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1
Q

Precursor of 6-mercaptopurine

A

Azathioprine

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2
Q

Antibody that binds CD3 on T cells

A

Muromonab

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3
Q

Antibody that binds IL-2 receptor on activated T cells

A

Daclizumab

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4
Q

Inhibits inosine monophosphate dehydrogenase

A

Mycophenolate mofetil

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5
Q

Inhibits calcineurin–>loss of IL-2 production–> blockage of T cell differentiation and activation

A

Cyclosporine

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6
Q

Metabolized by Xanthine Oxidase, therefore allopurinol increases its toxicity

A

Azathioprine

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7
Q

What are the main actions of Captopril?

A

ACE inhibitor

  • decrease Angiotensin II
  • lower GFR by preventing constriction of efferent arterioles
  • Prevents inactivation of bradykinin (vasodilator)
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8
Q

What are the main AE of ACE inhibition?

A

“Captopril’s CATCHH”

  • Cough (due to increased bradykinin)
  • Angioedema (contra in C1 esterase inhibitor deficient pts)
  • Teratogen
  • Creatinine increase (due to decreased GFR)
  • Hyperkalemia
  • Hypotension
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9
Q

Why is Captopril contraindicated in pts with bilateral renal artery stenosis?

A

ACE inhibitors will further decrease GFR, leading to renal failure

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10
Q

What antibiotics are safe in pregnancy?

A 
Penicillins and aminopenicillins
Piperacillin
Cephalosporins
Macrolides (erythromycin, azithromycin)
Metronidazole
Nitrofurantoin
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11
Q

What are the two low potency typical antipsychotics?

A

Chlorpromazine, Thioridazine

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12
Q

What is the typical AE of the low potency typical antipsychotics?

A

Anticholinergic AE

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13
Q

What are the typical AE of high potency typical antipsychotics?

A

EPS, Tardive dyskinesia, NMS

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14
Q

Name 5 high potency typical antipsychotics

A 
Haloperidol
Fluphenazine
Loxapine
Thiothixene
Trifluoperazine
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15
Q

Drug class: Loxapine

A

high potency typical antipsychotic

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16
Q

Drug class: Haloperidol

A

high potency typical antipsychotics

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17
Q

Drug class: Fluphenazine

A

high potency typical antipsychotics

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18
Q

Drug class: Chlorpromazine

A

Low potency typical antipsychotics

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19
Q

Drug class: Thioridazine

A

Low potency typical antipsychotic

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20
Q

Drug class: Thiothixene

A

high potency typical antipsychotics

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21
Q

Drug class: Trifluoperazine

A

high potency typical antipsychotics

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22
Q

Are the (+) or (-) symptoms of schizophrenia easier to treat?

A

Positive symptoms are easier to treat

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23
Q

Name 5 Atypical antipsychotics

A 
Clozapine
Olanzapine
Quetiapine
Risperidone
Aripiprazole
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24
Q

How do the adverse affects of the atypical antipsychotics differ from the typical antipsychotics?

A

Fewer EPS, LEss anticholinergic AE (atypicals used preferentially over the typicals!)
-WEIGHT GAIN

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25
Q

Drug class: Clozapine

A

Atypical antipsychotic

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26
Q

Drug class: Olanzapine

A

Atypical antipsychotic

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27
Q

Drug class: Quetiapine

A

Atypical antipsychotic

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28
Q

Drug class: Risperidone

A

Atypical antipsychotic

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29
Q

Drug class: Aripiprazole

A

Atypical antipsychotic

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30
Q

Which class of antipsychotics work better on the negative symptoms of schizophrenia?

A

Atypicals. Atypicals still have greater effect on the positive symptoms however

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31
Q

What are the three drugs used for treating Tourette syndrome???

A

Fluphenazine (High potency typical antipsychotic)
Pimozide (High potency typical antipsychotic)
Tetrabenazine (degrades DA)

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32
Q

What affect does DA have on prolactin release? What affect would this have on a patient taking an antipsychotic drug?

A

DA inhibits prolactin release

D2 receptors antagonists can lead to amennorhea or galactorrhea (due to increased prolactin secretion)

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33
Q

What receptors do low potency neuroleptics have effect on?

A

Block D2 DA receptors
Block Muscarinic receptors
Block alpha 1 receptors –> hypotension
Block histamine receptors –> sedation

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34
Q

What are the symptoms of Neuroleptic malignant syndrome?

A

Muscle rigidity–>Hyperpyrexia–>Myoglobinuria–>Delirium–>ANS instability

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35
Q

How do we treat NMS?

A

Dantrolene, Bromocriptine (DA agonist)

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36
Q

What receptors do the atypical antipsychotics have effect on?

A

Block DA receptors
Block serotonin receptors
Block alpha receptors (hypotension)
Block Histamine receptors (Weight gain, sedation)

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37
Q

What disorders are Atypical antipsychotics used to treat?

A

Mania disorders
Bipolar disorder
Refractory depression
Anxiety disorders

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38
Q

Which atypical antipsychotic has the highest risk of Weight gain (and diabetes as a result)?

A

Olanzapine

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39
Q

What is the strongest atypical antipsychotic?

40
Q

WHAT AE DO YOU HAVE TO KNOW ABOUT CLOZAPINE

A

Agranulocytosis

41
Q

What antipsychotic call for weekly monitoring of the CBC?

A

Clozapine (checking for agranulocytosis)

42
Q

What atypical antipsychotic is used to treat psychosis from Parkinson meds?

A

Quetiapine (lowest risk of EPS)

43
Q

Which drug used to treat bipolar disorder can concurrently be used to treat SIADH?

