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MRPsych > Pharmacology Nuggets > Flashcards

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
Q

Mechanism of action of Rivastigmine

A

A reversible and non-competitive AChE inhibitor

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26
Q

Mechanism of action of Memantine

A

NMDA antagonist

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27
Q

Reversible MAOis

A

Moclobemide and brofaromine

28
Q

Discoverer of Lithium

A

Cade

29
Q

Discoverer of Clozapine

A

Kane

30
Q

Discoverer of Chlorpromazine

A

Delay and Deniker

31
Q

Discoverer of Haloperidol

A

Janssen

32
Q

Discoverer of Imipramine

A

Kuhn

33
Q

Structural class of Risperidone

A

Benzisoxazole

34
Q

Structural class of Amisulpride and Sulpride

A

Subsituted Benzamides

35
Q

Structural class of Ziprasidone

A

Benzisothiazole

36
Q

Structural class of Clozapine

A

Dibenzodiazepine

37
Q

Structural class of Olanzapine

A

Thiobenzodiazepine

38
Q

Drugs eliminated renally unchanged

A

Lithium, amisulpride, sulpride, gabapentin, acamprosate, amantadine

39
Q

Best benzodiazepine for liver failure

A

Oxazepam - does not require hepatic oxidation

40
Q

Benzodiazepines that undergo direct phase 2 metabolism

A

Lorazepam, Temazepam, Oxazepam

41
Q

Drugs increased by Valproate’s competitive inhibition of their metabolism

A

TCAs especially clomipramine, Lamotrigine, Phenobarbitone

42
Q

Least sedating/anticholinergic TCAs

A

Lofepramine, Nortriptyline

43
Q

Treatment of anorgasmia associated with SSRIS

A

Cyproheptadine a sedating antihistamine

44
Q

Indication and mechanism for Acamprosate

A

Used for EToH withdrawl, possibly works through glutamate antagonism

45
Q

Pros and cons of Doxepin

A

Lower orthostatic hypotension, higher antihistaminic action

46
Q

TCAs from most sedating to least

A

Trimipramine, Amitriptyline, Dothiepine, Imipramine, Lofepramine, Nortriptyline

47
Q

Amisulpride vs. Sulpride mechanisms

A

Sulpride = pure D2 antagonist vs Amisulpride = D2/D3 antagonist

48
Q

Antibiotic that acts an irreversible MAOi

A

Linezolid

49
Q

TCA toxicity cause and treatment

A

Inhibition of fast inward Na channels in the heart. Treated with sodium bicarbonate.

50
Q

Most toxic benzodiazepine

A

Alprazolam

51
Q

Opioid than can cause serotonin syndrome with SSRIs

A

Pethidine/meperidine

52
Q

Treatment for tyramine-MAOi hypertensive crisis

A

Phentolamine or phenoxybenzamine

53
Q

Most risky TCAs for seizures/cardiotoxicity

A

Amitriptyline and dosulepin

54
Q

SSRI with some cardiac risk

A

Citalopram

55
Q

Treatment of Clozapine induced hypersalivation

A 
Pirenziprine - M1/M4 antagonist
Trihexyphenidyl
Hyoscine
Amitriptyline
Benztropine
Terazosin
56
Q

Opioid that can cause QTc prolongation

A

Methadone

57
Q

Abnormal Involuntary Movement Scale (AIMS) is used to measure

A

Tardive dyskinesia

58
Q

Drugs associated with risk of cleft-palate

A

Lamotrigine
Diazepam
SSRIs

59
Q

Best drug for atypical depression

A

MAOis

60
Q

Flumazenil mechanism of action

A

Competitive antagonist and benzodiazepine receptor

61
Q

Antidepressants with greatest CYP2D6 inhibition

A

Fluoxetine, Duloxetine

62
Q

Safest mood stabilizer to use with oral contraceptives

A

Sodium Valproate

63
Q

Effects of combining Sodium Valproate and Lamotrigine

A

Decreased Valproate levels, significantly increased Lamotrigine due to decreased clearance and competition for liver metabolism

64
Q

Switching from MAOi to SSRI

A

Withdraw and wait 2 weeks

65
Q

Specific side effect of Zopiclone

A

Metallic taste in mouth

MRPsych (20 decks)

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