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Pharmacology II > Pharm 2 exam 2 > Flashcards

Pharm 2 exam 2 Flashcards

1
Q

What drugs notably don’t have a potential for abuse?

A

Antipsychotics

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2
Q

Which drug is good for treating nausea?

A

Dronabinol (Cannabinoid)

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3
Q

What are the Peripheral Tissue Effects of opioids?

A

– Lowered activity of GI system – Urine retention – Uterine relaxation (bad for labor!)

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4
Q

Analgesia is mediated mainly by receptors in ______

A

spinal cord

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5
Q 
Name drug class:
 Reduction of Anxiety
 Sedative and Hypnotic
 Anterograde Amnesia
 Anticonvulsant
 Muscle Relaxant
 anesthetic
A

Benzodiazepines

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6
Q

Tramadol

A

Opiate agonist. Pain management. weak SNRI.

Caution in pts SSRI, tricyclics, or MAOIs

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7
Q

Which antidepressant helps with nicotine withdrawal?

A

Bupropion

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8
Q

How does someone get Anesthetic-induced corneal syndrome? What happens?

A

Occurs within 6 days to 6 weeks of self-administration of anesthetic (like proparacaine)
Loss of epithelium, inhibition of healing, stromal edema

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9
Q

Name drug:
– Anxiety • HTN, tachycardia, paranoia – Depression • Stimulation is followed by period of depression – Can induce seizures as well as arrhythmias

A

Cocaine

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10
Q

Modafinil

A

Psychomotor Stimulant, Amphetamine. UNIQUE MOA: Targets DA transporter to prevent DA reuptake.
Tx Narcolepsy
AE: Addiction, dependence and tolerance. – Insomnia, irritability, weakness, dizziness, tremor and hyperactive reflexes – Confusion, delirium, panic states, suicidal tendencies – Heart palpitations, arrhythmias, HTN, angina – Nausea, vomiting, abdominal cramps and diarrhea

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11
Q

What is the precursor of glutamate? How is glutamate broken down?

A

Glutamine + glutaminase = glutamate.

glutamine synthetase breaks it down

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12
Q

How does a local anesthetic block pain? How does this differ from opioids?

A

They block Na channel to prevent propagation of pain signal.

Opioids block pain in the spinal cord

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13
Q

What is the traditional treatment for mania?

A

Lithium

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14
Q

How does ethanol affect smooth muscle?

A

It relaxes smooth muscle to cause vasodilation. This can result in hypothermia, esp in cold places

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15
Q

Which drug blocks NMDA glutamate receptor to inhibit reuptake of DA, 5-HT, and NE?

A

Phencyclidine (PCP)

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16
Q

_____ neurons are the most numerous type

A

Multipolar

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17
Q

Paroxetine (Paxil)

A

SSRI. Tx depression. AE: Dry mouth, GI distress, Agitation, insomnia, Sexual dysfunction

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18
Q

Phenelzine

A

MAOI. Tx depression. Increase NE 5HT and DA. AE: Orthostatic hypotension, Serotonin syndrome, Sleep disturbances, weight gain, blurred vision, dry mouth, sexual dysfunction

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19
Q

What is the pathway of Epinephrine?

A

Tyrosine (tyrosine hydroxylase)> L-Dopa (aromatic AA decarb)> DA (DA beta hydroxylase)> NE > Epi

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20
Q

What makes ACh?

A

Acetyl + Choline through enzyme choline acetyltransferase = ACh

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21
Q

Methadone

A

Opioid Agonist. Longer duration of action than morphine. Good ORALLY
Helps to lessen withdrawal.
– Analgesia – Drowsiness/sedation – Euphoria – Dysphoria (confusion) – Pupillary constriction – Nausea and vomiting – Respiratory depression – Cough suppression – Decreased BP
– Lowered activity of GI system – Urine retention – Uterine relaxation (bad for labor!)
not for Shock, Bronchial asthma, Head injuries (can increase intracranial pressure), During labor (Obstetrics), Emphysema/asthma because reduces respiratory rate

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22
Q

What are the primary amine NTs?

A

Ach, DA, NE, Epi, 5-HT, Histamine

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23
Q

Opioids

A

Preanesthetic Medication and Intravenous General Anesthetic.

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24
Q

Tranylcypromine

A

MAOI. Tx depression. Increase NE 5HT and DA. AE: Orthostatic hypotension, Serotonin syndrome, Sleep disturbances, weight gain, blurred vision, dry mouth, sexual dysfunction

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25
Q

Lithium

A 
Tx Mania. MOA unknown.
AE:
Tremor
Ataxia
Aphasia
Mental confusion 
Decreased thyroid function
Polydipsia and polyuria
Edema
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26
Q

Lisdexamfetamine

A

Psychomotor Stimulant, Amphetamine. MOA: MAO stores this drug in vesicle instead of NE/DA, so these NTs are out in cleft longer)
AE: Addiction, dependence and tolerance. – Insomnia, irritability, weakness, dizziness, tremor and hyperactive reflexes – Confusion, delirium, panic states, suicidal tendencies – Heart palpitations, arrhythmias, HTN, angina – Nausea, vomiting, abdominal cramps and diarrhea

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27
Q

Which two drugs are especially good at treating restless legs syndrome?

A

Pramipexole or ropinirole (DA agonist for parkinson’s)

Pram- Ropi-

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28
Q

Benztropine

A

Anti-parkinson Drugs, Anticholinergic Agents, useful in early stages to reduce tremors. can cause blurry vision, bad for glaucoma pts

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29
Q

Barbiturates

A

Intravenous General Anesthetic. binds to GABA receptor to enhance GABA.

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30
Q

Citalopram (Celexa)

A

SSRI. Tx depression. AE: Dry mouth, GI distress, Agitation, insomnia, Sexual dysfunction

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31
Q

Which abused drugs cause excitation of DA neurons

A

Nicotine, alcohol

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32
Q

Temazepam

A

Benzodiazepine. binds to GABA receptor to enhance GABA; also decreases GABA release. CAN’T OVERDOSE
actions: Reduction of Anxiety, Sedative and Hypnotic, Anterograde Amnesia, Anticonvulsant, Muscle Relaxant, anesthetic
AE: Amnesia, daytime sedation, Disinhibition, Some reports of “bizarre” behavior and hallucinations

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33
Q

What receptors does glutamate bind to? Which one has a Mg block inside the channel?

