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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
which are the four opoid treatments seen in addictions
methadone buprenoprhine naletrexene naloxone
26
what are the half lives for these medications
methadone 15-20 hours -mui naloxone 30-120 mins - all receptors naltrexene - 4-6 hours buropjnhripine 24-42 hours
27
what is parkinson dx
neurodegenerative condition recognised by the triad of : pin rolling tremor, lead pipe cogwheeel rigidity, bradykinesia loss of doapnergic neurosn in substantia nigra
28
what is the management of parkinson
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
29
what is COMT
caecinol o methyl transferase entacapone encyme which brasks down doapmine
30
two medications cause pripaism
chlorpromazine trazadone
31
vigabtrin is associate with wha t
visual field defects its an antiepileptic medication irrversible inhibitor of GABA transminase increase GABA in CNS
32
varenicline and which receptor
alpha4 beta 2 nicitione receptor
33
downsidew of varencline
worsening MH SYMPTOMS
34
what are triptans
5HT1 agonists
35
which medication can cause nephrolithalsis
toperimate
36
best anti psyshotic in Renal impiarmene t
haloperidol
37
antidepressant in renal impairement
sertraline citalopram fluxetine
38
which mood stabiliser is OK in renal impairement and which is ci
LMOATRIGINE, VALPROATE OK DO NOT USE LITHOUM
39
anyxiolics in renal impiarement
lorazepam
40
anti demenetia med in renal impiarement
rivastigamine
41
what criteria can be used for SIADH
barter and schwartz
42
triad in sertaonin syndrome
clonus hyperreflexia altered conscious state
43
which tool is used to help diagnose seratonin syndrome
hunters decision rules for diagnosis usually within 2-3 doses of the medcation within 24 hours mild to lifethreatening
44
44
44
44
45
45
hjow to treatment seratonin syndrome
withdraw cause supportive care 5HT2 antagonist - cyprpohepatadine benzo fluids ITU
46
Neurolpetic malginant syndrome when does it usually occur
within 2 weeks of starting an antipsychotic but usually around day 9-14
47
how does NMS rpesent
fever hyporeflexia lead pipde rigidity leucocysosis raised ck Fluctating consciousness tachycardia confusion rigidity
47
how is nMS management occurs
bromziptive dantrolene rehydration stop for 5 days
48
what is chelation
binding of one drug to another forming insuoluve complex whichc annot be absorbed
49
an example of chelation
tetracycline binding to calcium/iron so no longer as effectiv
50
another was drugs can interact
compete for renal tubular transporter therefore reducing excretion
51
define pharmocydnamic pharmokinetic
drug affects body kinetic body on drug
52
synergism and antagonism
work togerther same affect e.g. apsirin and clopi therefore increased bleeding risk vs antagonsm e.g. vitamin K and warfarin -opposing effects
53
what can occur at a receptor
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
what does zopiclone work on
cyclopurroline ci IN RESP WEAKNESS E.G. MYantha gravis resp failure,
55
what does zopiderm work on
BZ1 receptors
56
which medicaiton has gucometation directly
lorazepam
57
what is 10mg diazepam equaivelent to
1mg lorazepam
58
how is the ga ba receptor activated
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
what is Daridorexant
Daridorexant is an orexin OX1- and OX2-receptor antagonist that blocks the action of orexin neuropeptides, thereby decreasing wakefulness. not in narcloepsy
60
mechanism of recreational drugs monamine transporter
ectasy cocaine amphetamines
61
which drugs intefere with g coupled protein receptors
GHB cannoboids opoids
62
which drugs work on 5ht
hallucinogens LSD DMT nitrious oxide
63
which drugs act on canniboid receptor
THC
64
Which act on GABA
benzo
65
what is difference between A and b mAOI
A sertonin noradrenaline B phenyloaline tyrtamine by B
66
what happens with MAOI and chesse
cheese reaction HTN tyrosine in foods
67
key facts aboout pregablin receptor elimination
kidney unchanged increased use leads to tolerance alpha 2 delta subunti high bioavailability
68
olazapine by IM where is it given name of it dose
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
management of antidepressant induced hyponatremia?
Demeclocycline.
70
Subutex
burphrnoine alone
71
what is suboxone
buprhohine and nalaxone 4;`1
72
what can stopping paroxetine do
cause suicidal thoughts
73
which medications can impact lamotigine levels
increase valproate decrease the pill
74
e first SSRI to be developed
zimeldine
75
what is allosteric modulation
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
what are positive allosteric modulation
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
what are negative allosteric
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
79
lowest risk of orthostatic hypotension
senapine and lurasidone.
80
zopiclone on which receptor
gaba A
81
what does CYP26 encode
CYP2D6 is a gene that encodes for an enzyme called debrisquine hydroxylase.
82
Chlorpromazine synthesis = Charpentier (sharpentier) Chlorpromazine introduction = Delay and Deniker

LS MRPSYCH (17 decks)

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