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MRCPsych Paper A > Pharmacology > Flashcards

Pharmacology Flashcards

1
Q

Venlafaxine mechanism

A

SNRI

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2
Q

Duloxetine mechanism

A

SNRI + weak inhibitor of dopamine re-uptake

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3
Q

Reboxetine mechanism

A

NaRI (Noradrenalin reuptake inhibitor)

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4
Q

Mirtazepine class and mechanism

A

NaSSA (noradrenaline and serotonin specific antidepressant).

5HT2 antagonist, 5HT3 antagonist, H1 antagonist, alpha-1 & alpha-2 antagonist, moderate muscarinic antagonist

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5
Q

St John’s Wort mechanism

A

Weak MAOI and weak SNRI (also considered by some to be a weak SSRI)

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6
Q

Trazodone mechanism

A

Weak SRI and 5HT antagonist

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7
Q

Moclobemide mechanism

A

Reversible inhibitor of monoamine oxidase type A

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8
Q

Agomelatine mechanism

A

Melatonergic agonist (MT1 and MT2 receptors) and 5-HT2C antagonist

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9
Q

Donepezil mechanism

A

Reversible acetylcholinesterase inhibitor

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10
Q

Rivastigmine

A

Reversible acetylcholinesterase inhibitor and butyrylcholinesterase inhibitor

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11
Q

Galantamine

A

Reversible acetylcholinesterase inhibitor and binds allosterically to the nicotinic acetylcholine receptor

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12
Q

Tacrine

A

Reversible acetylcholinesterase inhibitor

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13
Q

Memantine

A

NMDA antagonist

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14
Q

Valproate

A

GABA agonist and NMDA antagonist

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15
Q

Gabapentin

A

GABA agonist

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16
Q

Topiramate

A

GABA agonist, NMDA antagonist, and Na channel stabiliser

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17
Q

Carbamazepine

A

Stabilises Na channels

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18
Q

Phenytoin

A

Stabilises Na channels

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19
Q

Lamotrigine

A

NMDA antagonist and stabilises Na channels

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20
Q

Pregabalin

A

Potent ligand for the alpha-2-delta subunit of voltage-gated calcium channels in the central nervous system

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21
Q

Benzodiazepines

A

GABA-A agonists

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22
Q

Z-drugs

A

GABA-A agonists

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23
Q

Buspirone

A

5HT1A partial agonist

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24
Q

Amisulpride mechanism and class

A

Substituted benzamide

D2/D3 selective antagonist (low affinity selective antagonist of ‘D2 like’ receptors (D2=D3>D4) it has little affinity for D1 like’ receptors (D1 and D5) or non dopaminergic receptors (serotonin, histamine, adrenergic, and cholinergic)

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25
Q

Olanzapine mechanism and class

A

Thienobenzodiazepines

Dopamine and 5HT2 antagonism

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26
Q

Aripiprazole mechanism and class

A

Arylpiperidylindole (quinolone)

Partial agonist at 5HT1A and D2, and 5HT2A antagonist

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27
Q

Clozapine mechanism and class

A

Dibenzodiazepines

High affinity for D4, (to a lesser extent D1, D2, D3, D5) also 5 HT 1A partial agonist and 5HT2 antagonist

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28
Q

Ketamine

A

NMDA antagonist

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29
Q

Phencyclidine

A

NMDA antagonist

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30
Q

Lofexedine

A

Alpha 2 agonist

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31
Q

Clonidine

A

Alpha 2 agonist

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32
Q

Buprenorphine

A

Partial agonist at the mu-opioid receptor

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33
Q

Naloxone

A

Pure opioid antagonist (will reverse mu, delta, and kappa)

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34
Q

Atomoxetine

A

Noradrenaline reuptake inhibitor

35
Q

Varenicline

A

(Champix)Nicotinic receptor partial agonist

36
Q

Bupropion

A

(Zyban) Norepinephrine-dopamine reuptake inhibitor, and nicotinic acetylcholine receptor antagonist

37
Q

Disulfiram

A

Binds irreversibly to aldehyde dehydrogenase

38
Q

Acamprosate

A

Metabotropic glutamate receptor antagonist and GABA-A agonist

39
Q

Selegiline

A

selective, irreversible inhibition of monoamine oxidase type B (also inhibits MAO-A at higher doses

40
Q

Immunologic adverse drug reactions Type I

A

Type I reactions

These arise when a drug-IgE complex binds to mast cells with a release of histamine and other inflammatory mediators. They characteristically cause anaphylaxis, urticaria, and bronchospasm. They generally occurs minutes to hours after exposure.

41
Q

Immunologic adverse drug reactions Type II

A

Type II reactions

These occur when a IgG or IgM antibody binds to a cell which has been altered by a drug-hapten. They often manifest as blood abnormalities such as thromboctopenia and neutropenia. The timing of these reactions is variable.

