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Pharm Neuro IV Flashcards

1
Q

Chlorpromazine

A

Typical antipsychotic D2 antagonist low potency Schizophrenia (+ symp.) psychosis, acute mania, Tourette syndrome Side effects: ANS (dry mouth), sedation, hypotension

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2
Q

Haloperidol

A

Typical antipsychotics D2 antagonist High potency Schizophrenia (+ symp.), Huntington’s Side effects: EPS tardive dyskinesia Neuroleptic malignant syndrome

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3
Q

Clozapine

A

Atypical antipsychotics D2/5HT2A antagonist (low ratio) Schizophrenia (- symp) SE: weight gain, *agranulocytosis*, seizures, prolonged QT

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4
Q

Olanzapine

A

Atypical antipsychotics D2/5HT2A antagonist (low ratio) Schizophrenia (- symp) SE: weight gain, prolonged QT

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5
Q

Quetiapine

A

Atypical antipsychotics D2/5HT2A antagonist (low ratio) Schizophrenia: (- symp) SE: weight gain, prolonged QT, some sedation

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6
Q

Risperidone

A

Atypical antipsychotics D2/5HT2A antagonist (low ratio) Schizophrenia (- symp) SE: increased prolactin (lactation and gynecomastia) irregular menstruation and fertility issues, DM type II, prolonged QT

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7
Q

Aripiprazole

A

Atypical antipsychotics D2 and 5HT1A Partial agonist, 5HT2A antagonist high potency Schizophrenia (- symp) SE: weight gain, headache, anxiety, insomnia, nausea, constipation, lightheadedness

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8
Q

Ziprasidone

A

Atypical antipsychotics D2/5HT2A antagonist (low ratio)

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9
Q

Paroxetine

A

SSRI Block SERT SE: sedation, constipation, weight gain, dry mouth, serotonin syndrome, SIADH, sexual dysfunction, withdrawal symptoms (

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10
Q

Sertraline

A

SSRI Block SERT SE: *GI distress*, activation insomnia, constipation, dry mouth, weight gain, serotonin syndrome, SIADH, sexual dysfunction, withdraw symptoms (

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11
Q

Citalopram

A

SSRI Block SERT SE: fewest of the SSRIs

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12
Q

Escitralopram

A

SSRI Block SERT SE: fewest of the SSRIs

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13
Q

Bupropion

A

NE DA reuptake inhibitor (NDRI) Depression (Wellbutrin), smoking cessation (Zyban) SE: insomnia/agitation, stimulant effects, headache, *seizures at high dose* no sedation, no addiction, no tolerance and no sexual SE no interaction with EtOH

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14
Q

Venlafaxine

A

SNRI SERT and NET blocker Depression, anxeity, panic, PTSD SE: Hypertension, anxeity, nausea, withdrawal symptoms, sexual dys., sedation

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15
Q

Duloxetine

A

SNRI SERT and NET blocker Depression, Diabetic peripheral neuropathy SE: Hypertension, anxeity, nausea, withdrawal symptoms, sexual dys., sedation

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16
Q

Trazodone

A

Mixed serotonin receptor and alpha 1 receptor blocker Insomnia, High doses for depression SE: sedation, nausea, priapism (trazo*bone*), postural hypotension

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17
Q

Mirtazapine

A

Alpha-2 adrenergic antagonist increase release of NE and 5HT 5HT2 and 3 receptor antagonist depression, insomnia SE: sedation, increase appetite, weight gain, dry mouth

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18
Q

Amitriptyline

A

TCADs NET/SERT reuptake block Major depression, peripheral neuropathy, chronic pain, migraine prophylaxis SE: Sedation, antimuscarinic (Amitriptyline >Desipramine), orthostatic hypotension, Convulsions, Coma, Cardiotoxicity (arrhythmias), respiratory depression

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19
Q

Nortriptyline

A

TCADs NET/SERT reuptake block Major depression, peripheral neuropathy, chronic pain, migraine prophylaxis SE: Sedation, antimuscarinic, orthostatic hypotension, Convulsions, Coma, Cardiotoxicity (arrhythmias), respiratory depression

