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Step 1 Study Journal > Pharmacology > Flashcards

Pharmacology Flashcards

1
Q

Ethosuxamide

  • MOA
  • Use
  • ADRs
A
  • blocks T-type Ca channels
  • Absence seizures
  • GI, fatigue, HA, itchiness, SJS (EFGHIJ)
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2
Q

BDZ’S

  • MOA
  • Use
  • ADRs
A
  • Increase GABAa
  • SE
  • Tolerance and dependence!
  • Sedation, tolerance, dependence, cardiorespiratory depression
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3
Q

Phenobarbital

  • MOA
  • Use
  • ADRs
A
  • Increases GABA a action
  • simple, complex, tonic clonic, 1st line in neonates
  • Similar to BDZ’s, also induces cyp P450
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4
Q

Phenytoin, fosphenytoin

  • MOA
  • Use
  • ADRs (neuro, derm, MSK, heme, repro, other)
A
  • Blocks Na+ channels, zero-order kinetics
  • everything but absence
  • Neuro: nystagmus, diplopia, ataxia, sedation
  • Derm: hair, SJS, gingival hyperplasia, DRESS syndrome
  • MSK: osteopenia, SLE-like syndrome
  • HEME: megaloblastic anemia
  • REPRO: fetal hydantoin syndrome
  • other: cyp inducer
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5
Q

Carbamazepine

  • MOA
  • Use
  • ADRs
A
  • Blocks Na channels
  • everything but absence, trigeminal neuralgia
  • diplopia, ataxia, blood dycrasias (agranulocytosis, aplastic anemia), liver too, cyp inducer, SJS, SIADH, teratogen
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6
Q

Valproic Acid

  • MOA
  • Use
  • ADRs
A
  • Increases Na channel inactivation, increases GABA concentration by inhibiting GABA transaminase
  • everything (including absence), also for myoclonus, bipolar, migraine PPx
  • GI, hepatotoxicity, pancreatitis, neural tube defects, tremor, weight gain
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7
Q

Vigabatrin

  • MOA
  • Use
A
  • Increases GABA by inhibiting GABA transaminase

- simple, complex

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8
Q

Gabapentin

  • MOA
  • Use
  • ADRs
A
  • Inhibits high voltage activated Ca channels, GABA analog
  • simple, complex, peripheral neuropathy, postherpetic neuralgia
  • Sedation, ataxia
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9
Q

Topiramate

  • MOA
  • Use
  • ADRs
A
  • Blocks Na channels, increases GABA action
  • everything but absence, migraine PPx
  • Sedation, mental dulling, kidney stones, weight los
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10
Q

Lamotrigine

  • MOA
  • Use
  • ADRs
A
  • Blocks voltage gated Na channels
  • everything including absence seizures
  • SJS!!!
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11
Q

Levetiracetam

  • MOA
  • Use
  • ADRs
A
  • Unknown, GABA and glutamate??

- everything but absence

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12
Q

Tigabine

  • MOA
  • Use
  • ADRs
A
  • increase GABA by inhibiting reuptake

- simple, complex

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13
Q

Baclofen

  • MOA
  • Use
A
  • Activated GABAb receptors at spinal level, inducing skeletal mm relaxation
  • Muscle spasms
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14
Q

Cyclobenzaprine

  • MOA
  • Use
  • ADRs
A
  • entrally acting mm relaxants, similar to TCAs, similar anticholinergic ADRs
  • mm spasms
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15
Q

Triptans

  • MOA
  • Use
  • ADRs
A
  • 5HT-1b/d agonists, inhibit trigeminal activation (pain), prevent vasoactive peptide release, induce vasoconstriction
  • acute migraine, cluster headaches
  • coronary vasospasm, mild paresthesia
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16
Q

Methylphenidate, dextroamphetamine, methamphetamine

  • MOA
  • Use
A
  • Increased catecholamines in the synaptic cleft (NE and DA)

- ADHD, narcolepsy, appetite control

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17
Q

Name the typical antipsychotics
(haloperidol plus the -azines)
-which are high potency?
-which are low?

A

Haloperidol-high
trifluoperazine-high fluphezanizine-high thioridazine-low
chlorpromazine-low

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18
Q

Name the atypical antipsychotics

AACILOPQRZ

A

Aripiprazole, asenapine, clozapine, iloperidone, lurasidone, olanzapine, paliperidone, quetiapine, risperidone, ziprasidone

19
Q

LITHIUM

  • MOA
  • Use
  • ADRs
A
  • Unknown, probably phosphoinositol cascade
  • Bipolar disorder
  • tremor, nephrogenic diabetes insipidus, hypothyroidism, abstain anomaly
20
Q

Buspirone

  • MOA
  • Use
A
  • 5HT1a receptor agonist
  • Second line for GAD
  • no sedation, addiction, or tolerance
21
Q

SSRI’s (FPSC)

  • MOA
  • Use
  • ADRs
A

Fluoxetine, paroxetine, sertraline, citaloprma

  • 5-HT reuptake inhibition
  • depression, GAD, OCD, bulimia, social anxiety, PTSD, premature ejaculation, premenstrual dysphoria
  • GI distress, SIADH, sexual dysfunction
22
Q

