Pharmacology 3 Flashcards
Four major CNS stimulant drugs of abuse
Caffeine, nicotine, cocaine, amphetamines
Treatments available for nicotine addiction
Patch, gum, lozenge, bupropion, varenicline
CNS stimulant that acts by inhibiting reuptake of neurotransmitters; may cause pupil dilation, alter tactile sensation, irregular breathing, and cardiac toxicity
Cocaine
Amphetamine derivatives commonly abused
Methamphetamine (crystal meth), MDMA (methylenedioxymeth-amphetamine, or ecstasy)
Drug of abuse that was developed as a dissociative anesthetic; intoxication leads to both horizontal and vertical nystagmus, analgesia, psychosis, delirium, and seizures
PCP (phencyclidine, or angel dust)
Synthetic ergot derivative that can produce perceptual hallucinations and used as an illicit drug; may cause paranoia
LSD (lysergic acid diethylamide)
Active ingredient is tetrahydrocannabinol (THC); side effects include impairment of judgment, altered sense of time, increased appetite, and hallucinations
Marijuana
Use of all antipsychotic medication in this group of patients is associated with increased risk of deaths
Elderly with dementia-related psychosis
Antipsychotics that repress primarily the positive symptoms of schizophrenia
Typical antipsychotics
Primary mechanism of action of typical antipsychotics
Inhibits D2 receptors
Common endocrine side effects of all typical antipsychotic drugs
Hyperprolactinemia, galactorrhea
Two low potency, typical antipsychotic drugs
Chlorpromazine, thioridazine
Typical antipsychotic associated with retinopathy and cardiac toxicity
Thioridazine
Common side effects of low potency typical antipsychotic drugs
Dry mouth (anticholinergic), sedation (antihistamine), hypotension (α1 block)
Three high potency, typical antipsychotic drugs
Haloperidol, fluphenazine, trifluoperazine
Typical antipsychotic that can also be used for Tourette syndrome
Haloperidol
Side effects more commonly associated with high potency typical antipsychotic drugs
Dystonia, akathisia, bradykinesia, tardive dyskinesia (extrapyramidal symptoms)
Treatment for drug-induced acute extrapyramidal symptoms
Benztropine, diphenhydramine
Life-threatening side effect associated with typical antipsychotic drugs
Neuroleptic malignant syndrome
Treatment for drug-induced neuroleptic malignant syndrome
Dantrolene
Act via BZ1 subtype of GABA receptor, effects reversed by flumazenil
Zolpidem (ambien), Zaleplon, eszopiclone
Myocardial depression, respiratory depression, N/V, increases cerebral blood flow
Inhaled anesthetics
Halothane toxicity
Hepatotoxicity
Methoxyflurane toxicity
Nephrotoxicity
High potency, high lipid solubility, rapid entry into brain. Used for induction of anesthesia and short surgical procedures
Thiopental
Most common drug used for endoscopy; used adjunctively with gaseous anesthetics and narcotics
Midazolam
Used for sedation in ICU, rapid anesthesia induction, and short procedures. Less post-op nausea than thiopental
Propofol
Local anesthetics - Esters
Procaine, cocaine, tetracaine
Local Anesthetics - Amides
Lidocaine, Mepivacaine, Bupivicaine,
Bupivicaine toxicity
Cardiovascular toxicity
Prevents the release of calcium from the SR of skeletal muscle
Dantrolene
used to tx malignant hyperthermia and neuroleptic syndrome
Dantrolene
Dopamine Agonists
Bromocriptine(ergot), pramipexole, ropinirole (non-ergot)
COMT inhibitors, prevent L-dopa degradation
Entacapone, Tolcapone
Antimuscarinic that improves tremor and rigidity but has little effect on bradykinesia
Benztropine
Drug that is converted to dopamine in CNS by dopa decarboxylase
Levodopa
Peripheral decarboxylase inhibitor
Carbidopa
Selectively inhibits MAO-B, which preferentially metabolizes DA over NE and 5-HT, therefore increases dopamine. Adjunctive adent of L-dopa of Parkinson
Selegiline
NMDA receptor antagonist; helps prevent excitotoxicity (mediated by calcium) used for Alzheimer
Memantine
Toxicity of Memantine
Dizziness, confusion, hallucinations
3 AChE inhibitors used for Alzheimer
Donepezil, Galantamine, Rivastigmine
Dopamine receptor antagonist used for Huntington
Haloperidol
Inhibit vesicular monoamine transporter (VMAT), limit dopamine vesicle packaging and release used for Huntington
tetrabenazine and reserpine
5-HT 1B/1D agonist, inhibits trigeminal nerve activation; prevents vasoactive peptide release; induces vasoconstriction
Sumatriptan
Used for acute migraine, cluster HA attacks
Sumatriptan
Sumatriptan toxicity
coronary vasospasm, mild tingling
Sumatriptan is contraindications
Coronary artery disease or Prinzmetal Angina
