Neuro/Psych Pharm Flashcards
Latanoprost (mechanism, use, toxicity)
PGF2 analog that increases the outflow of aqueous humor; can cause darkening of the iris Pharmacology Neurology
Morphine, fentanyl, cofeine, heroin, methadone, meperidine, dextromethorphan, diphenoxylate (mechanism, use, toxicity)
Mu opioid agonists that open K channels and close Ca channels, inhibting synaptic transmission; addiction, respiratory depression, constipation, miosis Pharmacology Neurology
Butorphanol (mechanism, use, toxicity)
Mu opioid partial agonist; used to treat severe pain; causes withdrawal if being treated with full agonist Pharmacology Neurology
Tramadol (mechanism, use, toxicity)
Weak opioid agonist that inhibits serotonin and NE reuptake; increases risk for seizures Pharmacology Neurology
First-line therapy for simple partial seizures
Carbamazepine Pharmacology Neurology
First-line therapy for complex partial seizures
Carbamazepine Pharmacology Neurology
First-line therapies for tonic-clonic seizures (3)
Carbamazepine, phenytoin, valproate Pharmacology Neurology
First-line therapy for absence seizures
Ethosuximide Pharmacology Neurology
Phenytoin (mechanism, use, toxicity)
Increases Na channel inactivation and inhibits glutamate release; used for simple, complex, and tonic-clonic seizures and status epilecticus prophylaxis; nystagmus, gingival hyperplasia, hirsutism, megaloblastic anemia, teratogenic, drug-induced lupus, P450 inducer Pharmacology Neurology
Carbamazepine (mechanism, use, toxicity)
Increases Na channel inactivation; first-line for simple, complex, and tonic-clonic seizures and trigeminal neuralgia; agranulocytosis, aplastic anemia, P450 inducer, SIADH, liver toxicity Pharmacology Neurology
Lamotrigine (mechanism, use, toxicity)
Blocks Na channels; used for simple, complex, and tonic-clonic seizures; Steven-Johnson syndrome Pharmacology Neurology
Gabapentin (mechanism, use, toxicity)
Inhibits Ca channels; used for simple, complex, and tonic-clonic seizures, migraine prophylaxis, peripheral neuropathy, bipolar disorder; ataxia Pharmacology Neurology
Topiramate (mechanism, use, toxicity)
Blocks Na channels and increases GABA secretion; used for simple, complex, and tonic-clonic seizures and migraine prevention; mental dulling, kidney stones, weight loss Pharmacology Neurology
Phenobarbital (mechanism, use, toxicity)
Increases GABA channel action; first-line for simple, complex, and tonic-clonic seizures in children; P450 inducer Pharmacology Neurology
Valproate (mechanism, use, toxicity)
Increases Na channel inactivation and increases GABA levels; first-line for tonic-clonic seizures, used for simplex, complex, tonic-clonic, and myoclonic seizures; hepatotoxicity, neural tube defects, weight gain, tremor Pharmacology Neurology
Ethosuximide (mechanism, use, toxicity)
Blocks thalamic Ca channels; first-line for absence seizures; GI distress, Steven-Johnson syndrome Pharmacology Neurology
Benzodiazepines (mechanism, use, toxicity)
Increases frequency of GABA channel opening; first-line for status epilepticus (diazepam, lorazepam), used for eclampsia seizures (diazepam, lorazepam), anxiety, alcohol withdrawl, sleep walking, night terrors; sedation Pharmacology Neurology
Tiagabine (mechanism, use, toxicity)
Inhibits GABA reuptake; used for simple and complex seizures Pharmacology Neurology
Vigabatrin (mechanism, use, toxicity)
Irreversibly inhibits GABA transaminase, increasing GABA concentration; used for simple and complex seizures Pharmacology Neurology
Levetriacetam (mechanism, use, toxicity)
Unknown mechanism; used for simple, complex, and tonic-clonic seizures Pharmacology Neurology
Phenobarbital, pentobarbial, thiopental, secobarbital (mechanism, use, toxicity)
Increase duration of GABA channel opening; induction of anesthesia, sedative; CNS depression, P450 inducer, contraindicated in patients with porphyrias Pharmacology Neurology
Triazolam, oxazepam, midazolam (mechanism, use, toxicity)
Short-acting benzodiazepines; more addictive potential Pharmacology Neurology
Barbituates vs. benzodiazepines (mechanism)
Increase duration vs. increase frequency Pharmacology Neurology
Zolpidem, zaleplon, eszopiclone (mechanism, use, toxicity)
BZ1 subtype GABA channel agonists; used to treat insomnia Pharmacology Neurology
Ketamine (mechanism, use, toxicity)
Blocks NMDA receptor; used as an anesthetic; increases cardiac activity, hallucinations, bad dreams Pharmacology Neurology
