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1
Q

Cocaine

A

Indirect D Agonist (+NE/5HT) -> inc BP, HR, performance w/ euphoria + addiction + chronic stereotype move/paranoia/psychosis
MI: O2, ASA, NO, BNZ (no BBlock)
Aorta Dissect: BBlock (no ASA)Chronic: atherosclerosis, dilated cardiomyopathy
Resp: nasal perf, hypersens
CNS: seizure, hemorrhage, addict, sens, tolerance (withdrawal)Tx Dep: mondafinil, propranolol, baclofen (GABA-B agonist)

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2
Q

Mazindol

A

Cocaine + more NE
Use: obesityADE: CV, allergy, D/C, Impotence, Addict
Contra: glaucoma, MOAI, Guanethidine, TCAs

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3
Q

Amphetamine [Adderall]

A

Inc. Dopamine -> stimulate followed by crash
Use: ADHD
ADE: cocaine + memory/learning prob, formication, anorexia, psychosis, inc risk behavior (-> infection)
Preg: premature deliv, placental abruptionTx
OD: AlCl (acidify urine and trap)
!BBW! Abuse Potential
DDI: alk/acid urine, D block (chlorpromazine, haloperidol), dextromethorphan, Digoxin, MAOIs, 2D6 inh/ind

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4
Q

Dextro/Meth-amphetamine

A

Ice/SpeedMade from Ephedrine

CNS Stim > Periph -> high risk abuse

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5
Q

Methylphenidate

A

See Amphetamine
Mild CNS Stimulant
DDI: MAOIs, Alcohol, Phenytoin, Ergot, pseudoephedrine, 2D6 inh/ind

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6
Q

Phentermine

A

Inh. 5HT Reuptake (not an SSRI)
Use: Obesity (short term only)
ADE: inc monoamine, hyperthyroidism, MAOI contra

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7
Q

Modafenil [Provigil]

A

??? but no Dop effect -> low risk abuse
PK: induce microsomal enzyme -> dec OCPs, anticonvul, theophylline
ADE: headaches but NO GI/CV effect

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8
Q

Atomoxetine [Strattera]

A 
Inh NE Reuptake
Use: Adult ADHD
ADE: ab pain, induce mania
DDI: albuterol, epi, ergot, pseudoephedrine, 2D6 inh/ind
!BBW! inc risk suicide
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9
Q

Ephedrine

A

Inc NE and D Release

Use: narcolepsy, bronchodilate, depressionADE: CV (MI), heat stroke

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10
Q

Strichnine

A

Gly Receptor Antagonist -> dis inh everything -> ALL CNS Stim!!! -> convulsion
Found pesticides and contaminant street drugs
Tx OD: Diazepam

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11
Q

Caffeine

A

Adenosine Receptor Antagonist + Inc cGMP/cAMP (same messengers as D and NE)
Use: Apnea of Prematurity, Migraine

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12
Q

Clonidine/Guanfacine

A

Alpha2-Agonist (w/ heteroreceptor at PFC) -> improve prefrontal cortical function
Use: Tourette/Tics w/ ADHD
DDI: cyclosporine (C), bupropion (G)
NO Cyp Issues!

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13
Q

Haloperidol

A

1st Gen Antipsychotic, D2 AntagonismUse: for Tourette/Tics w/o ADHD
PK: need glucuronidation, 2D6, 3A4
DDI: anything interfere with metabolism –> QT prolong

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14
Q

Alprazolam [Xanax]

A

BNZ w/ intermediate onset, t1/2, duration
Use: anxiety, panic attacks
PK: not to nordiazepam -> rapid renal elim, depend on CYPs
ADE: sedation (resp depres/contra other sedatives), Cat D, tolerance/dependence
W/draw: w/ abrupt discontinue and short-acting, autonomic SNS, rebound anxiety/insomnia, convulsions

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15
Q

Chlordiazepoxide [Librium]

A

BNZ w/ intermediate onset, long duration and t1/2
Use: alcohol w/draw
PK: through nordiazepam -> slow metabolism, CYPs dependent
ADE: sedation (resp depres/contra other sedatives), Cat D, tolerance/dependence
W/draw: w/ abrupt discontinue and short-acting, autonomic SNS, rebound anxiety/insomnia, convulsions

