Pharmacotherapy Flashcards
1
Q
Chemical substances manufactured in the neuron to aid in transmission of information
A
NEUROTRANSMITTERS
2
Q
control of complex movements, motivation, cognition, regulation of emotional responses
A
DOPAMINE
3
Q
attention, learning, memory, sleep, wakefulness, mood regulation
A
NOREPINEPHRINE
4
Q
Fight-or-flight response
A
EPINEPHRINE
5
Q
food intake, sleep, wakefulness, temperature regulation, pain control, sexual behaviors, regulation of emotions
A
SEROTONIN
6
Q
alertness, control of gastric secretions, cardiac stimulation, peripheral allergic responses
A
HISTAMINE
6
Q
sleep and wakefulness cycle, signals muscles to become alert
A
ACETYLCHOLINE
6
Q
enhance, prolong, inhibit, or limit the effects of other neurotransmitters
A
NEUROPEPTIDES
7
Q
Enumerate the neurotransmitters (8)
A
- Dopamine
- Norepinephrine
- Epinephrine
- Serotonin
- Histamine
- Acetylcholine
- Neuropeptides
- GABA
7
Q
Modulates other neurotransmitters
A
GABA
7
Q
scientific study of chemical formulations, including their sources, properties, uses, actions, and effects
A
PHARMACOLOGY
8
Q
What are the 2 modulators?
A
- Neuropeptides
- GABA
9
Q
refers to the maximal therapeutic effect that a drug can achieve
A
EFFICACY
10
Q
describes the amount of the drug needed to achieve that maximum effect.
A
POTENCY
11
Q
How many times a day can you give a drug with shorter half-life?
A
3-4x
11
Q
time it takes for half of the drug to be removed from the bloodstream
A
HALF-LIFE
12
Q
How many times a day can you give a drug with longer half-life?
A
Once a day
13
Q
a drug will prove effective for a disease that differs from the one involved in original testing and FDA approval
A
OFF-LABEL USE
14
Q
Common type of drug with off-label Use
A
ANTICONVULSANT
14
Q
issued by the DFA, when a drug is found to have serious or life-threatening side effects, even if such side effects are rare
A
BLACK BOX WARNING
14
Q
Possible problems when psychotropic medications are stopped abruptly
A
- Rebound
- Withdrawal
15
Q
temporary return of symptoms or recurrence of the original symptoms
A
REBOUND
16
Q
new symptoms resulting from discontinuation of the drug
A
WITHDRAWAL
16
Q
- Maximum concentration of the drug in the bloodstream after it has been administered.
- Standard measurement in pharmacokinetics
A
Peak plasma concentration
17
Actual biochemical and physiological effects on living tissue
PHARMACOLOGICAL
18
Study of absorption, distribution, metabolism, and elimination of drugs
PHARMACOKINETICS
19
Phenomenon of drug metabolism at a specific location in the body which leads to a reduction in the concentration of the active drug (specifically when administered orally) before it reaches the site of action or systemic circulation
FIRST-PASS EFFECT
19
Time it takes for the drug to be removed from the bloodstream
Half-life
20
- Pharmacokinetic parameter that represents the efficiency of drug elimination
- It is the rate of elimination of a substance divided by its concentration
CLEARANCE
20
are the final changes in the clinical symptoms induced by a drug
TERTIARY EFFECTS
21
Also known as the desired effect or therapeutic effect
- Occurs as drug is synthesized, released, and metabolized, and acts on the receptor sites of neurotransmitter system
PRIMARY EFFECTS
22
- result from interaction among the neurotransmitter, neuropeptides, and hormones as they influence each other functions in the brain
- Known as a side effect of a medication, which may be harmful, neutral, or even beneficial
SECONDARY EFFECTS
23
2 kinds of neuroleptics
1. Typical
2. Atypical
23
Discontinuation or withdrawal symptoms occur with: (3)
1. Tricyclic antidepressants (TCA)
2. Monoamine oxidase inhibitors (MAOI)
3. Selective serotonin reuptake inhibitors (SSRIs)
24
Indications of neuroleptics
1. Schizophrenia
2. Acute mania
3. Delusional disorder
4. Psychotic depression
5. Drug-induced psychosis
24
These drugs treat psychotic symptoms, such as delusions and hallucinations, by blocking dopamine receptors.
