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Pharmacology > Pharm 2 Exam 4 > Flashcards

Pharm 2 Exam 4 Flashcards

1
Q

SSRIs MOA + Uses (Fluoxetine)

A
  • MOA: selectively blocks reuptake of serotonin in the synaptic gap
  • Takes several weeks to become therapeutic (teach pt’s correct expectations)
  • Do NOT abruptly stop
  • Uses: Major depression, OCD, bulimia nervosa, panic disorder, PTSD, anxiety
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2
Q

SSRI (Fluoxetine) ADEs

A
  • Sexual dysfunction
  • CNS stimulation (take in the AM)
  • Weight changes
  • Serotonin syndrome (confusion, anxiety, sweating - early sx)
  • Withdrawal syndrome
  • Hyponatremia
  • Rash, GI distress
  • Sleepiness
  • Bruxism (clenching and grinding teeth)
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3
Q

SSRI Interactions

A
  • MAOIs, TCAs, and St. John’s wort can increase risk of serotonin syndrome
  • Can increase warfarin levels and suppress platelet aggregation
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4
Q

SNRIs (Venlafaxine)

A
  • Selectively blocks serotonin and norepinephrine
  • Same uses
  • Don’t stop abruptly
  • ADEs: HA, nausea, agitation, anxiety, sleep disturbances
  • Monitor for hyponatremia especially in elder adults, weight loss, and increased diastolic pressure
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5
Q

Atypical Antidepressants (Buproprion)

A
  • Uses: Depression, SAD, smoking cessation
  • ADEs: HA, dizziness, dry mouth, constipation, GI distress, restlessness, insomnia
  • Interacts with MAOIs
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6
Q

Tricyclic Antidepressants (Imipramine, Amitriptyline) MOA + Uses

A
  • Blocks reuptake of serotonin and norepinephrine
  • Depression, depressive episodes of bipolar disorder, neuropathic pain
  • Not first line for depression
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7
Q

TCAs ADEs

A
  • Narrow therapeutic window
  • Orthostatic hypotension, anticholinergic effects, sedating (take at bedtime), cholinergic toxicity resulting in cardiac effects (get baseline EKG), decreases seizure threshold, excessive sweating
  • Overdose is just 8 times daily dose - careful with SI patients
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8
Q

TCA Interactions & Cautions

A
  • MAOIs or St. John’s wort increases risk of serotonin syndrome
  • Antihistamines or anticholinergics
  • CNS depressants
  • Caution with patients with: CAD, DM, liver, kidney, or respiratory disorders, BPH, urinary retention or obstruction, hyperthyroidism
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9
Q

MAOIs (Nardil - phenelzine)

A
  • Block MAO enzyme in the brain increasing dopamine, serotonin, and norepinephrine
  • Used in depression and bulimia nervosa
  • LOTS of interactions
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10
Q

Benzodiazepines

A
  • MOA: enhance action of GABA in CNS
  • ADEs: CNS depression, anterograde amnesia, paradoxical response (stimulation), resp depression, physical dependence, acute toxicity.
  • Antidote : flumazenil (Romazicon)
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11
Q

Benzo Interactions

A
  • CNS depressants such as alcohol
  • Contraindicated in pregnancy, sleep apnea, resp depression, history of substance abuse
  • Older adults might need decreased doses
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12
Q

Non-Benzodiazepines MOA + Uses (Ambien)

A
  • MOA: enhance the action of GABA in the CNS resulting in prolonged sleep duration and decreased awakenings
  • Uses: management of insomnia
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13
Q

Non-Benzos ADEs + Interactions

A
  • Main ADE: daytime sleepiness
  • Interacts with: CNS depressants (avoid alcohol)
  • Caution with pregnancy & breastfeeding, older adults, impaired kidney, liver, or resp function
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14
Q

Atypical Anxiolytics (BuSpar - buspirone)

A
  • MOA: binds to serotonin and dopamine receptors
  • Uses: panic disorder, social anxiety disorder, OCD, PTSD
  • Meant for short term but can be used long term
  • No sedation or CNS depression, or withdrawal
  • Tolerated better with less ADEs
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15
Q

Atypical Anxiolytics (BuSpar) ADEs and Interactions

A
  • Dizziness, lightheadedness, nausea, HA, agitation
  • Interacts with erythromycin, ketoconazole, St. John’s wort, and grapefruit juice = all increase effects; MAOIs
  • Use caution with liver and renal failure pt’s
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16
Q

