parkinson's disease (for tremor & rigidity, no Fx on bradykinesia)
Avoid if: Hx of GI/GU obstruction --> can exacerbate Sx
Benztropine
101
MoA: NMDA-R antagonist --> prevents excitotoxicity
Use: Alzheimer's Disease
ADRs: dizziness, confusion, hallucinations
Memantine
102
MoA: indirect cholinomimetic
Use: Alzheimer's disease
ADRs: Nausea, dizziness, insomnia
Acetylcholinesterase Inhibitors
103
Acetylcholinesterase Inhibitor used in Alzheimer's
Donepezil
104
Acetylcholinesterase Inhibitor used in Alzheimer's
Galantamine
105
Acetylcholinesterase Inhibitor used in Alzheimer's
Rivastigmine
106
MoA: amine-depleting
Use: Huntington's Disease (HD shows inc dopamine)
Reserpine
107
MoA: amine-depleting
Use: Huntington's Disease (HD shows inc dopamine)
Tetrabenazine
108
MoA: dopamine-R antagonist
Use: Huntington's Disease (HD shows inc dopamine)
Haloperidol
109
MoA: 5-HT_1B/1D agonist --> vasoconstiction, inhibition of trigeminal activation, & vasoactive peptide release
Use: acute migraine, cluster headache attacks
ADRs: coronary vasospasm, mild tingling; C/I in CAD or Pinzmetals' angina
Sumatriptan
110
benzodiazepines
Treatment for alcohol withdrawal
111
SSRIs
Treatment for bulimia
112
Acute: benzodiazepines
Chronic: buspirone, SSRIs
Treatment for anxiety
113
Methylphenidate
| Amphetamines
Treatment for ADHD
114
MAO-Is/SSRIs
Treatment for Atypical depression
115
"Mood Stabilizers" --> lithium, valproic acid, carbamazepine
| Atypical antipsychotics
Treatment for Bipolar Disorder
116
SSRIs, SNRIs
| TCAs (less)
Treatment for Depression
117
Mirtazapine
Treatment for Depression w/ insomnia
118
SSRIs
| Clomipramine
Treatment for OCD
119
SSRIs, TCAs, BZDs
Treatment for Panic Disorder
120
SSRIs
Treatment for PTSD
121
Antipsychotics (atypicals 1st))
Treatment for Schizophrenia
122
Antipsychotics (haloperidol, risperidone)
Treatment for Tourette's Syndrome
123
SSRIs
Treatment for Social Phobias
124
MoA: inc catecholamines at synaptic cleft (esp NE & dopamine)
Use: ADHD, narcolepsy, appetite control)
CNS stimulants
125
CNS stimulant
Methylphenidate
126
CNS stimulant
Dextroamphetamine
127
CNS stimulant
Mixed amphetamine salts
128
MoA: block dopamine D2-R (inc cAMP)
Use: Schizophrenia (pos Sx), psychosis, acute mania, Tourette's Syndrome
ADRs: Extrapyramidal sys side Fx, Neuroleptic malignant Syndrome, Tardive Dyskinesia, endocrine side Fx (e.g. hyperprolactinemia), dry mouth/constipation (anti-muscarinic), hypotension (anti-alpha), & sedation (anti-histamine)
Anti-psychotics
129
Neuroleptic malignant syndrome --> rhabdomyolysis -> rigidity & myoglobinuria; autonomic instability, hyperpyrexia
Tx: dantroline, D2 agonists
Pt presents w/ fever, encephalopathy, unstable vitals, elevated enzymes, & muscle rigidity (as ADR)
130
High-potency anti-psychotic
| ADRs: more neurological --> extrapyramidal Sx, tardive dyskinesia
Haloperidol
131
High-potency anti-psychotic
| ADRs: more neurological --> extrapyramidal Sx, tardive dyskinesia
Trifluoperazine
132
High-potency anti-psychotic
| ADRs: more neurological --> extrapyramidal Sx, tardive dyskinesia
Fluphenazine
133
Low-potency anti-psychotic
| ADRs: more non-neurological --> anticholinergic, antihistamine, & alpha-blockade; retinal deposits
Thioridazine
134
Low-potency anti-psychotic
| ADRs: more non-neurological --> anticholinergic, antihistamine, & alpha-blockade; corneal deposits
Chlorpromazine
135
MoA: Fx on 5-HT, dopamine, alpha, & H1 receptors
Use: schizophrenia (pos & neg Sx)
ADRs: fewer EPs & anti-cholinergic side Fx
Atypical Antipsychotics
136
Atypical Antipsychotic
Use: OCD, anxiety disorder, depression, mania, Tourette's Syndrome
ADRs: weight gain