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16
Q

Clonazepam [Klonopin]

A

BNZ w/ intermediate onset, short duration and t1/2
Use: anxiety
PK: through nordiazepam -> slow metabolism, CYPs dependent
ADE: sedation (resp depres/contra other sedatives), Cat D, tolerance/dependence
W/draw: w/ abrupt discontinue and short-acting, autonomic SNS, rebound anxiety/insomnia, convulsions

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17
Q

Clorazepate [Tranxene]

A

BNZ w/ rapid onset, long duration and t1/2PK: through nordiazepam -> slow metabolism, CYPs dependentADE: sedation (resp depres/contra other sedatives), Cat D, tolerance/dependenceW/draw: w/ abrupt discontinue and short-acting, autonomic SNS, rebound anxiety/insomnia, convulsions

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18
Q

Lorazepam [Ativan]

A

BNZ w/ intermediate onset, t1/2, duration as IV admin
Use: anxiety, +/- alcohol w/draw
PK: not to nordiazepam -> rapid renal elim, direct glucuronidaiton, NO CYPs
ADE: sedation (resp depres/contra other sedatives), Cat D, tolerance/dependence
Withdraw: w/ abrupt discontinue and short-acting, autonomic SNS, rebound anxiety/insomnia, convulsions

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19
Q

Oxazepam [Serax]

A

BNZ w/ slow onset, short duration and t1/2
PK: through nordiazepam -> slow metabolism, CYPs dependent
ADE: sedation (resp depres/contra other sedatives), Cat D, tolerance/dependence
W/draw: w/ abrupt discontinue and short-acting, autonomic SNS, rebound anxiety/insomnia, convulsions

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20
Q

Prazepam [Centrax]

A

BNZ w/ slow onset, long duration and t1/2
PK: through nordiazepam -> slow metabolism, CYPs dependent
ADE: sedation (resp depres/contra other sedatives), Cat D, tolerance/dependence
W/draw: w/ abrupt discontinue and short-acting, autonomic SNS, rebound anxiety/insomnia, convulsions

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21
Q

Buspirone [BuSpar]

A

Non-BNZ anti-anxiety, as effective but takes longer
Suppress 5HT and Enhance NE/D (really ?)
NO anti-convulsant, muscle relax, or sedative effects (only anti-anxiety)

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22
Q

Propranolol [Inderal]

A

Beta-Blocker for stage fright/performance anxiety
Dec somatic/autonomic symptoms of anxiety
No CNS alterations on emotion

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23
Q

Flumanezil [Romazicon]

A

BNZ Antagonist

Use: BNZ OD

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24
Q

Diazepam [Valium]

A

BNZ w/ rapid onset, long duration and t1/2
Use: muscle relax, alcohol w/draw
PK: through nordiazepam -> slow metabolism, CYPs dependent
ADE: sedation (resp depres/contra other sedatives), Cat D, tolerance/dependence
W/draw: w/ abrupt discontinue and short-acting, autonomic SNS, rebound anxiety/insomnia, convulsions

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25
Q

Triazolam [Halcion]

A

BNZ w/ rapid onset, short duration and t1/2
PK: through nordiazepam -> slow metabolism, CYPs dependent
ADE: sedation (resp depres/contra other sedatives), Cat D, tolerance/dependence
W/draw: w/ abrupt discontinue and short-acting, autonomic SNS, rebound anxiety/insomnia, convulsions

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26
Q

Flurazepam [Dalmane]

A

BNZ w/ rapid onset, long duration and t1/2
PK: through nordiazepam -> slow metabolism, CYPs dependent
ADE: sedation (resp depres/contra other sedatives), Cat D, tolerance/dependence
W/draw: w/ abrupt discontinue and short-acting, autonomic SNS, rebound anxiety/insomnia, convulsions

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27
Q

Amitriptyline [Elavil]

A

TCA Anti-Depressant
MoA: dec presynaptic reuptake 5HT, NE -> inc transmit and change receptor profile
Use: Major Depression; !LOW TI! -> arrhyth, cardiac failure, CHF
Acute: drowsy w/ dec cognition
Chronic (2-8wks): inc cognition w/o euphoria
PK: Lipid Sol -> to fat/brain; High ProBind -> inc Vd, T1/2, dec excret; demethylation, 2D6
ADE: Block mACh, 5HT, His -> ortho-hypo/syncopy, anti-mACh effects (contra Glaucoma), sedation, weight gain, sexual disturbanceDDI: EtOH, sedatives, block Clonidine

