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Pharmacology 2 > Parkinsonism, Antipsychotics, Antidepressants, Opioids, Drugs of Abuse > Flashcards

Parkinsonism, Antipsychotics, Antidepressants, Opioids, Drugs of Abuse Flashcards

1
Q

Drugs causing Parkinsonism

A

Typical antipsychotics
Reserpine
MPTP ( methylphenyltetrahydropyridine)

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2
Q

Primary drug for Parkinson’s, MOA?

A

Levodopa-Carbidopa

Levodopa is a dopamine precursor. Carbidopa inhibits peripheral metabolism via dopa decarboxylase

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3
Q

On-off phenomena

A

Alternating periods of improved mobility and akinesia

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4
Q

Wearing-off phenomena

A

Deterioration of drug effects in between medication doses

Due to progressive destruction of nigrostriatal neurons that occur with disease progression

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5
Q

Partial agonist at dopamine D2 in brain

A

Bromocriptine

Pergolide

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6
Q

Partial agonist at dopamine D3 receptors in brain

A

Pramipexole

Ropinirole

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7
Q

Used in off periods, alcoholism, opiate addiction. MOA?

A

Apomorphine
Partial D3 agonist
Antagonist at 5-HT and alpha adrenoceptors
Premedicate with trimethobenzamide to prevent severe nausea

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8
Q

MAO type B inhibitor

Decrease degradation of dopamine

A

Selegiline

Rasagiline

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9
Q

COMT inhibitor

Prolongs response to levodopa

A

Entacapone

Tolcapone

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10
Q

Antiparkinsonism and antiviral drug.

MOA?

A

Amantadine

Adenosine antagonist

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11
Q

Anticholinergic antiparkinsonism drugs

A 
Benztropine
Biperiden
Trihexyphenidyl
Orphenadrine
Blocks muscarinic receptors on cells in the striatum
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12
Q

MOA of typical antipsychotics. Examples?

A

Block of D2 receptors&raquo_space; 5-HT2 receptors
Chlorpromazine
Thioridazine
Haloperidol

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13
Q

Primary signs of Parkinsonism

A 
Tremors 
Rigidity 
Akinesia
Postural instability 
TRAP!
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14
Q

Locations of D2 receptors

A

Putamen, nucleus accumbens, cerebral cortex, hypothalamus

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15
Q

Pleasure center

A

Nucleus accumbens

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16
Q

Toxic effect of antipsychotics in endocrine system

A

Hyperprolactinemia- amenorrhea, galactorrhea, infertility, impotence

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17
Q

Perioral tremor, manifests around 4 mos-4 years

A

Rabbit syndrome

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18
Q

Used in rabbit syndrome

A

Benztropine

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19
Q

Typical antipsychotic with increased risk of corneal and lens deposits

A

Chlorpromazine

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20
Q

Typical antipsychotics with increased risk for retinal deposits

A

Thioridazine

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21
Q

Only antipsychotic with fatal overdose

A

Thioridazine

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22
Q

Used in schizophrenia, huntington’s disease, tourette’s syndrome.
Least sedating among typical antipsychotics

A

Haloperidol

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23
Q

MOA of atypical antipsychotics

A

Block of 5-HT2 receptors&raquo_space;D2 receptors

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24
Q

Only antipsychotic that reduces risk of suicide.

SE include agranulocytosis, hypersalivation, hyperglycemia, weight gain, ileus, seizures.

A

Clozapine

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25
Q

Used in anorexia nervosa, depression, schizophrenia

A

Olanzapine

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26
Q

Atypical antipsychotic whose SE include priapism, somnolence, fatigue, sleep paralysis, hypnagogic hallucinations.

A

Quetiapine

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27
Q

Only antipsychotic approved for schizophrenia in the young

A

Risperidone

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28
Q

Antipsychotic whose SE include QT prolongation, Torsades, postural hypotension.

A

Ziprasidone

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29
Q

Least sedating among atypical antipsychotics. Used in autism, cocaine dependence, depression, schizophrenia and other psychotic disorders.

A

Aripiprazole

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30
Q

Atypical antipsychotics

A 
Clozapine 
Olanzapine
Quetiapine
Risperidone
Ziprasidone
Aripiprazole
31
Q

Features of neuroleptic malignant syndrome?

Drug that can cause it?

A 
Haloperidol
FEVER
Fever
Encephalopathy
Vitals unstable 
Elevated CPK
Rigidity
32
Q

Treatment of bipolar disorder. Has slow onset of action.