A

Lithium
-Causes nephrogenic diabetes insipidus by blocking the integration of aquaporins into the membrane after stimulation by ADH

44
Q

What teratogenic effect is caused by lithium?

A

Ebstein anomaly

  • Tricuspid leaflets displaced inferiorly into right ventricle
  • Hypoplasia of right ventricle
  • Tricuspid regurge or stenosis
  • Patent foramen ovale
45
Q

What is the MC side effect of taking lithium?

46
Q

What mood stabilizers are used in the tx of bipolar disorder?

A

Lithium
Atypical antipsychotics
-Risperidone, aripiprazole, Olanzapine
Seizure medications
-Lamotrigine, valproic acid, carbamazepine

47
Q

What are the potential AE of lithium?

A 
Teratogenic
Polyuria (nephrogenic diabetes insipidus)
Arrhythmias
Hypothyroidism
Tremor, sedation, lethargy, dizziness
48
Q

Name 4 SSRIs

A

Citalopram
Sertraline
Paroxetine
Fluoxetine

49
Q

What are the two SNRIs?

A

Venlafaxine

Duloxetine

50
Q

Name 7 TCAs

A 
"triptylines, ipramines, doxepin, duloxetine"
Amitriptyline
Nortriptyline
Imipramine
Desipramine
Clomipramine
Doxepin
Amoxapine
51
Q

What is Imipramine classically used for?

A

TCA used for bedwetting (enuresis)

52
Q

Which TCA can be used for Fibromyalgia and Neuropathic pain?

A

Amitriptyline

53
Q

What are the notable AE of TCA overdose?

A 
"Tri-C's"
Convulsion
Coma
Cardiotoxicity
-also respiratory depression, Hyperpyrexia, confusion, hallucination
54
Q

How to treat cardiotoxicity caused by TCAs?

A

Sodium Bicarb (alkalinize the urine, TCAs are weak acids)

55
Q

What are the MAO inhibitors?

A 
"MAOI Takes Pride In Shanghai"
Phenelzine
Tranylcypromine
Isocarboxazid
Selegiline
56
Q

Is Selegiline used as an antidepressant?

A

No, Selegiline is an MAO-B inhibitor used to treat Parkinsonism. MAO-B selectively breaks down DA, so inhibiting it is helpful for Parkinson pts

57
Q

A pt stops taking their SSRI bc of lack of libido. What is a good alternative antidepressant this patient could take?

A

Bupropion (no sexual side effects)

  • Atypical antidepressant
  • NDRI (NE, DA reuptake inhibitor)
58
Q

What are the Atypical Antidepressants?

A

Bupropion
Mirtazepine
Trazodone

59
Q

What are the indications for Bupropion?

A

Atypical antidepressant used for both smoking cessation and depression

60
Q

What is the MOA for Bupropion?

A

NDRI=> NE, DA reuptake inhibitor

61
Q

Drug class: Mirtazepine

A

Atypical antidepressant

62
Q

Drug class: Bupropion

A

Atypical antidepressant

63
Q

Drug class: Trazodone

A

Atypical antidepressant

64
Q

What is the MOA of Mirtazepine?

A

Alpha-2 receptor antagonist (allows for increased NE and 5-HT)

  • recall the alpha2 receptor is located on the presynaptic terminal and has an inhibitory effect on NT release
  • Mirtazepine also antagonizes 5-HT receptors
65
Q

WHat is the MOA of Trazodone?

A

Blocks 5-HT and alpha1 adrenergic receptors

66
Q

What is Trazodone typically used for?

A

Treatment of insomnia (high levels are required for any antidepressant effects, so not used as an antidepressant often)

67
Q

What is the primary AE effect of Trazodone?

A

Priapism (trazoBONE)

68
Q

Why is bupropion contraindicated in an epileptic patient?

A

Lowers the seizure threshold

69
Q

Drug class: Nortriptyline

70
Q

Drug class: Selegiline

71
Q

Drug class: Bupropion

A

Atypical antidepressant, NDRI

72
Q

Drug class: Mirtazepine

A

Atypical antidepressant, alpha2 antagonist

73
Q

Drug class: fluvoxamine

74
Q

Drug class: doxepin

75
Q

Drug class: Phenelzine

76
Q

Drug class: Fluoxetine

77
Q

Drug class: Clomipramine

78
Q

Drug class: Imipramine

79
Q

Drug class: Amitriptyline

80
Q

Drug class: Milnacipran

81
Q

Drug class: Desipramine

82
Q

Drug class: Sertraline

83
Q

Drug class: Venlafaxine

84
Q

Drug class: Paroxetine

85
Q

Drug class: Tranylcypromine

86
Q

Drug class: Duloxetine

87
Q

Drug class: Citalopram

88
Q

Drug class: Desvenlafaxine

89
Q

Drug class: Trazodone

A

Atypical antidepressant, alpha1 blocker and 5-HT blocker

90
Q

Works well with SSRIs and increases REM sleep

91
Q

Appetite stimulant that’s likely to result in weight gain (Atypical antidepressant)

A

Mirtazepine

92
Q

Can be used for bed wetting in children

A

Imipramine

93
Q

Symptoms of serotonin syndrome?

A

Muscle rigidity
Hyperthermia
Cardiovascular collapse

94
Q

What happens if you ingest Tyramine while on MAOIs?

A

Hypertensive crisis, Hypertensive stroke, Cardiac arrhythmias.
-MAO normally metabolizes tyramine. Tyramine in excess will be converted to NE, which raises bp

95
Q

What drug is associated with dry mouth, blurred vision, tinnitus, mania

A

Amitriptyline (anticholinergic AE)

96
Q

For what condition is Buspirone indicated?

A

Generalized anxiety disorder

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