Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

HBHD > Pharm quiz > Flashcards

Pharm quiz Flashcards

1
Q

What do all antipsychotics do? Where in the brain do they work?

A

Antagonize D2; mesolimbic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are acute and chronic conditions associated with lithium use?

A

Acute: acute renal failure, seizure, coma, death
Chronic: chronic renal insufficiency (or is it just us getting old?), hypothyroidism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Side effects of stimulants

A

GI and headache (transient), insomnia, growth concerns, cardiac (monitor pulse and BP), tics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is amitriptyline used for? Imipramine? What is the name for this class of medications?

A

Amitriptyline - insomnia, neuropathic pain, migraine prophylaxis
Imipramine - pediatric enuresis after non-pharm strategies fail
Tricyclic antidepressants, tertiary amines

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Acamprosate

A

NMDA receptor antagonist

Decreases cravings but has psych AEs

Rx in alcohol use disorder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Aripirazole

A

atypical antipsychotic; has low levels of D2, 5HT, M2/3, and a1 effects

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

On which types of receptors do tricyclic antidepressants act?

A

Antidepressant effect - NE, 5HT

Also histamine, muscarinic, alpha –> helpful for neuropathic pain, insomnia, headache prophylaxis, but also AE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

How do benzodiazepines work?

A

Act on GABA-A receptor –> Cl- released –> hyper polarization –> reduced rate of firing –> anxiolysis
Increase the POTENCY of GABA, do not increase its effectiveness
Can develop tolerance (go back to baseline signal output and anxiety) and withdrawal (anxiety/panic, insomnia, tachycardia/HTN, tremors)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Addictive sedatives

A

Alc, benzos, barbs

Cross tolerance among 3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Sertraline

A

SSRI
Acts on presynaptic serotonin reuptake transporter (SERT) + decreasing responsiveness of 5HT auto receptors –> increase serotonin concentration in synapse
Dose-related QTc prolongation, 1st line in pregnancy & lactation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Duloxetine

A

SNRI

Acts on NE and 5HT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Imipramine

A

Tricyclic antidepressant

Acts on NE, 5HT, histamine, muscarinic, and alpha receptors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Dextroamphetamine

A

NDRI (DA/NE/5HT RI)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Zolpidem

A

“Z drug”
GABA-A receptor positive modulator that is highly selective for the a1 subunit
Mediate sedation/hypnosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are some drug-drug interactions to look out for with lithium?

A

NSAIDs, ACEis/ARBs, diuretics (hydrochlorothiazide)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are hormonal effects of D2 inhibition and why do these happen? (brain region)

A

Messing w/ tubulofundibular pathway that connects hypothalamus and pituitary glands. Leads to increased prolactin, gynecomastia, amennorhea, and decreased libido

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Buspirone + MOA

A

5HT-1A agonist, agonizes the inhibitory presynaptic 5HT1 serotonin auto receptor

Used for anxiety, decreased potential for addiction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Which benzodiazepines do NOT have active metabolites?

A

The LOT drugs: lorazepam, oxazepam, temazepam

Active metabolites = compounds that produce sedation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Venlafaxine

A

SNRI

Acts on NE and 5HT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What are some AEs of SNRIs?

A

Hypertension, tachycardia, diaphoresis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Mirtazapine + adverse effects

A

5HT, alpha, & histamine receptor affinity
Adverse effects: sedation, weight gain, blood dyscrasia (rare)
Commonly used in elderly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Fluoxetine

A

SSRI
Acts on presynaptic serotonin reuptake transporter (SERT) + decreasing responsiveness of 5HT auto receptors –> increase serotonin concentration in synapse
Longest half life of the SSRIs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What are drug interactions to look for with benzodiazepine use?

A

Synergistic with ethanol and other CNS depressants like barbiturates, can be fatal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Buproprion + uses

