Pharmacology Flashcards
1
Q
MOA of TCA
A
- Blocks reuptake of norepinephrine and serotonin
- H1, a1, M1 antagonism
2
Q
ADR of TCA
A
- GI upset
- Weight gain
- Sexual dysfunction
- Anticholinergic SE
- Sedation
- Orthostatic hypotension
- Arrhythmias
- Seizures
- Overdose can cause death
3
Q
MOA of SSRI
A
Selectively blocks serotonin reuptake
4
Q
ADR of SSRI
A
- GI upset
- Sexual dysfunction
- Headache, transient nervousness when initiating
- Insomnia (fluoxetine)
- Hyponatremia due to SIADH
- Bleeding risk
- EPS
- QTC prolongation (high dose citalopram or escitalopram in elderly)
5
Q
MOA of SNRI
A
Blocks reuptake of norepinephrine & serotonin
6
Q
ADR of SNRI
A
- GI upset
- Sexual dysfunction
- Headache, transient nervousness when initiating
- Hyponatremia due to SIADH
- Bleeding risk
- EPS
- Hypertension (venlafaxine)
- Urinary hesitation (duloxetine)
7
Q
MOA of vortioxetine
A
Blocks serotonin reuptake
8
Q
ADR of vortioxetine
A
- GI upset
- Sexual dysfunction
- Headache, transient nervousness when initiating
- Hyponatremia due to SIADH
- Bleeding risk
- EPS
9
Q
MOA of mirtazepine
A
- Increases norepinephrine & serotonin concentration
- A2 antagonism
- 5HT2 & 3 antagonism
- H1 antagonism
10
Q
ADR of mirtazepine
A
- Somnolence
- Increased appetite, weight gain
11
Q
MOA of bupropion
A
Blocks the repute of norepinephrine & dopamine
12
Q
ADR of bupropion
A
- Seizure
- Insomnia
- Psychosis
- Not for patients with eating disorders
13
Q
MOA of moclobemide
A
Reversible inhibitor of MAO inhibitor A
14
Q
ADR of MAO inhibitors
A
- Hypertensive crisis
- Cerebrovascular accident
- Arrhythmias
- Anxiety
- Weight gain
- Sexual dysfunction
15
Q
MOA of trazodone
A
- Blocks reuptake of serotonin
- H1, 5HT2A, a1 antagonism
16
Q
ADR of trazodone
A
- GI upset
- Sexual dysfunction
- Headache, transient nervousness when initiating
- Hyponatremia due to SIADH
- Bleeding risk
- EPS
- Sedation
- Orthostatic hypotension
- Priapism (rare)
17
Q
MOA of agomelatine
A
- Increases concentration of dopamine & norepinephrine
- MT-1 & 2 agonism
- 5HT-2C antagonism
18
Q
ADR of agomelatine
A
- GI upset
- weight gain
- LFT derangements
19
Q
MOA of esketamine
A
NMDA antagonism
20
Q
ADR of esketamine
A
- Dissociation
- Dizziness, sedation
- Nausea
- Anxiety
- Hypertension
21
Q
MOA of entacopone / tolcapone
A
- Blocks COMT conversion of dopamine or L-dopa into an inactive form
- Allows more levodopa to enter the brain
22
Q
MOA of selegiline / rasagiline
A
- Mild antiparkinson activity
- Inhibits MAO-b, thereby interfering with the breakdown of dopamine
- May delay mitral brain cell degeneration
23
Q
MOA of pramipexole
A
- Acts directly on dopamine receptors in the brain
- Prevents or delays onset of motor complications
24
Q
MOA of amantadine
A
- Mild anti-parkinson activity
- Enhances the release of stored dopamine (also unregulated D2 receptors and increases their sensitivity)
- Dopamine receptor agonist
