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Pharmacology > Parkinsons and Psychiatric Drugs > Flashcards

Parkinsons and Psychiatric Drugs Flashcards

1
Q

What is the drug of choice for parkinsonism?

A

LEVODOPA - CARBIDOPA

MOA: Levodopa is a dopamine precursor and carbidoba inhibits peripheral metabolism of DOPA decarboxylase

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2
Q

What is the phenomenon which manifests as alternating periods of improved mobility and akinesia, occurring over a few hours to days during treatment?

A

On-Off Phenomenon

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3
Q

What is the partial agonist at dopamine D3 receptors used in treatment of parkinsons disease during off periods?

A

Apomorphine

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4
Q

What is the phenomenon which manifests as deterioration of drug effect in between medication doses due to progressive destruction of nigostriatal neurons?

A

Wearing off phenomenon

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5
Q

What is the drug that blocks L-dopa metabolism by inhibiting COMT in periphery which is used as the drug of choice for wearing off phenomenon?

A

Entacapone

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6
Q

What is the difference between Entacapone and Tolcapone

A

Entacapone acts only on the periphery while Tolcapone acts both on the CNS and periphery

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7
Q

What are the side effects of Levodopa-carbidopa?

A

Emesis, Dyskinesia (Choreoathetosis), Behavioral changes, on off phenomenon, wearing off phenomenon, postural hypotension

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8
Q

What is the side effect of Apomorphine?

A

Severe nausea

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9
Q

What is the drug given as premedication to avoid severe nausea when giving Apomorphine?

A

Trimethobenzamide (an anti-emetic)

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10
Q

What is a partial agonist of D2 receptors used in the treatment of parkinsons? What are the side effects of giving this drug?

A

Bromocriptine

Side effects: Erythromelalgia (due to intermittent blockage of vessels) and pulmonary fibrosis

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11
Q

What drugs is classified as a MAO Type B inhibitors which are used in the treatment of parkinsons?

A

Selegiline and Rasagiline

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12
Q

What is an anti-parkinsonism drug which antagonizes the effects of adenosine at adenosine A2 receptors which is also used in the treatment of influenza? Side effect?

A

Amantadine

Side Effect: Livedo reticularis and peripheral edema

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13
Q

What drugs can cause livedo reticularis

A 
Amantadine
Hydroxyurea
Minocycline
Gemcitabine
Quinidine
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14
Q

What is a partial agonist of Dopamine D3 receptors used in the treatment of Parkinsons and Restless leg syndrome? What are its side effects?

A

Pramipexole

SE: compulsive gambling, hypersexuality, overeating, uncontrollable tendency to fall asleep

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15
Q

What is a typical antipsychotic which blocks D2 receptors» 5HT2 receptors which causes failure of ejaculation, postural hypertension, marked sedation, CORNEAL AND LENS DEPOSITS?

A

Chlorpromazine

Class: phenothiazine

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16
Q

What is the only antipsychotic which has fatal overdose and has the strongest autonomic effects?

A

Thioridazine
Class: Phenothiazine
Similar Drugs: Fluphenazine, Perphenazine, Prochlorperazine, Trifluoroperazine

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17
Q

What antipsychotic drug that can be used as an anti-emetic?

A

Prochlorperazine

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18
Q

Which among the typical antipscyhotics which has the weakest autonomic effects and is least sedating?

A

Haloperidol
Droperidol
Class: Butyrophenone

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19
Q

Which among the typical antipschotics which is used in the treatment of Huntington’s disease and Tourette’s syndrome?

A

Haloperidol

Droperidol

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20
Q

What is the difference between atypical and typical antipsychotics?

A

Typical antipsychotics blocks D2 receptors&raquo_space; 5HT2 receptors
Atypical antipsychotics blocks 5HT2 receptors
&raquo_space; D2 receptors

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21
Q

What are examples of atypical antipsychotic drugs?

A

Clozapine, olanzapine Quetiapine, Risperidone, Ziprasidone, Aripiprazole

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22
Q

What is the only anti-psychotic drug that reduces the risk of suicide?

A

Clozapine

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23
Q

What atypical antipsychotic drug that causes weight gain, hyperglycemia, hyperlipidemia, myocarditis, agranulocytosis, seizures, ileus and hypersalivation (sialorrhea)?

A

Clozapine

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24
Q

Drugs that causes agranulocytosis

A 
Clozapine
Colchicine
Co-trimoxazole
Aminopyrine
Phenylbutazone
PTU
Indomethacin
Tocainide
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25
Q

What is the antipsychotic drug that causes hypnagogic hallucinations, sleep paralysis, cataracts and priapism?

A

Quetiapine

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26
Q

Aside from clozapine, give an antipsychotic drug that also causes weight gain, hypoglycemia and hyperlipidemia

A

Olanzapine

27
Q

What is the only antipsychotic drug that is approved for schizophrenia in the youth?

A

Risperidone

28
Q

What is the anti-psychotic drug that can cause postural hypertension and torsade de pointes?

