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Pharmacology > Parkinsonism, Antipsychotics, Antidepressants,OPIOIDS, Abuse drugs > Flashcards

Parkinsonism, Antipsychotics, Antidepressants,OPIOIDS, Abuse drugs Flashcards

0
Q

Parkinson disease is a neurodegenerative disease caused by degeneration of dopaminergic neurons in _____

A

Substantia nigra

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1
Q

Parkinson disease is also known as?

A

Paralysis Agitans

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2
Q

Primary signs of Parkinsonism

A

TRAP - tremor, rigidity, akinesia and postural instability

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3
Q

Drugs that causes drug-induced Parkinsonism by depleting dopamine level

A
  1. Antipsychotic drugs
  2. Reserpine
  3. MPTP - methylphenyltetrahydropyridine
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4
Q

Antiparkinsonism drug: used as primary treatment for Parkinsons

A

Levodop-Carbidopa

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5
Q

Mechanism of using Levodopa-Carbidopa in Parkinson?

A

Levodopa is a dopamine precursor

Carbidopa inhibits peripheral metabolism via dopa decarboxylase

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6
Q

Partial agonist of dopamine D2 receptors in the brain for Parkinson’s disease, Levodopa intolerance and Hyperprolactinemia

A

Bromocriptine

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7
Q

Partial agonist drug at the dopamine D3 receptors in brain for Parkinsonism contraindicated in patients with active peptic ulcer disease or myocardial infarction

A

Pramipexole - SIMD: Ropinirole

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8
Q

Antiparkinsonism drug: for off-periods of Parkinson’s disease, erectile dysfunction and Alzheimer’s disease that may cause severe nausea

A

Apomorphine

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9
Q

A premedication drug of Apomorphine to avoid or prevent severe nausea

A

Trimethobenzamide

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10
Q

A MAO type inhibitor drug for Parkinson that causes serotonin syndrome when used with SSRIs

A

Selegiline - decreases degradation of dopamine.

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11
Q

COMT inhibitor drug used for Parkinson that may cause sleep disturbance, orange urine, hepatotoxicity and neuroleptic malignant

A

Entacapone - SIMD: Tolcapone

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12
Q

Antiviral drug used for Parkinson and influenza, that may improve bradykinesia, rigidity and tremor

A

Amantadine

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13
Q

Drugs that causes livedo reticularis

A

Amantadine, hydroxyurea, minocycline, gemcitabine and quinidine

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14
Q

Anticholinergic drug for Parkinson and extrapyramidal symptoms caused by antipsychotics. May cause exacerbation of tardive dyskinesias that results from prolonged use of antipsychotic drugs

A

Benztropine

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15
Q

Disease caused by excess of dopamine in specific neuronal tracts in the brain

A

Schizoprenia

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16
Q

Target action of the older antipsychotic drugs

A

D2 receptors in caudate putamen, nucleus accumbens, cerebral cortex and hypothalamus

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17
Q

Dopaminergic tract: that regulates the mentation and mood

A

Mesocortical-mesolimbic tract

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18
Q

Dopaminergic tract: associated with extrapyramidal function

A

Nigrostriatal tract

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19
Q

Dopaminergic tract: associated with control of prolactin release

A

Tuberoinfundibular tract

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20
Q

Dopaminergic tract: associated with anticipatory motivational phase of copulatory behavior

A

Incertohypothalamic tract

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21
Q

Dopaminergic tract: associated with eating behavior

A

Medullary-periventricular tract

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22
Q

Typical antipsychotic drug: that may cause failure of ejaculation, postural hypotension and corneal and lens deposits

A

Chlorpromazine

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23
Q

Typical antipsychotic drug: that has strongest autonomic effects and only antipsychotic with fatal dose

A

Thioridazine

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24
Q

Typical antipsychotic drug: that has a major extrapyramidal dysfunction. Weakest autonomic effects with least sedating among typical antipsychotics

A

Haloperidol

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25
Q

ATypical antipsychotic drug: that may cause weight gain and hyperglycemia. And only antipsychotic drug that reduces the risk of suicide

A

Clozapine

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26
Q

ATypical antipsychotic drug: also for anorexia nervosa, depression and bipolar disorder that may cause weight gain, hyperglycemia and hyperlipidemia

A

Olanzapine

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27
Q

Atypical antipsychotic drug: also for manic phase of Bipolar disorder may cause hypnagogic hallucinations, cataracts and priapism

A

Quetiapine

28
Q

Atypical antipsychotic drug: also for hiccups, and tourette syndrome. Only approved antipsychotic drug for pediatric age

A

Risperidone

29
Q

Atypical antipsychotic drug: that may cause QT prolongation. With increased mortality in elderly patients with dementia related psychosis

A

Ziprasidone

30
Q

Atypical antipsychotic drug: also for autism and cocaine dependence

A

Aripiprazole

31
Q

Syndrome that presents with fever, encephalopathy, vitals unstable, elevated CPK and rigidity

A

Neuroleptic malignant syndrome

32
Q

Drug for treatment of bipolar disorder, decreases manic behavior and reduces both the frequency and the magnitude of mood swings.