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28
Q

Imipramine [Togranil]

A

TCA Anti-DepressantMoA: dec presynaptic reuptake 5HT, NE -> inc transmit and change receptor profile
Use: Major Depression; !LOW TI! -> arrhyth, cardiac failure, CHF
Acute: drowsy w/ dec cognition
Chronic (2-8wks): inc cognition w/o euphoria
PK: Lipid Sol -> to fat/brain; High ProBind -> inc Vd, T1/2, dec excret; demethylation, 2D6
ADE: Block mACh, 5HT, His -> ortho-hypo/syncopy, anti-mACh effects (contra Glaucoma), sedation, weight gain, sexual disturbance
DDI: EtOH, sedatives, block Clonidine

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29
Q

Nortriptyline [Pamelor]

A

TCA Anti-Depressant
MoA: dec presynaptic reuptake 5HT, NE -> inc transmit and change receptor profile
Use: Major Depression; !LOW TI! -> arrhyth, cardiac failure, CHF
Acute: drowsy w/ dec cognition
Chronic (2-8wks): inc cognition w/o euphoria
PK: Lipid Sol -> to fat/brain; High ProBind -> inc Vd, T1/2, dec excret; demethylation, 2D6
ADE: Block mACh, 5HT, His -> ortho-hypo/syncopy, anti-mACh effects (contra Glaucoma), sedation, weight gain, sexual disturbance
DDI: EtOH, sedatives, block Clonidine

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30
Q

Desipramine [Norpramin]

A

TCA Anti-Depressant
MoA: dec presynaptic reuptake 5HT, NE -> inc transmit and change receptor profile
Use: Major Depression; !LOW TI! -> arrhyth, cardiac failure, CHF
Acute: drowsy w/ dec cognition
Chronic (2-8wks): inc cognition w/o euphoria
PK: Lipid Sol -> to fat/brain; High ProBind -> inc Vd, T1/2, dec excret; demethylation, 2D6
ADE: Block mACh, 5HT, His -> ortho-hypo/syncopy, anti-mACh effects (contra Glaucoma), sedation, weight gain, sexual disturbance
DDI: EtOH, sedatives, block Clonidine

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31
Q

Buproprion [Wellbutrin]

A

Atypical Anti-Depressant + Smoking CessationMoA: WEAK block D, 5HT, NE; metabolite SNRIAdmin: divided dose or slow releaseADE: Inc Monoamine -> agitation, anxiety, restlessness, Seizure

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32
Q

Venlafaxine [Effexor]

A

Atypical Anti-Depressant; SNRI w/o anti-His/mACh/adrenergic effects (less than TCAs)
PK: short T1/2, must taper (avoid reflexive depression)
ADE: small sustained HTN, sweat dizzy, N, anxiety, Serotonin Syndrome

33
Q

Duloxetine [Cymbalta]

A

Atypical Anti-Depressant; Most Potent SNRI

PK: 2D6/1A2, 50%bioaval, high ProBind

34
Q

Mirtazapine [Remeron]

A

Atypical Anti-Depressant
MoA: Inc 5HT/NE release by block presynapse alpha2-AD heteroreceptor; Block 5HT-2 Receptors
ADE: potent anti-His -> sedation, weight gain

35
Q

Trazodone [Desyrel, Oleptro ER]

A

Atypical Anti-Depressant
MoA: moderate SSRI, 5HT-2a antagonist + 5HT-1 partial agonist (SARI)
Use: depression w/ anxiety + sleep disturbance
PK: short T1/2, Inh 3A4Serotonin Syndrome

36
Q

Citalopram [Celexa]

A

SSRI Anti-Depressant (1st Line!) + anti-anxiety, panic, OCD, ADHD, eating disorders
MoA: Inh SERT -> potentiate/prolong 5HT action. Min effect @ mACh/His
Acute: CNS stimulation, anxiety, agitation
Chronic (2-6 wks): improve but stimulation remains
PK: high bioaval, high ProBind, long T1/2 (days), meta 2D6/2C19/3A4, inh 2D6/2C19
ADE (high TI): sex dysfunc, N/V -> least in general
Possible birth defects
OD (<24hrs): Serotonin Syndrome (esp.w/ MAOI)