33
Q

Teratogenic effect of lithium

A

Eibstein anomaly- low implanted tricuspid valve

34
Q

Treatment for overdose of lithium

A

Hemodialysis

35
Q

Threshold of toxicity of lithium

36
Q

Amine hypothesis of mood

A

Brain amines, NE and serotonin, are neurotransmitters in pathways that function in the expression of mood

37
Q

Classification of antidepressants

A 
Tricyclic antidepressants
Selective serotonin reuptake inhibitors 
Serotonin-norepinephrine reuptake inhibitors
Serotonin receptor antagonists 
Heterocyclic antidepressants 
Monoamine oxidase inhibitors
38
Q

TCAs. MOA?

A

Imipramine, amitriptyline

Block Norepinephrine and serotonin receptors

39
Q

TD and LD of TCAs

A

7 and 15 mg/kg

40
Q

Features of TCA toxicity

A

Coma
Convulsions
Cardiotoxicity

41
Q

Used in TCA overdose

A

Bicarbonate

42
Q

SSRIs

A 
Fluoxetine 
Paroxetine 
Citalopram
Escitalopram 
Sertraline
Fluvoxamine
43
Q

Halflife of SSRIs

44
Q

Drugs that can cause erectile dysfunction

A 
A SORE PEnis can't Fuck Hard!
SSRIs
Opiates
Risperidone
Ethanol
Propanolol
Estrogen 
Spironolactone 
Finasteride
Hydrochlorothiazide
45
Q

Serotonin syndrome

A 
FAT CHD
Fever 
Agitation
Tremor
Clonus
Hypereflexia
Diaphoresis
46
Q

SNRIs

A

Venlafaxine
Duloxetine
Desvenlafaxine

47
Q

Serotonin antagonist, can cause priapism

48
Q

Drugs that can cause priapism

A 
Trazodone
Papaverine
Sildenafil
Quetiapine
Alprostadil
Warfarin 
Bupropion 
Tigas PeniS Co, AyaW Bumaba!
49
Q

Can cause nightmares

A

mirtazapine (tetracyclic antidepressant)

50
Q

Used in smoking cessation. MOA?

A

Bupropion

Inhibits neuronal reuptake of dopamine and NE.

51
Q

Can cause hypertensive crisis when taken with tyramine.

A

Phenelzine. MAO type a and b inhibitor.

52
Q

Tx for serotonin syndrome

A

Antiseizure drugs, muscle relaxants, serotonin blockers (cryptoheptadine)

53
Q

Opioid with shortest halflife? Longest?

A

Remifentanil 3-4 mins

Buprenorphine 4-8 hours

54
Q

Opioid receptor for inhibition of respiration

A

mu. Greater affinity for endorphins

55
Q

Opioid receptor for development of tolerance

A

delta

Greater affinity for enkephalins

56
Q

Opioid receptor for slowed gastrointestinal transit

A

Kappa

Greater affinity for dynorphins

57
Q

Opioid side effects

A 
ARMED Chinese
Analgesia
Respiratory depression 
Miosis
Euphoria 
Drowsiness 
Constipation
58
Q

Most potent opioid

A

Ohmefentanyl

59
Q

Opioid that exerts hemodynamic effects on pulmonary circulation

60
Q

Full agonist opioids

A

Morphine
Fentanyl
Meperidine
Methadone

61
Q

Strong agonist at mu and kappa receptors. Used in labor analgesia

A

Meperidine

62
Q

Used in opioid dependence and opioid withdrawal

63
Q

Opioids: Partial agonists

A

Hydrocodone
Oxycodone
Dextromethorphan
Codeine

64
Q

Opioid for cough suppression

A

Dexteomethorphan

65
Q

Reduces craving in alcohol dependence

A

Nalbuphine

Naltrexone

66
Q

Opioid antagonist

A

Naloxone
Naltrexone
Nalmefene

67
Q

Opioid overdose triad

A

Pupillary constriction
Comatose state
Respiratory depression

68
Q

Street name for methylene dioxymetamphetamine MDMA

69
Q

MDMA overdose presentation

A 
Severe hypertension 
Hyperthermia 
Delirium
Psychomotor agitation 
Profound hyponatremia
70
Q

Cocaine overdose presentation

A

Mydriasis, vasoconstriction, thrombus formation, psychomotor agitation, severe hyperthermia, crack lung (hemorrhagic alveolitis)

71
Q

Angel dust

A

Phencyclidine

72
Q

Special K

73
Q

Hallucinogenic agents

A

Lysergic acid diethylamide
Mescaline
Psilocybin

74
Q

Partially purified cannabis sativa, more potent form

Pharmacology 2 (9 decks)

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