Pharm 12 Flashcards
Enhances dopaminergic neurotransmission.
SE’s include CNS excitation, acute toxic psychosis and livedo reticularis
Amantadine
MAO-B Inhibitor (which metabolizes dopamine), used adjunct to levodopa or as sole agent in newly diagnosed Parkinson pts
Selegiline
Inhibitors of catechol-O-methyltransferase (COMT), used as adjuncts in Parkinson and cause acute hepatic failure (monitor LFT’s)
Entacapone and Tolcapone
Agent decreases the excitatory actions of cholinergic neurons. May improve tremor and rigidity but have LITTLE effect on bradykinesia. Atropine-like side effects
Benztropine
Agent effective in physiologic and essential tremor
Propranolol
Agents used in Huntington’s Disease
Tetrabenazine (amine depleting drug), Haloperidol (antipsychotic)
Agents used in Tourette’s
Haloperidol or pimozide
Chelating agent used in Wilson’s disease
Penicillamine
Extrapyramidal dysfunction is more common with these agents, which block this subtype of dopamine receptor
Older high potency typical antipsychotic agents (haloperidol, fluphenazine, pimozide)
Block D2 receptors
Antipsychotics that reduce positive symptoms only
Older antipsychotics
Newer atypical antipsychotics that also improve some of the negative symptoms and help acute agitation
Olanzapine and aripiprazole
Newer atypical antipsychotic used for bipolar disorder, known to cause weight gain, and adversely affect diabetes
Olanzapine
Agent more frequently associated with extrapyramidal side effects that can be treated with benzodiazepine, diphenhydramine or muscarinic blocker
Haloperidol
Agents may exacerbate tardive dyskinesias (may be irreversible and there is no treatment)
Muscarinic blockers (atropine, scopolamine, ipratropium, benztropine, oxybuntin)
Antipsychotic having the weakest autonomic effects
Haloperidol
Only phenothiazine not exerting antiemetic effects.
Can cause visual impairment due to retinal deposits, and high doses have been associated with ventricular arrhythmias
Thioridazine
Anti-psychotics available in depot preparation (injected, slow release)
Fluphenazine and haloperidol
Reduced seizure threshold
Low-potency typical antipsychotics (chlorpromazine, thioridazine) and clozapine (atypical)
Orthostatic hypotension and QT prolongation
Low potency (chlorpromazine, thioridazine) and risperidone (atypical)
Increased risk of developing cataracts
Quetiapine
Drug increases the renal clearance hence decreases levels of lithium
Theophylline
Lithium is associated with this congenital defect
Cardiac anomalies and is contraindicated in pregnancy or lactation
Example of three antidepressants that are indicated for obsessive compulsive disorder
Clomipramine, fluoxetine and fluvoxamine
Neurotransmitters affected by the action of antidepressants
Norepinephrine and serotonin
Usual time needed for full effect of antidepressant therapy
2 to 3 weeks
Population group especially sensitive to side effects of antidepressants
Elderly patients
All antidepressants have roughly the same efficacy in treating depression, agents are chosen based on these criterion
Side-effect profile and prior pt response
Well-tolerated and are first-line antidepressants
SSRI’s, bupropion, and venlafaxine
Most useful in patients with significant anxiety, phobic features, hypochondriasis, and resistant depression
Monamine oxidase inhibitors
Condition will result from in combination of MAOI with tyramine containing foods (ex. wine, cheese, and pickled meats)
Hypertensive crisis