37
Q

Escitalopram [Lexapro]

A

SSRI Anti-Depressant (1st Line!) + anti-anxiety, panic, OCD, ADHD, eating disorders
MoA: Inh SERT -> potentiate/prolong 5HT action. Min effect @ mACh/His
Acute: CNS stimulation, anxiety, agitation
Chronic (2-6 wks): improve but stimulation remains
PK: high bioaval, high ProBind, long T1/2 (days), meta 2D6/2C19/3A4, inh 2D6/2C19
ADE (high TI): sex dysfunc, N/V -> least in generalPossible birth defects
OD (<24hrs): Serotonin Syndrome (esp.w/ MAOI)

38
Q

Fluoxetine [Prozac]

A

SSRI Anti-Depressant (1st Line!) + anti-anxiety, panic, OCD, ADHD, eating disorders
MoA: Inh SERT -> potentiate/prolong 5HT action. Min effect @ mACh/His
Acute: CNS stimulation, anxiety, agitation
Chronic (2-6 wks): improve but stimulation remains
PK: high bioaval, high ProBind, meta 2D6/2C19/3A4, inh 2D6/2C19,
super long T1/2 (7-9 d): norfluoxetine active metabolite -> weekly admin
ADE (high TI): sex dysfunc, N/V -> least in general
Possible birth defects
OD (<24hrs): Serotonin Syndrome (esp.w/ MAOI)

39
Q

Paroxetine [Paxil]

A

SSRI Anti-Depressant (1st Line!) + anti-anxiety, panic, OCD, ADHD, eating disorders
MoA: Inh SERT -> potentiate/prolong 5HT action. Min effect @ mACh/His
Acute: CNS stimulation, anxiety, agitation
Chronic (2-6 wks): improve but stimulation remains
PK: high bioaval, high ProBind, long T1/2 (days), meta 2D6/2C19/3A4, inh 2D6/2C19
ADE (high TI): sex dysfunc, N/V -> least in general
Birth Defects!!!
OD (<24hrs): Serotonin Syndrome (esp.w/ MAOI)

40
Q

Sertraline [Zoloft]

A

SSRI Anti-Depressant (1st Line!) + anti-anxiety, panic, OCD, ADHD, eating disorders
MoA: Inh SERT -> potentiate/prolong 5HT action. Min effect @ mACh/His
Acute: CNS stimulation, anxiety, agitation
Chronic (2-6 wks): improve but stimulation remains
PK: high bioaval, high ProBind, long T1/2 (days), meta 2D6/2C19/3A4, inh 2D6/2C19
ADE (high TI): sex dysfunc, N/V -> least in generalPossible birth defects
OD (<24hrs): Serotonin Syndrome (esp.w/ MAOI)

41
Q

Fluvoxamine [Luvox]

A

SSRI Anti-Depressant (1st Line!) + anti-anxiety, panic, OCD, ADHD, eating disorders
MoA: Inh SERT -> potentiate/prolong 5HT action. Min effect @ mACh/His
Acute: CNS stimulation, anxiety, agitation
Chronic (2-6 wks): improve but stimulation remains
PK: high bioaval, high ProBind, long T1/2 (days), meta 2D6/2C19/3A4, inh 2D6/2C19
ADE (high TI): sex dysfunc, N/V -> least in general
Possible birth defects
OD (<24hrs): Serotonin Syndrome (esp.w/ MAOI)

42
Q

Phenelzine [Nardil]

A

MAOI Anti-Depressant (last resort)Use: ONLY if other meds fail and ECT not option
MoA: block monoamine metabolism via Irreversible Inh of MAO-A (NE/5HT/tyramine) and MAO-B (D)
Acute: CNS stim, agitation, euphoria
Chronic (2-6 wks): improve, stim remains
PK: daily dose, acetyl to inactive, inc duration due to irreversible
DDI: cheese! (tyramine), sympathomimetics (HTN), meperidine/dextromethorpham (hyperreflex, delirium, convulsion, death), SSRI (serotonin syndrome), etc…
ADE (due inc monoamine): sleep disturbance (inc arousal), OrthoHypo, weight gain, sex dysfunc, Serotonin Syndrome