A

AMPA, NMDA, and kainate. NMDA is blocked by Mg

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34
Q

Ketamine

A

Intravenous General Anesthetic. Unknown MOA

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35
Q

Quetiapine (Seroquel)

A

2nd generation antipsychotic. D2 antagonist (and D3, D4, 5HT blocker) UNIQUE: tx Mania and Bipolar Disorder (good for depression)

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36
Q

____ helps ease opiate withdrawal

A

methadone

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37
Q

Thiothixene

A

1st generation antipsychotic. D2 antagonist.
AE:
Metabolic side effects (weight gain, DBM, etc)
Antiemetic effects
Beta-blocking effect (causes orthostatic hypotension w/ reflex tachycardia and arrhythmias)
Affects Ach (blurred vision, dry mouth)
Extrapyramidal side effects (Acute dystonia, akathisia, Tardive dyskinesia, Parkinson’s-like sign)

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38
Q 
Name drug's AE:
 Tremor
 Ataxia
 Aphasia
 Mental confusion
 Decreased thyroid function
 Polydipsia and polyuria
 Edema
A

Lithium

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39
Q

Dexmethylphenidate

A

Psychomotor Stimulant, Amphetamine. MOA: MAO stores this drug in vesicle instead of NE/DA, so these NTs are out in cleft longer)
AE: Addiction, dependence and tolerance. – Insomnia, irritability, weakness, dizziness, tremor and hyperactive reflexes – Confusion, delirium, panic states, suicidal tendencies – Heart palpitations, arrhythmias, HTN, angina – Nausea, vomiting, abdominal cramps and diarrhea

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40
Q

What a local anesthetic allow you to perform on the cornea?

A

Debridement • Diagnosis • Techniques

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41
Q

After GABA is removed from the synaptic cleft, it it taken up by the ____

A

Astrocytes

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42
Q

Clomipramine

A

Tricyclic antidepressants. block reuptake of NE and 5HT (but not DA). AE: Dry mouth, Confusion, Weight gain, Blurred vision, Increased IOP, Sedation, Sexual dysfunction

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43
Q

Chlorpromazine (Thorazine)

A

1st generation antipsychotic. D2 antagonist.
AE:
Metabolic side effects (weight gain, DBM, etc)
Antiemetic effects
Beta-blocking effect (causes orthostatic hypotension w/ reflex tachycardia and arrhythmias)
Affects ACh (blurred vision, dry mouth)
Extrapyramidal side effects (Acute dystonia, akathisia, Tardive dyskinesia, Parkinson’s-like sign)

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44
Q

Proparacaine

A

Local anesthetic. MOA: target Na channels in axon to prevent pain propagation to spinal cord. Not for prolonged use

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45
Q

___ and ___ are responsible for the progression of Alzheimer’s

A

Polymerization of beta amyloid protein forming tau tangles and fibrils

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46
Q

The monoamine theory of depression states that…

A

5-HT and NE are low in depression, but there is little evidence

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47
Q

Codeine

A

Partial Opioid Agonist, antitussive. good ORALLY

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48
Q

What can cause a Kayser Fleischer ring on the cornea?

A

Wilson’s Disease (copper metabolism problem that causes movement problems)

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49
Q

Both NE and 5-HT are (excitatory/inhibitory) NTs

A

Excitatory, except alpha 2

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50
Q

Escitalopram (Lexapro)

A

SSRI. Tx depression. AE: Dry mouth, GI distress, Agitation, insomnia, Sexual dysfunction

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51
Q

Trihexyphenidyl

A

Anti-parkinson Drugs, Anticholinergic Agents, useful in early stages to reduce tremors. can cause blurry vision, bad for glaucoma pts

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52
Q

What can treat narcolepsy?

A

Amphetamine, Armodafinil, Modafinil

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53
Q

Which ion is especially excitotoxic?

A

Calcium

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54
Q

Zaleplon

A

Benzodiazepine-like drug. short-term binds to GABA receptor to enhance GABA. Tx insomnia

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55
Q

Dextroamphetamine + Amphetamine

A

Psychomotor Stimulant, Amphetamine. MOA: MAO stores this drug in vesicle instead of NE/DA, so these NTs are out in cleft longer)
Tx: ADHD
AE: Addiction, dependence and tolerance. – Insomnia, irritability, weakness, dizziness, tremor and hyperactive reflexes – Confusion, delirium, panic states, suicidal tendencies – Heart palpitations, arrhythmias, HTN, angina – Nausea, vomiting, abdominal cramps and diarrhea

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56
Q

Clonazepam (Klonopin)

A

Benzodiazepine. binds to GABA receptor to enhance GABA; also decreases GABA release. CAN’T OVERDOSE
actions: Reduction of Anxiety, Sedative and Hypnotic, Anterograde Amnesia, Anticonvulsant, Muscle Relaxant, anesthetic
AE: Amnesia, daytime sedation, Disinhibition, Some reports of “bizarre” behavior and hallucinations

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57
Q

Which abused drugs block DA uptake

A

Cocaine, amphetamine, ecstasy

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58
Q

Fentanyl

A

Opioid Agonist.
– Analgesia – Drowsiness/sedation – Euphoria – Dysphoria (confusion) – Pupillary constriction – Nausea and vomiting – Respiratory depression – Cough suppression – Decreased BP
– Lowered activity of GI system – Urine retention – Uterine relaxation (bad for labor!)
not for Shock, Bronchial asthma, Head injuries (can increase intracranial pressure), During labor (Obstetrics), Emphysema/asthma because reduces respiratory rate

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59
Q

Zolpidem

A

Benzodiazepine-like drug. short-term binds to GABA receptor to enhance GABA. Tx insomnia

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60
Q

Name drug:
Low doses produce euphoria and arousal as well as relaxation – Improves attention, learning, problem solving, and reaction time. – High doses cause central respiratory paralysis and severe hypotension (medullary paralysis)

A

Nicotine

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61
Q

Alprazolam (Xanax)

A

Benzodiazepine. binds to GABA receptor to enhance GABA; also decreases GABA release. CAN’T OVERDOSE
actions: Reduction of Anxiety, Sedative and Hypnotic, Anterograde Amnesia, Anticonvulsant, Muscle Relaxant, anesthetic
AE: Amnesia, daytime sedation, Disinhibition, Some reports of “bizarre” behavior and hallucinations

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62
Q

Diazepam (Valium)

A

Benzodiazepine. TX MUSCLE SPASMS binds to GABA receptor to enhance GABA; also decreases GABA release. CAN’T OVERDOSE
actions: Reduction of Anxiety, Sedative and Hypnotic, Anterograde Amnesia, Anticonvulsant, Muscle Relaxant, anesthetic
AE: Amnesia, daytime sedation, Disinhibition, Some reports of “bizarre” behavior and hallucinations

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63
Q

What are opioids used for?