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20
Q

Imipramine

A

TCADs NET/SERT reuptake block Major depression, enuresis SE: Sedation, antimuscarinic, orthostatic hypotension, Convulsions, Coma, Cardiotoxicity (arrhythmias), respiratory depression

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21
Q

Desipramine

A

TCADs NET reuptake block Major depression, peripheral neuropathy, chronic pain, migraine prophylaxis SE: Sedation, antimuscarinic (Amitriptyline >Desipramine), orthostatic hypotension, Convulsions, Coma, Cardiotoxicity (arrhythmias), respiratory depression

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22
Q

Clomipramine

A

TCADs (NET)/SERT reuptake block Major depression, OCD, peripheral neuropathy, chronic pain, migraine prophylaxis SE: *Sedation*, antimuscarinic , orthostatic hypotension, Convulsions, Coma, Cardiotoxicity (arrhythmias), respiratory depression

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23
Q

Phenelzine

A

MAOI Atypical depression, anxeity SE: Hypertensive crisis (tyramine), CNS stimulation, Serotonin syndrome

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24
Q

Fluoxetine

A

SSRI Block SERT SE: Hypertension, anxeity, nausea, withdrawal symptoms (lower risk with fluox), sexual dys., sedation

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25
Q

Selegiline

A

MAOI Parkinson’s SE: Hypertensive crisis (tyramine), CNS stimulation, Serotonin syndrome

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26
Q

Lithium

A

mechanism unknown (inhibition of phosphoinositol cascade) Mood stabilizer for bipolar blocks relapse and acute manic events SE: narrow therapeutic index (monitoring) LMNOP Movement (tremor) Nephrogenic Diabetes Insipitus O-hypOthyroid Pregnancy problems (Ebstein anomaly) polyuria (diabetes insipitus),

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27
Q

Carbamazepine

A

Antimanic agent

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28
Q

Alprazolam

A

Benzodiazepine agonist intensify GABA effects (binding alpha 1 and 2-5) Increase freq. of Cl- channel opening short acting, high potency acute management of anxiety. (situational anxiety) ,SE: Dependence, additive depressant effects w/ EtOH, anterograde amnesia, abuse

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29
Q

Flurazepam

A

Benzodiazepine agonist intensify GABA effects (binding alpha 1 and 2-5) Increase freq. of Cl- channel opening Anxiety, spasticity, detox, night terrors, sleepwalking, general anesthetic (amnesia, muscle relaxant), insomnia SE: Dependence, additive depressant effects w/ EtOH, anterograde amnesia, abuse

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30
Q

Diazepam

A

Benzodiazepine agonist intensify GABA effects (binding alpha 1 and 2-5) Increase freq. of Cl- channel opening longer half life acute management of anxiety. (situational anxiety) SE: Dependence, additive depressant effects w/ EtOH, anterograde amnesia, abuse

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31
Q

Oxazepam

A

Benzodiazepine agonist intensify GABA effects (binding alpha 1 and 2-5) Increase freq. of Cl- channel opening; short acting anxiety, insomnia, withdraw from EtOH SE: Dependence, additive depressant effects w/ EtOH, anterograde amnesia, abuse

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32
Q

Triazolam

A

Benzodiazepine agonist intensify GABA effects (binding alpha 1 and 2-5) Increase freq. of Cl- channel opening; short acting Insomnia SE: Dependence, additive depressant effects w/ EtOH, anterograde amnesia, abuse

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33
Q

Lorazepam

A

Benzodiazepine agonist intensify GABA effects (binding alpha 1 and 2-5) Increase freq. of Cl- channel opening short half life, high potency acute management of anxiety. (situational anxiety) good for elderly SE: Dependence, additive depressant effects w/ EtOH, anterograde amnesia, abuse

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34
Q

Midazolam

A

Benzodiazepine agonist intensify GABA effects (binding alpha 1 and 2-5) Increase freq. of Cl- channel opening; short acting anesthesia (adjunct), anxiety, insomnia SE: Dependence, additive depressant effects w/ EtOH, anterograde amnesia, abuse