43
Q

Lithium [Lithobid]

A

Mood Stabilizer (1st Line)
Use: maintenance (not acute) of manic condition, 60% effective
MoA: ??? Inh IPO3 signaling, AC signaling
PK: rapid/complete absorb -> rapid distribute w/ conc in bone, renal clear, T1/2 20hr, NO metabolism
ADE: VERY Narrow TI!! -> hit all high flow organs, tremor, ataxia, sedation, edema, hypothyroid, nephro DI, Cat D, cardio sick sinus (brady/tachy mix), acne, folliculitis, exacerbate psoriasis, Serotonin Syndrome
DDI: diuretics and NSAIDs

44
Q

Valproate/Divalproex [Depacon]

A

Mood Stabilizer/Anti-Convulsant
Use: maintenance (not acute) of manic condition alone or w/ Li or other antipsychotics
MoA (4): Inh Volt-Gate Na Channel by stable inactive state, Block Ca Channel (T-type), Stim GABA synth, Inh GABA breakdown, Inc K conductance
PK: Inh 2C9/UGT -> affect itself and many drugs
DDI: displace phenytoin plasma binding
ADE: N, ab pain, heartburn, sedation, hept tox, Serotonin Syndrome

45
Q

Carbamazepine [Tegretol]

A

Mood Stabilizer
Use: maintenance (not acute) of manic condition alone or w/ Li or other antipsychotics
MoA: Inh Volt-Gate Na Channel (prolong inactive)
PK: good absorb, ProBound/poor solub, Induce 2C/3A and UGT -> dec own conc and others
Toxic:diplopia, ataxia, GI upset, drowsiness, rash, APLASTIC Anemia

46
Q

Lamotrigine [Lamictal]

A

Mood Stabilizer
Use: maintenance (not acute) of manic condition alone or w/ Li or other antipsychotics
MoA: Inh Volt-Gate Na Channel (prolong inactive)

47
Q

Selegiline

A

MAOI Anti-Depressant (last resort)
Use: ONLY if other meds fail and ECT not option
MoA: block monoamine metabolism via Irreversible Inh of MAO-A (NE/5HT/tyramine) and MAO-B (D)
Acute: CNS stim, agitation, euphoria
Chronic (2-6 wks): improve, stim remains
PK: daily dose, acetyl to inactive, inc duration due to irreversible
DDI: cheese! (tyramine), sympathomimetics (HTN), meperidine/dextromethorpham (hyperreflex, delirium, convulsion, death), SSRI (serotonin syndrome), etc…
ADE (due inc monoamine): sleep disturbance (inc arousal), OrthoHypo, weight gain, sex dysfunc

48
Q

St. John’s Wort

A

Treat Depression?

Induces CYPs, Serotonin Syndrome

49
Q

Chlorpromazine [Thorazine]

A

Phenothiazene, Typical 1st Gen Anti-Psychotic
MoA: D2 Antagonist -> Inh positive symptoms, Inc prolactin
Anti-Cholinergic -> minimize ESP
Low Potency -> Inc Anti-Cholinergic (min ESP)
PK: erratic absorp, high Vd (lipid high ProBind), cross placenta/milk, 2D6/3A4 meta (not ind)
DDI: Inh 2D6 -> Inc SSRI/TCA
ADE: juandice, skin rxn, impair glucose tolerance, anti-diuretic, OrthoHypo, CVD

50
Q

Fluphenazine [Modecate]

A

Phenothiazene, Typical 1st Gen Anti-Psychotic
MoA: D2 Antagonist -> Inh positive symptoms, Inc prolactin
Anti-Cholinergic -> minimize ESP
High Potency -> Inc ESP, less anti-cholingeric
PK: erratic absorp, high Vd (lipid high ProBind), cross placenta/milk, 2D6/3A4 meta (not ind)
DDI: Inh 2D6 -> Inc SSRI/TCA
ADE: acute dystonia, akathesia, parkinsonian, neuroleptic malignant syndrome, perioral tremor, tardive dyskinesia

51
Q

Haloperidol [Haldol]