A

Relief of pain, kinda anesthesia, antidiarrheal, antitussive (codeine), Dyspnea (SOB, tx morphine meperidine), opiate addiction tx (methadone)

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64
Q

Thioridazine

A

1st generation antipsychotic. D2 antagonist.
AE:
Metabolic side effects (weight gain, DBM, etc)
Antiemetic effects
Beta-blocking effect (causes orthostatic hypotension w/ reflex tachycardia and arrhythmias)
Affects Ach (blurred vision, dry mouth)
Extrapyramidal side effects (Acute dystonia, akathisia, Tardive dyskinesia, Parkinson’s-like sign)

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65
Q

Rotigotine

A

Anti-parkinson Drugs and restless legs syndrome tx, Dopamine Agonists. Effective past failing point of other drugs. less dyskinesia than levodopa, but anorexia, nausea, vomiting, postural hypotension, and psychiatric reactions are common

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66
Q

Anticholinergics

A

Preanesthetic Medication. Prevent bradycardia and secretion of fluids into the respiratory tract

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67
Q

Oxycodone

A

(OxyContin) Opioid Agonist. Similar to morphine, good ORALLY.
– Analgesia – Drowsiness/sedation – Euphoria – Dysphoria (confusion) – Pupillary constriction – Nausea and vomiting – Respiratory depression – Cough suppression – Decreased BP
– Lowered activity of GI system – Urine retention – Uterine relaxation (bad for labor!)
not for Shock, Bronchial asthma, Head injuries (can increase intracranial pressure), During labor (Obstetrics), Emphysema/asthma because reduces respiratory rate

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68
Q

The synapse is ____ wide

A

20 nm

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69
Q

Varenicline

A

Psychomotor Stimulant. Parasympathetic Agonist. MOA: partial agonist at neuronal nicotinic receptor. Good for reducing rewards of smoking

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70
Q

What can treat Tourette tics?

A 
haloperidol (1st generation antipsychotic. D2 antagonist)
  or clonidine (alpha 2 agonist)
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71
Q

Which drug is a melatonin receptor agonist?

A

Ramelteon

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72
Q

Bupivacaine

A

Local anesthetic. MOA: target Na channels in axon to prevent pain propagation to spinal cord. Not for prolonged use.
Longest duration injectible

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73
Q

Hydrocodone

A

Partial Opioid Agonist. Similar to morphine, good ORALLY

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74
Q

Buspirone

A

5HT receptor agonist. Tx anxiety

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75
Q

Triazolam

A

Benzodiazepine. binds to GABA receptor to enhance GABA; also decreases GABA release. CAN’T OVERDOSE
actions: Reduction of Anxiety, Sedative and Hypnotic, Anterograde Amnesia, Anticonvulsant, Muscle Relaxant, anesthetic
AE: Amnesia, daytime sedation, Disinhibition, Some reports of “bizarre” behavior and hallucinations

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76
Q

Benzodiazepines

A

Preanesthetic medication and Intravenous General Anesthetic. Benzodiazepine. binds to GABA receptor to enhance GABA; also decreases GABA release. CAN’T OVERDOSE

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77
Q

Midazolam (Versed)

A

Benzodiazepine. binds to GABA receptor to enhance GABA; also decreases GABA release. CAN’T OVERDOSE
actions: Reduction of Anxiety, Sedative and Hypnotic, Anterograde Amnesia, Anticonvulsant, Muscle Relaxant, anesthetic
AE: Amnesia, daytime sedation, Disinhibition, Some reports of “bizarre” behavior and hallucinations

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78
Q

Heroin

A

Opioid Agonist.
– Analgesia – Drowsiness/sedation – Euphoria – Dysphoria (confusion) – Pupillary constriction – Nausea and vomiting – Respiratory depression – Cough suppression – Decreased BP
– Lowered activity of GI system – Urine retention – Uterine relaxation (bad for labor!)
not for Shock, Bronchial asthma, Head injuries (can increase intracranial pressure), During labor (Obstetrics), Emphysema/asthma because reduces respiratory rate

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79
Q

Aripiprazole (Abilify)

A

2nd generation antipsychotic. D2 antagonist (and D3, D4, 5HT blocker). UNIQUE: tx Mania and Bipolar Disorder

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80
Q

Nortriptyline

A

Tricyclic antidepressants. block reuptake of NE and 5HT (but not DA). AE: Dry mouth, Confusion, Weight gain, Blurred vision, Increased IOP, Sedation, Sexual dysfunction

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81
Q

Antacids

A

Preanesthetic Medication

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82
Q

Desflurane

A

Inhaled General Anesthetic. interacts with ion channel proteins

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83
Q

Chlordiazepoxide (Librium)

A

Benzodiazepine. binds to GABA receptor to enhance GABA; also decreases GABA release. CAN’T OVERDOSE
actions: Reduction of Anxiety, Sedative and Hypnotic, Anterograde Amnesia, Anticonvulsant, Muscle Relaxant, anesthetic
AE: Amnesia, daytime sedation, Disinhibition, Some reports of “bizarre” behavior and hallucinations

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84
Q

Chronic use of ___ actually depletes DA

A

Cocaine

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85
Q

Donepezil (Aricept)

A

Alzheimer’s treatment (and myasthenia gravis tx), Cholinesterase inhibitor.
AE: tremors, nausea, anorexia, bradycardia, diarrhea, myalgia

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86
Q

(drug class) produces dyskinesias less frequently than levodopa, but other side effects more common

A

DA agonists (in parkinson’s)

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87
Q

Procaine (Novocain)

A

Local anesthetic. MOA: target Na channels in axon to prevent pain propagation to spinal cord. Not for prolonged use

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88
Q

What glutamate channels let Na through? Which one does Na, K, and Ca?

A

AMPA, NMDA, and kainate, but NMDA lets the other ions through

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89
Q

Mepivacaine

A

Local anesthetic. MOA: target Na channels in axon to prevent pain propagation to spinal cord. Not for prolonged use

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90
Q

For preanesthetic meds, what reduces anxiety. Causes sedation. Prevents allergic reactions. Reduces gastric acidity. Prevents vomiting. And reduces pain?

A

Benzodiazepines reduce anxiety. Barbiturates cause sedation. Antihistamines revent allergic reactions. Rantidine reduces gastric acidity. Antiemetics prevent vomiting. Opioids reduce pain

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91
Q

Levorphanol

A

Opioid Agonist.
– Analgesia – Drowsiness/sedation – Euphoria – Dysphoria (confusion) – Pupillary constriction – Nausea and vomiting – Respiratory depression – Cough suppression – Decreased BP
– Lowered activity of GI system – Urine retention – Uterine relaxation (bad for labor!)
not for Shock, Bronchial asthma, Head injuries (can increase intracranial pressure), During labor (Obstetrics), Emphysema/asthma because reduces respiratory rate

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92
Q

Opening GABA channels lets ___ to flow ___ the cell

A

Cl flows into the cell (hyperpolarizing it)

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93
Q

What can treat ADHD?

A

Amphetamines. Especially Dextroamphetamine (w/ wo/ Amphetamine), Methylphenidate

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94
Q

What can treat alcohol or opiate addiction?

