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LS MRPSYCH > pharmcology III > Flashcards

pharmcology III Flashcards

1
Q

what should be avoided in hepatic impairment

A

TCA
MAOI

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2
Q

which meds are safe in hepatic impairment

A

lithium
lorazepam
zopiclone
sertraline
citalopram
paroxetine
vortioxene

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3
Q

what is seen on CT in herpes encephalitis

A

CT changes in temporal lobes / frerior frontal too

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4
Q

what is the cause for herpes encephalitis

A

95% causes by HSV 1

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5
Q

symptoms of herpes encephalitis

A

fever
headache
sieuzre
vomiting
aphasia
cold sores

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6
Q

diagnosis and Rx in herpes encephalitis

A

MRI&raquo_space;»
CSF raised protein
aciclovir

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7
Q

which antidepressants are safe for use in HIV patients

A

fluxoetine
paroxetine

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8
Q

what does prolactin increase risk of

A

breast cancer and oesghageal cancer

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9
Q

which antipsyhcotics cause raised prolactin

A

rispiderone
paliperdone
sulpride
all typical
amisulpide

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10
Q

how does doapmine work with prolactin

A

dopamine inhibits prolactin

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11
Q

what is lamotrigine used for

A

to prevent and manage depression in bipolar
also used for epilpsey

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12
Q

how does lamotrigine work

A

stabilises nA
blocks calcium
NMDA receptor antogreine

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13
Q

which other anti psychotics impact lamotrigine levels

A

inducer- speed enzyme so reduce level
Carbmazeine, phenytoin

inhibitor - reduce enzyme therefore increase levels
Na valproate

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14
Q

when is lithium contradicted

A

addision
brugada
heart diseases
renal impairment

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15
Q

what is diabetes inspidus

A

unresponsive to ADH vasopressin

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16
Q

what is used to Rx diabetes inspidaus

A

amiloride
indomethacin
desmopressin

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17
Q

what is used to monitor for ltihium toxicity

A

AMDISEN

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18
Q

when a new dose of lithium is started whas the monitoring rquirement

A

weekly until stable
then 3 monhtly when stable by ice but mausldey says 6 mon

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19
Q

what is modafinil
who for

A

it s used to promote wakeful attention , viligence, it is a dosapmine reuptake inhibtor
narcolepsye wthout catplexy

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20
Q

how does MS present

A

initially very unspecific
tiredness 75%
pins needles
trigmeninal neuralgia
lhermitte phenomnia
spasctic weakness
tremor
sexual dysunfction
urinary incontention

uffhoff hpenhemoa - raised body temp
optic neuritis

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21
Q

neuromuscular blocking drugs

A

depolarizing neuromuscular blocking agents (eg, succinylcholine) and nondepolarizing neuromuscular blocking agents (eg, rocuronium, vecuronium, atracurium, cisatracurium, mivacurium

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22
Q

name the opoid receptors

A

mui
gamma
kappa

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23
Q

name the specifc feature of each receptor

A

mui
analgesia, euphoria, constopation, respiratory depression , dependence

delta
anoxilytic
analgesia

kappa -mood regulator
analgesia
dysphoria

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24
Q

where are the dominergic cells in the brain

A

ventral tegemenal area

where dopamine into mucleus

which stimulis mui cells

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25
Q

which are the four opoid treatments seen in addictions

A

methadone
buprenoprhine
naletrexene
naloxone

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26
Q

what are the half lives for these medications

A

methadone 15-20 hours -mui
naloxone 30-120 mins - all receptors
naltrexene - 4-6 hours
buropjnhripine 24-42 hours

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27
Q

what is parkinson dx

A

neurodegenerative condition
recognised by the triad of : pin rolling tremor, lead pipe cogwheeel rigidity, bradykinesia
loss of doapnergic neurosn in substantia nigra

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28
Q

what is the management of parkinson

A

doapmine receptor agonist - bromcriptine, ropinirole,

levodopa
- decarboyxlase inhibitor -metabolism of levodopa into doapmine

MAOI-B selegine parkinson breakdown of doapmine secretation by neiron

amantadine
increase doapmien release
ataxia, slurred speech, confusion, diziness

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29
Q

what is COMT

A

caecinol o methyl transferase entacapone

encyme which brasks down doapmine

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30
Q

two medications cause pripaism

A

chlorpromazine
trazadone

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31
Q

vigabtrin is associate with wha t

A

visual field defects

its an antiepileptic medication
irrversible inhibitor of GABA transminase
increase GABA in CNS

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32
Q

varenicline and which receptor

A

alpha4 beta 2 nicitione receptor

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33
Q

downsidew of varencline

A

worsening MH SYMPTOMS

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34
Q

what are triptans

A

5HT1 agonists

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35
Q

which medication can cause nephrolithalsis

A

toperimate

36
Q

best anti psyshotic in Renal impiarmene t

A

haloperidol

37
Q

antidepressant in renal impairement

A

sertraline
citalopram
fluxetine

38
Q

which mood stabiliser is OK in renal impairement and which is ci

A

LMOATRIGINE, VALPROATE OK

DO NOT USE LITHOUM

39
Q

anyxiolics in renal impiarement

A

lorazepam

40
Q

anti demenetia med in renal impiarement

A

rivastigamine

41
Q

what criteria can be used for SIADH

A

barter and schwartz

42
Q

triad in sertaonin syndrome

A

clonus
hyperreflexia
altered conscious state

43
Q

which tool is used to help diagnose seratonin syndrome

A

hunters decision rules for diagnosis

usually within 2-3 doses of the medcation within 24 hours
mild to lifethreatening

