Neuro/Psych Pharm Flashcards

1
Q

Latanoprost (mechanism, use, toxicity)

A

PGF2 analog that increases the outflow of aqueous humor; can cause darkening of the iris Pharmacology Neurology

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1
Q

Morphine, fentanyl, cofeine, heroin, methadone, meperidine, dextromethorphan, diphenoxylate (mechanism, use, toxicity)

A

Mu opioid agonists that open K channels and close Ca channels, inhibting synaptic transmission; addiction, respiratory depression, constipation, miosis Pharmacology Neurology

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2
Q

Butorphanol (mechanism, use, toxicity)

A

Mu opioid partial agonist; used to treat severe pain; causes withdrawal if being treated with full agonist Pharmacology Neurology

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3
Q

Tramadol (mechanism, use, toxicity)

A

Weak opioid agonist that inhibits serotonin and NE reuptake; increases risk for seizures Pharmacology Neurology

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4
Q

First-line therapy for simple partial seizures

A

Carbamazepine Pharmacology Neurology

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5
Q

First-line therapy for complex partial seizures

A

Carbamazepine Pharmacology Neurology

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6
Q

First-line therapies for tonic-clonic seizures (3)

A

Carbamazepine, phenytoin, valproate Pharmacology Neurology

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7
Q

First-line therapy for absence seizures

A

Ethosuximide Pharmacology Neurology

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8
Q

Phenytoin (mechanism, use, toxicity)

A

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

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9
Q

Carbamazepine (mechanism, use, toxicity)

A

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

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10
Q

Lamotrigine (mechanism, use, toxicity)

A

Blocks Na channels; used for simple, complex, and tonic-clonic seizures; Steven-Johnson syndrome Pharmacology Neurology

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11
Q

Gabapentin (mechanism, use, toxicity)

A

Inhibits Ca channels; used for simple, complex, and tonic-clonic seizures, migraine prophylaxis, peripheral neuropathy, bipolar disorder; ataxia Pharmacology Neurology

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12
Q

Topiramate (mechanism, use, toxicity)

A

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

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13
Q

Phenobarbital (mechanism, use, toxicity)

A

Increases GABA channel action; first-line for simple, complex, and tonic-clonic seizures in children; P450 inducer Pharmacology Neurology

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14
Q

Valproate (mechanism, use, toxicity)

A

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

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15
Q

Ethosuximide (mechanism, use, toxicity)

A

Blocks thalamic Ca channels; first-line for absence seizures; GI distress, Steven-Johnson syndrome Pharmacology Neurology

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16
Q

Benzodiazepines (mechanism, use, toxicity)

A

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

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17
Q

Tiagabine (mechanism, use, toxicity)

A

Inhibits GABA reuptake; used for simple and complex seizures Pharmacology Neurology

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18
Q

Vigabatrin (mechanism, use, toxicity)

A

Irreversibly inhibits GABA transaminase, increasing GABA concentration; used for simple and complex seizures Pharmacology Neurology

19
Q

Levetriacetam (mechanism, use, toxicity)

A

Unknown mechanism; used for simple, complex, and tonic-clonic seizures Pharmacology Neurology

20
Q

Phenobarbital, pentobarbial, thiopental, secobarbital (mechanism, use, toxicity)

A

Increase duration of GABA channel opening; induction of anesthesia, sedative; CNS depression, P450 inducer, contraindicated in patients with porphyrias Pharmacology Neurology

21
Q

Triazolam, oxazepam, midazolam (mechanism, use, toxicity)

A

Short-acting benzodiazepines; more addictive potential Pharmacology Neurology

22
Q

Barbituates vs. benzodiazepines (mechanism)

A

Increase duration vs. increase frequency Pharmacology Neurology

23
Q

Zolpidem, zaleplon, eszopiclone (mechanism, use, toxicity)

A

BZ1 subtype GABA channel agonists; used to treat insomnia Pharmacology Neurology

24
Q

Ketamine (mechanism, use, toxicity)

A

Blocks NMDA receptor; used as an anesthetic; increases cardiac activity, hallucinations, bad dreams Pharmacology Neurology

