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Neuromodulators Flashcards

1
Q

indication: anxiety, panic disorder

dosing (1/4, 1/2, 1, 2, mg) - 1 tab tid

A

alprazolam

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2
Q

Selectively binds to GABA-A-BZD receptors, thereby enhancing GABA effects

A

alprazolam (benzodiazepine anxiolytic)

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3
Q

gaba pathways are?

A

inhibitory

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4
Q

competitive drug

A

drug is competing for same binding site as the endogenous substrate (ex: gaba receptor: gaba)

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5
Q

is benzodiazepine competitive?

A

no, it binds to a different site than gaba

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6
Q

benzodiazepine + alcohol =

A

deadly! because they bind the same receptor

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7
Q
  • Common:diplopia,drowsiness, anterograde amnesia,confusion,dizziness,hypotension
  • Hypersensitivity:StevensJohnson Syndrome, angioedema
A

alprazolam

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8
Q
  • Common: diplopia,drowsiness, anterograde amnesia,confusion,dizziness,hypotension
  • Hypersensitivity: Stevens Johnson Syndrome, angioedema
A

alprazolam

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9
Q
  • Cyclosporine, Azoles, and Erythromycins: Reduce this drugs metabolism
  • Chlorpheniramine, Diphenhydramine, Opioids –> Additive
A

alprazolam

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10
Q

CONTRAINDICATIONS/CAUTIONS

• Unstable Myasthenia Gravis

A

alprazolam

*can cause double vision; mg has dysfunctional acetycholine pathway

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11
Q

zolpidem (ambien), eszopiclone (lunesta), zaleplon (sonata)

A

non-benzodiazepine

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12
Q

• INDICATION: Insomnia
• DOSING[5/10mg] • 1 tab qhs


A

zolpidem

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13
Q

• CLINICAL PHARMACOLOGY– Non WBZD Sedative Hypnotic
• Mechanism of Action
– Selective agonist ofG ABAAWBZD-1 receptor

A

zolpidem

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14
Q

ADVERSE EFFECTS
• Common:headache,sinusitis, pharyngitis
• CNS:amnesia, suicidal ideation, aggression,hallucinations

A

zolpidem

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15
Q

not as dangerous as other benzadiazepine drugs

A

zolpidem

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16
Q

DRUG INTERACTIONS
• Cyclosporine, AzoleAntifungals: Reduced#metabolism#of#Zolpidem#
• Classic#An:histaminics,#Opioids:# Addi:ve#

A

zolpidem

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17
Q

DRUG INTERACTIONS
• Cyclosporine, Azole, Antifungals: Reduced metabolism of drug
• Classic Antihistaminics,Opioids: Additive

A

zolpidem

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18
Q

which drug has the same moa as amphetamine?

A

pyramed (hydroxyamphetamine + tropicamide)

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19
Q

– Stimulates#CNS#through#a# sympathomimetic#mechanism#involving#
the#enhanced#release#and#reduced# reuptake#of#norepinephrine#and# dopamine#

A

amphetamine

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20
Q

what drug blocks the reuptake receptors for NE ?

A

cocaine

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21
Q

photosensitivity, elevated BP, infection, headache

adverse: dependency, abuse, psychosis, growth suppression, heart failure, stevens johnsons syndrome

A

amphetamine adverse effects

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22
Q

CAIs (renal excretion decreased in alkaline urine)
Sympathomimetics (hypertensive crisis, arrhythmia)
Ophthalmic Beta-Blockers & Alpha-2 Agonists (hypertensive crisis)
NSAIDs (caffeine-based additive effects)
Decongestants (additive)

A

drug interactions with amphetamine

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23
Q

pt with adhd and large cups presents at clinic. what do we do?

A

workup for glaucoma and call pcp –> unusually large cupping is a risk factor for it; the use of amphetamine could be contributing factor

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24
Q

pt with adhd and large cups presents at clinic. what do we do?