A

Amphetamine-like structure, lowers seizure threshold
Inhibits reuptake of DA and NE
Used for smoking cessation, mild-moderate ADHD, anxiety, AD-associated sexual dysfunction, bipolar depression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
3 drugs used to treat alcohol addiction
disulfiram, acamprosate, naltrexone
26
Guanfacine
a agonist *pre-synaptically inhibits NE release, post-synaptically increases blood flow in prefrontal cortex* AEs: headache, hypotension, dry mouth, fatigue
27
Amphetamine
NDRI (DA/NE/5HT RI)
28
Typical antipsychotics
Potent: fluphenazine, haloperidol | Less potent: chlorpromazine
29
Citalopram
SSRI Acts on presynaptic serotonin reuptake transporter (SERT) + decreasing responsiveness of 5HT auto receptors --> increase serotonin concentration in synapse Dose-related QTc prolongation, 1st line in pregnancy & lactation
30
Fluphenazine
potent typical antipsychotic (strong antag) also has 5HT + medium M2/3 effects
31
What are some general symptoms of lithium toxicity?
Nausea/vomiting/diarrhea, new or worsened tremor, altered mental status, ataxia, seizure, coma, death Caution in renal dysfunction!
32
On which types of receptors do SNRIs act?
NE and 5HT
33
Haloperidol
potent typical antipsychotic (strong D2 antag) also has 5HT + low M2/3 effects AND K+, so watch for cardiac effects (long QT) Sometimes used IV to calm pts w/ psychotic symptoms
34
Atypical antipsychotics (4)
Aripiprazole, clozapine, olazapine, risperidone (last 3 have especially high 5HT effects, but also D2)
35
What are 5HT antagonism AEs?
Metabolic syndrome (weight gain, dyslipidemia, hyperglycemia, potentially DMT2)
36
Treatment for OD of BZs
Flumazenil
37
Why should you avoid B blockers in stimulant overdose?
unopposed alpha effects
38
Methylphenidate
Stimulant used for ADHD, first-line blocks DAT and NAT, decreasing reuptake
39
Lisdexamfetamine
NDRI (DA/NE/5HT RI)
40
Escitalopram
SSRI Acts on presynaptic serotonin reuptake transporter (SERT) + decreasing responsiveness of 5HT auto receptors --> increase serotonin concentration in synapse Dose-related QTc prolongation, 1st line in pregnancy & lactation
41
What should you tell patients to avoid if prescribing an MAOi?
Must avoid high tyramine foods (for example, aged meats and cheeses, alcoholic beverages)
42
What type of schizophrenic symptoms do antipsychotics generally treat?
Positive symptoms (esp typicals)
43
What are the MAOi's mechanism of action?
Within nerve terminal, catecholamines are rendered inactive by monoamine oxidase (MAO) If MAO is inhibited, DA & NE amounts increase, making more available for synaptic release
44
Ramelteon
Melatonin receptor agonist --> sleep | Taken 30 mins before bed to mimic normal melatonin levels
45
Alprazolam
Short-acting benzodiazepine
46
a agonists address which components of ADHD?
hyperactivity and impulsivity
47
Linezolid
Monoamine oxidase inhibitor | Increases levels of DA, NE, and 5HT
48
Naltrexone
Opioid receptor antagonist Daily oral or monthly injection Decreases rewards of alcohol **Need to be free of opioids**
49
Zaleplon
"Z drug" GABA-A receptor positive modulator that is highly selective for the a1 subunit Mediate sedation/hypnosis
50
Fluvoxamine
SSRI Acts on presynaptic serotonin reuptake transporter (SERT) + decreasing responsiveness of 5HT auto receptors --> increase serotonin concentration in synapse Twice a day dosing, niche OCD
51
Flumazenil
Benzodiazepine reversal agent | Competitively inhibits the binding of benzos to the GABA receptor
52
Zopiclone/Eszopiclone
"Z drug" GABA-A receptor positive modulator that is highly selective for the a1 subunit Mediate sedation/hypnosis
53
Atomoxatine
selective NE/DA re-uptake inhibitor (not serotinergic) nausea, anorexia, increased BP/HR, insomnia, fatigue anti-depressant INCREASE SUICIDALITY *takes weeks to work*
54
What are lithium's indications for use?
Bipolar disorder: acute mania, maintenance, depression Reduced suicide risk Schizoaffective disorder Adjunct to antidepressant for Major Depressive Disorder
55
Disulfiram
Alcohol deterrent blocks metabolism in breakdown of alcohol, increasing acetylaldehyde (leads to NV, sweating, decreased BP) Needs to be taken daily
56
Compare and contrast MoA of methylphenidate with amphetamines
MPH blocks NAT and DAT (decreases reuptake) Amphetamines directly increase the release of NE and DA and also decrease reuptake Same efficacy
57
Midazolam
