Pharmacological Profiles Flashcards
What 5 classes fall under Psychotherapeutics?
- Sedatives & Hypnotics
- Antianxiety Drugs
- Antidepressants
- Antipsychotics
- CNS Stimulants
Why is using sedatives and hypnotics to treat insomnia not recommended?
Because long term use can lead to risk of dependence
What causes Dose-dependent suppression of the CNS, including sleep, sedation, and unconsciousness.
Sedatives and Hypnotics
What depresses the sensory cortex, decrease motor activity, alter cerebellar function, and produce drowsiness, sedation, and hypnosis?
Barbiturates
What is an example of a barbiturate?
Phenobarbital
Barbiturates can produce dose-dependent ___________
respiratory depression
Sedatives & Hypnotics can be used for:
- Sedation
- Seizures
What patients should not take sedatives and hypnotics?
history of addiction
Antianxiety drugs can be further subdivided into:
- Benzodiazepines (benzos)
- Non- Benzodiazepines (non-benzos)
Benzodiazepine Action:
Bind to specific receptors in the GABA complex, which enhances inhibitory neurotransmitter
Non-Benzo:
Act on brain’s dopamine and serotonin receptors
Benzos end in:
Non-benzos end in:
- pam, -lam
- one, -ine
Benzodiazepines cause:
- CNS depression
- may produce tolerance with long-term use and may cause dependence
- have NO analgesic properties
Benzodiazepines can be used to treat what 3 things?
- Sedative/hypnotic
- anti-anxiety
- anti-seizure
Adverse effects of long term use of benzodiazepines:
Withdrawal syndrome after 4-6 weeks of therapy
Never discontinue abruptly decrease over 4-6 weeks.
Symptoms of withdrawal:
- Fatigue
- metallic taste
- HA
- numbness in extremities
- sweating
- dry mouth
Which antianxiety drug has less abuse potential?
Bu Spar
Contraindication for benzos
- comatose patients
- CNS depression
- uncontrolled severe pain
- glaucoma
- pregnancy
Which has a higher risk of dependency when used long term,
Benzos or non-benzos?
Benzos
Which is recommended for short term use only,
Benzos or non-benzos?
Benzos
What do benzos and non-benzos treat?
Anxiety
What is for short term use to treat anxiety?
benzodiazepines
What is used to treat long term anxiety?
- SSRI
- SNRI
Which is a lower risk of dependency when used long term,
Benzos or non-benzos?
Non-benzos
What are some examples of Non-benzos?
- Bu Spar
- Hydroxyzine
- Sertraline
What are the 6 classes of Antidepressants?
- Tricyclic antidepressants (TCAs)
- Monoamine Oxidase Inhibitors (MAOI)
- Selective Serotonin Reuptake Inhibitors (SSRI)
- Serotonin-norepinephrine reuptake inhibitors (SNRIs)
- Serotonin Reuptake inhibitor/Antagonist (SRI/A)
- Dopamine/Norepinephrine-Reuptake Inhibitor (D/NRI)
What are some examples of Benzos?
- Diazepam
- Lorazepam
- Alprazolam
What increases levels of norepinephrine and serotonin by inhibiting their reuptake and blocking the action of acetylcholine.
TCAs
What inhibits the activity of Monoamine oxidase resulting in increased neuro-hormones?
MAOI
What increases serotonin by inhibiting neuronal uptake to CNS?
SSRI
What are antidepressants used to treat?
- Depression
- Anxiety
- OCD
- Smoking cessation
What are antidepressants used to treat?
- Depression
- Anxiety
- OCD
- Smoking cessation
What should not be taken within 14 days of MAOIs?
TCAs
Fluoxetine is less effective in patients who…?
smoke
Wellbutrin is contraindicated for patients with what?
seizure disorder
Antidepressants end in:
- ine
- one
Pt’s should not use what herbal remedy with antidepressants?
St. John’s Wort
How long must patients take Antidepressants before reaching the therapeutic dose?
4-6 weeks
What are first line medications for depression?
SSRIs
What is an example of a TCA antidepressant?
Amitriptyline
What is an example of an MAOI antidepressant?
Nardil
What is an example of a SRI/A antidepressant?
Trazadone
What is an example of a D/NRI antidepressant?
Bupropion
What are some examples of SSRI?
- Fluoxetine
- Sertraline
- Paroxetine
- Citalopram
What blocks dopamine receptors, and alter dopamine release and turnover?