ANTIPSYCHOTIC DRUG / NEUROLEPTICS
25
Neuroleptics or antipsychotic drugs act by blocking the actions of dopamine in the ________ of the _______ of the brain
nigrostriatal area: mesolimbic area
38
________ antipsychotics decrease hostility and agitation
TYPICAL
39
Examples of typical antipsychotics (3)
PBT
1. Phenothiazines
2. Butyrophenones
3. Thioxanthenes
40
Example of Dopamine system stabilizer
Aripiprazole
41
Types of Phenothiazines
1. Apipathic
2. Piperidine
3. Piperazines
42
A phenothiazine that is low in antipsychotic potency and high in sedation effects. Give example
Apipathic
Ex. Chlorpromazine
43
A phenothiazine with medium potency in antipsychotic actions, sedation, and EPS
Piperidine
Ex. Thioridazine
44
> Phenothiazine thatis effective in controlling psychotic symptoms with little or no sedation
> more likely to produce EPS and TD
Piperazine
Ex. Fluphenazine
45
Neuroleptics that minimize agitation and keep the patient as comfortable as possible.
Butyrophenones
Ex. Haloperidol
46
These work similar to Phenothiazines
- Work as dopamine-2 (D2) receptor antagonists and suppress the effect of dopamine in the brain.
Thioxanthenes
Ex. Taractan
47
a group of movement disorders caused by certain medications, particularly antipsychotics and other dopamine receptor-blocking agents
EXTRA PYRAMIDAL EFFECTS (EPS)
48
Examples of EPS
1. Akathisia
2. Pseudoparkinsonism
3. Tardive Dyskinesia
3. Acute dystonia
4. Neuroleptic Malignant Syndrome
49
Subjective feeling of restlessness; intense need to move about
Akathisia
50
- Stiff, stooped posture
- Mask like facial expression
- Coarse pill rolling movements
Pseudoparkinsonism
51
- Abnormal tension or muscle tone
- Tightening of the jaw and thickening of tongue
Acute dystonia
52
Syndrome of permanent, involuntary movements of the tongue
Tardive Dyskinesia
53
Tardive dyskinesia symptoms
1. Tongue protrusion
2. Lip smacking
3. Mouth puckering
4. Facial grimacing
5. Writhing movements
6. Excessive eye blinking
54
Most fatal EPS that is associated with effects on the hypothalamus and medulla. It causes:
- Hyperpyrexia
- Changes in consciousness
- Elevated PR & BP
- Hypoxia
Neuroleptic Malignant Syndrome (NMS)
55
Antipsychotics that block the activity of both serotonin and dopamine
- Symptoms relief occurs with fewer EPS
Atypical antipsychotics
56
Example of atypical antipsychotics
1. Clozapine
2. Risperidone
3. Amilsupride
57
A dopamine receptor antagonist, used to treat emergencies like **acute psychosis and delirium**
Inapsine
58
These drugs interact with the monoamine neurotransmitter systems in the brain, particularly the neurotransmitters norepinephrine and serotonin.