A

Typical 1st Gen Anti-Psychotic
MoA: D2 Antagonist -> Inh positive symptoms, Inc prolactin
Anti-Cholinergic -> minimize ESP
High Potency -> Inc ESP, less anti-cholingeric
PK: IV/IM admin, erratic absorp, high Vd (lipid high ProBind), cross placenta/milk, 2D6/3A4 meta (not ind)
DDI: Inh 2D6 -> Inc SSRI/TCA
ADE: acute dystonia, akathesia, parkinsonian, neuroleptic malignant syndrome, perioral tremor, tardive dyskinesia

52
Q

Clozapine [Clozaril]

A

Atypical 2nd Gen Anti-Psychotic
MoA: D2 Antagonist -> Inh positive symptoms
5HT-2a Antagonist -> Inh negative symptoms, reduce ESP
Low Potency -> Inc Anti-Cholinergic (min ESP)
PK: erratic absorp, high Vd (lipid high ProBind), cross placenta/milk, 2D6/3A4 meta (not ind)
DDI: Inh 2D6 -> Inc SSRI/TCA
ADE: Inc risk DMII, weight gain, metabolic syndrome
Dose Limit: blood dyscrasis (agranulocytosis)

53
Q

Risperidone [Risperdal]

A

Atypical 2nd Gen Anti-PsychoticMoA: D2 Antagonist -> Inh positive symptoms5HT-2a Antagonist -> Inh negative symptoms, reduce ESP at low dose, inc at high doseDOC in child/teen
PK: active metabolite Paliperadone, depot availabl, eerratic absorp, high Vd (lipid high ProBind), cross placenta/milk, 2D6/3A4 meta (not ind)
DDI: Inh 2D6 -> Inc SSRI/TCA

54
Q

Olanzapine [Zyprexa]

A

Atypical 2nd Gen Anti-Psychotic
MoA: D2 Antagonist -> Inh positive symptoms
5HT-2a Antagonist -> Inh negative symptoms, reduce ESP
PK: erratic absorp, high Vd (lipid high ProBind), cross placenta/milk, 2D6/3A4 meta (not ind)
DDI: Inh 2D6 -> Inc SSRI/TCA
ADE: Inc risk DMII, weight gain, metabolic syndrome (highest)

55
Q

Quetiapine [Seroquel]

A

Atypical 2nd Gen Anti-Psychotic
MoA: D2 Antagonist -> Inh positive symptoms
5HT-2a Antagonist -> Inh negative symptoms, reduce ESP
PK: erratic absorp, high Vd (lipid high ProBind), cross placenta/milk, 2D6/3A4 meta (not ind)
DDI: Inh 2D6 -> Inc SSRI/TCA
ADE: Inc risk DMII, weight gain, metabolic syndrome (intermediate)

56
Q

Ziprasidone [Geodon]

A

Atypical 2nd Gen Anti-Psychotic
MoA: D2 Antagonist -> Inh positive symptoms
5HT-2a/1a/2c Antagonist -> Inh negative symptoms, limited ESP
PK: erratic absorp, high Vd (lipid high ProBind), cross placenta/milk, 2D6/3A4 meta (not ind)
DDI: Inh 2D6 -> Inc SSRI/TCA
ADE: Inc risk DMII, weight gain, metabolic syndrome (intermediate/low)

57
Q

Aripiprazole [Abilify]

A

Atypical 2nd Gen Anti-Psychotic
MoA: D2 Partial Agonist -> red full agonist and min positive symptoms
5HT-2a Antagonist/5HT-1a partial agonist -> Inh negative symptoms, reduce ESP
Low Potency -> Inc Anti-Cholinergic (min ESP)
PK: erratic absorp, high Vd (lipid high ProBind), cross placenta/milk, 2D6/3A4 meta (not ind)
DDI: Inh 2D6 -> Inc SSRI/TCA
ADE: minimal

58
Q

Lurasidone [Latuda]

A

Atypical 2nd Gen Anti-Psychotic
MoA: D2 Antagonist -> Inh positive symptoms
5HT-2a Antagonist/5HT-1a partial agonist -> Inh negative symptoms
Still risk of ESP
Low Potency -> Inc Anti-Cholinergic (min ESP)
PK: erratic absorp, high Vd (lipid high ProBind), cross placenta/milk, 2D6/3A4 meta (not ind)
DDI: Inh 2D6 -> Inc SSRI/TCA