- Inhibits the presynaptic uptake of catecholamines
- NMDA receptor antagonist (blocks glutamate)
25
MOA of trihexyphenidyl
- Blocks M1 receptors
- Targets tremors & stiffness
26
MOA of donepezil
Cholinesterase inhibitor
27
Metabolism of cholinesterase inhibitors
- Galantamine (liver)
- Rivastigmine (kidneys)
28
MOA of memantine
- Non-competitive NMDA antagonist
- Blocks NMDA receptor mediated excitotoxicity
29
MOA of lithium
- Normalises or inhibits the secondary messenger system and reduces PKC
- Reduces 5HT reuptake
- Reduces dopamine release
30
MOA of sodium valproate
- Increases GABA levels
- Reduces dopamine turnover
- May reduce PKC
- Normalises Na+ and Ca2+ channels
- Has antikindling effects
31
DDI of levodopa
- Pyridoxine (less concern when DCI is used)
- Iron
- Protein
- Dopamine antagonists (metoclopramide, prochlorperazine, FGA, risperidone)
32
DDI of MAO-B inhibitors
- SSRI, SNRI, TCA (washout needed)
- Pethidine, tramadol
- Linezolid
- Dextromethorphan
- Dopamine
- Sympathomimetics
33
DDI of entacapone
- Iron, calcium
- MAO-A inhibitors
- Catecholamine drugs
- Enhances anticoagulation effect of warfarin
34
1A2 substrates
Theophylline
Amiodarone
Warfarin-R
Agomelatine
Clozapine
Haloperidol
Olanzapine
Phenothiazines
Ziprasidone
35
1A2 inhibitors
Fluvoxamine
Fluoroquinolones
Macrolides
Isoniazid
Ketoconazole
36
1A2 inducers
Cigarette smoking
Phenytoin
Phenobarbital
Rifampicin
Montelukast
37
2C19 substrates
Warfarin-R
Lanso/panto/es/omeprazole
Tolbutamide
38
2C19 inhibitors
Fluvoxamine
Es/omeprazole
Ticlopidine
Fluoxetine
Moclobemide
Voriconazole
39
2D6 substrates
Metoprolol
Codeine, hydrocodone, oxycodone, tramadol
Despiramine
Phenothiazines
Haloperidol
Aripiprazole
Risperidone
Olanzapine
Brexpiprazole
Zuclopenthixol
40
2D6 inhibitors
Fluoxetine
Paroxetine
Bupropion
Duloxetine
41
2D6 inducers
Phenytoin
Phenobarbital
Carbamazepine
Rifampicin
42
3A4 substrates
Statins
CCBs
Cyclosporin, tacrolimus
Fentanyl, alfentanil
Midazolam
Cariprazine
Lurasidone
Aripiprazole
Risperidone
Ziprasidone
Quetiapine
Brexpiprazole
43
3A4 inhibitors
Clarithromycin
Ritonavir
Itra/keto/voriconazole
GF juice
Diltiazem
Fluvoxamine
Ciprofloxacin
44
Antipsychotics with short half-lives
Chlorpromazine
Sulpiride
Ziprasidone
Quetiapine
Clozapine
45
High potency antipsychotics
Fluphenazine
Haloperidol
Trifluoperazine
Amisulpride
Aripiprazole
Risperidone
Olanzapine
46
Antipsychotics with a1 antagonism
Chlorpromazine
Haloperidol
Trifluoperazine
Risperidone
Quetiapine
Clozapine
Olanzapine
47
Antipsychotics with H1 antagonism
Chlorpromazine
Quetiapine
Clozapine
Olanzapine
48
Antipsychotics with M1 antagonism
Chlorpromazine
Trifluoperazine
Quetiapine
Clozapine
Olanzapine
49
DDI for lithium
Increased CNS toxicity:
- Carbamazepine
- Phenytoin
- Diltiazem
- Verapamil
- Methyldopa
- Losartan
- Metronidazole
Increased lithium:
- Sodium depletion
- Thiazides
- ACEi/ARB
- NSAIDs
- Dehydration
- Fluoxetine
Reduced lithium:
- Theophylline
- Caffeine
