MOAs for Test 4 Flashcards

1
Q
(Lecture 1)
This class of drugs blocks the reuptake of norepinephrine and serotonin (precursors to SNRI) into the presynaptic neuron which increases [monoamine] in the synaptic cleft (debated); also blocks alpha adrenergic, histamine, and muscarinic receptors.
A

Tricyclic Antidepressants

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

(Lecture 1)
This drug class Inhibits serotonin reuptake, without affecting reuptake of norepinephrine or dopamine into the presynaptic neuron;
they DO NOT SIGNIFICANTLY EFFECT histamine, muscarinic, or other receptors

A

SSRIs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

(Lecture 1)

These drugs/classes carry a risk of serotonin syndrome because they INHIBIT SEROTONIN REUPTAKE

A
  • Cocaine
  • Dextromethorphan (DM)
  • Meperidine
  • SSRIs
  • TCAs
  • Trazodone
  • Venlafaxine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q
(Lecture 1)
This drug/class carries a risk of serotonin syndrome because it is a DOPAMINE AGONIST
A

L- dopamine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q
(Lecture 1)
This drug/class carries a risk of serotonin syndrome because it is a SEROTONIN PRECURSOR
A

L-tryptophan

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q
(Lecture 1)
These drug/class carries a risk of serotonin syndrome because it INHIBITS SEROTONIN METABOLISM
A

MAOIs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

(Lecture 1)

These drugs/classes carry a risk of serotonin syndrome because they INCREASE SEROTONIN RELEASE

A
  • Amphetimines
  • Lithium
  • MDMA (ecstacy)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

(Lecture 1)

These drugs/classes carry a risk of serotonin syndrome because they are SEROTONIN RECEPTOR AGONISTS

A
  • Triptans
  • Buspirone
  • Lysergic Acid Diethylamide
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

(Lecture 1)
This drug class inhibits the reuptake of 5HT and NE, increasing their levels (may be dose-related);
it displays LITTLE activity for alpha-adrenergic, cholinergic, or histamine receptors

A

SNRIs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

(Lecture 1)

This drug inhibits dopamine AND Norepinephrine (at high doses) with minimal activity on serotonin

A

Bupropion (an NDRI)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

(Lecture 1)
This drug modestly inhibits serotonin uptake (less than SSRIs); are antagonist for pre-synaptic 5HT(2A), H(1), and alpha(1) receptors

A

Trazodone

a serotonin receptor antagonist

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

(Lecture 1)
This drug inhibits 5HT(2A), H(1), and alpha(1) receptors AND ALPHA 2 receptors, but does not have reuptake inhibition effect.

A

Mirtazapine

a serotonin Receptor Antagonist

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

(Lecture 1)

This drug inhibits 5HT(2) family of receptors, alpha(1) receptors, and reuptake of serotonin and norepinephrine

A

Nefazodone

a serotonin receptor antagonist

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q
(Lecture 1)
This drug class blocks the enzyme responsible for the breakdown of NE, dopamine, and serotonin which increases the stores of these neurotransmitters in the neurons
A

MAOIs

Two forms: MAO-A, MAO-B

Foods that interact with these medications occur because they inhibit MAO in the GI tract that normally breaks down tyramine, resulting in increased levels of catecholamines.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

(Lecture 1)

These drugs are non-selective MAOIs which are considered last line agents in antidepression

A

Phenelzine

Tranylcypromine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

(Lecture 1)
This MAO-B INHIBITOR is used in the treatment of MDD (and Parkinson’s) and claims to exhibit longer time to relapse and less sexual dysfunction and weight gain

A

Selegiline Transdermal System

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

(Lecture 1)
The MOA of this drug is unknown, but may inhibit 2 signal transduction pathways; it is used in the tx of the manic phase for bi-polar patients and anti-manic effects can occur in 1-2 weeks; it appears to be neuroprotective.

