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Miscellaneous Flashcards

Active metabolites

1
Q

What is the active metabolite of diazepam

A

desmethyldiazepam

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1
Q

What is the active metabolite of dothiepin

A

Dothiepinsulfoxide

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2
Q

What is the active metabolite of fluoxetine

A

norfluoxetine

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3
Q

What is the active metabolite of imipramine

A

desipramine

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4
Q

What is the active metabolite of risperidone

A

9-hydroxyrisperidone

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5
Q

What is the active metabolite of amitriptyline

A

nortriptyline

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6
Q

What is the active metabolite of codeine

A

morphine

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7
Q

What are the active metabolite of clozapine

A

N-desmethylclozapine
Clozapine N-oxide

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8
Q

What is a prodrug?

A

Drugs that need to be metabolised to become their active form

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9
Q

What is modafinil licensed for?

A

Excessive sleepiness associated with narcolepsy

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10
Q

What is modafinil used for off license?

A

OSA
Shift work sleep disorder
Adjunctive treatment for depression

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11
Q

How does modafinil work?

A

Weak inhibitor of dopamine reuptake

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12
Q

How does agomelatine work?

A

Antidepressant - agonist at melatonin M1 and M2 receptors and antagonist at 5HT2C receptors

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13
Q

What is a partial agonist?

A

produces the biological response but cannot produce 100% of the response even at very high doses.

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14
Q

What is a competitive antagonist?

A

Competitive antagonists bind to the receptor in a reversible way without affecting a biological response. They make the agonist look less potent.

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15
Q

What is an inverse agonist?

A

Have opposite effects from those of full agonists

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16
Q

What is an agonist antagonist

A

Some substances can bind to certain receptors and act as an agonist and at other receptors they act as an antagonist.

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17
Q

What drugs have a narrow therapeutic index?

A

Carbamazepine
Lithium
Phenytoin
Warfarin
Digoxin
Gentamicin

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18
Q

Which psychiatric drugs can interact with oral contraceptives resulting in a reduced contraceptive effect?

A

St John’s Wort
Carbamazepine
Phenytoin
Topiramate
Barbiturates

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19
Q

What is the most common side effect of sildenafil?

20
Q

What area of the body is most commonly affected by tardive dyskinesia?

21
Q

When does tardive dyskinesia worsen?

A

emotional arousal

22
Q

Which drugs must be protected from moisture?

A

sodium valproate
topiramate

23
Q

Which drug must be protected from sunlight and moisture ?

24
Q

Which drug state can produce a biological response?

A

Drugs unbound in plasma

25
Q

What APs should be avoided in renal impairment?

A

Amisulpride
Sulpiride

26
Q

What is best choice AP in renal impairment ? First and second generation ?

A

First - haloperidol
Second - olanzapine

27
Q

which ADs are preferable in renal impairment?

A

Sertraline
Citalopram
Fluoxetine

28
Q

Which mood stabilisers are preferred in renal impairment?

A

Valproate
Lamotrigine

29
Q

Which anxiolytics are preferred in renal impairment?

A

Lorazepam
Zopiclone

30
Q

Which anti-dementia drugs are preferred in renal impairment?

A

Rivastigmine

31
Q

What is volume of distribution?

A

Indicates how a drug distributes in the body.
Tells you if a drug concentrates in the plasma or spreads out.

32
Q

Give the calculation for volume of distribution

A

Amount of drug in the body/concentration in the plasma

33
Q

Do lipid soluble drugs have a higher or lower volume of distribution? Why?

A

Higher
Can cross cell membranes more easily and distribute into tissues.

34
Q

What influences volume of distribution?

A

the drug’s lipid or water solubility
plasma protein binding
tissue binding.

35
Q

Which class of drugs are associated with paradoxical reactions?

36
Q

What are the increased risk factors for disinhibitory drug reactions?

A

LD
Extremes of age
Hx of aggression or poor impulse control
Benzo with short half life
High dose
IV admin

37
Q

What is mechanism of action of flumazenil?

A

Selective GABA-A antagonist - competitive

38
Q

What is the half life of flumazenil?

39
Q

What other meds are blocked by flumazenil?

40
Q

What is range of duration of flumazenil?

A

20-50 mins

41
Q

Which AP is most likely to cause priapism and why

A

Chlorpromazine due to potent alpha-adrenergic blocking properties

42
Q

What AD is associated with priaprism

43
Q

What are the side effects of histamine H1 blockade?

A

weight gain
sedation

44
Q

What are the side effects of alpha 1 blockade

A

orthostatic hypotension
sedation
sexual dysfunction
priapism

45
Q

What are the side effects of muscarinic central M1 blockade

A

agitation
delirium
memory impairment
confusion
seizures

46
Q

What are the side effects of muscarinic peripheral M1 blockade

A

dry mouth
ataxia
blurred vision
narrow angle glaucoma
constipation
urinary retention
tachycardia

Clinical pharmacology (24 decks)

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