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Pharmacology > Pharmacology: Psych/Neuro > Flashcards

Pharmacology: Psych/Neuro Flashcards

1
Q

Methyphenidate

A

CNS stimulant

- Increase catecholamines in the synaptic cleft

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2
Q

Dextroamphetamine

A

CNS stimulant

- Increase catecholamines in the synaptic cleft

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3
Q

Mixed amphetamine salts

A

CNS stimulant

- Increase catecholamines in the synaptic cleft

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4
Q

Haloperidol

A

High potency, first generation antipsychotic

  • Block DA2 receptors, incr cAMP
  • Increased EPS: restlessness, involuntary mvmts, uncontrollable speech
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5
Q

Trifluoperazine

A

High potency, first generation antipsychotic

  • Block DA2 receptors, incr cAMP
  • Increased EPS: restlessness, involuntary mvmts, uncontrollable speech
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6
Q

Fluphenazine

A

High potency, first generation antipsychotic

  • Block DA2 receptors, incr cAMP
  • Increased EPS: restlessness, involuntary mvmts, uncontrollable speech
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7
Q

Chlorpromazine

A

Low potency, first generation antipsychotic

  • Less EPS SEs
  • More antiACh, antiH, anti-alpha SEs: dry mouth, sedating, hypotension
  • CORNEAL deposits!
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8
Q

Thioridazine

A

Low potency, first generation antipsychotic

  • Less EPS SEs
  • More antiACh, antiH, anti-alpha SEs: dry mouth, sedating, hypotension
  • reTinal deposits!
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9
Q

Eye effects of chlorpormazine vs. thioridazine

A

C: Corneal deposits
T: reTinal deposits (e.g. retinitis pigmentosa)

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10
Q

Dantrolene

A

Muscle relaxant
- Abolishes excitation-contraction coupling in muscle cells, probably by action on RyR
Tx: NMS (for muscle rigidity), malignant hyperthermia

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11
Q

Bromocriptine

A

D2 agonist

Tx: NMS

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12
Q 
Order these EPS side effects in order of appearance:
Akathisia
Akinesia
Acute dystonia
Tardive dyskinesia
A
  1. Acute dystonia - 4 hrs
  2. Akinesia (parkinsonian sx) - 4 days
  3. Akathisia (restlessness/out of body feeling) - 4 wks
  4. Tardive dyskinesia (involuntary repetitive body movements) - 4 mos
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13
Q

Olanzapine

A

Atypical antipsychotic
- Various 5HT2, DA, alpha, H1 effects
Tx: Schizophrenia; Olanz also for OCD, anxiety, depression, mania, Tourette’s
SE: weight gain! (like clozapine)

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14
Q

Clozapine

A

Atypical antipsychotic
- Various 5HT2, DA, alpha, H1 effects
Tx: Schizophrenia
SE: weight gain (like olanzapine), seizures! agranulocytosis!

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15
Q

Quetiapine

A

Atypical antipsychotic
- Various 5HT2, DA, alpha, H1 effects
Tx: Schizophrenia

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16
Q

Risperidone

A

Atypical antipsychotic
- Various 5HT2, DA, alpha, H1 effects
Tx: Schizophrenia

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17
Q

Aripiprazole

A

Atypical antipsychotic
- Various 5HT2, DA, alpha, H1 effects
Tx: Schizophrenia

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18
Q

Ziprasidone

A

Atypical antipsychotic
- Various 5HT2, DA, alpha, H1 effects
Tx: Schizophrenia
SE: Prolong QT!

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19
Q

Which drugs have these SEs?