44
Q
A
44
Q
A
44
Q
A
44
Q
A
45
Q
A
45
Q

hjow to treatment seratonin syndrome

A

withdraw cause
supportive care
5HT2 antagonist - cyprpohepatadine
benzo
fluids
ITU

46
Q

Neurolpetic malginant syndrome when does it usually occur

A

within 2 weeks of starting an antipsychotic but usually around day 9-14

47
Q

how does NMS rpesent

A

fever
hyporeflexia
lead pipde rigidity
leucocysosis
raised ck
Fluctating consciousness
tachycardia
confusion
rigidity

47
Q

how is nMS management occurs

A

bromziptive dantrolene rehydration
stop for 5 days

48
Q

what is chelation

A

binding of one drug to another forming insuoluve complex whichc annot be absorbed

49
Q

an example of chelation

A

tetracycline binding to calcium/iron so no longer as effectiv

50
Q

another was drugs can interact

A

compete for renal tubular transporter
therefore reducing excretion

51
Q

define pharmocydnamic
pharmokinetic

A

drug affects body
kinetic
body on drug

52
Q

synergism and antagonism

A

work togerther same affect e.g. apsirin and clopi
therefore increased bleeding risk
vs antagonsm e.g. vitamin K and warfarin -opposing effects

53
Q

what can occur at a receptor

A

interacton at a receptor leading to allosteric modulation
drug bindign at a site on a receptor
different to alloteric which changes shape and activity

54
Q

what does zopiclone work on

A

cyclopurroline

ci IN RESP WEAKNESS E.G. MYantha gravis resp failure,

55
Q

what does zopiderm work on

A

BZ1 receptors

56
Q

which medicaiton has gucometation directly

A

lorazepam

57
Q

what is 10mg diazepam equaivelent to

A

1mg lorazepam

58
Q

how is the ga ba receptor activated

A

alpha and beta subunits proteins form the bindign site for GABA

activation occurs when conformational change to the central pore
chloride ions enter the neuron and cause hyperpolarisation to neuron

59
Q

what is Daridorexant

A

Daridorexant is an orexin OX1- and OX2-receptor antagonist that blocks the action of orexin neuropeptides, thereby decreasing wakefulness.

not in narcloepsy

60
Q

mechanism of recreational drugs
monamine transporter

A

ectasy
cocaine
amphetamines

61
Q

which drugs intefere with g coupled protein receptors

A

GHB
cannoboids
opoids

62
Q

which drugs work on 5ht

A

hallucinogens

LSD
DMT
nitrious oxide

63
Q

which drugs act on canniboid receptor

A

THC

64
Q

Which act on GABA

A

benzo

65
Q

what is difference between A and b mAOI

A

A sertonin noradrenaline
B phenyloaline tyrtamine by B

66
Q

what happens with MAOI and chesse

A

cheese reaction
HTN
tyrosine in foods

67
Q

key facts aboout pregablin
receptor
elimination

A

kidney unchanged
increased use leads to tolerance
alpha 2 delta subunti
high bioavailability

68
Q

olazapine by IM

where is it given
name of it
dose

A

Olanzapine pamoate / embonate c

significant weight gain and is associated with inadvertent intravascular injection or post injection syndrome.

Only gluteal injection is licensed (deltoid injection is less effective).

The maximum dose is 300mg every 2 weeks which is equivalent to 20 mg / day.

69
Q

management of antidepressant induced hyponatremia?

A

Demeclocycline.

70
Q

Subutex

A

burphrnoine alone

71
Q

what is suboxone

A

buprhohine and nalaxone
4;`1

72
Q

what can stopping paroxetine do

A

cause suicidal thoughts

73
Q

which medications can impact lamotigine levels

A

increase valproate
decrease the pill

74
Q

e first SSRI to be developed

A

zimeldine

75
Q

what is allosteric modulation

A

Allosteric modulation involves a drug binding to a site on a receptor that is different from the active site (allosteric site). This binding can change the receptor’s shape and activity, either enhancing (positive allosteric modulation) or inhibiting (negative allosteric modulation) the effect of the primary ligand.
P

76
Q

what are positive allosteric modulation

A

positive allosteric modulators (PAMs): These enhance the effects of the primary ligand. For example, benzodiazepines act as PAMs at the GABA-A receptor, increasing the effect of the neurotransmitter GABA and resulting in sedative and anxiolytic effects.

77
Q

what are negative allosteric

A

Negative allosteric modulators (NAMs): These inhibit the effects of the primary ligand. For example, some experimental drugs that act as NAMs at the mGluR5 receptor are being studied for the treatment of disorders like anxiety and depression by dampening overactive glutamatergic signalling.

78
Q
A
79
Q

lowest risk of orthostatic hypotension

A

senapine and lurasidone.

80
Q

zopiclone on which receptor

A

gaba A

81
Q

what does CYP26 encode

A

CYP2D6 is a gene that encodes for an enzyme called debrisquine hydroxylase.

82
Q
A

Chlorpromazine synthesis = Charpentier (sharpentier)
Chlorpromazine introduction = Delay and Deniker

LS MRPSYCH (10 decks)

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