PQ Flashcards
Mecanismo de ação: benzodiazepínicos x barbitúricos?
Benzodiazepines act by binding to the benzodiazepine binding site, which allosterically modulates the bonding of GABA, resulting in an increased frequency of chloride ion channel opening (they don’t function through direct activation of the GABA A receptor).
Barbiturates act at a separate allosteric site and work by prolonging the duration of channel openings in response to GABA.
GABA A x GABA B
GABA A
GABA B receptors mediate their actions using G proteins
Ácido valproico: o que faz?
Reduces GABA catabolism
Anticonvulsant
Quetiapina é um anti…?
Antipsicótico de 2a geração
Preferred medications for bipolar maintenance treatment?
Lithium, valproate, quetiapine
Bipolar maintenance treatment should be avoided with which therapy?
Antidepressant monotherapy
They have the potential to precipitate manic episodes
Bupropion: contraindications?
Patients with seizure disorders or current or prior diagnosis of bulimia or anorexia nervosa (potential electrolyte imbalances).
Not associated with sexual dysfunction (as other selective serotonin reuptake inhibitors)
Clozapine: side effects?
Antipsychotic clozapine related to agranulocytosis.
Carbamazepine and valproate can also be associated with bone marrow abnormalities.
Tricyclic antidepressants inhibit…?
The reuptake of norepinephrine and serotonin. They also inhibit fast sodium channel conduction (can cause fatal cardiac arrhythmias in overdose) and hypotension
Amphetamines increase the release of … by vesicles in presynaptic neurons
Dopamine and norepinephrine
Dopamine binds to D2 receptors on pituitary lactotrophs, resulting in…?
Decreased prolactin secretion from the anterior pituitary gland
Dopamine hyperactivity in the mesolimbic pathway is associated with…?
Positive psychotic symptoms (eg hallucinations and delusions)
Which are the 4 major dopaminergic pathways in the brain?
Mesocortical
Mesolimbic
Nigrostriatal
Tuberoinfundibular
OCD’s first-line treatment?
SSRI (selective serotonin reuptake inhibitor)
They cause an immediate increase in availability of synaptic serotonin and a subsequent cascade of downstream neurobiological effects
In the CNS, acetylcholine is involved primarily in… ?
Arousal, memory and learning
Degeneration of cholinergic neurons is associated with Alzheimer dementia
Primary excitatory neurotransmitter?
Glutamate
Primary inhibitory neurotransmitter?
GABA
Glycine is also an inhibitory neurotransmitter
Histamine is a neurotransmitter involved in…?
Maintaining wakefulness
Norepinephrine is a catecholamine involved in…?
Mood, anxiety, alertness, learning and memory
Second-generation antipsychotics associated with…?
Metabolic adverse effects (eg weight gain, dyslipidemia, hyperglicemia…)
EX. olanzapine, clozapine, risperidone, quetiapine
Clozapine: 1% risk of agranulocytosis
Mood stabilizer lithium has the potencial to cause…?
adverse effects
Hypothyroidism and renal function impairment
Blood urea nitrogen, creatinine and thyroid funcion tests should be routinely monitored
First-generation antipsychotics associated with…?
Extrapyramidal symptoms due to their potent D2 antagonism
Both FGAs and SGAs have been associated with seizure risk
How to differentiate schizoaffective disorder from bipolar disorder with psychotic features or major depression with psychotic features?
Temporal relationship between psychotic symptoms and mood symptoms. In bipolar disorder and major depression with psychotic features, psychotic symptoms occur exclusively during manic or depressive episodes
Generalized anxiety disorder (GAT) - treated with … ?
Buspirone
Chronic lithium toxicity can be precipitated by volume depletion and drug interactions with … ?
Thiazide diuretics, ACE inhibitors and nonsteroidal anti-inflammatory drugs (NSAIDs)
Valproate is used for…?
Bipolar disorder, epilepsy and to prevent migraine headache
Trazodone is a … used off-label most often as a hypnotic to treat … associated with depression or antidepressant treatment
Sedating antidepressant
Insomnia
It’s been associated with the rare but serious side effect of priapism (persistent erection of the penis >4h that is not associated with sexual excitement)