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35
Q

Temazepam

A

Benzodiazepine agonist intensify GABA effects (binding alpha 1 and 2-5) Increase freq. of Cl- channel opening insomnia, anxiolytic, anticonvulsant, muscle relaxant SE: Dependence, additive depressant effects w/ EtOH, anterograde amnesia, abuse

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36
Q

Flumazenil

A

Benzodiazepine receptor ANTagonist used for OD of Benzo

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37
Q

Zolpidem

A

Non-BDZ Activate BZ1 subtype of GABA receptor Insomnia SE: Ataxia, headache, confusion less dependence risk, less amnesia

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38
Q

Eszopiclone

A

Non-BDZ Activate BZ1 subtype of GABA receptor Insomnia SE: Ataxia, headache, confusion less dependence risk, less amnesia

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39
Q

Zaleplon

A

Non-BDZ Activate BZ1 subtype of GABA receptor (GABA Cl- channel) Insomnia SE: Ataxia, headache, confusion less dependence risk, less amnesia

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40
Q

Pentobarbital

A

Barbiturates increase *duration* of GABA CL- channel opening Anxiety, seizures, insomnia, anesthesia (thiopental) SE: Respiratory and CV depression! CNS depression (worse w/ EtOH), dependence, DDI (P-450 inducer)

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41
Q

Phenobarbital

A

Barbiturates increase *duration* of GABA CL- channel opening Anxiety, seizures, insomnia, anesthesia (thiopental) SE: Respiratory and CV depression! CNS depression (worse w/ EtOH), dependence, DDI (P-450 inducer)

42
Q

Ramelteon

A

Melatonin Receptor Agonist

43
Q

Buspirone

A

5HT1A partial agonist (D2 antagonist) Anxiety

44
Q

Chloral hydrate

A

Enhance GABA receptor sedative-hyponitic class Short term insomnia treatment

45
Q

Cocaine

A

DAT (+SERT, NET) Stimulant

46
Q

Amphetamines

A

DAT (+SERT, NET) stimulant

47
Q

MDMA

A

ecstasy SERT>DAT, NET stimulants

48
Q

Nicotine

A

nicotinic receptor Stimulants

49
Q

Stimulants

A

Nicotine Cocaine Meth MDMA (ecstasy)

50
Q

Depressants

A

Alcohol Barbiturates Benzodiazepines

51
Q

Barbiturates

A

increase GABA-A, decrease NMDA

52
Q

Benzos

A

Increase GABA-A only antagonist: flumazenil

53
Q

Dissociative Anesthetics

A

Phencyclidine (PCP) Ketamine

54
Q

Phencyclidine

A

NMDA receptor antagonist

55
Q

Ketamine

A

NMDA receptor antagonist

56
Q

Opioid analgesics

A

Morphine heroin fentanyl meperidine

57
Q

Morphine

A

Mu-opioid receptor (Gi/o) agonist treat w/ naloxone

58
Q

Heroin

A

Mu-opioid receptor (Gi/o) agonist treat w/ naloxone

59
Q

Fentanyl

A

Mu-opioid receptor (Gi/o) agonist treat w/ naloxone

60
Q

Meperidine

A

Mu-opioid receptor (Gi/o) agonist treat w/ naloxone

61
Q

Cannabinoids

A

CB-1 receptor (Gi/o) agonist

62
Q

Hallucinogens

A

Lysergic acid diethyl amide (LSD) Mescaline (peyote)

63
Q

LSD

A

5HT-2A receptor (Gq) partial agonist

64
Q

Methadone

A

Treat opioid dependence binds Mu receptor agonist and NMDA antagonist

65
Q

Buprenorphine

A

partial mu agonist (avoid respiratory depression) Treat opioid addiction

66
Q

Nicotine

A

Help stop smoking Nicotinic receptors

67
Q

Varenicline

A

treat nicotine addiction agonist of nicotinic receptors

68
Q

Clonidine

A

Alpha 2 agonist treat withdrawal from EtOH, Opioids, smoking

69
Q

Disulfiram

A

Antabuse blocks enzyme acetaldehyde dehydrogenase treat alcoholism SE: metallic taste, headache, drowsiness, optic neuritis, peripheral neuropathy, hepatitis Contraindications: Risk MI, CVA, pregnant or if cognitively