  1. Restlessness, involuntary mvmts, incontrollable speech
  2. Dry mouth, constipation, sedation, hypotension
  3. Weight gain
  4. Agranulocytosis
  5. Prolonged QT
A
  1. Typical, high potency antipsychs: haloperidol, trifluoperazine, fluphenazine
  2. Typical, low potency antipsychs: chlorpromazine (corneal), thioridazine (retinal)
  3. clozapine, olanzapine
  4. clozapine
  5. ziprasidone
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20
Q

Lithium

A

Mood stabilizer
- Unk MOA
Tx: BPD (blocks relapse and acute manic events), SIADH
SEs: MNOP
- Movement (tremor)
- Nephrogenic DI (ADH antagonist) resulting in polyuria
- hypOthyroid
- Pregnancy problems: Ebstein’s anomaly, malformation of the great vessels

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21
Q

Buspirone

A

Serotonin agonist

  • Stimulates 5-HT1A receptors
  • No sedation, addiction, tolerance
  • No interaction with EtOH (unlike BZDs, barbs)
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22
Q

Amitriptyline

A

Tertiary TCA
- Blocks 5HT > NE reuptake
Tx: MDD, fibromyalgia
SE: more antiACh than secondary TCAs (tachycardia–M2 decr HR, urinary retention, more confusion and hallucinations in elderly –like AD), sedation
Toxicity: Convulsions! Coma! Cardiotoxicity! Resp depression, hyperpyrexia

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23
Q

Imipramine

A 
Tertiary TCA
- Blocks 5HT > NE reuptake
Tx: MDD, fibromyalgia, BEDWETTING
SE: antiACh effects, sedation
Toxicity: Convulsions! Coma! Cardiotoxicity!  Resp depression, hyperpyrexia
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24
Q

Clompramine

A 
Tertiary TCA
- Blocks 5HT > NE reuptake
Tx: MDD, fibromyalgia, OCD
SE: antiACh effects, sedation
Toxicity: Convulsions! Coma! Cardiotoxicity!  Resp depression, hyperpyrexia
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25
Q

Doxepin

A 
Tertiary TCA
- Blocks 5HT > NE reuptake
Tx: MDD, fibromyalgia
SE: antiACh effects, sedation
Toxicity: Convulsions! Coma! Cardiotoxicity!  Resp depression, hyperpyrexia
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26
Q

Tertiary vs. Secondary TCAs

A

Tertiary: 5HT > NE, more antiACh effects
- urinary retention, tachy, dry mouth
- confusion and hallucination in elderly
Secondary: NE > 5HT

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27
Q

Nortriptyline

A

Secondary TCA
- Blocks NE > 5HT reuptake
Tx: MDD, fibromyalgia
Better for elderly! Less anti-Ach effects (confusion, hallucinations)

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28
Q

Desipramine

A

Secondary TCA
- Blocks NE > 5HT reuptake
Tx: MDD, fibromyalgia
LEAST sedating! But lower sz threshold

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29
Q

Amoxapine

A

Secondary TCA
- Blocks NE > 5HT reuptake
Tx: MDD, fibromyalgia

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30
Q

NaHCO3

A

antidote for TCA toxicity

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31
Q

Fluoxetine

A

SSRI

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32
Q

Paroxetine

A

SSRI

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33
Q

Sertraline

A

SSRI

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34
Q

Citalopram

A

SSRI

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35
Q

Cyproheptadine

A

5-HT2 receptor antagonist

- treats Serotonin Syndrome (hyperthermia, myoclonus, CV collapse, flushing, diarrhea, seizures)

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36
Q

Venlafaxine

A

SNRI

Depression, GAD

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37
Q

Duloxetine

A

SNRI
Depression, diabetic peripheral neuropathy
Great effect on NE than venlafaxine

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38
Q

Tranylcypromine

A

MAOI
- incr NE. 5HT, DA
Atypical depression (hypersomnia, overeating, mood reactivity, weight gain, sensitivity to rejection); anxiety, hypochondriasis
SEs: Hypertensive crisis with Tyr ingestion and beta agonists; CNS stimulation
**Don’t give with SSRIs or meperidine (opioid) to prevent serotonin syndrome!!

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39
Q

Phenelzine

A

MAOI
- incr NE. 5HT, DA
Atypical depression; anxiety; hypochondriasis
SEs: Hypertensive crisis with Tyr ingestion and beta agonists; CNS stimulation
**Don’t give with SSRIs or meperidine (opioid) to prevent serotonin syndrome!!

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40
Q

Isocarboxazid

A

MAOI
- incr NE. 5HT, DA
Tx: Atypical depression; anxiety; hypochondriasis
SEs: Hypertensive crisis with Tyr ingestion and beta agonists; CNS stimulation
**Don’t give with SSRIs or meperidine (opioid) to prevent serotonin syndrome!!

