Pharmacology Flashcards
What are short acting benzodiazepines?
Alprazolam
Triazolam
Oxazepam
Midazolam
What medication should be used for ADHD?
Stimulants (e.g. methylphenidate)
What medication should be used for Bipolar disorder?
Lithium, valproic acid, carbamazepine (mood stabilizers)
Atypical antipsychotics
What medication should be used for Bulimia?
SSRIs
What medication should be used for Depression?
SSRIs
What medication should be used for Generalized Anxiety disorder?
SSRIs
SNRIs
What medication should be used for Alcohol withdrawal
Long acting benzos (diazepam, lorazepam, chlordiazepoxide)
What medication should be used for OCD?
SSRIs
Clomipramine
What medication should be used for Panic disorder?
SSRIs
Venlafaxine
Benzos
What medication should be used for PTSD?
SSRIs
Venlafaxine
What medication should be used for Schizophrenia?
Atypical antipsychotics
What medication should be used for Social phobias?
SSRIs
Beta-blockers
What medication should be used for Tourette syndrome?
Antipsychotics (fluphenazine, pimozide)
Tetrabenazine
Clonidine
What is the mechanism of action of CNS stimulants (methylphenidate, dextroamphetamine, methamphetamine)?
Increase catecholamines in synaptic cleft, especially norepinephrine and dopamine
What are clinical uses of CNS stimulants?
ADHD, narcolepsy
Name the typical anti-psychotics
Haloperidol
+ “azines”
Trifluoperazine
Fluphenazine
Thioridazine
Chlorpromazine
What is the mechanism of action of typical antipsychotics?
Block dopamine D2 receptors
What are clinical uses of typical antipsychotics?
Schizophrenia (primarily positive symptoms)
Psychosis
Acute mania
Tourette syndrome
What are major side effects of typical antipsychotics?
Extrapyramidal symptoms - tardive dyskinesia
Endocrine side effects - DA antagonism –> hyperprolactinemia –> galactorrhea
Anticholinergic side effects - dry mouth, constipation
QT prolongation
Neuroleptic Malignant Syndrome - rare
What are the characteristics of Neuroleptic Malignant syndrome (due to typical antipsychotic use)?
Mnemonic: FEVER
- Fever
- Encephalopathy
- Vitals unstable
- Enzymes increase
- Rigidity of muscles
Name the atypical antipsychotics
Mnemonic: It’s ATYPICAL for OLd CLOSets to QUIETly RISPER from A to Z
Olanzapine Clozapine Quetiapine Risperidone Ariprazole Ziprasidone
What is the mechanism of action of atypical antipsychotics?
Varied effects on 5-HT2, dopamine, and alpha- and histamine1- receptors
What are clinical uses of atypical antipsychotics?
Schizophrenia - positive AND negative symptoms Bipolar disorder OCD Anxiety disorder Depression Mania Tourette syndrome
Compare the side effects of typical and atypical antipsychotics
Typical - Extrapyramidal and anticholinergic side effects
Atypical - fewer EPS and anticholinergic effects, but more weight gain due to effects at other receptors
Both cause QT prolongation
What is a specific side effect of Clozapine?
Agranulocytosis (requires weekly WBC monitoring)
What is a specific side effect of Risperidone?
Increase prolactin –> galactorrhea and gynecomastia
Increase prolactin –> decreased GnRH, LH, and FSH –> irregular menstruation and fertility issues
What are clinical uses of Lithium?
Mood stabilizer - bipolar disorder to prevent manic events
What are side effects of Lithium?
Mnemonic: My HO is NeeDI and Pregnant
Movement - tremor
HypOthyroidism
Nephriogenic Diabetes Insipidus
Pregnancy problems - Ebstein anomaly
What is the mechanism of action of Buspirone?
Stimulates 5-HT1A receptors
What are clinical uses of Buspirone?
Generalized Anxiety Disorder
Mnemonic: always anxious if the BUS will be ON time, so take BUSpirONe
What is an advantage that Buspirone has over benzos and barbiturates?
Does not interact with alcohol
Name the SSRIs
Fluoxetine
Paroxetine
Sertraline
Citalopram
Mnemonic: FLashbacks PARalyze SEnior CITizens
What is the mechanism of action of SSRIs?
Serotonin reuptake inhibitors (duh)
What are the clinical uses of SSRIs?
Depression GAD Panic disorder OCD Bulimia Social phobias PTSD
What are common side effects of SSRIs?
GI distress
SIADH
Sexual dysfunction
What is Serotonin syndrome?
Caused by any drug that increases 5-HT (SSRIs, SNRIs, MAOIs, TCAs)
Most commonly occurs when SSRIs and MAOIs given together
Symptoms include:
- Hyperthermia
- Confusion
- Myoclonus
- CV instability
- Flushing
- Diarrhea
- Seizures
When do SSRIs take effect?
4-8 weeks
Name the SNRIs
Venlafaxine
Duloxetine
What is the mechanism of action of SNRIs?
Inhibit serotonin and norepinephrine reuptake
What are clinical uses of SNRIs?
Depression - both
Venlafaxine - GAD, panic disorder, PTSD
Duloxetine - diabetic peripheral neuropathy
Name the Tricyclic Antidepressants
Amitriptyline Nortriptyline Imipramine Desipramine Clomipramine Doxepin Amoxapine
What is the mechanism of action of TCAs?
Inhibit serotonin and norepinephrine reuptake
What are side effects of TCAs?
Mnemonic: TRI - C’s
Convulsions
Coma
Cardiotoxicity
Name the MAOIs
Tranylcypromine
Phenelzine
Isocarboxazid
Selegiline (selective MAO-B)
What is the mechanism of action of MAOIs?
Inhibit MAO, preventing breakdown of amine neurotransmitters and thereby increasing their levels (NE, 5HT, DA)
What is a major side effects of MAOIs?
Hypertensive crisis with ingestion of tyramine (wine, cheese, fava beans, liver)
What is Bupropion commonly used for?
Smoking cessation
What is the mechanism of action of Mirtzapine?
Alpha-2 antagonist (increase release of NE and 5HT)
5HT2 and 5HT3 receptor antagonist
What is the mechanism of action of Trazodone?
Inhibits 5HT2 and alpha-1 adrenergic receptors
What is Mirtazapine commonly used for?
Depression - especially in patients with insomnia or who need to gain weight (causes weight gain)
What is Trazodone commonly used for?
Insomnia
What are main side effects of Trazodone?
Called trazoBONE - priapism
What are clinical uses of MAOIs?
Atypical depression
What is the treatment for Neuroleptic Malignant Syndrome?
Dantrolene (muscle relaxant)