A

Lithium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q
(Lecture 2)
This drug class acts directly on postsynaptic dopamine receptors and do not require enzymatic conversion. Specifically, D2 receptor stimulation improves rigidity and bradykinesia in Parkinson's
A

Dopamine agonists

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

(Lecture 2)

This short-acting dopamine agonist stimulates post-synaptic D2-type receptors

A

Apomorphine

Will probably cause severe N/V… prophylax with trimethobenzamide

20
Q

(Lecture 2)
This Aromatic L-amino Acid Decarboxylase (AAAD) inhibitor DOES NOT CROSS THE BBB; prevents peripheral conversion and metabolism of levopdopa to dopamine in the peripheral tissues, thereby allowing increased availability of levodopa to cross into the CNS

A

Carbidopa

21
Q

(Lecture 2)
This precursor to dopamine HAS THE ABILITY TO CROSS THE BBB and replenish depleted dopamine in the brain; it is CONVERTED TO DOPAMINE IN THE PERIPHERY

A

Levodopa

22
Q

(Lecture 2)
This drug irreversibly inhibits the metabolism of dopamine by MAO-B (ONLY!! -> lower risk of HTN CRISIS) which results in increased dopamine levels in the brain

A

Selegiline

LAST DOSE SOULD BE EARLY AFTERNOON TO PREVENT INSOMNIA

23
Q

(Lecture 2)
This MAOI has not yet had selectivity for MAO-B definitively established, but provides sx relief to PTs suffering from Parkinson’s and has possible neuroprotective effects

A

Rosagiline

  • 5X MORE POTENT THAN SELEGILINE
  • NOT METABOLIZED TO AMPHETAMINE
  • HTN CRISIS POTENTIAL needs ADDITIONAL TESTING
  • DO NOT take with TYRAMINE-containing foods
24
Q

(Lecture 2) This class of drugs blocks the excitatory neurotransmitter ACTH to try and restore balance with dopamine

A

Anticholinergics

EX: Benzatropine; Trihexyphenidyl

25
Q

(Lecture 2)
This NMDA Receptor Inhibitor’s MOA is not completely understood, does not work if dopamine release is already at maximum and has an adverse risk of LIVEDO RETICULARIS

A

Amantadine

26
Q
(Lecture 2)
This class of drug prevents the dreakdown of dopamine, leaving more levodopa available to cross the BBB
A

COMT Inhibitors

EX: Tolcapone, Entacapone, Stalevo

27
Q

(Lecture 3)
These drugs work by blocking/preventing the spead of electrical discharge by one of several mechanisms:
- Enhancement of GABAnergic transmission
-Diminution of excitatory transmission
-Modification of ionic conductance through ion channels

A

Anticonvulsants

28
Q

(Lecture 3)

This drug is a fast sodium channel blocker used as part of Tx in status epilepticus; DO NOT USE in absence seizures

A

Phenytoin

PREGNANCY CAT D

29
Q

(Lecture 3)
This drug is also a fast sodium blocker and is the PRODRUG for another drug with a similar name and is preferred when parenteral administration is needed

A

Fosphenitoin

1mg PHENYTOIN = 1.5mg FOSPHENYTOIN

30
Q

(Lecture 3)
This drug is a fast sodium channel blocker, a CYP3A4 INDUCER and AUTO-INDUCER, used to tx primary gen. tonic-clonic simple, or complex partial seizures as well as TGN and bipolar disease

A

Carbamazepine

31
Q

(Lecture 3)
This drug is a fast sodium channel blocker, is a CYP inducer, and used similarly to carbamazepine (but less potent) and reserved for PTs who do not tolerate it well

A

Oxcarbazepine

32
Q

(Lecture 3)

This drug’s MOA is to increase GABA mediated chloride influx (inhibitory neurons)

A

Primidone

-IS METABOLIZED TO PHENOBARBITAL AND PHENYLETHYLMALONAMIDE

(Phenobarbital has the same basic MOA)