59
Q

Perphenazine [Trilafon]

A

Phenothiazene, Typical 1st Gen Anti-Psychotic
MoA: D2 Partial Agonist -> Inh positive symptoms, Inc prolactin
Anti-Cholinergic -> minimize ESP
High Potency -> Inc ESP, less anti-cholingeric
PK: erratic absorp, high Vd (lipid high ProBind), cross placenta/milk, 2D6/3A4 meta (not ind)
DDI: Inh 2D6 -> Inc SSRI/TCA
ADE: acute dystonia, akathesia, parkinsonian, neuroleptic malignant syndrome, perioral tremor, tardive dyskinesia

60
Q

Trifluoperazine [Stelazine]

A

Phenothiazene, Typical 1st Gen Anti-Psychotic
MoA: D2 Partial Agonist -> Inh positive symptoms, Inc prolactin
Anti-Cholinergic -> minimize ESPHigh Potency -> Inc ESP, less anti-cholingeric
PK: erratic absorp, high Vd (lipid high ProBind), cross placenta/milk, 2D6/3A4 meta (not ind)
DDI: Inh 2D6 -> Inc SSRI/TCA
ADE: acute dystonia, akathesia, parkinsonian, neuroleptic malignant syndrome, perioral tremor, tardive dyskinesia

61
Q

Amantadine [Endantadine]

A

Use w/ Parkinsonian in Neuroleptic Malignant Syndrome

MoA: ? dopamine agonist

62
Q

Dantrolene [Dantrium]

A

Muscle Relaxer

Use: Neuroleptic Malignant Syndrome + Malignant Hyperthermia

63
Q

Physostigmine

A

Reversible Cholinesterase Inhibitor

Use: Anti-Cholinergic Poisoning

64
Q

Bromocriptine [Cycloset]

A

Dopamine Agonist

Use: Neuroleptic Malignant Syndrome

65
Q

Cyproheptadine

A

5HT and Histamine Antagonist

Use: Serotonin Syndrome

66
Q

Acamprosate [Campral]

A

Alcohol Dependence

MoA: modify EtOH metabolism and VTA/NA reward response

67
Q

Disulfiram [Antabuse]

A

Inh Acetaldehyde Dehydrogenase
Use: promote alcohol sobriety
Accumulation of Acetaldehyde -> discomfort + possible reinforcement of alcohol seeking behaviorN/V + skin flushing (*Asian Polymorph)
Disulfiram-Like: sulfonylureas, Cefotetan, Ketoconazole, Procarbazine, Metronidazole

68
Q

Ethanol

A

BAL: 400 (coma, resp insuff, death)
PK: liver ZERO order
1. alcohol dehydrogenase -> acetaldehyde -> 2. acetaldehyde dehydrogenase -> acetate
ADE: CNS depression, acetominophen toxic (2E1), bleeding (w/ NSAIDs), Fetal Alcohol Syndrome, Wernicke-Korsakoff (B1 def.), anemia (B12 def.), etc.

69
Q

Ethylene Glycol

A

Alcohol Dehydrogenase -> acidosis + nephrotoxic

Tx: Fomepizole or Alcohol

70
Q

Methanol

A

Alcohol Dehydrogenase -> acidosis + retinal damage

Tx: Fomepizole or Alcohol

71
Q

Fomepizole [Antizol]

A

Inh Alcohol Dehydrogenase

Use: ethylene glycol or methanol toxicity

72
Q

Thiamine [Vit B1]

A

Deficient in chronic alcoholics -> metabolism dysfunction + Wernicke-Korsakoff Encephalopathy
1st Thiamine + 2nd Glucose (otherwise encephalopathy worse)

73
Q

Benadryl

A

1st Gen Anti-His + Anti-Cholinergic

74
Q

Ginseng

A

Can Cause Serotonin Syndrome

75
Q

LSD

A

?

76
Q

Naltrexone

A

Opiate Antagonist

Use: opiate OD, minimize addiction

77
Q

Sumatriptan

A

TriptanCan cause Serotonin Syndrome

Do NOT combine with other drugs that can also cause

78
Q

Pentobarbital

A

Barbituate

79
Q

Pyridoxine [Vit B6]

A

Required for synthesis of monoamines

Psych Pharm (8 decks)

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