A

Benzodiazepines

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95
Q

Lorazepam

A

Benzodiazepine. binds to GABA receptor to enhance GABA; also decreases GABA release. CAN’T OVERDOSE
actions: Reduction of Anxiety, Sedative and Hypnotic, Anterograde Amnesia, Anticonvulsant, Muscle Relaxant, anesthetic
AE: Amnesia, daytime sedation, Disinhibition, Some reports of “bizarre” behavior and hallucinations

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96
Q

Estazolam

A

Benzodiazepine. binds to GABA receptor to enhance GABA; also decreases GABA release. CAN’T OVERDOSE
actions: Reduction of Anxiety, Sedative and Hypnotic, Anterograde Amnesia, Anticonvulsant, Muscle Relaxant, anesthetic
AE: Amnesia, daytime sedation, Disinhibition, Some reports of “bizarre” behavior and hallucinations

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97
Q

Nitrous oxide

A

Inhaled General Anesthetic. interacts with ion channel proteins

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98
Q

Biperiden

A

Anti-parkinson Drugs, Anticholinergic Agents, useful in early stages to reduce tremors. can cause blurry vision, bad for glaucoma pts

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99
Q

AE of SSRIs?

A

Dry mouth, GI distress, Agitation, insomnia, Sexual dysfunction

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100
Q

What do extrapyramidal side effects cause?

A

Acute dystonia (spasms)
akathisia (squirm)
Tardive dyskinesia (facial movements)
Parkinson’s-like signs.

These can arise from 1st gen antipsychotics

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101
Q

Which drug is a 5HT agonist and causes symp ANS activation?

A

Lysergic acid diethylamide (LSD)

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102
Q

Desipramine

A

Tricyclic antidepressants. block reuptake of NE and 5HT (but not DA). AE: Dry mouth, Confusion, Weight gain, Blurred vision, Increased IOP, Sedation, Sexual dysfunction

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103
Q

For infected/inflamed patients, what should you change about your injection anesthetics?

A

You’ll likely need to use a larger dose because infection and/or inflammation is usually associated with acidosis. This ionizes drugs making them harder to enter cells.

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104
Q

Caffeine

A

Psychomotor stimulant. Methylxanthine. MOA: Blockade of adenosine receptors in CNS. indirectly increases DA. Simulates HCl secreation
AE: – Insomnia, anxiety, agitation – Emesis and convulsions at higher doses. Tolerence
Theophylline and theobromine are also metabolites of caffeine

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105
Q

Which NT Is only found in the CNS?

A

GABA

106
Q

___ is the only illicit drug that can cause death by dose AND from hyperthermia (because it impairs sweating and cutaneous vasodilation)

A

Cocaine

107
Q

Bipolar neurons are commonly ____neruons

A

Interneurons

108
Q

Greatest effect of opioid analgesics are at ___ receptors

A

Mu

109
Q

Amantadine

A

Anti-parkinson Drugs, Induces DA release. MOA unknown. Effective until “critical point”

110
Q

AE MAOIs?

A
  • Orthostatic hypotension
  • Serotonin Syndrome (acute HTN, cardiac problems, NE release makes Ser Syn worse. avoid tyramine to improve)
  • Sleep disturbances, weight gain, blurred vision, dry mouth, sexual dysfunction
111
Q

First generation antipsychotics characteristics:

A

(Thio- -azine Halo-)
Very good at treating positive signs of schizophrenia
D2 antagonists
Affects movement (bad)

112
Q

Eszopiclone

A

(Lunesta) Benzodiazepine-like drug. short-term binds to GABA receptor to enhance GABA. Tx insomnia

113
Q

How do you reverse the effects of Barbiturates?

A

You can’t! there is no barbiturate blockers, unlike Flumazenil for os

114
Q

Mirtazapine

A

alpha 2 blocker, enhances 5HT and NE neurotransmission. Atypical antidepressant. Also is a sedative

115
Q 
Name drug class MOA:
  increase in K conductance and a decrease in Ca conductance through inhibition of adenylyl cyclase and a decrease in the concentration of cAMP.
A

Opioids

116
Q

Which drug causes a phase I block? What is it?

A

Succinylcholine (Depolarizing agent). The muscle fiber can’t repolarize

117
Q

Pentobarbital (Nembutal)

A

Barbiturate. binds to GABA receptor to enhance GABA.
ACTIONS: CNS depression (for anesthesia)Suppress CO2 response, Induce CYP450 (decrease conc of other drugs including this class), Sedative and Hypnotic, anticonvulsant (not as common), anesthetic
AE: Addiction, Sedation, Hypotension, Lethal overdose

118
Q

Cisatracurium

A

Muscle relaxant, nondepolarizing Agent. less likely to produce toxic metabolite, Most commonly used in clinical practice.
MOA: Nicotinic antagonist
AE: Hyperkalemia, increased IOP, muscle pain
Tx: Surgical relaxation, Endotracheal Intubation, Control of ventilation (reduce chest wall resistance), Treatment of convulsions

119
Q

What is akathisia?

A

Pacing/squirming. It’s an extrapyramidal side effect. This can arise from 1st gen antipsychotics

120
Q

Trazodone

A

weak 5HT reuptake inhibitor. Atypical antidepressant

121
Q

Which GABA receptor is useful for drug targets?

A

GABAa, (ionotropic)

122
Q

Which drug is only available in combination with sodium fluorescein?

A

Benoxinate

123
Q

Succinylcholine

A

Muscle relaxant, Depolarizing Agent. Very short duration of action.
MOA: nicotinic agonist that doesn’t easily break down.
Causes flaccid paralysis because muscle can’t repolarize (phase I block)
Prolonged exposure causes difficulty in depolarization (phase II block)
AE: Cardiac arrhythmias, Hyperkalemia, increased IOP, muscle pain.
Succinylcholine can be antagonized with nondepolarizing blocker

124
Q

Tetracaine

A

Local anesthetic. available in gel for minor surgical procedures
MOA: target Na channels in axon to prevent pain propagation to spinal cord

125
Q

Cocaine causes ____ of normal pupil ( _____ in Horner’s)

A

Cocaine causes dilation of normal pupil ( no dilation in Horner’s syndrome)

126
Q 
Name drug class:
 CNS depression (for anesthesia)
 Suppress CO2 response
 Induce CYP450 (decrease conc of other drugs including this class)
 Sedative and Hypnotic
 anticonvulsant (not as common)
 anesthetic
A

Barbiturates

127
Q

Buprenorphine

A

Mixed Opiate Agonist-Antagonist. Show agonist activity in drug naïve patients or antagonist activity in patients with opioid dependence

128
Q

___% of pts don’t respond to a particular antidepressant

A

40%

129
Q

What is Tardive dyskinesia?