25
Q

Order of sensory loss when using local anesthetics

A

Pain -> temperature -> touch -> pressure Pharmacology Neurology

26
Q

Succinylcholine (mechanism, use, toxicity)

A

ACh receptor agonist, produces sustained depolarization and desensitization; used as a paralytic; hypercalcemia, hyperkalemia, malignant hyperthermia Pharmacology Neurology

27
Q

Tubocurarine, -curium drugs (mechanism, use, toxicity)

A

ACh antagonists; used as paralytics Pharmacology Neurology

28
Q

Dantrolene (mechanism, use, toxicity)

A

Inhibits release of Ca from sarcoplasmic reticulum and skeletal muscle; used to treat malignant hyperthermia and neuroleptic-malignant syndrome Pharmacology Neurology

29
Q

Levodopa/carbidopa (mechanism, use, toxicity)

A

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

30
Q

Selegiline (mechanism, use, toxicity)

A

MAO-B (prefers dopamine for breakdown) inhibitor, inhibits dopamine breakdown; used to treat parkinson symptoms; enhances adverse effects of levodopa Pharmacology Neurology

31
Q

Donepezil, galantamine, rivastigmine (mechanism, use, toxicity)

A

ACh esterase inhibitors; used to treat Alzheimer’s disease; cholinergic symptoms Pharmacology Neurology

32
Q

Sumatriptan (mechanism, use, toxicity)

A

Agonist at 1B/1D serotonin receptors; used to treat acute migraines and cluster headaches; coronary vasospasm Pharmacology Neurology

33
Q

Trifluoperzine, fluphenazine, haloperidol (mechanism, use, toxicity)

A

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

34
Q

Chlorpromazine, thioridazine (mechanism, use, toxicity)

A

Low potency antipsychotics that antagonize D2 receptors; used to treat schizophrenia, psychosis, mania, and Tourette’s; corneal deposits (chlorpromazine), retinal desporits (thioridazine) Pharmacology Psychiatry

35
Q

Olanzapine, clozapine, quetiapine, risperidone, aripripazole, ziprasidone (mechanism, use, toxicity)

A

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

36
Q

Lithium (mechanism, use, toxicity)

A

Unknown mechanism; used for bipolar disorder and SIADH; tremor, sedation, edema, hypothyroidism, polyuria Pharmacology Psychiatry

37
Q

Buspirone (mechanism, use, toxicity)

A

Agonizes 1A serotonin receptors; used for generalized anxiety disorder; no side effects, but takes 1-2 weeks for improvement Pharmacology Psychiatry

38
Q

Fluoxetine, paroxetine, sertraline, citalopram (mechanism, use, toxicity)

A

Block reuptake of serotonin from the synaptic cleft; depression and others; sexual dysfunction, sertonin syndrome (hyperthermia, myoclonus, flushing, diarrhea, seizures) Pharmacology Psychiatry

39
Q

Venlafaxine, duloxetine (mechanism, use, toxicity)

A

Block reuptake of NE and serotonin from synaptic cleft; depression, diabetic neuropathy (duloxetine); hypertension Pharmacology Psychiatry

40
Q

-iptyline, -ipramine, doxepin, amoxapine (mechanism, use, toxicity)

A

TCAs, block reuptake of NE and serotonin; depression, bewetting (imipramine), OCD (clomipramine); convulsions, coma, arrhythmias, sedation, hypotension, anti-cholinergic effects Pharmacology Psychiatry

41
Q

Tranylcypromine, phenelzine, isocarboxazid, selegiline (mechanism, use, toxicity)

A

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

42
Q

Bupropion (mechanism, use, toxicity)

A

Increases NE and dopamine; used for smoking sensation, depression; seizures Pharmacology Psychiatry

43
Q

Mirtazapine (mechanism, use, toxicity)

A

Alpha-2 antagonist, increases NE and serotonin release, and serotonin receptor agonist; used for depression; sedation, increased appetite with weight gain; Pharmacology Psychiatry

44
Q

Maprotiline (mechanism, use, toxicity)

A

Blocks NE reuptake; used for depression; sedation, hypotension Pharmacology Psychiatry

45
Q

Trazodone (mechanism, use, toxicity)

A

Inhibits serotonin uptake; used for insomnia; pripism Pharmacology Psychiatry