Lecture 7: Neuropharmacology

Question 0

What is the drug type of choice for depression?

Answer 0

SSRI’s

Question 1

What do all commonly used depression drugs share their effects on?

Answer 1

Serotonergic or noradrenergic neurotransmitter systems

Question 2

What is the lag time of SSRI treatment?

Answer 2

3-4 week lag

Question 3

What two therapies should depression patients undergo?

Answer 3

1. CBT (Cognitive behavioral therapy)

2. Drug therapy (Neurotransmitter/other)

Question 4

What is the most commonly used SSRI?

Answer 4

Fluoxetine (Prozac)

Question 5

Why does fluoxetine (prozac) have less potential for withdrawal syndromes after discharge?

Answer 5

It has a long half life

Question 6

What causes extreme drowsiness and can be useful for sleep disorders?

Answer 6

TCA’s (Tricyclic Antidepressants)

Question 7

In what kind of patients should TCA’s (Tricyclic antidepressants) be avoided in?

Answer 7

Elderly patients

Question 8

What drug might have improved treatment responses over SSRI’s?

Answer 8

SNRI’s (Serotonin-Norepinephrine Reuptake Inhibitors)

Question 9

What causes Priapism? What is priapism?

Answer 9

Serotonin Receptor Antagonists

Priapism is a painful erection that lasts too long

Question 10

What is buproprion indicated for

Answer 10

Depression and smoking cessation

Question 11

What is the highest dose of buproprion you want to give someone and why?

Answer 11

450 mg

More than this will cause seizures

Question 12

What kind of drug may cause weight gains and metabolic syndrome?

Answer 12

Atypical Antipsychotics

Question 13

What is a major problem with atypical antipsychotics?

Answer 13

Weight gain and metabolic syndrome

Question 14

What is well known for causing serotonin syndrome if used in combination with other antidepressants?

Answer 14

MAOI (monoamine oxidase inhibitors)

Question 15

Why do you not want o use MAOI’s with other antidepressants?

Answer 15

May cause serotonin syndrome

Question 16

What can happen if you take MAOI with what kind of food?

Answer 16

May become hypertensive (emergency level) if there is tyramine in the food

Question 17

What is the major issue with Benzo’s?

Answer 17

Addictive potential and may cause memory loss

Question 18

What are two unfortunate associations with seizure drugs?

Answer 18

1. Significant side effects

2. Major drug interactions

Question 19

What drug is nystagmus seen with and under what conditions?

Answer 19

> 20 mcg/ml of Phenytoin causes toxic effects, the first of which is nystagmus

Question 20

What (3) drugs can induce Parkinson’s disease?

Answer 20

1. Metoclopramid
2. Haloperidol
3. Phenothaizines

Question 21

What is Levodopa or carbidopa for?

Answer 21

Parkinson’s disease

Question 22

What phenomenon do you see with lovodopa or carbidopa?

Answer 22

A “Wearing off phenomenon” after 1-2 hours
or
An “On/Off phenomenon” of disabling dyskinesias

Question 23

What drug may actually be able to slow the progression of Parkinson’s disease?

Answer 23

Dopamine Agonists

1. Ropinerol (Requip)
2. Pramipexole (Mirapex)

Question 24

What should insomnia medications be used for and under what time period?

Answer 24

They should only be used to help with sleep hygiene and only for short durations of time.

Question 25

What are 2 major problem with Benzodiazepines?

Answer 25

1. Can easily be abused

2. Addictive

Question 26

What drug causes sleepwalking?

Answer 26

Zolpidem (Ambien)

Question 27

What 2 drug types are preferred over barbiturates for sleep inducing?

Answer 27

1. Benzodiazepines

2. Z compounds

Question 28

What are the only type of sleep inducing medications you want to use with the elderly?

Answer 28

Short half life hypnotics