33
Q

(Lecture 3)
This drug and its derivatives block t-type CALCIUM currents, blocks SODIUM channels, INCREASES GABA PRODUCTION and DECREASES GABA DEGRADATION

A

Valproic acid

34
Q

(Lecture 3)
This drug inhibits the a2delta subunit of voltage-dependent ALCIUM channels and is an analog of GABA, but does not directly impact the GABA receptor

A

Gabapentin

ADEs include DROWSINESS, FATIGUE, DIZZINESS, and WEIGHT GAIN

35
Q

(Lecture 3)
This drug is a GABA derivative similar to Gabapentin that binds pre-synaptically to the a2deltasubunit of the voltage-gated calcium channel AND BLOCKS INFLUX OF Ca2+ IN HYPER-EXCITED NEURONS

A

Pregabalin

ADEs include DIZZINESS and WEIGHT GAIN

36
Q

(Lecture 3)
The way this drug is used is mostly unknown, but is thought to block T-type calcium channels; it is the DOC in absence seizures.

A

Ethosuximide

37
Q

(Lecture 3)
This drug acts by decreasing glutamate and aspartate release, delays repetitive firing of neurons, and blocks fast sodium channels

A

Lamotrigine

38
Q

(Lecture 3)
This drug acts by blocking fast sodium channels, enhancing GABA activity, antagonizing AMPA/kainate activity, and is a weak carbonic anhydrase inhibitor

A

Topiramate

39
Q

(Lecture 3)
This drug binds at voltage gated POTASSIUM CHANNELS and may also exert therapeutic effects through augmentation of GABA-MEDIATED CURRENTS

A

Ezogabine

ADEs include URINARY RETENTION, UTI, QT PROLONGATION, PSYCHOSIS, RETINAL ABNORMALITIES and VISION LOSS (req. periodic vision tests), and SKIN DISCOLORATION

40
Q

(Lecture 3)

This drug works by ENHANCING THE SLOW INACTIVATION OF SODIUM CHANNELS

A

Lacosamide

ADEs include Prolonged PR INTERVAL, AV BLOCKS, MULTIORGAN HYPERSENSITIVITY, NEUTROPENIA

41
Q

(Lecture 3)

This drug IRREVERSIBLY INHIBITS GABA-T and is a MONOTHERAPY FOR INFANTILE SPASMS

A

Vigabactrin

ADEs include VISION LOSS (needs periodic vision testing); RESTRICTED DISTRIBUTION PROGRAM, MRI ABNORMALITIES, DEPRESSION, and WEIGHT GAIN

42
Q

(Lecture 3)

This drug works at BOTH SODIUM AND CALCIUM CHANNELS, is used in the tx of BIPOLAR D/O, and is a SULFONAMIDE

A

Zonisamide

ADEs include RASH, SJS/TEN, APLASTIC ANEMIA, AGRANULOCYTOSIS, NEPHROLITHIASIS

CHILDREN MAY ALSO HAVE FEVER AND HYPERHIDROSIS when using it

43
Q

(Lecture 3)

This drug has WEAK INHIBITORY EFFECTS ON GABA-RECEPTOR BINDING, benzo receptor binding, is a adjunct for Lennox Gastaut

A

Felbamate

ADEs include APLASTIC ANEMIA, LIVER FAILURE

44
Q

(Lecture 3)
This drug ENHANCES THE ACTIVITY OF GABA and is an ADJUNCTIVE therapy for partial seizures, but has a potential ADE of NONCONVULSIVE STATUS EPILEPTICUS

A

Tiagabine

Other ADEs include SJS/TEN

45
Q

(Lecture 3)
This drug is used in the tx of Eclampsia; possibly works by potent cerebral vasodilator properties which reduce the chance of seizures caused by vasospasm decreasing cerebral blood flow

A

MAGNESIUM SULFATE