Antipsychotics
What do antipsychotics do?
block dopamine receptors, alter dopamine release and turnover
Antipsychotics are classified into what 2 categories?
- typical (1st generation)
- atypical (2nd generation)
Phenothiazine are classified as what type of antipsychotic?
typical (1st gen)
Which antipsychotics are newer and have fewer adverse reactions, typical or atypical?
atypical
Antipsychotics are used to treat what?
acute or chronic psychoses, accompanied by increased psychomotor activity
What are examples of 1st gen psychotics?
Haloperidol, Prochlorperazine
What are examples of 2nd gen psychotics?
Quetiapine, Olanzapine
What are some contraindications for taking antipsychotics?
- Severely depressed
- Hypotension
What are the 2 types of CNS stimulants?
- Amphetamines
- Anorexiants
CNS stimulants work by:
Increasing levels of neurotransmitters in the CNS
What are CNS stimulants used to treat?
- Narcolepsy
- ADHD
When are CNS stimulants contraindicated?
- Risk of dependence
- Hypertension
- Glaucoma
CNS stimulants should be taken when?
In the am 30-45min before breakfast and lunch
What are examples of Amphetamines?
- Methylphenidate
- Dextroamphetamine
What is an example of an Anorexiants?
Phentermine
What reduces excitability of neurons in the brain?
Anticonvulsants
What are the 5 types of seizures?
- Psychomotor: aura, alterations, hallucinations
- Tonic-clonic: contraction/relaxation of the muscles
- Myoclonic: forceful musculature contraction
- Absence: brief loss of consciousness
- Epilepsy: permanent, recurrent seizures
What do anticonvulsants do?
decrease the incidence and severity of seizures
What are some contraindications for CNS Stimulants?
- CNS depression
- pregnancy
- psychoses
What is used to treat seizures?
Benzodiazepines
Anticonvulsant meds end in:
-pam, -lam
What are some examples of Anticonvulsant meds?
- Diazepam
- Lorazepam
- Midazolam
- Clonazepam
- Phenytoin
- Ethosuximide
- Valporic acid
What class of drug is this?
Phenothiazines act on the chemoreceptor trigger zone to inhibit nausea and vomiting.
Anti-emetics
Dimenhydrinate, Scopolamine, and Meclizine act as antiemetic
mainly by diminishing what?
motion sickness
What antiemetic decreases nausea and vomiting by its effects on gastric emptying?
Metoclopramide
What antiemetic blocks the effects of serotonin at 5-HT3 receptor sites?
Ondansetron
What med works primarily by inhibiting the chemoreceptor trigger zone or by depressing the sensitivity of the vestibular apparatus of the inner ear?
Antivertigo
What is used for the prophylaxis or treatment of nausea or vomiting?
Antiemetic
What is used for the treatment of vertigo?
Antivertigo
adverse effects of antiemetics?
drowsiness
Contraindications for antiemetics:
- severe CNS depression
- PREGNANCY
- Do not use with ALCOHOL
Examples of Antiemetics:
-zine
1) Phenothiazine
2) Prochlorperazine
3) Chlorpromazine
4) Metoclopramide
5) Ondansetron
6) Promethazine
Examples of Antivertigo meds:
- Meclizine
- Diphenhydramine
- Benzodiazepines
What removes the feeling or sensation (chemical changes to the nerve impulse)?
Anesthetic
What alleviates or relieves the pain from a patient?
Analgesic
What works by inhibiting transport of ions across neuronal membranes, thereby preventing initiation and conduction of normal nerve impulses.
Local anesthetics
What works by causing neuro-inhibition and anesthesia, where the patient is dissociated from the surrounding.
Ketamine
What typically increases blood pressure (BP), heart rate (HR), and cardiac output (CO) by increasing sympathetic tone.
ketamine
What excites opioid receptors within the insular cortex, putamen, and thalamus, thereby producing analgesia?
Ketamine
How long does Ketamine IM take effect?
3-4 min
What are utilized to produce a loss of sensation prior to minor
painful procedures?
Local anesthetics
Ketamine can have detrimental effects in patients with?
ischemic heart disease
Ketamine is contraindicated in patients with…
- schizophrenia
- conditions in which increase in blood pressure would be
hazardous. - airway instability
How much Ketamine is given IM for pain control?
20-40mg
How much Ketamine is given IV for analgesia?
10-20mg