A

Lithium - protective effects against suicide and self-harm

33
Q

Lithium as mood stabilizer may cause bradycardia and teratogen : Ebstein’s anomaly. It is usually contraindicated in?

A

Sick sinus syndrome

34
Q

Treatment for lithium overdose

A

Hemodialysis

35
Q

Threshold for lithium toxicity

A

2meq/L

36
Q

Two neurotransmitters in pathways that function in expression of mood. Decrease of activity results in depression

A

NE and serotonin

37
Q

Antidepressant drug: for major depressive disorder (backup) , phobias and enuresis. With additive effect with other depressants

A

Imipramine - TCAs

38
Q

Features of Tricyclic Antidepressant overdose

A

Coma, convulsions and cardiotoxicity

39
Q

Treatment for TCAs toxicities that reverses cardiotoxicity

A

Bicarbonate

40
Q

Antidepressant drug: as first line for major depressive disorder may cause erectile dysfunction and withdrawal syndrome.

A

Flouxetine - and Fluvoxamine are CYP450 inhibitors

41
Q

Drugs that causes erectile dysfunction

A

SSRIs, opiates, risperidone, ethanol, propanolol, estrogens, spironolactone, finasteride and hydrochlorothiazide

42
Q

Antidepressant drug: for major depression, may cause hypertensive crisis. May cause serotonin syndrome when taken with SSRIs

A

Phenelzine - MOAs inhibitor

43
Q

Life threatening syndrome when SSRIs are taken with MAO inhibitor that may present with severe muscle rigidity, myoclonus, hyperthermia and seizures

A

Serotonin Syndrome

44
Q

First line treatment for neurologic malignant syndrome

A

Diphenhydramine

45
Q

Which opioid has the shortest half life?

A

Remifentanil - 3-4mins

46
Q

Opioid with the longest half life

A

Buprenorphine - 4-8 hours

47
Q

Opioid receptor: inhibition of respiration

A

Mu receptor with highest affinity for endorphins

48
Q

Opioid receptor: for development of tolorance

A

Delta receptor with affinity for enkephalins

49
Q

Opioid receptor: slowed gastrointestinal transit

A

Kappa receptor with affinity to dynorphins

50
Q

Opioid drug: for severe pain and may decrease preload in MI

A

Morphine - strong agonist on mu receptor, non selective

51
Q

Opioid drug: for severe pain and breakthrough cancer pain. May be given transdermally or via lollipop.

A

Fentanly

52
Q

Most potent opioid

A

Olimefentanyl

53
Q

Opioid drug: for moderate to severe pain. Opioid of choice for pain relief in pancreatitis

A

Meperidine - does not cause miosis and biliary spasm

54
Q

Opioid drug: for moderate to severe pain. Currently investigated for treatment for leukemia

A

Methadone - full agonist

55
Q

Opioid drug: for cough suppression and may cause serotonin syndrome

A

Dextromethorphan - decreases sensitivity of cough receptors

56
Q

Opioid drug: for mild to moderate pain. Withdrawn because of fatal cardiotoxicity, commonly used in suicide

A

Propoxyphene

57
Q

Opioid drug: strong agonist in kappa receptor, for alcohol dependence and balanced anesthesia

A

Nalbuphine

58
Q

Opioid drug: for opioid overdose. Precipitates abstinence syndrome in patients with opioid dependence

A

Naloxone

59
Q

Opioid drug: for moderate pain. Fibromyalgia and neuropathic pain. Lowers seizure threshold and contraindicated for patients with history of seizures

A

Tramadol

60
Q

May present as pupillary constriction, comatose and respiratory depression

A

Opioid overdose

61
Q

Treatment for opioid toxicities

A

Naloxone

62
Q

Triad of opioid toxicities

A

Pupillary constriction
Comatose state
Respiratory depression

63
Q

Refers to a state characterized by signs and symptoms, frequently the opposite of those caused by a drug, when it is withdrawn from chronic use or when the dose is abruptly lowered

A

Dependence

64
Q

Refers to compulsive drug-using behaviour in which the person uses the drug for personal satisfaction, often in the face of known risks to health

A

Addiction

65
Q

Condition that refers to decreased response to a drug, necessitating a larger doses to achieve the same effect

A

Tolerance

66
Q

Signs and symptoms that occur on discontinuation or withdrawal of a drug in a dependent person

A

Abstinence syndrome - withdrawal symdrome

67
Q

Drug that causes euphoria and self-confidence. Chronic use may result to psychotic state, development of necrotizing arteritis leading to cerebral hemorrhage and renal failure.

A

Amphetamines - metamphetamines, dextroamphetamines

68
Q

Also known as Ecstacy

A

Methylene dioxymethamphetamine

Pharmacology (11 decks)

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