Parkinsonism, Psych, Opioids, Abuse Flashcards
Primary drug for Parkinsonism
Levodopa Carbidopa
Levodopa is contraindicated in patients with a history of
Psychosis
Phenomenon in Parkinson wherr there is alternating periods of inproved mobility and akinesia over a few hours or days during the treatment
On- Off Phenomena
Phenomenon in Parkinson where there is deterioration of drug effect in between doses
Due to progressive destruction of nigrostriatal neurons that occur with disease progression
Wearing off Phenomenon
Partial agonist at dopamine D2 receptors in thr brain
Used in Parkinson, Levodopda intolerance and hyperprolactinemia
Can cause erythromelalgia
Bromocriptine
Antiparkinsonism that is a partial agonist at D3 receptors
Compulsive gambling, hypersexuality overeating
Pramipexole
Ropinirole
Antiparkinsonism drug that is a partial D3 agonist
Used for off periods of Parkinsonism
Severe nausea
Apomorphine
Patients who are taking apomorphine should take this drug first to prevent severe nausea
Trimethobenzamide
Antiparkinsonism drug that partially inhibits MAO B at a certain dose
Can cause serotonin syndrome when used with SSRI TCA Meperidine
Selegiline
Rasagiline
COMT inhibitor that blocks L-dopa metabolism and prolongs response to levodopa
Orange urine
Hepatotoxic
Neuroleptic malignant syndrome
Rhabdomyolysis
Entacapone
Tolcapone
Drug used to potentiate dopaminergic action
Can cause livedo reticularis
Amantadine
Drugs that can cause livedo reticularis
A MAN reads fHM and GQ
Amantadine Hydroxyurea Minocycline Gemcitabine Quinidine
Anticholinergic drug used for Parkinsons that blocks muscarinic receptors
Used to prevent EPS caused by antipsychotics
Little effect on bradykinesia
Benztropine Biperiden Trihexyphenidyl Orphenadine Procyclidine
This drug is effective in some schizophrenic patients resistant to treatment with other antipsychotics
Clozapine
Dopaminergic tract for mentation and mood
Mesocortical-Mesolimbic
Dopaminergic tract for extrapyramidal function
Nigrostriatal
Dopaminergic tract for control of prolactin release
Tuberoinfundibular
Irreversible disorder characterized by repetitive involuntary movements like tongue protrusion and lip smacking
Tardive dyskinesia
Typical antipsychotic that blocks D2 receptors
EPS, failure of ejculation, corneal and lens deposits, NMS
Chlorpromazine
Only antipsychotic with fatal overdose
Strongest autonomic effects
Thioridazine
Fluphenazine
Perphenazine
Typical antipsychotic used for schizophrenia, manic phase of bipolar, Huntington and Tourette
Weakest autonomic effects
Less sedating
Haloperidol
Atypical antipsychotic used for refractory schizophrenia
Only antipsychotic that reduces risk of suicide
Clozapine
Antipsychotic than can cause agranulocytosis
Clozapine
Watch clozely for agranulocytosis
Atypical antipsychotic that can cause weight gain
Olanzapine= Obesity
Most sedating atypical antipsychotic
Quetiapine= Quiet- apine
Atypical antipsychotic less sedating than quetiapine
Hyperprolactinemia
Risperidone
Rise and Shine
Rise to a pair
Only antipsychotic approved for schizophrenia in the youth
Risperidone
Atypical antipsychotic that can cause postural hypotension, QT prolongation
Ziprasidone
Least sedating atypical antipsychotic
Aripiprazole
Features of Neuroleptic Malignant Syndrome
FEVER Fever Encephalopathy Vitals unstable Elevated CPK Rigidity
Threshold for lithium toxicity
2 meq/L
Treatment for lithium overdose
Dialysis
Neurotransmitters involved in the expression of mood
NE
Serotonin
Antidepressant ( TCA) used for enuresis and MDD not responsive to other drugs
Imipramine
IHI-pramine
3 Cs of TCA toxicity
Cardiotoxicity
Convulsions
Coma
TCAs mode of action is the blocksde of which transporters?
NE and 5HT
ANS and histamine
First line for MDD
Fluoxetine Paroxitine Citalopram Escitalopram Sertraline Vilazodone
SSRIs can cause serotonin syndrome when used with what drug?
MAOIs
SSRI approved only for OCD
Fluvoxamine
SSRI that can cause diarrhea
Sertraline
Squirtraline
Drugs that can cause erectile dysfunction
A SORE PeniS can’t Fuck Hard
SSRI Opiates Risperidone Ethanol, Estrogen Propranolol Spironolactone Finasteride Hydrochlorothiazide
Drugs that can cause priapism
Tigas PeniS Qo, AyaW Bumaba
Trazodone Papaverine Sildenafil Quetiapine Alprostadil Warfarin Bupropion
Tetracyclic antidepressant used for major depression
Mirtazapine
Tetracyclic antidepressant that inhibits neuronal reuptake of dopamine and NE
Used for smoking cessation
Bupropion
MAOI (Phenelzine) can cause hypertensive crisis when taken with
Tyramine
Treatment for NMS
Diphenhydramine
Opioid with shortest half life
Remifentanil (3-4 mins)
Opioid with longest half life
Buprenorphine ( 4-8 hours)
Opioid analgesic against mu receptors
Used for severe pain and adjunct for anesthesia
Morphine
Antidote for morphine
Naloxone
Opioid that is a strong agonist against mu receptors. Inhibits pain at spinal and supraspinal sites
Used in severe pain, chronic pain, cancer pain
Fentanyl
Most potent opioid
Ohmefentanyl
Strong opioid agonist at mu and kappa receptors
Used for spasmodic pain
Meperidine
Strong opioid agonist at mu receptors
Used for opioid dependence and withdrawal
Methadone
Partial opioid agonist at mu and kappa receptors used for chronic, neuropathic and cancer pain
Can cause hypogonadism, hearing loss
Hydrocodone
Oxycodone
Partial opioid agonist used for cough suppression
Dextrometorphan
Codeine
Weak agonist at mu receptors used for mild to moderate pain and restless legs syndrome
Withdrawn because of fatal cardiotoxicity
Commonly used in suicide
Propoxyphene
Mixed opioid agonist-antagonist
Strong agonist at kappa and weak antagonist at mu receptors
Used for alcohol dependence
Nalbuphine
Dual acting opioid analgesic
Weak agonist at mu receptors for moderate pain
Lowers seizure threshold, nausea and vomiting
Tramadol
Dopamine plays a primary role in the expression of reward in what part of the brain
Mesolimbic system
Loss of appetite in methamphetamine use is due to increase in this neurotransmitter
Serotonin
Congener of methamphetamine that act as sexual enhancers
MDMA
Ecstasy
Treatment for MDMA overdose
Supportive
Hypertonic saline for hyponatremia
Known effect of MDMA overdose
Profound hyponatremia
Cocaine inhibits CNS transporters of these neurotransmitters
Dopamine
Norepinephrine
Serotonin
Cocaine can cause a feeling that insects are crawling under the skin
Delusional parasitosis
Most dangerous hallucinogenic agent
PCP
Phencyclidine
Active ingredient tetrahydrocannabinol
Dream like state
Tachycardia
Reddened conjunctiva
Dry mouth
Marijuana
