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Pharmacology Nuggets Flashcards

1
Q

Receptor responsible for antipsychotic induced weight gain

A

5HT2C

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2
Q

Receptor responsible for antipsychotic postural hypotension

A

Alpha-1 antagonism

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3
Q

High risk side effect of Bupropion

A

Seizures at doses >400mg a day

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4
Q

Mood stabilizers that cause rashes

A

Carbamazepine (10-15% benign maculopapular rash)

Lamotrigine

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5
Q

Mood stablizer that causes PCOS

A

Sodium valproate causes hyperandrogenism and provokes the development of PCOS

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6
Q

Antipsychotic most likely to cause QTc prolongation

A

Ziprasidone

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7
Q

Drug likely to cause visual hallucinations

A

Levodopa

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8
Q

Drug likely to cause halo of light around objects

A

Digoxin

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9
Q

Antipsychotic most likely to cause impotence/sexual side effects

A

Risperidone

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10
Q

SSRI that has the most anticholinergic SEs

A

Paroxetine

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11
Q

Alpha-2 adrenergic agonists used for short term opioid detoxification

A

Lofexidine

Clonidine

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12
Q

Mechanism of action of Atomoxetine

A

Selective inhibition of presynaptic norepinephrine transporter

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13
Q

Mood stabilizer that can be given as a loading dose in mania

A

Valproate

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14
Q

Mechanism of Carbamazepine’s autoinduction

A

Increasing CYP3A4

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15
Q

Active metabolites of amtriptyline and imipramine

A

Amtriptyline –> Nortriptyline

Imipramine –> Desipramine

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16
Q

Equation for the volume of distribution of a drug

A

Quantity of drug / plasma concentration at time of administration

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17
Q

Optimal plasma levels for TCAs: Nortriptyline, Imipramine and Desipramine

A

Nortriptyline 50-100 ng/ml
Imipramine 150-300 ng/ml
Desipramine 150-300 ng/ml

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18
Q

Most potent liver enzyme inducers

A

Phenytoin
Phenobarbitone
Primidone
Carbamazepine

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19
Q

Fluoxetine increases levels of 1) and enhances action of 2)

A

1) Haloperidol, carbamazepine and phenytoin

2) Oral anticoagulants and propanolol

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20
Q

Structural class of Buspirone

A

Azaspirone

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21
Q

Structural class of Bupropion

A

Aminoketone

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22
Q

Structural class of Flupenthixol and Zuclopenthixol

A

Thioxanthenes

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23
Q

Structural class of Droperidol and Haloperidol

A

Butyrophenones

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24
Q

1st line mood stabilizer for mixed affective and manic episodes

A

Sodium Valproate

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25
Mechanism of action of Rivastigmine
A reversible and non-competitive AChE inhibitor
26
Mechanism of action of Memantine
NMDA antagonist
27
Reversible MAOis
Moclobemide and brofaromine
28
Discoverer of Lithium
Cade
29
Discoverer of Clozapine
Kane
30
Discoverer of Chlorpromazine
Delay and Deniker
31
Discoverer of Haloperidol
Janssen
32
Discoverer of Imipramine
Kuhn
33
Structural class of Risperidone
Benzisoxazole
34
Structural class of Amisulpride and Sulpride
Subsituted Benzamides
35
Structural class of Ziprasidone
Benzisothiazole
36
Structural class of Clozapine
Dibenzodiazepine
37
Structural class of Olanzapine
Thiobenzodiazepine
38
Drugs eliminated renally unchanged
Lithium, amisulpride, sulpride, gabapentin, acamprosate, amantadine
39
Best benzodiazepine for liver failure
Oxazepam - does not require hepatic oxidation
40
Benzodiazepines that undergo direct phase 2 metabolism
Lorazepam, Temazepam, Oxazepam
41
Drugs increased by Valproate's competitive inhibition of their metabolism
TCAs especially clomipramine, Lamotrigine, Phenobarbitone
42
Least sedating/anticholinergic TCAs
Lofepramine, Nortriptyline
43
Treatment of anorgasmia associated with SSRIS
Cyproheptadine a sedating antihistamine
44
Indication and mechanism for Acamprosate
Used for EToH withdrawl, possibly works through glutamate antagonism
45
Pros and cons of Doxepin
Lower orthostatic hypotension, higher antihistaminic action
46
TCAs from most sedating to least
Trimipramine, Amitriptyline, Dothiepine, Imipramine, Lofepramine, Nortriptyline
47
Amisulpride vs. Sulpride mechanisms
Sulpride = pure D2 antagonist vs Amisulpride = D2/D3 antagonist
48
Antibiotic that acts an irreversible MAOi
Linezolid
49
TCA toxicity cause and treatment
Inhibition of fast inward Na channels in the heart. Treated with sodium bicarbonate.
50
Most toxic benzodiazepine
Alprazolam
51
Opioid than can cause serotonin syndrome with SSRIs
Pethidine/meperidine
52
Treatment for tyramine-MAOi hypertensive crisis
Phentolamine or phenoxybenzamine
53
Most risky TCAs for seizures/cardiotoxicity
Amitriptyline and dosulepin
54
SSRI with some cardiac risk
Citalopram
55
Treatment of Clozapine induced hypersalivation
``` Pirenziprine - M1/M4 antagonist Trihexyphenidyl Hyoscine Amitriptyline Benztropine Terazosin ```
56
Opioid that can cause QTc prolongation
Methadone
57
Abnormal Involuntary Movement Scale (AIMS) is used to measure
Tardive dyskinesia
58
Drugs associated with risk of cleft-palate
Lamotrigine Diazepam SSRIs
59
Best drug for atypical depression
MAOis
60
Flumazenil mechanism of action
Competitive antagonist and benzodiazepine receptor
61
Antidepressants with greatest CYP2D6 inhibition
Fluoxetine, Duloxetine
62
Safest mood stabilizer to use with oral contraceptives
Sodium Valproate
63
Effects of combining Sodium Valproate and Lamotrigine
Decreased Valproate levels, significantly increased Lamotrigine due to decreased clearance and competition for liver metabolism
64
Switching from MAOi to SSRI
Withdraw and wait 2 weeks
65
Specific side effect of Zopiclone
Metallic taste in mouth

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