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41
Q

Selegiline

A

MAO-I (MAOB selective, which is more location specific - neurons, astroglia, plts)
- incr NE. 5HT, DA
Tx: Parkinson’s; atypical depression; anxiety; hypochondriasis
SEs: Hypertensive crisis with Tyr ingestion and beta agonists; CNS stimulation
**Don’t give with SSRIs or meperidine (opioid) to prevent serotonin syndrome!!

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42
Q

Buproprion

A 
Atypical antidepressant
- Incr NE and DA (unk MOA)
Tx: depression, smoking cessation
**Sz in bulimic pts!
No sexual SE
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43
Q

Mirtazapine

A

Atypical antidepressant
- alpha2 antagonist, incr release of NE and 5HT via decr neg feedback
- potent 5HT2 and 5HT3 antagonist
SE: incr appetite! sedation, weight gain, dry mouth

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44
Q

Maprotiline

A

Atypical antidepressant
- Blocks NE reuptake
SE: sedation, orthostatic hypotension

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45
Q

Trazodone

A

Atypical antidepressant
- Main action is to inhibit 5HT reuptake
Tx: insomnia
SEs: PRIAPISM, postural hypotension, sedation, nausea

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46
Q

Epinephrine

A

Alpha-agonist
- Decrease aqueous humor due to vasconstriction
SE: mydrasis (do not use in closed-angle glaucoma!); stinging

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47
Q

Brimondine

A

Alpha-agonist
- Decrease aqueous humor due to vasconstriction
SE: no pupillary or vision changes

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48
Q

Timolol

A

Beta-blocker
- Decrease aqueous humor due to vasconstriction
SE: no pupillary or vision changes

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49
Q

Betaxolol

A

Beta-blocker
- Decrease aqueous humor due to vasconstriction
SE: no pupillary or vision changes

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50
Q

Carteolol

A

Beta-blocker
- Decrease aqueous humor due to vasconstriction
SE: no pupillary or vision changes

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51
Q

Acetazolamide

A

Diuretic, inh CA
- Decrease aqueous humor due to decr HCO3-
SE: no pupillary or vision changes

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52
Q

Pilocarpine

A

Direct cholinomimetic
- incr aqueous humor outflow, contract ciliary muscle and open trabecular meshwork
SE: miosis, cyclospasm (contraction of the ciliary muscle in the eye)
**Pilocarpine good for emergencies! Good for opening meshwork into canal of Schlemm

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53
Q

Carbachol

A

Direct cholinomimetic
- incr aqueous humor outflow, contract ciliary muscle and open trabecular meshwork
SE: miosis, cyclospasm (contraction of the ciliary muscle in the eye)

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54
Q

Physostigmine

A

Indirect cholinomimetic
- incr aqueous humor outflow, contract ciliary muscle and open trabecular meshwork
SE: miosis, cyclospasm (contraction of the ciliary muscle in the eye)

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55
Q

Echothiopate

A

Indirect cholinomimetic
- incr aqueous humor outflow, contract ciliary muscle and open trabecular meshwork
SE: miosis, cyclospasm (contraction of the ciliary muscle in the eye)

56
Q

Latanoprost

A

Prostaglandin (PGF2alpha)
- Increase outflow of aqueous humor
SE: darkens iris (browning)

57
Q

Morphine

A

Opioid analgesic

58
Q

Fentanyl

A

Opioid analgesic

59
Q

Codeine

A

Opioid analgesic

60
Q

Heroin

A

Opioid analgesic

61
Q

Methadone

A

Opioid analgesic

62
Q

Detromethorphan

A

Opioid analgesic

- Cough suppr

63
Q

Deiphenoxylate

A

Opioid analgesic

- For diarrhea

64
Q

Loperamide

A

Opioid analgesic

- For diarrhea

65
Q

Opioid tolerance does NOT develop to…

A
  1. miosis

2. constipation

66
Q

Butorphanol

A

Partial agonist at mu opiod receptors, agonist at kappa receptors
- Causes w/d if on full opioid agonist

