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pharm drugs > Neuro part 4 > Flashcards

Neuro part 4 Flashcards

1
Q

Depression diagnosis

A

Presence of 2 or more symptoms affecting energy level, sleep, appetite, self-esteem, concentration, and decision-making

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2
Q

Depression two categories

A

Major depressive disorder- 2 or more weeks

Dysthymic disorder- more than 2 months

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3
Q

causes for depression

A

Deficiency or imbalance of monamines
Receptor downregulation and changes in sensitivity

Neurohistological changes

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4
Q

mechanisms of antidepresants

A

Block reuptake of serotonin or norepinephrine
Block receptors that shut off the release of monamines
increase release of norepinephrine release

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5
Q

Serotonin syndrome

A

accumulation of high levels of serotonin

hyperthermia, dramatic swings in HR/BP, truncal rigidity that progress to respiratory failure

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6
Q

General Monitoring and risk with antidepressants

A

Monitor DDI- interactions due to CYP450 metabolism, anticholinergic effects
tapered to avoid withdrawal symptoms
serotonin syndrome
increased risk of suicidality in patients <24 years

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7
Q

escitalopram (Lexapro), sertraline (Zoloft)- Class, MOA, AE

A

SSRI
MOA: inhibit reuptake of 5-HT in CNS
Less anticholinergic and cardiovascular effects than other classes
Common AE: HA, N/V/D, insomnia, sexual side effects

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8
Q

Venlafaxine (Effexor), duloxetine (Cymbalta) class, MOA, AE

A

SNRI
MOA: inhibit reuptake of 5-HT and NE in CNS
Common AE: HA, nausea, sweating, sexual dysfunction, insomnia

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9
Q

Bupropion (Wellbutrin) MOA, AE

A

MOA: inhibits NE and DA reuptake

Common AE: HA, nausea, significant insomnia, tremor, dry mouth, ↓ appetite
Risk of seizures, especially at high doses or with electrolyte abnormalities

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10
Q

when is SNRI 1st line

A

concomitant neuropathic pain or fibromyalgia

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11
Q

TCA MOA

A

Inhibit the reuptake of serotonin and NE

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12
Q

TCA AE

A

Common AE: weight gain, sexual dysfunction, sedation (histamine receptors), anticholinergic effects (muscarinic receptors), hypotension/dizziness (alpha receptors)

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13
Q

when should most SSRI be taken?

A

morning

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14
Q

taking Bupropion (Wellbutrin) is at risk

A

Risk of seizures, especially at high doses or with electrolyte abnormalities

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15
Q

Common AE with antidepressant

A

HA, GI upset, sexual dysfunction, insomnia, BP issues

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16
Q

Therapeutic Concerns with Antidepressants

A

Monitor BP and HR (arrhythmia)
TCAs and SSRIs may cause tremor
AE such as sedation and decreased alertness may hinder participation in PT

17
Q

treatment for anxiety

A

SRI and SNRIs = common first line treatment
Can be used for long-term maintenance
Propranolol
Buspirone = maintenance in generalized anxiety

18
Q

Alprazolam (Xanax) Class, MOA, AE

A

Benzodiazepines
Basic MOA: binds BZD receptors on GABA channels to enhance GABA inhibitory effects
Common AE: sedation, ataxia, memory problems

19
Q

Alprazolam (Xanax) uses and how to take it

A

use for acute anxiety or short-term while waiting on matintence med
avoid taking it for maintance because of dependence
If taking long-term must taper to avoid rebound and withdrawal

20
Q

Buspirone (Buspar)

A

to bind to 5-HT1a, 5-HT2 and dopamine receptors

21
Q

Buspirone (Buspar) advantage

A

No risk of abuse

No physiologic dependence or withdrawal

22
Q

Buspirone (Buspar) advantage disadvantage

A

dizziness

Metabolized by CYP3A4 = potential DDI

23
Q

Therapeutic Concerns with Anxiolytics

A

Older adults + benzodiazepine = increased fall risk
Benzodiazepines also disturb the sleep cycle
Sedative effect

24
Q

Schizophrenia causes

A

diminished dopamine activity

Reduced prefrontal bloodflow during cognitive tasks

25
Q

Drug treatment for schizophrina

A

antipsycotics

FGA and SGA (1st line b/c less EPS and TD)

26
Q

FGA MOA, AE

A

D2 receptor block in other areas contribute to EPS

EPS is acute (parkinsonism, akathisia and dystonic reaction) or delayed (TD, sometimes irreversible

27
Q

Quetiapine (Seroquel) Class, MOA, AE

A

SGA
MOA: block D2 receptors but less than FGA; more affinity for 5-HT2
Higher risk of metabolic dysfunction (glucose and lipid abnormalities, weight gain) – monitor for new onset dyslipidemia, diabetes

28
Q

Rehab Concerns: FGA Agents

A

Patient at risk for cardiac abnormalities
impaired thermoregulation
EPS

29
Q

Rehab Concerns: SGA Agents

A

Produce significant weight gain, hyperglycemia, and lipid abnormalities
Increased risk for cardiac abnormalities
Increased risk for heat intolerance

30
Q

Pathogenesis of bipolar disorder

A

dysregulation in dopamine and serotonin systems

31
Q

Lithium uses

A

acute manic episode

Maintenance treatment

32
Q

Acute depressive episode treatment for bipolar

A

SSRI and bupropion

33
Q

Lithium AE

A

Refer if s/sx of toxicity: persistent diarrhea, vomiting, coarse tremor, mild ataxia, drowsiness, muscular weakness

pharm drugs (10 decks)

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