A

Ziprasidone

29
Q

What is the anti-psychotic drug that has no atropine-like effects, little or no tendency to cause hyperglycemia, hyperprolactinemia or weight gain and causes increased mortality in elderly patients with dementia-related psychosis

A

Ziprasidone

30
Q

Which among the antipsychotic drugs is least sedating? It has also no atropine-like effects, little or no tendency to cause hyperglycemia, hyperprolactinemia and weight gain?

A

Aripiprazole

31
Q

What is the drug of choice for bipolar disorder which acts by decreasing cAMP and inhibiting inositol-1-phosphatase?

A

Lithium

32
Q

What congenital anomaly does Lithium cause?

A

Ebstein’s anomaly

33
Q

What are the other side effects of Lithium?

A

Thyroid enlargement, Nephrogenic diabetes insipidus, edema, acneiform skin eruptions, Leukocytosis and bradycardia.

34
Q

What mood stabilizer is contraindicated in patients with sick sinus syndrome?

A

Lithium

35
Q

What is the treatment for lithium toxicity?

Threshold for toxicity: 2 meqs

A

Hemodialysis

36
Q

What are the symptoms of neuroleptic malignant syndrome?

A

Fever, encephalopathy, vitals unstable, elevated CPK, Rigidity

37
Q

What is the treatment for neuroleptic malignant syndrome?

A

Dantrolene

38
Q

What are examples of tricyclic antidepressants

A 
Imipramine
Clomipramine
Despiramine
Amitryptyline
Nortryptilline
39
Q

What are the signs of TCA overdose?

A

Coma, Convulsions, Cardiotoxicity

40
Q

What is the treatment for TCA overdose?

A

Administration of bicarbonate (if QRS duration>100msec or a ventricular arrhythmia is present) - reverses cardiotoxicity

41
Q

What is the drug of choice for depression?

A 
Selective Serotonin Reuptake Inhibitors (SSRIs)
Fluoxetine
Escitalopram
Paroxetine
Sertraline
Citalopram
Fluvoxamine
42
Q

What are the drugs that causes erectile dysfunction

A 
SSRIs
Opiates
Risperidone
Ethanol
Propranolol
Estrogens
Spironolactone
Finasteride
Hydrochlorothiazide
43
Q

Examples of Serotonin-Norepinephrine Reuptake Inhibitor

A

Venlafaxine
Duloxetine
Desvenlafaxine

44
Q

What is the antidepressant drug used in the treatment of fibromyalgia

A

Venlafaxine

45
Q

What is the side effect of venlafaxine? Duloxetine?

A

Venlafaxine: Hypertension
Duloxetine: hepatotoxicity

46
Q

What are the SSRIs that are Cytochrome P450 inhibitors?

A

Fluoxetine

Fluvoxamine

47
Q

What is the SNRI that is a cytochrome P450 inhibitor

A

Venlafaxine

48
Q

Examples of antidepressants that block 5HT2 receptor?

A

Trazodone

Nefazodone

49
Q

What are the side effects of serotonin antagonists?

A

Orthostatic hypotension
Priapism (Trazodone)
Hepatotoxicity (Nefazodone)

50
Q

Drugs that cause priapism

A 
Trazodone
Papaverine
Sildenafil
Quetiapine
Warfarin
Bupropion
51
Q

What drug is a heterocyclic antidepressant which is a strong norepinephrine reuptake inhibitor and weak serotonin reuptake inhibitor and blocks dopamine D2 receptors?

A

Amoxapine

52
Q

What are the side effects of Amoxapine?

A 
Autonomic effects
Akathisia
Parkinsonism
Amenorrhea-galactorrhea syndrome
Seizures
Cardiotoxicity
53
Q

Which antidepressant which lowers seizure threshold?

A

Amoxapine

54
Q

Which antidepressant that increases amine release from nerve endings by antagonism of presynaptic alpha2 adrenoreceptors and blocks 5HT2 receptors

A

Mirtazapine

55
Q

What are the side effects of Mirtazapine?

A

Weight gain and marked sedation

56
Q

Which antidepressant that inhibits neuronal reuptake of dopamine and norepinephrine and increases dopamine and norepinephrine activity?

A

Bupropion

57
Q

What is the side effect of Bupropion?

A

Lowers seizure threshold

58
Q

What are the two antidepressants that lower the seizure threshold?

A

Bupropion and Amoxapine

59
Q

What are examples of monoamine oxidase inhibitors that are used as antidepressants?

A

Phenelzine
Selegiline
Tranylcypromine

60
Q

What happens when monoamine oxidase inhibitors are taken with cheese?

A

Hypertensive crisis

due to tyramine, an indirect-acting sympathomimetic present in cheese

61
Q

What are the signs and symptoms of serotonin syndrome?

A 
Fever
Agitation
Tremor
Clonus
Hyperreflexia
Diaphoresis
62
Q

What is the treatment for Serotonin syndrome

A

1st line treatment: Sedation, paralysis, intubation and ventilation
Other treatment: Cooling, Cryproheptadine and Chlorpromazine

63
Q

What are the symptoms of malignant hyperthermia

A 
Fever
Acidosis
Rhabdomyolysis
Trismus
Clonus
Hypertension
64
Q

What is the treatment for malignant hypertension?

A

Dantrolene

Pharmacology (13 decks)

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