A

Involuntary, tic-like movements of lips, jaw, tongue, and may include trunk and limbs. This can arise from 1st gen antipsychotics

130
Q

Unipolar neurons tend to be ____ neurons

A

Sensory

131
Q

Doxepin

A

Tricyclic antidepressants. block reuptake of NE and 5HT (but not DA). AE: Dry mouth, Confusion, Weight gain, Blurred vision, Increased IOP, Sedation, Sexual dysfunction

132
Q

Olanzapine

A

2nd generation antipsychotic. D2 antagonist (and D3, D4, 5HT blocker)

133
Q

Duloxetine (Cymbalta)

A

SNRI. Tx depression (associated with chronic pain). AE: LESS SEVERE Dry mouth, Confusion, Weight gain, Blurred vision, Increased IOP, Sedation, Sexual dysfunction

134
Q

Rocuronium

A

Muscle relaxant, nondepolarizing Agent. highly dependant on liver metabolism
MOA: Nicotinic antagonist
AE: Hyperkalemia, increased IOP, muscle pain
Tx: Surgical relaxation, Endotracheal Intubation, Control of ventilation (reduce chest wall resistance), Treatment of convulsions

135
Q

Oxazepam

A

Benzodiazepine. binds to GABA receptor to enhance GABA; also decreases GABA release. CAN’T OVERDOSE
actions: Reduction of Anxiety, Sedative and Hypnotic, Anterograde Amnesia, Anticonvulsant, Muscle Relaxant, anesthetic
AE: Amnesia, daytime sedation, Disinhibition, Some reports of “bizarre” behavior and hallucinations

136
Q

Nicotine

A

Psychomotor Stimulant. Parasympathetic Agonist. MOA: causes ganglionic stimulation/blockade at low/high doses
CNS: Low doses produce euphoria and arousal as well as relaxation – Improves attention, learning, problem solving, and reaction time. – High doses cause central respiratory paralysis and severe hypotension (medullary paralysis)
PNS: – Low doses • Increase blood pressure and heart rate • Decreased coronary blood flow • Increase bowel motor activity – High doses • Decreased blood pressure • Activity of GI tract and bladder cease
AE: Irritability and tremors – Intestinal cramps, diarrhea – Increased heart rate and blood pressure

137
Q

Baclofen

A

Muscle relaxant, Centrally Acting Spasmolytic Drugs.
MOA: GABAb agonist.
tolerance can develop.
tx: lower back pain, reducing cravings in alcoholics, in migraine patients

138
Q

To cross the BBB, drugs need to be charged or uncharged?

A

Uncharged

139
Q

Benoxinate (Fluress)

A

Local anesthetic. Less toxic than other topicals. Only available in combination with sodium fluorescein (Fluress)
MOA: target Na channels in axon to prevent pain propagation to spinal cord.
Not for prolonged use

140
Q

Galantamine

A

Alzheimer’s treatment (and myasthenia gravis tx), Cholinesterase inhibitor.
AE: tremors, nausea, anorexia, bradycardia, diarrhea, myalgia

141
Q

D_ is also present on the axon terminals

A

D2

142
Q

Theophylline

A

Psychomotor stimulant. Methylxanthine. MOA: Blockade of adenosine receptors in CNS. indirectly increases DA. Simulates HCl secreation. found in tea
AE: – Insomnia, anxiety, agitation – Emesis and convulsions at higher doses. Tolerence

143
Q

Name drug:
– Low doses • Increase blood pressure and heart rate • Decreased coronary blood flow • Increase bowel motor activity – High doses • Decreased blood pressure • Activity of GI tract and bladder cease

A

Nicotine

144
Q

Pramipexole

A

Anti-parkinson Drugs and restless legs syndrome tx, Dopamine Agonists. Effective past failing point of other drugs. less dyskinesia than levodopa, but anorexia, nausea, vomiting, postural hypotension, and psychiatric reactions are common

145
Q

Valproic acid

A

Tx mania (and epilepsy). Targets voltage-gated Na channels

146
Q 
Name drug class AE:
 Amnesia
 Daytime sedation
 Disinhibition
 Some reports of “bizarre” behavior and hallucinations
A

Benzodiazepines

147
Q

____ generation antipsychotics have a higher risk of metabolic side effects (like diabetes, hypercholesterolemia, weight gain)

A

Second gen (Ari- -apine -idone)

148
Q

When should you NOT give opiates?

A

– Shock
– Bronchial asthma
– Head injuries (can increase intracranial pressure)
– During labor (Obstetrics)
– Emphysema/asthma because reduces respiratory rate

149
Q

Venlafaxine (Effexor)

A

SNRI. Tx depression (associated with chronic pain). AE: LESS SEVERE Dry mouth, Confusion, Weight gain, Blurred vision, Increased IOP, Sedation, Sexual dysfunction

150
Q

Sertraline

A

SSRI. Tx depression. AE: Dry mouth, GI distress, Agitation, insomnia, Sexual dysfunction. UNIQUE: undergoes extensive 1st pass metabolism

151
Q

What are the 4 stages of anesthesia?

A

Stage 1 Analgesia
Stage 2 Excitement (delirium/violent)
Stage 3 Surgical anesthesia (eye and pupil movement stop)
Stage 4 Medullary paralysis (can be hard to come out of, death)

152
Q

Dextroamphetamine

A

(Dexedrine) Psychomotor Stimulant, Amphetamine. MOA: MAO stores this drug in vesicle instead of NE/DA, so these NTs are out in cleft longer)
Tx: ADHD
AE: Addiction, dependence and tolerance. – Insomnia, irritability, weakness, dizziness, tremor and hyperactive reflexes – Confusion, delirium, panic states, suicidal tendencies – Heart palpitations, arrhythmias, HTN, angina – Nausea, vomiting, abdominal cramps and diarrhea

153
Q

Ziprasidone

A

2nd generation antipsychotic. D2 antagonist (and D3, D4, 5HT blocker)

154
Q

What can Wilson’s Disease cause?

A

Tremor, rigidity, hypokinesia, dysphagia, and Kayser Fleischer ring

155
Q

Clorazepate

A

Benzodiazepine. binds to GABA receptor to enhance GABA; also decreases GABA release. CAN’T OVERDOSE
actions: Reduction of Anxiety, Sedative and Hypnotic, Anterograde Amnesia, Anticonvulsant, Muscle Relaxant, anesthetic
AE: Amnesia, daytime sedation, Disinhibition, Some reports of “bizarre” behavior and hallucinations

156
Q

Amitriptyline

A

Tricyclic antidepressants. block reuptake of NE and 5HT (but not DA). AE: Dry mouth, Confusion, Weight gain, Blurred vision, Increased IOP, Sedation, Sexual dysfunction

157
Q

Oxymorphone

A

Opioid Agonist.
– Analgesia – Drowsiness/sedation – Euphoria – Dysphoria (confusion) – Pupillary constriction – Nausea and vomiting – Respiratory depression – Cough suppression – Decreased BP
– Lowered activity of GI system – Urine retention – Uterine relaxation (bad for labor!)
not for Shock, Bronchial asthma, Head injuries (can increase intracranial pressure), During labor (Obstetrics), Emphysema/asthma because reduces respiratory rate

158
Q

Which abused drugs should epileptics not take?

