Final exam Review Flashcards
D1 receptors activate (+Gs) adenylyl cyclase = excitatory
D2 receptors inhibit (Gi) adenylyl cyclase, activate K+ currents (increase K+ conductance and supress Ca2+
currents (supress Ca2+ conductance)
The actions of dopamine in the brain are mediated by a family of dopamine receptors.
*D1 and D2 receptors are abundant in the striatum and are the most important receptor sites with regard to the causes and treatment of Parkinson’s disease.
which Parkinsons drug can cause: uncontrollable somnolence. (which requires discontinuation of the medication).
NONERGOT DOPAMINE AGONISTS
Pramipexole
Ropinirole
Rotigotine
Nonergot dopaminergic agonist. FDA-approved as rescue therapy for the acute treatment of “off” episodes of akinesia in patients on dopaminergic therapy. Administered SC.
APOMORPHINE
name that drug
similar to zolpidem in its hypnotic actions.
Causes fewer residual effects on psychomotor and cognitive functions compared to zolpidem or the benzodiazepines. (This may be due to its rapid elimination, with a half-life of approximately 1 hour.)
Metabolized by aldehyde oxidase and CYP3A4.
ZALEPLON
act only on the BZ1 subtype of benzodiazepine receptors; these are GABAA receptors that contain α1 subunits.
***use if a pt has anxiety+insomnia and wants “minimal daytime sedative effects”
ANTIEPILEPTIC DRUG with an AE of
Gingival hyperplasia
Phenytoin
ANTIEPILEPTIC DRUG with an AE of
Rash, Stevens-Johnson syndrome. Should be discontinued at the first sign of rash.
*black box warning*
Lamotrigine
The drugs of choice for absence seizures are
ethosuximide and valproate.
List the 3 CYP450 inducers in the list of anti-epileptics which would naturally mean these 3 carry the hightest risk of Newborn Hemmorrhagic Disease
Phenobarbital
Phenytoin
Carbamazepine
fetal exposure to older antiepileptic drugs, particularly ________and _______, is associated with congenital anomalies.
_____________ is associated with the highest risk of congenital malformations, and with developmental delay.
valproate and phenobarbital,
valproate
whats protocol for treating status epilepticus
Myoclonic Seizures DOC
Valproate is the drug of choice.
Na+ channel inhibitor
AE: hepatoxicity (measure LFTs)
CI in pregnancy
used for Migraine prophylaxis, Myoclonic seizures, bipolar
Tx for Febrile Convulsions
diazepam given IV or as a rectal solution.
pt was on Fluoxetime (SSRI) for depression but now has sexual dysfunction, which antidepressant is KNOWN well for NOT being associated with sexual AE and whyyyy
bc its not serotinergic
BUPROPION
NDRI Norepi Dopamine Reuptake inhibitor==> more release of both
FLUID rentions and weight gain are an AE effect of this drug, therefore it is CI in pts with class III or IV CHF
- FDA requires Hepatotox monitoring
- this drug specifically shows significant improvements in LIPID PROFILE
__name that drug__
PIOGLITAZONE
AE of Benztropine
Park your Mercedes-Benz.
Dry mouth, urinary retention, pupil dilation, hallucination
(Antimuscarinic; improves tremor and rigidity but has little effect on bradykinesia in Parkinson disease).
livedo reticularis is an AE of what drug
Amantadine (antiviral)—Parkinsons drug
livedo reticularis (purple discoloration of skin in a lace lke pattern). goes away when discontinued
Amitriptyline
nortriptyline
Phenelzine
imipramine
Clozapine
Citalopram
which ANTIDEPRESSANT above for a pt with Coronary Vasucular disease history: MI & Second Degree heart blocks
what class are each of these?
CItalopram (SSRI)-no CYP interactions
Phenelzine-(MAO-I: Hydrazine)-for refractory depression
Amitriptyline, nortriptyline, imipramine = TCA; Tri-C’s: Convulsions, Coma, Cardiotoxicity (arrhythmia due to Na+ channel inhibition) SO NO IN THIS PT
Clozapine-NERP, its an atypical antipsychotic
tx for Ethylene glycol/methanol intoxication
Fomepizole (alcohol dehydrogenase inhibitor)
talk about GABA and Glutamate and their activation/inhibition in relation to their effects on Epilepsy
if you inhibit the GABAa receptor and activate the Glutamate receptor –> + Trigger a seizure
vice versa
if you inhibit the Glutamate receptor and activate Gaba-nergic transmission –> inhibit a seizure
SSRI’s are DOC for how many anxiety disorders, list them
GAD
Panic disorder (for long term)
Social anxiety disorder
OCD
PTSD
but NOT Performance anxiety —use Propanolo for that!
Benzo’s are used in ACUTE situations UNTILS SSRI’s kick in
Nystagmus is a clinical manigestation of which Psychedelic Agent
PCP/Phencyclidine/angel dust
_____________ & ___________reduce arterial pressure mainly by myocardial depression (reduced cardiac output), with little effect on peripheral vascular resistance
In contrast, _________, ____________, ______________produce greater vasodilation and have minimal effect on cardiac output.
which group of drugs may be better choices for patients with impaired myocardial function?
Halothane and enflurane
isoflurane, desflurane and sevoflurane (SID)
Isoflurane, desflurane and sevoflurane may be better choices for patients with impaired myocardial function.
• ____________sensitizes the myocardium to circulating catecholamines, which may lead to ventricular arrhythmias
. This effect is less marked for isoflurane, sevoflurane and desflurane. (SID)
Halothane
which one of the following RAISES ICP and which one LOWERS ICP?
Propofol
Etomidate
Ketamine
Barbituate
which one of the following RAISES ICP and which one LOWERS ICP?
Propofol, Etomidate & Barbituate LOWERS ICP
Ketamine RAISES ICP
which IV anesthetic has ANTIEMETIC properties
Propofol
the ONLY IV anesthetic to possess both analgesic properties and CV stimulation is….
KETAMINE
PCP analogs that act as dissociative anesthetics. Block NMDA receptors
IV anesthetic Used for induction of anesthesia and short surgical procedures.
what patient population should be concerned if taking these?
Barbiturates (Thiopental) & (Methohexital)
Asthmatics bc AE = coughing, chest wall spasm, laryngospasm, bronchospasm
TINNITUS is a classic AE of what type of Drug Toxicity
MILD Salicylate Aspirin Tox (150-200mg)
Bipolar disorder (manic depression) tx: list most common ones
lithium
valproic acid
carbamazepine
atypical antipsychotics.
Focal to massive hepatic necrosis, list the drugs that can cause this (hepatotoxicity)
think “HAVAc”
Halothane
Amanita phalloides (death cap mushroom)
Valproic acid
Acetaminophen
Agranulocytosis is an AE of which
Clozapine (Atypical antipsychotic)
Carbamazepine (antiepileptic)
Propylthiouracil (PTU)-a thioamide
Methimazole (a thioamide)
Colchicine
Ganciclovir
if a pt is experiencing alcohol WITHDRAWAL,
what is (are) the DOC
- how about if they are old people or have liver failure , which meds would you use and hwhy
- which of these are long, intermediate and short acting?*
BENZO’s
the following 2 bc of their long t1/2s
Diazepam (long acting)
Chlordiazepoxide (long acting)
if they are old or have a jacked up liver
use (bc they skip first pass met in liver)
Lorazepam (long acting)
Oxazepam (short acting)