67
Q

Tramadol

A

Very weak opioid agonist, also inhibits 5HT and NE

- Decreases sz threshold

68
Q

Phenytoin

A

Na channel inactivation
1st line: GTC, Status PPX (vs BZD for acute)
Also: Simple- and complex-partial

69
Q

Fosphenytoin (IV form)

A

Na channel inactivation
1st line: GTC, Status
Also: Simple- and complex-partial

70
Q

Carbamazepine

A

Na channel inactivation

1st line: Trigeminal neuralgia, GTC, simple- and complex-partial

71
Q

Lamotrigine

A

Na channel inactivation

72
Q

Gabapentin

A

GABA analog, but inhibits Ca2+ channels

Peripheral neuropathy, BPD

73
Q

VPA

A

Na channel inactivation, incr GABA

1st line: GTCs, myoclonic seizures

74
Q

Topiramate

A

Na channel inactivation, incr GABA

75
Q

Phenobarbital

A

Barbiturate, incr GABA via incr DURATION of Cl- channel opening (vs. BZD incr freq)
1st line: pregnant women and children
- incr P450

76
Q

Ethosuximde

A

Blocks T type Ca channels
1st line: Absence
SJS

77
Q

Diazepam

A

Lond acting BZD, incr GABA action by incr FREQ of Cl- channel opening
1st line: acute status

78
Q

Lorazepam

A

Intermediate BZD, incr GABA action by incr FREQ of Cl- channel opening
1st line: acute status

79
Q

Tigabine

A

Inh GABA reuptake

80
Q

Vigabatrin

A

Incr GABA via irrev inhibition of GABA transaminase

81
Q

Levetriacetam

A

Unk MOA, may modulate GABA and Glu release

82
Q

Pentobarbital

A

Barbiturate, incr GABA via incr DURATION of Cl- channel opening (vs. BZD incr freq)
1st line: pregnant women and children
- incr P450

83
Q

Thiopental

A

Barbiturate, incr GABA via incr DURATION of Cl- channel opening (vs. BZD incr freq)

  • 1st line: pregnant women and children
  • Anesthesia induction (high lipid solubility, high potency)
  • incr P450
  • DECR cerebral BF (may incr cerebral metabolic demand?)
84
Q

Secobarbital

A

Barbiturate, incr GABA via incr DURATION of Cl- channel opening (vs. BZD incr freq)
1st line: pregnant women and children
- incr P450

85
Q

Triazolam

A

Short acting BZD

86
Q

Alprazolam

A

Short acting BZD

87
Q

Oxazepam

A

Short acting BZD

88
Q

Midazolam

A

Short acting BZD

89
Q

Estrazolam

A

Intermediate acting BZD (along with lorazepam and temazepam)

90
Q

Temazepam

A

Intermediate acting BZD (along with lorazepam and estrazolam)

91
Q

Flurazepam

A

Long acting BZD (along with diazepam, chlordiazepoxide, clorazepate)

92
Q

Chlordiazepoxide

A

Long acting BZD (along with diazepam, flurazepam, clorazepate)

93
Q

Clorazepate

A

Long acting BZD (along with diazepam, chlordiazepoxide, flurazepam)

94
Q

Zolpedim

A

aka Ambien

Non-BZD hypnotic

95
Q

Zaleplon

A

Non-BZD hypnotic

96
Q

Eszopiclone

A

Non-BZD hypnotic

97
Q

Flumazenil

A

Competitive antagonist at GABA BZD receptor site

- OD of BZD or non-BZD hypnotics

98
Q

Halothane

A

Inhaled anesthetic

- Hepatotoxicity

99
Q

Enflurane

A

Inhaled anesthetic

- Proconvulsant

100
Q

Isoflurane

A

Inhaled anesthetic

101
Q

Sevoflurane

A

Inhaled anesthetic

102
Q

Methoxyflurane

A

Inhaled anesthetic

- Nephrotoxicity

103
Q

NO

A

Inhaled anesthetic

SE: expansion of trapped gas

104
Q

Arylcyclohexylamines (Ketamine)

A

Dissociative anesthetic
- Blocks NMDA receptor
- Incr cerebral BF (decr cerebral metabolic demand)
SE: CV stimulation