A

Bupropion (weak SNRI)

159
Q

What is a benzodiazepine antagonist?

A

Flumazenil

160
Q

Tremors (other movement disorder) can be treated with …..

A

Propranolol (beta blocker)

161
Q

Dronabinol

A

Hallucinogens. Cannabinoid that decreases inhibition of presynaptic cannabinoid receptors
tx nausea

162
Q

Secobarbital

A

Barbiturate. binds to GABA receptor to enhance GABA.
ACTIONS: CNS depression (for anesthesia)Suppress CO2 response, Induce CYP450 (decrease conc of other drugs including this class), Sedative and Hypnotic, anticonvulsant (not as common), anesthetic
AE: Addiction, Sedation, Hypotension, Lethal overdose

163
Q

Alzheimer’s is from damage to the ____ in the brain

A

Neocortex

164
Q

What are the 4 GABA binding sites?

A

GABA, Barbiturate, Benzodiazepine, Ethanol

165
Q

What drugs are bad for glaucoma pts?

A

Cholinergic receptor blockers (trihexyphenidyl, benztropine, and biperiden) -tropine -den -dyl

166
Q

Apomorphine

A

Anti-parkinson Drugs and restless legs syndrome tx, Dopamine Agonists. Effective past failing point of other drugs. less dyskinesia than levodopa, but anorexia, nausea, vomiting, postural hypotension, and psychiatric reactions are common

167
Q

AE of Tricyclic antidepressants? Which drug class has similar but less severe AE?

A

Antagonize muscarinic, histamine, and adrenergic receptors causing:
Dry mouth, Confusion, Weight gain, Blurred vision, Increased IOP, Sedation, Sexual dysfunction

SNRIs have similar but less severe side effects.

168
Q

Propofol

A

Intravenous General Anesthetic. Unknown MOA

169
Q

What are the CNS effects of opioid stimulation?

A

– Analgesia – Drowsiness/sedation – Euphoria – Dysphoria (confusion) – Pupillary constriction – Nausea and vomiting – Respiratory depression – Cough suppression – Decreased BP

170
Q

What is the pathway for GABA?

A

Glutamine (glutaminase)> Glutamate (glutamic acid decarboxylase)> GABA

171
Q

_______(anesthesia agent) are not very good for pain. Pt can come out of sleep because of pain!

A

Inhalation agents are not very good for pain

172
Q

Which antidepressant is also a sedative?

A

Mirtazapine (Alpha 2 blocker), Trazodone and Nefazodone.

Also Tricyclic antidepressants

173
Q

Activation of ___ opioid receptors causes less Ca influx into the presynaptic nerve terminal, decreasing number of vesicles that can release NT. It basically decreases NT release

A

Kappa

174
Q

Which drug is found in tea?

A

theophylline

175
Q

What is the functional duration of short, intermediate, and long duration benzodiazepines?

A

5 hours
15 hours
2 days

176
Q

Antihistamines

A

Preanesthetic Medication. Prevention of allergic reactions

177
Q

Phencyclidine

A

(PCP) Hallucinogens. MOA: block NMDA glutamate receptor to inhibit reuptake of DA, 5-HT, and NE.
Effects: insensitivity to pain WITHOUT loss of consciousness (separation of mind and body), numbness of extremities, staggered gait, slurred speech, and muscular rigidity
alters perception wo/ reward and euphoria
AE: High doses can cause anesthesia, stupor, or coma where the eyes stay open
Flashbacks and psychosis

178
Q

Flurazepam

A

Benzodiazepine. binds to GABA receptor to enhance GABA; also decreases GABA release. CAN’T OVERDOSE
actions: Reduction of Anxiety, Sedative and Hypnotic, Anterograde Amnesia, Anticonvulsant, Muscle Relaxant, anesthetic
AE: Amnesia, daytime sedation, Disinhibition, Some reports of “bizarre” behavior and hallucinations

179
Q

Risperidone

A

2nd generation antipsychotic. D2 antagonist (and D3, D4, 5HT blocker)

180
Q

Which drugs alter perception wo/ reward or euphoria? Can cause flashbacks and psychosis?

A

Lysergic acid diethylamide (LSD) and

Phencyclidine (PCP)

181
Q

What can cause the development of extrapyramidal side effects?

A

Psychosis drug treatment (1st gen)

182
Q

Carbamazepine

A

Tx mania (and epilepsy). Targets voltage-gated Na channels.

183
Q

Imipramine

A

Tricyclic antidepressants. block reuptake of NE and 5HT (but not DA). AE: Dry mouth, Confusion, Weight gain, Blurred vision, Increased IOP, Sedation, Sexual dysfunction

184
Q

What are the 3 stages of anesthesia?

A

Induction, maintenance, and recovery

185
Q

Hydromorphone (Dilaudid)

A

Opioid Agonist.
– Analgesia – Drowsiness/sedation – Euphoria – Dysphoria (confusion) – Pupillary constriction – Nausea and vomiting – Respiratory depression – Cough suppression – Decreased BP
– Lowered activity of GI system – Urine retention – Uterine relaxation (bad for labor!)
not for Shock, Bronchial asthma, Head injuries (can increase intracranial pressure), During labor (Obstetrics), Emphysema/asthma because reduces respiratory rate

186
Q

Cocaine

A

Psychomotor Stimulant.and topical anesthetic (alpha agonist). MOA: Monoamine reuptake inhibitor (NE, 5HT, DA especially). Chronic depletes DA
Effect: • Increases mental awareness and induces euphoria • Produce hallucinations and delusions • Increases motor activity. Produces fight/flight response from increased NE

187
Q

Selegiline

A

MAO-B Inhibitor. Tx depression AND Parkinson’s Disease. Increase (a little NE) 5HT and DA. AE: Orthostatic hypotension, Serotonin syndrome, Sleep disturbances, weight gain, blurred vision, dry mouth, sexual dysfunction

188
Q

Acamprosate

A

Tx alcohol dependence. unknown MOA

189
Q

Which antidepressant class is especially effective at treating chronic pain with depression?

A

SNRIs

190
Q

Which antidepressant class has the longest half life?