A

workup for glaucoma and call pcp –> unusually large cupping is a risk factor for it; the use of amphetamine could be contributing factor

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25
Q

class of drugs that are often overprescribed

A

antidepressants

26
Q 
Escitalopram [Lexapro®]
Sertraline [Zoloft®]
Fluoxetine [Prozac®]
Paroxetine [Paxil®]
Fluvoxamine [Luvox®]
Citalopram [Celexa®]
A

SSRI ANTIDEPRESSANTS

27
Q

INDICATION
Major Depressive Disorder, Generalized Anxiety Disorder
DOSING [5/10/20mg]
10-20mg qd

A

Escitalopram indication

28
Q

what drug is the “S” enantiomer of citalopram which is a racemic mixture. What does this suggest?

A

escitalopram; our body responds to S structure

29
Q 
ESCITALOPRAM
CLINICAL PHARMACOLOGY
Antidepressant: SSRI
Mechanism of Action
Selective serotonin reuptake inhibitor (SSRI)
A

escitalopram moa

30
Q

ADVERSE EFFECTS
Common: dizziness
Distinguishing: suicidal risk, serotonin syndrome, neuroleptic malignant syndrome (NMS), seizures
Ocular: dry eye, blur, diplopia, conjunctivitis, ptosis

A

adverse effects of escitalopram

31
Q

ADVERSE EFFECTS
Common: dizziness
Distinguishing: suicidal risk, serotonin syndrome, neuroleptic malignant syndrome (NMS), seizures
Ocular: dry eye, blur, diplopia, conjunctivitis, ptosis

A

adverse effects of escitalopram

32
Q

what combo of drugs could result in heme?

A

escitalopram + nsaid + omega 3

33
Q

what combo of drugs could result in heme?

A

escitalopram + nsaid + omega 3

34
Q

INDICATION
Depression, Anxiety, Neuropathic Pain (DM), Fibromyalgia
DOSING [20/30/60mg]
60mg qd

A

duloxetine indications

35
Q

CLINICAL PHARMACOLOGY
Antidepressant, Analgesic: SNRI
Mechanism of Action
Selective Serotonin & Norepinephrine reuptake inhibitor (SNRI)

A

duloxetine moa

36
Q

ADVERSE EFFECTS
Common: blurred vision, headache, dizziness, sweating, ED, HTN, orthostatic hypotension, syncope, yawning, constipation
Distinguishing: serotonin syndrome
Hypersensitivity: Angioedema, Stevens-Johnson syndrome
Ocular: Glaucoma

A

duloxetine adverse effects

37
Q

DRUG INTERACTIONS
Opioids (additive)
NSAIDs & Omega-3/6 (hemorrhage)
Beta-Blockers (reduced beta-blocker metabolism

A

duloxetine drug interactions

38
Q

CAUTIONS
Bleeding risk
Angle closure glaucoma

A

duloxetine contraindiction

39
Q

types of antidepressants that arent used as much

A

tricyclic antidepressant

40
Q

most prescribed atypical antidepressant

41
Q 
INDICATION
Major Depressive Disorder*, Insomnia#
DOSING [50-300mg]
*50-100mg bid-tid
#25-50mg qhs
A

trazadone indication

42
Q

CLINICAL PHARMACOLOGY
Antidepressant, Anti-Insomnia
Mechanism of Action
Selective Serotonin (5-HT) Reuptake Inhibitor (SSRI); adrenergic α1-blocker & 5-HT2A/C blocker

A

trazadone moa

43
Q

TRAZODONE
ADVERSE EFFECTS
Common: headache, dizziness, blurred vision, ocular irritation
Distinguishing: Suicidal ideation, 5-HT syndrome
CVS: hemorrhage

A

TRAZODONE

ADVERSE EFFECTS

44
Q

acts similar to tomaxafen used to treat breast cancer

45
Q

DRUG INTERACTIONS
Cyclosporine, Macrolides, Azoles (QT prolongation & impaired hepatic metabolism)
NSAIDs (hemorrhage)