Antidepressant drugs
59
Indications of antidepressants
1. Dysthymia
2. OC disorders
3. Panic Disorders
4. Somatoform
5. Eating disorder
60
The largest group of antidepressants
Heterocyclics
61
Inhibit the presynaptic reuptake of norepinephrine (catecholamine) and 5-HT (indolamine)
Heterocyclics
62
Example of heterocyclics
1. Amoxapine ( Asendin)
2. Desipramine (Norpramin)
3. Nortriptyline (Aventyl)
63
- First line tx of major depression
- Potently and selectively inhibit neuronal reuptake pump of 5-HT
- Safer in overdose and not potentiated by alcohol
Selective Serotonin Reuptake Inhibitors (SSRIs)
64
Example of SSRI
1. Prozac
2. Zoloft
3. Citalopram
65
What do you need to avoid when taking SSRIs
1. Diazepam
2. Alcohol
3. Tryptophan
66
How many days before you can take MAOI after taking SSRIs
14 day clearance
67
- First effective antidepressant
- Increased availability of norepinephrine and 5-HT
- Cause hypertensive reaction when combined with tyramine-rich food
Monoamine Oxidase Inhibitors (MAOI)
68
MAOIs can cause hypertensive reaction when combined with _________ food
Tyramine-rich
69
Give a drug that needs to be avoided when taking MAOIs
1. Phenylethylamine ephedrine
2. Phenylephrine decongestants
3. Bronchodilators demerol
70
A unicyclic antidepressant that inhibit reuptake of norepinephrine and dopamine
Dopamine-Norepinephrine Reuptake Inhibitors (DNRIs)
Ex. Bupropion (Wellbutrin)
71
- Blocks reuptake of norepinephrine, 5-HT, dopamine
- Tx of major depression, chronic pain syndrome, ADHD
Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs)
Ex. Venlafaxine (Effexor)
72
- Potent antagonist at postsynaptic 5-HT receptor sites
- Low incidence of sexual disturbances, enhance sleep normalization properties, anti anxiety effects
Serotonin Modulators
Ex:
1. Trazodone(Desyrel)
2. Nefazodone (Serzone)
73
Facilitate 5-HT and norepinephrine transmission
First new class agents
Norepinephrine-Serotonin Modulator
Ex. Mirtazapine (Remeron)
74
- Used to treat bipolar disorder by acting on the neurotransmitters of the brain.
- Normalizes the reuptake of neurotransmitter such as serotonin, norepinephrine, acetylcholine, and dopamine
- Reduces the release of norepinephrine through competition with calcium
Mood Stabilizing drugs
75
Examples of mood stabilizing drugs
1. Lithium
2. Carbamazepine
3. Valproic acid
4. Gabapentin
76
Normal level of lithium
1.0 mEq/L
77
Lithium is checked every?
2-3 days
78
Used to treat anxiety disorders, insomnia, OCD, depression, PTSD, and alcohol withdrawal.
Antianxiety Drugs
79
________ are the antianxiety agents used most frequently
Benzodiazepines
80
- It mediates the actions of the amino acid GABA
- Can cause physical dependence
Benzodiazepines
81
- Not a CNS depressant
- Increases norepinephrine metabolism
- No tolerance or dependence
Buspirone (Buspar)
82
- Referred as mood elevators
- Used to potentiate antidepressant agents in tx resistant depression
Stimulant Drugs
83
Example of stimulant drugs (3)
1. Dextroamphetamine (Dexedrine)
2. Methylphenidate (Ritalin)
3. Pemoline (Cylert)
84
It is a sensitizing agent that causes an adverse reaction when alcohol is ingested.
Disulfiram (Antabuse)
85
Most common alternatives to lithium for treatment of bipolar I disorder
Anticonvulsant drugs
86
Used to treat medication - induced movement disorders such as Neuroleptic - induced Parkinsonism
Antiparkinsonian agents
87
Examples of antiparkinsonian agents
1. anticholinergic agents
2. antihistaminergic agents
3. dopaminergic agonists
88
this block the action of acetylcholine receptors in the brain and peripheral nervous system in an attempt to correct an imbalance between deficiency of dopamine and abundance of acetylcholine
Anticholinergic agents
89
Ex of anticholinergics
1. Benztropine (Cogentin)
2. Biperiden (Akineton)
90
- Functions as hypnotics and anxiolytics
- Act by competitively antagonizing histamine at the H1 histamine receptor
Antihistaminergic agents
91
Example of antihistaminergic agents
1. Diphenhydramine (Benadryl)
2. Orphenadrine (Norflex)
92
Increase the release of dopamine in the nigrostriatal pathway for clients with parkinsonism
Dopaminergic Agonists and Precursor
93
Example of Dopaminergic
1. Amantadine (Symmetrel)
2. Levodopa (Dopar, Larodopal)
94
