Neuropharm IV

Question 1

What are anticonvulsants used for mood stabilization in mania?

Answer 1

carbamazepine, lmotrigine, vlproate (some gabapentin, though no data to suggest efficacy)

Question 2

What is the MOA of Li?

Answer 2

bypasses the synapse and helps with both mania and depression. Unknown MOA, but it may inhibit inositol phosphatases and their signlaing pathways (PLC to PIP2 to DAG and IP2 to PKC/ increased Ca). may also influence gene expression and glycogen synthase kinase, reduce cAMP production and amine release, and disrupt excitability.

Question 3

Pharmkinetics/dynamics of Li. Use. Cautions.

Answer 3

readily absorbed
renal excretion
avoid during pregancy because it causes developmental abnormalities- though, think carefully about this, because mania can be very dangerous and threaten life of mom AND fetus. narrow therapeutic window.

Question 4

What are characteristics of Li toxicity?

Answer 4

ataxia, (diarrhea, nausea, vomiting), confusion, arrhythmias, hydration issues

Question 5

What are some side effects of Li?

Answer 5

polydipsia, polyuria, thyroid enlargement, benign ECG/EEG changes,

Question 6

What is the MOA of valproate?

Answer 6

unclear, though we know it inhibits metabolism

may be an Na channel blocker or incr. GABA responses.

Question 7

What are toxicities and sides of valproate?

Answer 7

toxicity: hepatic, GI, CNS (tremor/fatigue)
sides: hair loss, weight gain (may be treatment limiting, PCOS, inhib of hepatic metabolism

Question 8

What is one main caution with carbamazepine?

Answer 8

induces hepatic metabolism: other drugs, INCLUDING OCPs, become less effective.

Question 9

What is toxicity and sides of carbamazepine?

Answer 9

toxicity: fatigue, nausea, diplopia, ataxia, hepatic
sides: hyponatremai, weight gain

Question 10

What is lamotrigin used for? MOA?

Answer 10

for type II bipolar (depression w/ hypomania)

unclear, but again, may be Na channel b;ocker or decr. glutamate release.

Question 11

Waht is the toxicity and sides of lamotrigine?

Answer 11

toxicity: headache, fatigue
sides: rash- 0.8% chance of Stevens-Johnsons

Question 12

What is the interaction btw valproate and lamotrigne?

Answer 12

valproate reduces clearance of lamotrigine. this is maximal even at very low doses of valproate.

Question 13

What are examples and effects of psychomotor stimulants?

Answer 13

;caffeine and other methyl xanthines
nicotine
cocaine
amphetamines
methylphenidate.
cause euphoria, energy, increased motor activity

Question 14

What are some examples of hallucinogens?

Answer 14

LSD (lysergic acid diethylamide)
thetraydrocannabinol (THC)
phencyclidine (PCP)

Question 15

What are methylxanthines? MOA?

Answer 15

coffe, tea, cocoa

uncertain MOA but probably incr. cyclic AMP, GM{, block of adensine receptors, release of Ca from intracellular stores

Question 16

What do methylxanthines do?

Answer 16

alerting, but may cause anxiety, tremmor, increased HR, arrythmias, relaxed smooth muscles, increase acid secretion (careful with coffee + GERD), weak diuretic.

Question 17

Clinical uses and toxicities of methylxanthines?

Answer 17

insomnia, anxiety tremor, seizures at very high levels. Also withdrawal symptoms.
used to be used to treat asthma because it would relax bronchial smooth muscle.

Question 18

MOA for nicotine

Answer 18

agonist of nicotinic receptors that activates autonomic ganglia. may also act at muscarinic receptors. can lead to blockade at very high levels.

Question 19

What are the effects of nicoteine

Answer 19

Although at low levels may promote alertness, learning, and memory, at higher levels it cal nead to respiratory distress and medullary hypotension. it also increases BP and HR. Body quickly develops tolerance.

Question 20

What is the difference between crack and cocaine?

Answer 20

Crak is a free base that is volatile and can be smoked

cocaine is a salt and must be snorted or ingested

Question 21

What does cocoain do?

Answer 21

stim of dopamine in limibic system leads to euphoria, greater alertness, increased motor. But can lead to a tremor or seqires at high levels. also leads to increased HP, BP, and pupillary dilation.

Question 22

What is the half life of cocain? Whata re some adverse effects?

Answer 22

half life is 30-89 minutes- users must dose frequently. Adverse effects:
vasoconstriction ielding MI or stroke, hypertension that yeilds CNS hemorrhage, sezures, anxiety, psychosi/mania.

Question 23

How might I treat cocoaine withdrawal?

Answer 23

antipsychotics, benzodiazepines,

Question 24

What do amphetamines do?

Answer 24

action similar to cocaine but with greater CNS effects.