A

trazadone drug interaction

46
Q

_______ activity in the mesolimbic system is the pleasure center that is thought to drive psychotic behavior

47
Q

1st generation antipsychotics initially were relatively selective dopamine receptor inhibitors
Newer antipsychotics have a variety of selectivities accounting for a range of activities and side effects

A

1st generation antipsychotics initially were relatively selective ____________.
Newer antipsychotics have a ___________ accounting for a range of activities and side effects

48
Q

most prescribed antipsychotic

A

quetiapine

49
Q

most prescribed antipsychotic

A

quetiapine

50
Q

INDICATION
Schizophrenia, Bipolar Disorder
DOSING [25-400mg]
200-400 mg bid

A

quetiapine INDICATION

51
Q

QUETIAPINE
CLINICAL PHARMACOLOGY
2nd Gen Anti-Psychotic, Bipolar Disorder
Mechanism of Action
Antagonizes D2 receptors & 5-HT2 receptors
Ancillary effects may arise from antagonism of H1 and α1

A

QUETIAPINE

Mechanism of Action

52
Q

which antipsychotic drug produces cataracts?

A

quetiapine

53
Q 
QUETIAPINE
ADVERSE EFFECTS
Common: headache, anemia
Ocular: cataracts
Hypersensitivity: Stevens-Johnson syndrome
A

QUETIAPINE

ADVERSE EFFECTS

54
Q

which antipsychotic drug can cause stevens johnson synderome?

A

quetiapine

55
Q

QUETIAPINE
DRUG INTERACTIONS
Macrolides, Azoles, CsA (Prolonged QT segment)
Classic (sedating) Anti-histaminics (additive CNS depression)

A

QUETIAPINE

DRUG INTERACTIONS

56
Q

Patients with Alzheimer disease have a significant loss of cholinergic neurons in the temporal lobe and entorhinal cortex. Most of the drugs available to treat the disease are acetylcholinesterase (AChE) inhibitors
Antagonists of the NMDA-glutamate receptor are often neuro-protective, preventing the loss of neurons following ischemic and other injuries.

A

Patients with _______ disease have a significant loss of cholinergic neurons in the temporal lobe and entorhinal cortex. Most of the drugs available to treat the disease are ______.
_________ of the NMDA-glutamate receptor are often neuro-protective, preventing the loss of neurons following ischemic and other injuries.

57
Q

used to treat glaucoma and alzheimers; only drug selective for nmda

58
Q 
DONEPEZIL
INDICATION
Alzheimer Dementia
DOSING [5/10/23 mg]
1 tabs qhs
A

DONEPEZIL

INDICATION

59
Q 
DONEPEZIL
CLINICAL PHARMACOLOGY
Alzheimer Disease / Dementia
Mechanism of Action
Indirect (central) acting; reversibly binds to and inactivates acetylcholinesterase
A

DONEPEZIL
CLINICAL PHARMACOLOGY
Mechanism of Action

60
Q 
DONEPEZIL
ADVERSE EFFECTS
Common: headache, dizziness, arthritis
SERIOUS ADVERSE EFFECTS
CNS: Seizures, dream disturbances
Circulatory: Hemolytic anemia
CV: AV block, bradycardia, syncope
DONEPEZIL
ADVERSE EFFECTS
Common: headache, dizziness, arthritis
SERIOUS ADVERSE EFFECTS
CNS: Seizures, dream disturbances
Circulatory: Hemolytic anemia
CV: AV block, bradycardia, syncope
A

donepezil adverse effects

61
Q 
DONEPEZIL
ADVERSE EFFECTS
Common: headache, dizziness, arthritis
SERIOUS ADVERSE EFFECTS
CNS: Seizures, dream disturbances
Circulatory: Hemolytic anemia
CV: AV block, bradycardia, syncope
DONEPEZIL
ADVERSE EFFECTS
Common: headache, dizziness, arthritis
SERIOUS ADVERSE EFFECTS
CNS: Seizures, dream disturbances
Circulatory: Hemolytic anemia
CV: AV block, bradycardia, syncope
A

donepezil adverse effects

systemic pharm (16 decks)

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