SNRIs (VDLDM)

  • MOA
  • US
  • ADRs
A

Vegans don’t like dairy or meat: venlafaxine, desvenlafaxine, levomilnacipran, duloxetine, milnacipran

  • inhibit 5-HT and NE reuptake
  • depression, GAD, diabetic neuropathy, venlafaxine for social anxiety, panic, PTSD, OCD
  • Increased BP, stimulant, sedation, nausea
23
Q

TCAs (ANIDCDA)

  • MOA
  • USE
  • ADRs
A

amitriptyline, nortirptyline, imipramine, desipramine, clomipramin, doxepin, amoxapine

  • block reuptake up 5-HT and NE
  • depression, OCD, peripheral neuropathy, chronic pain, migraine PPx
24
Q

TCA ADRs:

A
  • convulsions, coma, cardiotoxicity

- Rx of arrhythmia: NAHCO3

25
Q

MAOi’s

  • Increase levels of what?
  • use
A

Tranylcypromine, Phenelzine, Isocarboxazid, Selegeline

  • NE, DA, 5-HT
  • atypical depression, anxiety
26
Q

MAOi’s ADRs

A
  • HTN crisis
  • Washout period
  • Not used with SSRIs, TCAs, St. John’s wort, meperidine, dexgromethorphan
27
Q

Bupropion

  • MOA
  • Uses
  • ADRs
  • Which patient populations should you avoid this drug with?
A
  • Increases NE and DA
  • Smoking cessation, second line antidepressant
  • NE and DA–>stimulant: tachycardia, insomnia
  • HAs, seizures in anorexic/bulimic its due to low potassium
28
Q

Mirtazapine

  • MOA
  • USE
  • ADRs
A
  • Alpha2 antagonist, increase NE and 5-HT release, also Antagonist of 5-HT2 5-HT3, and H1
  • Second line antidepressant
  • Sedation, increased appetite, with gain, dry mouth
29
Q

Trazadone

A

Blocks 5-ht2, alpha 1, and H1 receptors

  • Insomnia ,high doses for depression
  • Sedation, nausea, priapism, postural hypotension
30
Q

Varenicline

A

Nicotinic ACh partial agonist

  • Smoking cessation
  • Causes sleep disturbance
31
Q

MOA of opioid analgesics

A

Agonists at opioid receptors

  • Open K+ channels, close Ca++ channels, decreases synaptic transmission
  • Inhibit release of ACh, NE, 5-HT, glutamate, substance P
32
Q

Pentazocine

A

Kappa agonist and mu antagonist

  • analgesia for mod to severe pain
  • can cause withdrawal if also taking full opiod antagonist
33
Q

Butorphanol

A

Kappa agonist and my partial agonist

  • analgesia for severe pain (migraine, labor)
  • Withdrawal with full opioid agonist
34
Q

Tramadol

A

Weak opioid agonist, inhibits 5-HT and NE reuptake

  • Chronic pain
  • Opioid ADRs, decreases seizure threshold, serotonin syndrome
35
Q

Thiopental

  • MOA
  • Use
A
  • Increases duration of GABAa opening

- induction of anesthesia

36
Q

BDZ’s

  • Use
  • MOA
A
  • anxiety, spasticity, SE, eclampsia, etOH detox, night terrors, sleepwalking, anesthesia, sleep aid
  • Increase frequency of GABAa channel opening
37
Q

BDZ’s (ATOM)

A

alprazolam, triazolam, oxazepam, midazolam

38
Q

Barbiturates (PPTS)

A

phenobarbital, pentobarbital, thiopental, secobarbital

39
Q

Inhaled anesthetics (MDHESIN)

A

My dentist hates everything, so inhale nitrous

methoxyflurane, desflurane, halothane, enflurane, sevoflurane, isoflurane, N2O

40
Q

IV anesthetics (TMKPO)

A

the mighty king proposes foolishly to oprah

thiopental, midazolam, ketamine, propofol, opioids

41
Q

Neuroleptics

  • MOA
  • Uses
  • ADRs
  • -extrapyramidal
  • -ENDO
  • -alpha 1
  • -muscarinic
  • -histamine
  • -CV
A
  • Block D2 receptors increasing cAMP
  • schizophrenia, huntington disease, OCD
  • Lipid soluble, stay in body fat, extrapyramidal ADRs,
  • ENDO: high PRL–>galactorrhea, oligomenorrhea, gynecomastia
  • -dry mouth, constipation
  • -orthostatic hypotension
  • -sedation
  • -QT prolongation
  • -NMS
  • -Tardive dyskinesia
42
Q

Rx of NMS

-sxs of NMS

A
  • dantrolene and bromocriptine

- FEVER: fever, encephalopathy, vitals unstable, enzymes up, rigidity

43
Q

atypical antipsychotics

A
  • Not understood, D2 antagonists, aripiprazole partial D2 agonist, varied D, alpha, H-1, and 5-HT effects
  • Shizo, bipolar, OCD, anxiety, depression, mania, tourette
  • prolong QT
  • metabolic syndrome with pines
  • risperidone–>hyperprolactinemia
44
Q

Chlordiazepoxide

A
  • Delirium tremens

- Works like a BDZ

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