105
Q

Propofol

A

Potentiates GABA

- Rapid anesthesia induction and short procedures

106
Q

Procaine

A

Ester local anesthetic

- block Na ch

107
Q

Cocaine

A

Ester local anesthetic
- block Na ch
SE: HTN, hypotension, arrhythmia

108
Q

Tetracaine

A

Ester local anesthetic

- block Na ch

109
Q

Lidocaine

A

Amide local anesthetic (give if ester allergic)

- block Na ch

110
Q

Mepivacaine

A

Amide local anesthetic (give if ester allergic)

- block Na ch

111
Q

Bupivacaine

A

Amide local anesthetic (give if ester allergic)
- block Na ch
SE: Severe CV tox!

112
Q

Succinylcholine

A

Depolarizing NM blocking agent

  • Phase I (prolonged depol): no antidote, potentiated by AChE-I
  • Phase II (repol but not blocked): give AChE-I e.g. neostigmine as antidote
113
Q

Tubocurarine

A

Non-depolarizing NM blocking agent
- Competitive ACh R antagonist
Rev blockade with AChE-I (neostigmine, edrophonium)

114
Q

Atracurium

A

Non-depolarizing NM blocking agent
- Competitive ACh R antagonist
Rev blockade with AChE-I (neostigmine, edrophonium)

115
Q

Mivacurium

A

Non-depolarizing NM blocking agent
- Competitive ACh R antagonist
Rev blockade with AChE-I (neostigmine, edrophonium)

116
Q

Pancuronium

A

Non-depolarizing NM blocking agent
- Competitive ACh R antagonist
Rev blockade with AChE-I (neostigmine, edrophonium)

117
Q

Vecuronium

A

Non-depolarizing NM blocking agent
- Competitive ACh R antagonist
Rev blockade with AChE-I (neostigmine, edrophonium)

118
Q

Rocuronium

A

Non-depolarizing NM blocking agent
- Competitive ACh R antagonist
Rev blockade with AChE-I (neostigmine, edrophonium)

119
Q

Dantrolene

A

Prevents release of Ca from SR of skeletal muscle

  • Malignant hyperthermia
  • NMS
120
Q

Bromocriptine

A

DA agonist

ergot (not preferred)

121
Q

Pramipexole

A

DA agonist

122
Q

Ropinirole

A

DA agonist

non-ergot (preferred)

123
Q

Amantadine

A

Incr DA release, blocks viral uncoating (M2 protein)

124
Q

L-dopa/carbidopa

A

Incr DA in CNS
- Carbidopa inh periph decarboxylase
SE: ARRHYTHMIAS from peripheral conversion of DA

125
Q

Selegiline

A

selective MAOB inh (MAOB prefers to metabolize DA)

- Prevent L-dopa degradation

126
Q

Entacapone

A

COMT inh

- Prevent L-dopa degradation

127
Q

Tolcapone

A

COMT inh

- Prevent L-dopa degradation

128
Q

Benztropine

A

Antimuscarinic, improves tremor and rigidity but little effect on bradykinesia

129
Q

Baclofen

A

GABA derivative, GABA-B agonist

For spasticity and alcoholism

130
Q

Memantine

A

NMDA R antagonist
- prevent excitotoxicity mediated by Ca
Alzheimers

131
Q

Donepezil

A

AchE inhibitor

Alzheimers

132
Q

Galantamine

A

AchE inhibitor

Alzheimers

133
Q

Rivastigmine

A

AchE inhibitor

Alzheimers

134
Q

Vit E

A

Antioxidant

135
Q

Reserpine

A

blocks the vesicular monoamine transporter (VMAT), prevent NT packaging into vesicles and release (they then get degraded by MAO and COMT)
- Huntington’s (hyperkinetic mvmnt)

136
Q

Tetrabenazine

A

blocks the vesicular monoamine transporter (VMAT), prevent NT packaging into vesicles and release (they then get degraded by MAO and COMT)
- Huntington’s (hyperkinetic mvmnt)

137
Q

Sumatriptan

A

5-HT1B/1D agonist
- Vasocontriction, inh trigeminal activation and Vasoactive peptide relsease
Tx: acute migraine, cluster Ha
SE: coronary vasospasm!

Pharmacology (15 decks)

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