Olanzapine
137
Atypical Antipsychotic
| ADRs: weight gain, seizures, agranulocytosis
Clozapine
138
Atypical Antipsychotic
Quetiapine
139
Atypical Antipsychotic
| ADR: hyperprolactinemia (DA-antag)
Risperidone
140
Atypical Antipsychotic
Aripiprazole
141
Atypical Antipsychotic
| ADR: QT prolongation
Ziprasidone
142
MoA: unclear, possibly phosphoinositol cascade inhibition
Use: bipolar disorder (mood stabilizer --> blocks relapse & acute manic events); SIADH (ADH antag)
ADRs: MNOP --> Movement (tremor), Nephrogenic diabetes insipidus, hypOthyroidism, Pregnancy problems (cardiac defects --> Ebstein anomaly & malformation of great vessels); also sedation, edema, heart block,
Lithium
143
MoA: stimulates 5-HT receptors
Use: generalized anxiety disorder
[ADRs: no sedation, addiction, tolerance, or additive CNS depression w/ EtOH]
Buspirone
144
MoA: block NE & serotonin reuptake
Use: major depression, fibromyalgia
ADRs: sedation, alpha-blockade, atropine-like (tachycardia, urinary retention, C/I in glaucoma)
OD: 3C: Convulsions, Coma, Cardiotoxicity; also resp depression, hyperpyrexia; elderly --> confusion & halucinations
OD Tx: NaHCO3 for cardiotox
Tricyclic antidepressants
145
Tricyclic antidepressant
| ADR: tertiary --> more anticholinergic Fx
Amitriptyline
146
Tricyclic antidepressant
| ADR: secondary --> fewer anticholinergic Fx (better in elderly)
Nortriptyline
147
Tricyclic antidepressant
| Use: bedwetting
Imipramine
148
Tricyclic antidepressant
| ADRs: lower seizure threshold, least sedating
Desipramine
149
Tricyclic antidepressant
| Use: OCD
Clomipramine
150
Tricyclic antidepressant
Doxepin
151
Tricyclic antidepressant
Amoxapine
152
MoA: serotonin-specific reuptake inhibitors
Use: depression, OCD good for suicidal pts
SSRIs
153
Serotonin syndrome: due to interaction of 2 drugs that increase serotonin, e.g. SSRIs, MAO-I, meperidine (MC --> SSRI + MAO-I)
Tx: cyproheptadine (5-HT-R antagonist)
Depressed pt presenting w/ hyperthermia, myoclonus, hypotension, flushing, diarrhea, seizures
154
SSRI
Fluoxetine
155
SSRI
Paroxetine
156
SSRI
Sertraline
157
SSRI
Citalopram
158
MoA: inhibit serotonin & NE reuptake
Use: depression
ADRs: MC inc BP; stimulant Fx, sedation, nausea
SNRIs
159
SNRI
| Use: generalized anxiety disorder
Venlafaxine
160
SNRI (greater NE effect)
| Use: diabetic peripheral neuropathy
Duloxetine
161
MoA: nonselective MAO inhibition, inc amine neurotransmitter levels (NE, serotonin, dopamine)
Use: atypical depression, anxiety, hypochondriasis
ADRs: Hypertensive crisis (w/ tyramine or beta-agonists), CNS stimulation; C/I w/ SSRIs or meperidine
MAO-I
162
MAO-I
Tranylcypromine
163
MAO-I
Phenelzine
164
MAO-I
Isocarboxazid
165
MAO-I
| Use: also alkylating agent used in cancer chemoTx)
Procarbazine
166
MoA: inc NE & dopamine (unknown mech)
Use: atypical antidepressant; smoking cessation
ADRs: stimulant Fx (tachycardia, insomnia), headache, seizures in bulimic pts [no sexual side Fx]
Bupropion
167
MoA: alpha2-antag --> inc NE & 5-HT release; potent 5-HT2 & 5-HT3 antag
Use: atypical antidepressant
ADRs: sedation, inc appetite, weight gain, dry mouth
Mitazapine
168
MoA: blocks NE reuptake
Use: atypical antidepressant
ADRs: sedation, orthostatic hypotension
Maprotiline
169
MoA: inhibits serotonin reuptake
Use: insomnia (antidepressent Fx = v. high dose)
ADRs: sedation, nausea, priapism, postural hypotension
Trazodone
170
MoA: 5-HT2-R antagonist)
Use: Serotonin Syndrome
Cyproheptadine
171
modafinil (CNS stimulant thought to inc DA signalling; effective, well tolerated, low abuse potential)
DOC for narcolepsy
172
propranolol (beta-blockers)
DOC for essential tremor