42
Q

Immunologic adverse drug reactions Type III

A

Type III reactions

These occur when drug-antibody complexes activate the complement system. They present with fever, rash, urticaria and vasculitis. These occur 1 to 3 weeks after exposure.

43
Q

Immunologic adverse drug reactions Type IV

A

Type IV reactions

These arise when the MHC system presents drug molecules to T cells. They result in allergic contact dermatitis and rashes. They occur 2 to 7 days after cutaneous exposure.

44
Q

Chlorpromazine class

A

Phenothiazines (Aliphatic side chain)

45
Q

Pipothiazine

A

Phenothiazines (Piperidine side chain) (also includes Thioridazine)

46
Q

fluphenazine

A

Phenothiazines (Piperizine side chain)

47
Q

Trifluoperazine

A

Phenothiazines (Piperizine side chain)

48
Q

Haloperidol

A

Butyrophenones

49
Q

Flupenthixol

A

Thioxanthenes

50
Q

zuclupenthixol

A

Thioxanthenes

51
Q

Benzoxasoles

A

Risperidone

52
Q

Dibenzothiazepines

A

Quetiapine

53
Q

Serotonin receptors

A
  • 5-HT3 is ligand gated
  • 5-HT3 is most associated with nausea
  • 5-HT7 is associated with circadian rhythms
  • 5-HT2 stimulation is thought to underlie the effects of insomnia, agitation, and sexual dysfunction associated with SSRI use
54
Q

Antidepressants for Nocturnal enuresis in children

A

Amitriptyline, Imipramine, Nortriptyline

55
Q

Antidepressants for Phobic and obsessional states

A

Clomipramine

56
Q

Antidepressants for Adjunctive treatment of cataplexy associated with narcolepsy

A

Clomipramine

57
Q

Antidepressants for Panic disorder and agoraphobia

A

Citalopram, Escitalopram, Sertraline, Paroxetine, Venlafaxine

58
Q

Antidepressants for Social anxiety/ phobia

A

Escitalopram, Paroxetine, Sertraline, Moclobemide, Venlafaxine

59
Q

Antidepressants for Generalised anxiety disorder

A

Escitalopram, Paroxetine, Duloxetine, Venlafaxine

60
Q

Antidepressants for OCD

A

Escitalopram, Fluoxetine, Fluvoxamine, Paroxetine, Sertraline

61
Q

Antidepressants for Bulimia nervosa

A

Fluoxetine

62
Q

Antidepressants for PTSD

A

Paroxetine, Sertraline

63
Q

Which CYP450 shows the greatest phenotypic variation

A

CYP2D6

64
Q

Which CYP450 is involved in clozapine metabolism

A

CYP1A2

65
Q

Grapefruit juice inhibits which CYP450s

A

CYP3A4 and CYP1A2

66
Q

Notable inducers of the CYP450 system

A

smoking, alcohol, barbiturates, carbamazepine, Phenytoin, and St John’s Wort

67
Q

Notable inhibitors of the CYP450 system

A

chlorpromazine, SSRI’s, and grapefruit juice.

68
Q

Illicit Drugs which interfere with ionotropic receptors or ion channels

A

Alcohol, nicotine, benzodiazepines, ketamine

69
Q

Illicit Drugs which interfere with G coupled receptors

A

Opioids, cannabinoids, y-hydroxybutyrate (GHB)

70
Q

Illicit Drugs that target monoamine transporters

A

Amphetamine, ecstasy, cocaine

71
Q

Histamine H1 blockade casues

A

Weight gain, sedation

72
Q

Alpha 1 blockade casues

A

Orthostatic hypotension, sedation, sexual dysfunction, priapism

73
Q

Muscarinic central M1 blockade casues

A

Agitation, delirium, memory impairment, confusion, seizures

74
Q

Muscarinic peripheral M1 blockade casues

A

Dry mouth, ataxia, blurred vision, narrow angle glaucoma, constipation, urinary retention, tachycardia

75
Q

Mesolimbic pathway is responsible for which effect of antipsychotics

A

therapeutic benefit

76
Q

Mesocortical pathway is responsible for which effect of antipsychotics

A

negative symptoms

77
Q

Nigrostriatal pathway is responsible for which effect of antipsychotics

A

EPSEs

78
Q

Tuberoinfundibular pathway is responsible for which effect of antipsychotics

A

hyperprotactinemia

79
Q

Vitamin B1 =

A

thiamine

80
Q

Vitamin B2 =

A

riboflavin

81
Q

Vitamin B3 =

A

niacin

82
Q

Vitamin B5 =

A

pantothenic acid

83
Q

Vitamin B9 =

A

folic acid

84
Q

Vitamin B12 =

A

cyanocobalamin

MRCPsych Paper A (2 decks)

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