70
Q

Naltrexone

A

antagonists at μ-opioid receptor, the κ-opioid receptor (KOR) to a lesser extent reverses effects of opioids and EtOH SE: Nausea, Headaches, anxiety, sedation If on opiates or heroin will go into withdrawal

71
Q

d-Amphetamine

A

Adderall Inhibits or reverses the transporter proteins for the monoamine Increases releases of monoamines Inhibits breakdown of monoamines

72
Q

Methylphenidate

A

Ritalin Blocks the dopamine transporter and norepinephrine transporter more remains in synaptic cleft

73
Q

-ipramine

74
Q

-etine

75
Q

-triptyline

76
Q

-zepam

77
Q

-zolam

78
Q

-barbital

A

Barbiturate

79
Q

-azine

A

Typical antipsychotics

80
Q

Nitrous Oxide

A

Gaseous anesthetics low potency, good analgesic paired with barbiturates or opioids rapid onset and recovery Problems: Concentration effect (faster uptake) Diffusion hypoxia (not enough O2) Second gas effect (more of paired GA)

81
Q

Volatile anesthetics

A

Desflurane Enflurane Halothane Isoflurane Sevoflurane

82
Q

Desflurane

A

Volatile anesthetics induce and maintain surgical anesthesia low blood and fatty tissue solubility (fast onset and recovery) Con: smells bad Do NOT use with pts w/ Family history of malignant hyperthermia

83
Q

Enflurane

A

Volatile anesthetics Maintenance of GA in adults Good analgesic and muscle relaxant fast induction and recovery Con: can trigger seizures

84
Q

Halothane

A

Volatile anesthetics mod to high potency; poor analgesic Three issues: -Respiratory and CV failure -Hepatotoxicity (metabolized in liver) -Malignant Hyperthermia

85
Q

Isoflurane

A

Volatile anesthetics most widely used Pros: more potent, less hepatotoxicity, less risk of seizure, good muscle relaxant Con: bad odor can lead to coughing

86
Q

Sevoflurane

A

Volatile anesthetics pleasant odor used for induction Con: releases fluoride ions–>renal toxicity

87
Q

IV anesthetics

A

Propofol Etomidate Thiopental

88
Q

Propofol

A

IV anesthetic Potentiates GABA-A receptor activity rapid onset, faster recovery than thiopental less nausea post-op

89
Q

Etomidate

A

IV anesthetic non-barbiturate hypnotic potentiates GABA-A no analgesia minimal depression of CV and respiratory function (larger safety margin) Con: can cause involuntary movements, lots of nausea and vomiting and pain on injection.

90
Q

Thiopental

A

Barbiturate (short acting) Potentiates GABA-A IV anesthetic Induction and short surgical procedures High potency, high lipid solubility, rapid entry into brain

91
Q

IV adjuncts for GA

A

Diazepam Ondansteron (anti-emetic) Fentanyl (analgesic) Glycopyrrolate (Anticholinergic) Ketamine (NMDA antagonist) Morphine Neuromuscular blocking agents Dantrolene (Ca2+ channel blocker)

92
Q

Diazepam

A

Valium Benzo–potentiates GABA-A used pre-op for induction and *sedative* purposes

93
Q

Ondansteron

A

5-HT3 receptor antagonist Anti-emetic reduces post-op nausea and vomiting

94
Q

Fentanyl

A

Mu receptor agonist Analgesics

95
Q

Glycopyrrolate

A

Anticholinergic drug reduce GA-induced hypotension, bradycardia, and excess salivations (prevent choking)

96
Q

Ketamine

A

NMDA receptor antagonist IV anesthetic–produces dissociative anesthesia (catatonia, amnesia, analgesia)

97
Q

Morphine

A

Mu receptor agonist Analgesics

98
Q

Neuromuscular blocking agents

A

Vecuronium Relax skeletal muscle (esp for abdominal surgeries)

99
Q

Dantrolene

A

prevents release of Ca2+ from sarcoplasmic reticulum of skeletal muscle Malignant hyperthermia and neuroleptic malignant syndrome

100
Q

Phenytonin

Neuro IV pharm (3 decks)

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