Short-acting benzodiazepine | Sedative-hypnotic
58
NRTIs address which components of ADHD?
hyperactivity (atomoxatine)
59
Clonazepam
Intermediate-acting benzodiazepine
60
Lorazepam
Short-acting benzodiazepine Safe in liver disease (minimal first-pass metabolism) Sedative-hypnotic
61
Trazodone + adverse effects
Serotonin reuptake inhibitor (high doses), 5HT2a antagonist Histamine, alpha adrenergic activity too Mostly used as an add-on for insomnia AEs: orthostatic hypotension, sedation, priapism (rare)
62
What is NMS and how is it treated?
Neuroleptic malignant syndrome; due to D2 inhibition. Can be caused by all antipsychotics (although typicals = higher risk) treatment is dantroline (ryanodine receptor inhibitor, decreases calcium influx) Can also use Bromocriptine (Parkinson's drug) Use benzos for anxiety
63
What else can benzodiazepines be used for (besides as an anxiolytic)?
Alcohol withdrawal, surgical anesthesia, anti epileptic
64
Buprenorphine
Partial opioid agonist, tapered use for withdrawal Often combined w/ naloxone (Suboxone) - opioid antagonist
65
Benzodiazepine toxicities
Drowsiness/sleepiness, dizziness, fatigue/lethargy, vertigo/dizziness, reduced motor coordination, memory loss, confusion, hypotension, respiratory depression (things you would expect if neurons are firing more slowly)
66
Amitriptyline
Tricyclic antidepressant | Acts on NE, 5HT, H, M, and alpha receptors
67
What antipsychotic do you need to watch for cardiac effects?
Haloperidol - K+ channel blocking effects (prolonged QT)
68
What does "receptor reserve" mean in the context of antipsychotics?
Only 60% of D2 receptor occupancy needed to see max effects so there is a "receptor reserve" (allows you to tailor dose relatively safely for patients)
69
Paroxetine
SSRI Acts on presynaptic serotonin reuptake transporter (SERT) + decreasing responsiveness of 5HT auto receptors --> increase serotonin concentration in synapse Mild anticholinergic, withdrawal syndrome
70
Bonus points- name the 6 SSRIs and 2 SNRIs (also function as anxiolytics!)
SSRIs: Citalopram, escitalopram, fluoxetine, fluvoxamine, sertraline, paroxetine SNRIs: Duloxetine, venlafaxine
71
Phenelzine
Monoamine oxidase inhibitor | Increases levels of DA, NE, and 5HT
72
Methadone
long-acting opioid
73
How and where do stimulants act?
Increase NE and DA in prefrontal cortex
74
Chlorpromazine
lower potency typical antipsychotic (med D2) 5HT, M2/3 (med), H1 action (lower potency more prone to sedation)
75
Diazepam
``` Long-acting benzodiazepine Active metabolites (sedating) ```
76
What are M2/3 antagonism AEs?
Anticholinergic effects - dry mouth, constipation, urinary retention, blurred vision
77
Buproprion
Stimulant used for ADHD (less addiction potential), depression, and smoking Watch out for seizures and avoid in eating disorders Doesn't cause sexual dysfunction symptoms, less weight gain
78
Chlordiazepoxide
``` Long-acting benzodiazepine Active metabolites (sedating) ```
79
Clonidine
a agonist *pre-synaptically inhibits NE release, post-synaptically increases blood flow in prefrontal cortex* AEs: headache, hypotension, dry mouth, fatigue
80
Clozapine
Atypical antipsychotic High 5HT, M2/3, and a1, and H1 activity; lower D2 activity Watch for BP, metabolic syndrome, anti-cholinergic symptoms, drowsiness AGRANULOCYTOSIS/NEUTROPENIA - can be fatal so must monitor closely. Give growth factors for tx
81
H1 antagonism AEs?
Being tired AF (but can't do anything about it b/c needs to cross the BBB); high potency typical antipsychotics less prone to sedation
82
What are EPS? (4) and why do these happen (brain region)?
``` Pseudoparkinsonism Acute dystonia (spasms, esp in face/neck) Akathisia (restlessness, pacing) Tardive dyskinesia (mouth smacking, chewing, involuntary movements) ``` Nigrostriatial pathway inhibition
83
What benefits do atypical antipsychotics have?
Less EPS
84
Temazepam
Intermediate-acting benzodiazepine | Sedative-hypnotic
85
Risperidone
atypical antipsychotic High 5HT, M2/3, and a1, and H1 activity; mod to high D2 activity
86
Why are benzodiazepines addictive?
Stimulate dopamine release into the nucleus accumbens via mesolimbic pathway
87
Olazapine
atypical antipsychotic High 5HT, M2/3, and a1, and H1 activity; lower D2 activity
88
Stimulants address which components of ADHD?
hyperactivity, impulsivity, inattention

HBHD (1 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions