Medication Flashcards
Why should antipsychotics not be prescribed for patients in alcohol withdrawal?
Reduce seizure threshold
Safest SSRI in pregnancy
Fluoxetine
Percentage of patients developing metabolic syndrome in CATIE study
30-40%
Benzo with half life of 15 hours
Lorazepam
Zero Order Kinetics
Rate of drug elimination is independent of the concentration and is constant.
Pentalomine
IM injection to treat HTN secondary to MAO-induced hypertension. Alpha-1-adrenoreceptor antagonist. Chlorpromazine is 2nd line.
Difference between iatrogenic cushing’s presentation to endogenous?
Mania/euphoria vs depression
Why is Clozapine recommended as drug of choice to avoid EPSEs?
High affinity for D4 receptors which are more highly concentrated in the front cortex and amygdala than in the basal ganglia.
Drugs not to be used as augmentation with Clozapine?
Pimozide (Cardiotoxicity), Olanzapine (no evidence)
Sigma receptors associated with which medication?
Fluvoxamine and Sertraline act on sigma 1 as agonists, anxiolytic and antipsychotic.
Reason why Clozapine is effective in refractory schizophrenia
Dissociates quickly
How does ecstasy work?
Increases release of seretonin, blocks dopamine reuptake, blocks enzyme tryptophan hydroxylase,
Prolonged withdrawal effects if given in pregnancy
SHORT HALF LIFE PAROXETINE.
Benzo halflives
Ultra long: Diazepam (200-20) then Clonazepam (50-18). Shortest (Oxazepam 4-15)
Long acting Opioid antagonist
Naltrexone - only to be given in detox-ed dependents.
Varenicicline mechanism of action
Alpha 4 beta 2 nicotinic partial agonist
Medication to treat REM sleep disorder
Clonazepam very effective.
Receptors involved in nausea and vomiting in SSRIs
Agonism of 5HT3 and antagonism of 5HT4
Prophylactic seizure control on Clozapine with..
Depends on the diagnosis i.e. if Schizoaffective choose sodium valproate, if psychosis poorly controlled choose Lamotrigine. If needs weight loss, choose Topiramate.
2mg Lorazepam = how much diazepam?
20mg
Which anticholinesterase inhibitor is unique in that it is an positive allosteric modulator of nicotinic receptors
Galantamine
Half life of Aripiprazole
75 hours - think once daily dosing.
First order kinetics
Dependent on drug concentration.
Buproprion
Dopamine and noreadrenaline reuptake inhibitor. PLUS antagonist at nicotinic Ach receptor
Pure antagonist at D2 receptors?
Typical antipsychotics. Atypical have antagonism at 5HT2 receptors.
Cocaine
Triple reuptake inhibitor (Dopamine, Noradrenaline and Seretonin).
Modafinil
Dopamine reuptake inhibitor
Clozapine receptor differences
Antagonism at D4 receptor
Third generation antipsychotics
Aripiprazole and Cariprazine - partial agonist at D2 receptors (Cariprazine D3). Cariprazine good for persistent negative symptoms.
Buspirone
5HT1a partial agonist
SSRI with longer half life
Fluoxetine
SSRI with shortest half life
Paroxetine, Fluvoxamine - withdrawal symptoms
SNRIs?
Venlafaxine and Duloxetine
Trazadone
Agonist at 5HT2 Receptors and Seretonin reuptake inhibitors.
Use of Clonadine and Lofexadine
Opiate withdrawal where not using opiate substitutes.
H1 antagonist
Promethazine crosses BBB (first gen).
