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Pharm 2_Exam 2 > Lecture 04_Spring > Flashcards

Lecture 04_Spring Flashcards

1
Q

Phenytoin (Dilantin) is a/an _____ drug that works by blocking ___ channels

A

Antiepileptic Drug

Na-channel blockade (also Ca, NMDA)

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2
Q

____ = restlessness

A. Tardive dyskinesia
B. Acute dystonic reaction
C. Parkinsonism
D. Akathesia
E. Neuroleptic Malignant Syndrome
A

D. Akathesia

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3
Q

T or F. Nondepolarizing NMBs will cause flaccid paralysis in Neuroleptic Malignant Syndrome (NMS) but NOT in MH

A

True

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4
Q

What is the advantage of using Fosphenytoin over Phenytoin?

A

Fosphenytoin (Prodilantin) = pheyntoin prodrug; can infuse more quickly without hypotension

Phenytoin: must give as a slow infusion to avoid hypotension (<50 mg/min)

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5
Q

___ = Hyperthermia, muscular hypertonicity, autonomic instability, mental status changes

A. Tardive dyskinesia
B. Acute dystonic reaction
C. Parkinsonism
D. Akathesia
E. Neuroleptic Malignant Syndrome
A

E. Neuroleptic Malignant Syndrome

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6
Q

What is MAO (Monoamine Oxidase)?

A

enzyme that metabolizes catecholamines (monoamines) including dopamine, serotonin, epi, norepi

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7
Q

SSRIs when taken with MAOIs, carbamazepine, or Linezolid (antibiotic) can lead to what?

A

SEROTONIN SYNDROME (anxiety, restlessness, chills, ataxia, insomnia)

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8
Q

The following drugs belong to which drug class

Chloropromazine (Thorazine)
clozapine (Clozaril)
haloperidol (Haldol)risperidone (Risperdal) droperidol

A

anti-psychotics

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9
Q

______, ______, and _____ are the best drugs to stop a seizure QUICKLY

A

barbiturates, benzodiazepines, propofol

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10
Q

____ block reuptake of norepinephrine and have anticholinergic side effects

A

TCAs

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11
Q

_____ should be used with caution hypoalbuminemic pts because it is 90% protein-bound

A

Phenytoin

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12
Q

What class of antidepressants have a narrow therapeutic index and are lethal in overdose?

A

TCAs

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13
Q

Increased levels of TCAs, some neuroleptics, and antiarrhythmics are seen with which class of antidepressants and why?

A

Selective Serotonin Reuptake Inhibitors (SSRIs) because they cause Hepatic cytochrome P-450 inhibition

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14
Q

___ = acute muscle rigidity/cramping in face/neck/tongue, larynx

A. Tardive dyskinesia
B. Acute dystonic reaction
C. Parkinsonism
D. Akathesia
E. Neuroleptic Malignant Syndrome
A

B. Acute dystonic reaction

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15
Q

What is the difference in MAO-A subtype and MAO-A subtype?

A

MAO-A subtype:
metabolism of serotonin, norepi, epi and also tyramine. Together with COMT vanillylmandelic acid (VMA) (seen in pheos)

MAO-B subtype: metabolism of tyramine

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16
Q

Which centrally acting drug class is associated with the following side effects: Insomnia, agitation, headache, nausea, diarrhea, sexual dysfunction, platelet dysfunction

A

SSRIs

17
Q

Which of the following is not an antieptiliptic drug?

A. Keppra
B. Neurontin
C. Dilantin
D. Sinemet

A

D. Sinemet (Levodopa)

18
Q

__ = rigidity, tremor, bradykinesia/akinesia

A. Tardive dyskinesia
B. Acute dystonic reaction
C. Parkinsonism
D. Akathesia
E. Neuroleptic Malignant Syndrome
A

C. Parkinsonism

19
Q

T or F. The main difference between NMS and MH is that Dantrolene will not treat NMS.

A

False.

20
Q

T or F. All neuroleptics are associate with Extrapyramidal effects (movement disorders).

A

False. all neuroleptics except clozapine

21
Q

___ = abnormal involuntary movements of face, neck, and tongue

A. Tardive dyskinesia
B. Acute dystonic reaction
C. Parkinsonism
D. Akathesia
E. Neuroleptic Malignant Syndrome
A

A. Tardive dyskinesia

22
Q

Which two drugs are often used together for Parkinson’s patients and why?

A

Levodopa (Sinemet) and carbidopa

Levodopa (Sinemet) = Dopamine precursor can cross blood-brain barrier (unlike dopamine)

Dopa decarboxylase converts it to dopamine

Usually given with carbidopa (prevents decarboxylation before crossing the BBB)

23
Q

Which of the following are contraindicated in Parkinson’s pts?

A. Haloperidol
B. Droperidol
C. Reglan
D. All of the above

A

D

24
Q

Which antieptileptic is most commonly used to treat chronic neuropathic pain or diabetic neuropathy?

A

Gabapentin (Neurontin)

25
Q

Which class of antidepressants requires a tyramine-free diet and why? Which MAOI subtype does not require this diet?

A

Monoamine Oxidase Inhibitors (MAOIs) because Tyramine deaminated in the liver by both MAO-A (mostly) and MAO-B and build-up of tyramine leads to an indirect sympathomimetic response (like pheo!!)

MAO-B inhibitors (selegiline) – no dietary restrictions except at very high doses

26
Q

____ and ____ should be avoided in patients taking Lithium.

A

Diuretics (loop, thiazide) and NSAIDs

Lithium - (Treatment of choice for bipolar/manic-depressive disorder)

27
Q

Which of the following can be treated with Benedryl?

A. Tardive dyskinesia
B. Acute dystonic reaction
C. Parkinsonism
D. Akathesia
E. Neuroleptic Malignant Syndrome
A

B. Acute dystonic reaction

Pharm 2_Exam 2 (4 decks)

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