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Pharmacology Flashcards

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1
Q

MOA of TCA

A
  • Blocks reuptake of norepinephrine and serotonin
  • H1, a1, M1 antagonism
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2
Q

ADR of TCA

A
  • GI upset
  • Weight gain
  • Sexual dysfunction
  • Anticholinergic SE
  • Sedation
  • Orthostatic hypotension
  • Arrhythmias
  • Seizures
  • Overdose can cause death
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3
Q

MOA of SSRI

A

Selectively blocks serotonin reuptake

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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)
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5
Q

MOA of SNRI

A

Blocks reuptake of norepinephrine & serotonin

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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)
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7
Q

MOA of vortioxetine

A

Blocks serotonin reuptake

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8
Q

ADR of vortioxetine

A
  • GI upset
  • Sexual dysfunction
  • Headache, transient nervousness when initiating
  • Hyponatremia due to SIADH
  • Bleeding risk
  • EPS
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9
Q

MOA of mirtazepine

A
  • Increases norepinephrine & serotonin concentration
  • A2 antagonism
  • 5HT2 & 3 antagonism
  • H1 antagonism
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10
Q

ADR of mirtazepine

A
  • Somnolence
  • Increased appetite, weight gain
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11
Q

MOA of bupropion

A

Blocks the repute of norepinephrine & dopamine

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12
Q

ADR of bupropion

A
  • Seizure
  • Insomnia
  • Psychosis
  • Not for patients with eating disorders
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13
Q

MOA of moclobemide

A

Reversible inhibitor of MAO inhibitor A

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14
Q

ADR of MAO inhibitors

A
  • Hypertensive crisis
  • Cerebrovascular accident
  • Arrhythmias
  • Anxiety
  • Weight gain
  • Sexual dysfunction
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15
Q

MOA of trazodone

A
  • Blocks reuptake of serotonin
  • H1, 5HT2A, a1 antagonism
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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)
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17
Q

MOA of agomelatine

A
  • Increases concentration of dopamine & norepinephrine
  • MT-1 & 2 agonism
  • 5HT-2C antagonism
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18
Q

ADR of agomelatine

A
  • GI upset
  • weight gain
  • LFT derangements
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19
Q

MOA of esketamine

A

NMDA antagonism

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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
Q

MOA of trihexyphenidyl

A
  • Blocks M1 receptors
  • Targets tremors & stiffness
26
Q

MOA of donepezil

A

Cholinesterase inhibitor

27
Q

Metabolism of cholinesterase inhibitors

A
  • Galantamine (liver)
  • Rivastigmine (kidneys)
28
Q

MOA of memantine

A
  • Non-competitive NMDA antagonist
  • Blocks NMDA receptor mediated excitotoxicity
29
Q

MOA of lithium

A
  • Normalises or inhibits the secondary messenger system and reduces PKC
  • Reduces 5HT reuptake
  • Reduces dopamine release
30
Q

MOA of sodium valproate

A
  • Increases GABA levels
  • Reduces dopamine turnover
  • May reduce PKC
  • Normalises Na+ and Ca2+ channels
  • Has antikindling effects
31
Q

DDI of levodopa

A
  • Pyridoxine (less concern when DCI is used)
  • Iron
  • Protein
  • Dopamine antagonists (metoclopramide, prochlorperazine, FGA, risperidone)
32
Q

DDI of MAO-B inhibitors

A
  • SSRI, SNRI, TCA (washout needed)
  • Pethidine, tramadol
  • Linezolid
  • Dextromethorphan
  • Dopamine
  • Sympathomimetics
33
Q

DDI of entacapone

A
  • Iron, calcium
  • MAO-A inhibitors
  • Catecholamine drugs
  • Enhances anticoagulation effect of warfarin
34
Q

1A2 substrates

A

Theophylline
Amiodarone
Warfarin-R
Agomelatine
Clozapine
Haloperidol
Olanzapine
Phenothiazines
Ziprasidone

35
Q

1A2 inhibitors

A

Fluvoxamine
Fluoroquinolones
Macrolides
Isoniazid
Ketoconazole

36
Q

1A2 inducers

A

Cigarette smoking
Phenytoin
Phenobarbital
Rifampicin
Montelukast

37
Q

2C19 substrates

A

Warfarin-R
Lanso/panto/es/omeprazole
Tolbutamide

38
Q

2C19 inhibitors

A

Fluvoxamine
Es/omeprazole
Ticlopidine
Fluoxetine
Moclobemide
Voriconazole

39
Q

2D6 substrates

A

Metoprolol
Codeine, hydrocodone, oxycodone, tramadol
Despiramine
Phenothiazines
Haloperidol
Aripiprazole
Risperidone
Olanzapine
Brexpiprazole
Zuclopenthixol

40
Q

2D6 inhibitors

A

Fluoxetine
Paroxetine
Bupropion
Duloxetine

41
Q

2D6 inducers

A

Phenytoin
Phenobarbital
Carbamazepine
Rifampicin

42
Q

3A4 substrates

A

Statins
CCBs
Cyclosporin, tacrolimus
Fentanyl, alfentanil
Midazolam
Cariprazine
Lurasidone
Aripiprazole
Risperidone
Ziprasidone
Quetiapine
Brexpiprazole

43
Q

3A4 inhibitors

A

Clarithromycin
Ritonavir
Itra/keto/voriconazole
GF juice
Diltiazem
Fluvoxamine
Ciprofloxacin

44
Q

Antipsychotics with short half-lives

A

Chlorpromazine
Sulpiride
Ziprasidone
Quetiapine
Clozapine

45
Q

High potency antipsychotics

A

Fluphenazine
Haloperidol
Trifluoperazine
Amisulpride
Aripiprazole
Risperidone
Olanzapine

46
Q

Antipsychotics with a1 antagonism

A

Chlorpromazine
Haloperidol
Trifluoperazine
Risperidone
Quetiapine
Clozapine
Olanzapine

47
Q

Antipsychotics with H1 antagonism

A

Chlorpromazine
Quetiapine
Clozapine
Olanzapine

48
Q

Antipsychotics with M1 antagonism

A

Chlorpromazine
Trifluoperazine
Quetiapine
Clozapine
Olanzapine

49
Q

DDI for lithium

A

Increased CNS toxicity:
- Carbamazepine
- Phenytoin
- Diltiazem
- Verapamil
- Methyldopa
- Losartan
- Metronidazole

Increased lithium:
- Sodium depletion
- Thiazides
- ACEi/ARB
- NSAIDs
- Dehydration
- Fluoxetine

Reduced lithium:
- Theophylline
- Caffeine

Psych (5 decks)

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