CNS stimulants (Ritalin - methylphenidate) MOA + Uses

A
  • MOA: raise levels of serotonin, norepinephrine, and dopamine in CNS
  • Uses: ADHD & Conduct disorder
17
Q

CNS stimulants ADEs & Interactions

A
  • ADEs: CNS stimulation (last dose before 4pm), weight loss, cardiovascular effects, psychotic manifestations, withdrawal medications, hypersensitivity reactions
  • Contraindications: High potential for substance use disorder, CV disorders, severe anxiety, and psychosis
  • Interacts with MAOIs, caffeine, phenytoin, warfarin, phenobarbital, OTC cold medicines
18
Q

Norepinephrine selective reuptake inhibitors (Srattera- atomoxetine)

A
  • MOA: blocks reuptake of norepinephrine
  • Used for ADHD
  • ADEs: appetite suppression, weight loss, growth suppression, GI effects, SI, hepatotoxicity
  • Interacts with MAOIs, Paxil, Prozac, Quinidine
19
Q

TCAs for ADHD (desipramine)

A
  • MOA: block reuptake of norepinephrine and serotonin
  • Can also be used for autism spectrum disorder, depression, panic, OCD
20
Q

Alpha-2 adrenergic agonists for ADHD (guanfacine)

A
  • MOA: activate presynaptic alpha-2 adrenergic receptors
  • ADEs: CNS effects, CV effects, weight gain
  • Interacts with CNS depressants, antihypertensives, high-fat foods
21
Q

Atypical Antipsychotics for ADHD (risperidone)

A
  • MOA: blocks serotonin, dopamine, norepinephrine, histamine, and acetylcholine receptors
  • Used for conduct disorder, autism spectrum disorder, PTSD, relief of psychotic manifestations
22
Q

1st generation Antipsychotics (Chlorpromazine - Thorazine) MOA + Uses

A
  • MOA: block dopamine, acetylcholine, histamine, norepinephrine in brain and periphery
  • Used for: treatment of acute and chronic psychotic disorders, manic bipolar disorders, schizophrenia spectrum, tourette’s
23
Q

1st generation Antipsychotics ADEs

A
  • Extra-pyramidal side effects such as movement disorders
  • neuroleptic malignant syndrome
  • Anticholinergic effects, neuroendocrine effects, seizures, skin effects, orthostatic hypotension, sedation, sexual dysfunction, agranulocytosis, severe dysrhythmias
24
Q

2nd generation Antipsychotics MOA + Uses (Risperidone - Risperdal)

A
  • MOA: mainly block serotonin and dopamine (to a lesser degree). Also blocks Ach, Norepi, histamine
  • Used for: schizophrenia spectrum, psychotic episodes induced by levodopa, relief of psychotic manifestations
25
Q

2nd gen Antipsychotics ADEs

A
  • DM and poor glucose level control
  • Weight gain, hypercholesterolemia, orthostatic hypotension, anticholinergic effects, mild EPS
  • Agitation, dizziness, sedation, sleep disruption
26
Q

Lithium Carbonate for Bipolar (Lithane)

A
  • MOA: produces neurochemical changes in the brain, including serotonin receptor blockade
  • Used to control acute mania, prevention of the return of mania/depression, decreases incidence of suicide
27
Q

Lithium carbonate ADEs

A
  • GI distress (n/v, ab pain)
  • Fine hand tremors
  • Polyuria, thirst
  • Weight gain, renal toxicity, hypothyroidism with goiter
  • Bradydysrhythmias, hypotension, and electrolyte imbalances
28
Q

Dopamine Replacement for PD (Levodopa/Carbidopa - Sinemet)

A
  • Most effective treatment but usually beneficial effects wear off in 5 years
  • “Off times” increase closer to 5 year mark
29
Q

Levodopa/Carbidopa - Sinemet ADEs

A
  • N/V, drowsiness
  • Dyskinesias
  • Orthostatic hypotension
  • CV effects (beta-1 stimulation)
  • Psychosis
30
Q

Dopamine Agonists (Ropinirole- Requip)

A
  • Used in early stages of PD; given with Sinemet in later stages
  • ADEs: Sleepiness, orthostatic hypotension, psychosis, impulse control disorder, dyskinesia, nausea
31
Q

COMT Inhibitors (Entacapone, Tolcapone)

A
  • MOA: inhibits breakdown of Levodopa/Carbidopa
  • ADEs: same as dopamine agonists; GI symptoms
  • Use caution with impaired hepatic function

Pharmacology (6 decks)

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