A

SSRIs (24 hours or more)

191
Q

Lidocaine

A

Local anesthetic. Only FDA approved topical lidocaine formulation for ophthalmic procedures
MOA: target Na channels in axon to prevent pain propagation to spinal cord.
Not for prolonged use

192
Q

Armodafinil

A

Psychomotor Stimulant, Amphetamine. UNIQUE MOA: Targets DA transporter to prevent DA reuptake.
Tx Narcolepsy
AE: Addiction, dependence and tolerance. – Insomnia, irritability, weakness, dizziness, tremor and hyperactive reflexes – Confusion, delirium, panic states, suicidal tendencies – Heart palpitations, arrhythmias, HTN, angina – Nausea, vomiting, abdominal cramps and diarrhea

193
Q

What drug class shows amphetamine-like metabolites?

A

MOA inhibitors

194
Q

Which amphetamines have a more unique MOA?

A

Armodafinil and Modafinil (-finil)

195
Q

Dantrolene

A

Muscle relaxant, Direct-acting Muscle Relaxant.
MOA: blocks Ca channel in sarcoplasmic reticulum of skeletal muscle
Does not affect cardiac nor smooth muscle

196
Q

Which SSRI has once a week dosing?

A

Fluoxetine, 50 hr half life with potent metabolites

197
Q

How long does it take for an antidepressant to take effect?

A

2 to 12 weeks!

198
Q

What benzodiazepine is a muscle relaxant?

A

Diazepam (Valium)

199
Q

Activation of ____ opioid receptors leads to opening of K channels producing hyperpolarization , lowering AP frequency.

A

Mu or Delta

200
Q

What is Dynorphin?

A

A natural opiate. Protein that is synthesized within the cell body of a neuron

201
Q

Which amphetamine slowly enters the brain?

A

Methylphenidate (ritalin)

202
Q

Ropinirole

A

Anti-parkinson Drugs and restless legs syndrome tx, Dopamine Agonists. Effective past failing point of other drugs. less dyskinesia than levodopa, but anorexia, nausea, vomiting, postural hypotension, and psychiatric reactions are common

203
Q

Ramelteon (Rozerem)

A

Melatonin receptor agonist. other hypnotic. Tx insomnia

204
Q

What are the body’s natural opiates called?

A

Dynorphins, enkephalins, and endorphins

205
Q

What opioid do you want to avoid for patients taking SSRIs, tricyclics or MAOIs?

A

Tramadol

206
Q

Some think that Schizophrenia is from too ____ activity of the mesolimbic DA system.

A

much

207
Q

What evidence casts doubt on the monoamine theory of depression?

A

Chemical effect of antidepressants is very fast, but clinical effect is delayed by a few weeks, indicating possible “downstream effect”

208
Q

What is the “first choice” drugs for depression?

A

Tricyclic antidepressants and SSRIs (especially)

209
Q

Bupropion (Wellbutrin, Zyban)

A

weak SNRI. Atypical antidepressant. Helps with nicotine withdrawal. NOT for seizure pts.

210
Q

What ADHD tx is preferred in children?

A

Methylphenidate (ritalin)

211
Q

Rasagiline

A

Anti-Parkinson Drugs, MAOIs, inhibits DA-specific MAO-B

212
Q

Name drug class:
– Analgesia – Drowsiness/sedation – Euphoria – Dysphoria (confusion) – Pupillary constriction – Nausea and vomiting – Respiratory depression – Cough suppression – Decreased BP

A

Opioid

213
Q

What drug only treats anxiety and does not induce sedation?

A

Buspirone

214
Q

Amphetamine

A

Psychomotor Stimulant, Amphetamine. MOA: MAO stores this drug in vesicle instead of NE/DA, so these NTs are out in cleft longer)
Effects: Increased alertness, decreased fatigue, depressed appetite and insomnia, stimulates adrenergic system.
Tx: ADHD to increase DA. and Narcolepsy
AE: Addiction, dependence and tolerance. – Insomnia, irritability, weakness, dizziness, tremor and hyperactive reflexes – Confusion, delirium, panic states, suicidal tendencies – Heart palpitations, arrhythmias, HTN, angina – Nausea, vomiting, abdominal cramps and diarrhea

215
Q

Flumazenil

A

Benzodiazepine blocker. reverses anesthesia

216
Q

Which injection anesthetic has the longest duration? Shortest?

A

Bupivacaine (12 hours).

Procaine (45 min)

217
Q

Ethanol displays ___ order kinetics

A

Zero order kinetics

218
Q

Levodopa/Carbidopa

A

Anti-parkinson Drugs, DA precursor, effective up to a certain point (several years).
AE: affects NE and DA neurons in all of the brain. Also anorexia, tachycardia, nausea, hypotension.
Carbidopa prevents L-Dopa from being processed by NE neurons in PNS, making more L-Dopa available to the brain

219
Q

Phenobarbital

A

Barbiturate. binds to GABA receptor to enhance GABA.
ACTIONS: CNS depression (for anesthesia)Suppress CO2 response, Induce CYP450 (decrease conc of other drugs including this class), Sedative and Hypnotic, anticonvulsant (not as common), anesthetic
AE: Addiction, Sedation, Hypotension, Lethal overdose

220
Q 
Name drug class withdrawal response:
  Irritability, insomnia, nausea, vomiting, diarrhea, chills alternating with flushing, sweating, muscle cramps, pupil dilation
A

Opioids

221
Q

Tizanidine

A

Muscle relaxant, Centrally Acting Spasmolytic Drugs
MOA: Alpha-2 agonist
AE: Drowsiness
also effective for migraine

222
Q

What is good for reducing rewards of smoking?

A

Varenicline

223
Q

Which drug causes a phase II block? What is it?

A

Succinylcholine (Depolarizing agent). Prolonged exposure causes desensitized repolarization

224
Q

Which abused drugs disinhibit DA neurons

A

Opioids, benzodiazepines

225
Q

Atracurium

A

Muscle relaxant, nondepolarizing Agent. metabolite can cause seizures
MOA: Nicotinic antagonist.
AE: Hyperkalemia, increased IOP, muscle pain, cardiovascular effects.
Tx: Surgical relaxation, Endotracheal Intubation, Control of ventilation (reduce chest wall resistance), Treatment of convulsions

226
Q

What are the uses of neuromuscular blocking drugs?