Order of sensory loss when using local anesthetics
Pain -> temperature -> touch -> pressure Pharmacology Neurology
Succinylcholine (mechanism, use, toxicity)
ACh receptor agonist, produces sustained depolarization and desensitization; used as a paralytic; hypercalcemia, hyperkalemia, malignant hyperthermia Pharmacology Neurology
Tubocurarine, -curium drugs (mechanism, use, toxicity)
ACh antagonists; used as paralytics Pharmacology Neurology
Dantrolene (mechanism, use, toxicity)
Inhibits release of Ca from sarcoplasmic reticulum and skeletal muscle; used to treat malignant hyperthermia and neuroleptic-malignant syndrome Pharmacology Neurology
Levodopa/carbidopa (mechanism, use, toxicity)
Converted to dopamine by dopa decarboxylase in CNS/inhibits peripheral dopa decarboxylase activity; used to treat parkinson symptoms; can cause arrhythmias and “on/off” phenomenon Pharmacology Neurology
Selegiline (mechanism, use, toxicity)
MAO-B (prefers dopamine for breakdown) inhibitor, inhibits dopamine breakdown; used to treat parkinson symptoms; enhances adverse effects of levodopa Pharmacology Neurology
Donepezil, galantamine, rivastigmine (mechanism, use, toxicity)
ACh esterase inhibitors; used to treat Alzheimer’s disease; cholinergic symptoms Pharmacology Neurology
Sumatriptan (mechanism, use, toxicity)
Agonist at 1B/1D serotonin receptors; used to treat acute migraines and cluster headaches; coronary vasospasm Pharmacology Neurology
Trifluoperzine, fluphenazine, haloperidol (mechanism, use, toxicity)
High potency antipsychotics that antagonize D2 receptors; used to treat schizoprehnia, psychosis, mania, and Tourette’s; hyperprolactinemia, anti-cholinergic symptoms (dry mouth, constipation), extrapyramidal effects (dyskinesia), neuroleptic malignany syndrome, tardive dyskinesia (haloperidol) Pharmacology Psychiatry
Chlorpromazine, thioridazine (mechanism, use, toxicity)
Low potency antipsychotics that antagonize D2 receptors; used to treat schizophrenia, psychosis, mania, and Tourette’s; corneal deposits (chlorpromazine), retinal desporits (thioridazine) Pharmacology Psychiatry
Olanzapine, clozapine, quetiapine, risperidone, aripripazole, ziprasidone (mechanism, use, toxicity)
Atypical antipsychotics with unknown mechnism; used for schizophrenia, bipolar disorder, OCD, and others; weight gain (olanzapine, clozapine), agranulocytosis (clozapine), seizures (clozapine), prolonged QT (ziprasidone) Pharmacology Psychiatry
Lithium (mechanism, use, toxicity)
Unknown mechanism; used for bipolar disorder and SIADH; tremor, sedation, edema, hypothyroidism, polyuria Pharmacology Psychiatry
Buspirone (mechanism, use, toxicity)
Agonizes 1A serotonin receptors; used for generalized anxiety disorder; no side effects, but takes 1-2 weeks for improvement Pharmacology Psychiatry
Fluoxetine, paroxetine, sertraline, citalopram (mechanism, use, toxicity)
Block reuptake of serotonin from the synaptic cleft; depression and others; sexual dysfunction, sertonin syndrome (hyperthermia, myoclonus, flushing, diarrhea, seizures) Pharmacology Psychiatry
Venlafaxine, duloxetine (mechanism, use, toxicity)
Block reuptake of NE and serotonin from synaptic cleft; depression, diabetic neuropathy (duloxetine); hypertension Pharmacology Psychiatry
-iptyline, -ipramine, doxepin, amoxapine (mechanism, use, toxicity)
TCAs, block reuptake of NE and serotonin; depression, bewetting (imipramine), OCD (clomipramine); convulsions, coma, arrhythmias, sedation, hypotension, anti-cholinergic effects Pharmacology Psychiatry
Tranylcypromine, phenelzine, isocarboxazid, selegiline (mechanism, use, toxicity)
Inhibit breakdown of NE, serotonin, and dopamine; used for atypical depression, anxiety, and hypochondriasis; hypertensive crisis (tyramine in wine/cheese), don’t use with other serotonin agonists Pharmacology Psychiatry
Bupropion (mechanism, use, toxicity)
Increases NE and dopamine; used for smoking sensation, depression; seizures Pharmacology Psychiatry
Mirtazapine (mechanism, use, toxicity)
Alpha-2 antagonist, increases NE and serotonin release, and serotonin receptor agonist; used for depression; sedation, increased appetite with weight gain; Pharmacology Psychiatry
Maprotiline (mechanism, use, toxicity)
Blocks NE reuptake; used for depression; sedation, hypotension Pharmacology Psychiatry
Trazodone (mechanism, use, toxicity)
Inhibits serotonin uptake; used for insomnia; pripism Pharmacology Psychiatry