A

Surgical relaxation, Endotracheal Intubation, Control of ventilation (reduce chest wall resistance), Treatment of convulsions

227
Q

Memantine

A

Alzheimer’s tx, NMDA receptor antagonist (blocks glutamate), reduces cytotoxic Ca. Less toxic than cholinesterase inhibitors.
AE (don’t memorize): – Confusion – Anxiety – Chills – Cough – Dry Mouth

228
Q

Isoflurane

A

Inhaled General Anesthetic. interacts with ion channel proteins

229
Q

Meperidine (Demerol)

A

Opioid Agonist. Analgesic, sedative, respiratory depressant. NO miotic effect
Weak antitussive and antidiarrheal properties
Slower development of tolerance and dependence than morphine.
– Analgesia – Drowsiness/sedation – Euphoria – Dysphoria (confusion) – Nausea and vomiting – Respiratory depression – Cough suppression – Decreased BP
– Lowered activity of GI system – Urine retention – Uterine relaxation (bad for labor!)
not for Shock, Bronchial asthma, Head injuries (can increase intracranial pressure), During labor (Obstetrics), Emphysema/asthma because reduces respiratory rate

230
Q

Methylphenidate

A

(Ritalin) Psychomotor Stimulant, Amphetamine. MOA: MAO stores this drug in vesicle instead of NE/DA, so these NTs are out in cleft longer)
Tx: ADHD
UNIQUE enters brain slowly
AE: Addiction, dependence and tolerance. – Insomnia, irritability, weakness, dizziness, tremor and hyperactive reflexes – Confusion, delirium, panic states, suicidal tendencies – Heart palpitations, arrhythmias, HTN, angina – Nausea, vomiting, abdominal cramps and diarrhea

231
Q

_____ have fewer and less severe side effects than tricyclic antidepressants and MAOIs

A

SSRIs

232
Q

What drugs can cause blurry vision?

A

Cholinergic receptor blockers (trihexyphenidyl, benztropine, and biperiden) -tropine -den -dyl

233
Q

What is the pathway of 5-HT?

A

Tryptophan (Tryptophan hydroxylase)> 5-HTP (aromatic AA decarboxylase)> 5-HT

234
Q

Sevoflurane

A

Inhaled General Anesthetic. interacts with ion channel proteins

235
Q

Morphine

A

Opioid Agonist. Analgesic, sedative, respiratory depressant, antitussive, antidiarrheal, miotic.
not for Shock, Bronchial asthma, Head injuries (can increase intracranial pressure), During labor (Obstetrics), Emphysema/asthma because reduces respiratory rate

236
Q

Entacapone

A

Anti-Parkinson Drugs, COMT Inhibitor to allow for more L-Dopa.
AE: Diarrhea, abdominal pain, orthostatic hypotension, sleep disturbances

237
Q

How is physical dependence on opioids?

A

Very common but requires chronic use

238
Q

Tetrahydrocannabinol (THC)

A

Hallucinogens. MOA: Decreases inhibition on presynaptic cannabinoid receptors
Effects: euphoira, drowsiness/relaxation, Depresses short-term memory and mental activity, impairs motor ability. APPETITE STIMULATION, visual hallucinations, delusions, enhancement of sensory activity, NOVELTY
AE: heavy users feel bored when not taking drug. – Reddening of the conjunctiva – Increased progression of HIV – Increased heart rate – Decreased blood pressure
Bad glaucoma treatment

239
Q

Nefazodone

A

weak 5HT reuptake inhibitor. Atypical antidepressant

240
Q

What is the future treatment strategy for Alzheimer’s? what is done currently?

A

Reduce presence and aggregation of beta amyloid protein .

Current: Cholinesterase inhibitors and Glutamatergic antagonists

241
Q

Haloperidol (Haldol)

A

1st generation antipsychotic. D2 antagonist. UNIQUE: tx for Tourette tics
AE:
Metabolic side effects (weight gain, DBM, etc)
Antiemetic effects
Beta-blocking effect (causes orthostatic hypotension w/ reflex tachycardia and arrhythmias)
Affects Ach (blurred vision, dry mouth)
Extrapyramidal side effects (Acute dystonia, akathisia, Tardive dyskinesia, Parkinson’s-like sign)

242
Q

Naltrexone

A

Tx alcohol dependence. opiate antagonist. Used w/ psychotherapy support

243
Q

Rivastigmine

A

Alzheimer’s treatment (and myasthenia gravis tx), Cholinesterase inhibitor.
AE: tremors, nausea, anorexia, bradycardia, diarrhea, myalgia

244
Q

It is very hard or impossible to overdose on…

A

Benzodiazepines (by themselves)

245
Q

Protriptyline

A

Tricyclic antidepressants. block reuptake of NE and 5HT (but not DA). AE: Dry mouth, Confusion, Weight gain, Blurred vision, Increased IOP, Sedation, Sexual dysfunction

246
Q 
Name drug class AE:
 Addiction
 Sedation
 Hypotension
 Lethal overdose
A

Barbiturates

247
Q

Naloxone

A

(Narcan) Opioid antagonist. Tx opiate overdose (that is not a coma). IV ONLY
Coma = Pinpoint pupils, respiratory depression, coma

248
Q

Lysergic acid diethylamide

A

(LSD) Hallucinogens. MOA: 5HT agonist and symp ANS activation
alter perception wo/ reward and euphoria
AE: Hyperreflexia, nausea and muscular weakness. TRUE dependence is rare.
Flashbacks and psychosis

249
Q

What are the symptoms of Alzheimer’s Disease?

A

Impairment of memory and judgement, Impairment of abstract thinking, Changes in personality

250
Q

Vecuronium

A

Muscle relaxant, nondepolarizing Agent. highly dependant on liver metabolism
MOA: Nicotinic antagonist
AE: Hyperkalemia, increased IOP, muscle pain
Tx: Surgical relaxation, Endotracheal Intubation, Control of ventilation (reduce chest wall resistance), Treatment of convulsions

251
Q

Nalbuphine

A

Mixed Opiate Agonist-Antagonist. Show agonist activity in drug naïve patients or antagonist activity in patients with opioid dependence

252
Q

Antiemetics

A

Preanesthetic Medication. Prevent nausea and possible aspiration of stomach contents

253
Q

Fluoxetine

A

SSRI. Tx depression. AE: Dry mouth, GI distress, Agitation, insomnia, Sexual dysfunction UNIQUE: very long half-life (dose once/week), especially good with bipolar

254
Q

Articaine

A

Local anesthetic. MOA: target Na channels in axon to prevent pain propagation to spinal cord. Not for prolonged use

255
Q

The resting membrane potential of a neuron is ___

A

-65 mV

256
Q

What drug can induce psychotic behavior?

A

Ldopa

257
Q

Disulfiram

A

Tx alcohol dependence. inhibits aldehyde dehydrogenase

258
Q

Clozapine

A

2nd generation antipsychotic. D2 antagonist (and D3, D4, 5HT blocker)

259
Q

Etomidate

A

Intravenous General Anesthetic. Unknown MOA

260
Q

fluphenazine

A

1st generation antipsychotic. D2 antagonist.
AE:
Metabolic side effects (weight gain, DBM, etc)
Antiemetic effects
Beta-blocking effect (causes orthostatic hypotension w/ reflex tachycardia and arrhythmias)
Affects ACh (blurred vision, dry mouth)
Extrapyramidal side effects (Acute dystonia, akathisia, Tardive dyskinesia, Parkinson’s-like sign)

261
Q

Which Alzheimer’s drugs have less side effects?

A

Memantine (NMDA antagonist, prevents influx of Ca)

Pharmacology II (7 decks)

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