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Neuro IV pharm > Red-line Drugs Neuro IV > Flashcards

Red-line Drugs Neuro IV Flashcards

1
Q

Chlorpromazine

A

Typical antipsychotic D2 antagonist

low potency

Schizophrenia (+ symp.) psychosis, acute mania, Tourette syndrome

Side effects: ANS (dry mouth), sedation, hypotension

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2
Q

Haloperidol

A

Typical antipsychotics D2 antagonist

High potency

Schizophrenia (+ symp.), Huntington’s

Side effects: EPS tardive dyskinesia Neuroleptic malignant syndrome

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3
Q

Clozapine

A

Atypical antipsychotics

D2/5HT2A antagonist (low ratio)

Schizophrenia (- symp)

SE: weight gain, *agranulocytosis*, seizures, prolonged QT

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4
Q

Quetiapine

A

Atypical antipsychotics

D2/5HT2A antagonist (low ratio)

Schizophrenia: (- symp)

SE: weight gain, prolonged QT, some sedation

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5
Q

Paroxetine

A

SSRI Block SERT

SE: sedation, constipation, weight gain, dry mouth, serotonin syndrome, SIADH, sexual dysfunction, withdrawal symptoms

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6
Q

Escitralopram

A

SSRI Block SERT

SE: fewest of the SSRIs

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7
Q

Bupropion

A

NE DA reuptake inhibitor (NDRI)

Depression (Wellbutrin), smoking cessation (Zyban)

SE: insomnia/agitation, stimulant effects, headache, *seizures at high dose* no sedation, no addiction, no tolerance and no sexual SE no interaction with EtOH

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8
Q

Venlafaxine

A

SNRI SERT and NET blocker

Depression, anxeity, panic, PTSD

SE: Hypertension, anxeity, nausea, withdrawal symptoms, sexual dys., sedation

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9
Q

Trazodone

A

Mixed serotonin receptor and alpha 1 receptor blocker

Insomnia, High doses for depression

SE: sedation, nausea, priapism (trazo*bone*), postural hypotension

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10
Q

Amitriptyline

A

TCADs NET/SERT reuptake block

Major depression, peripheral neuropathy, chronic pain, migraine prophylaxis

SE: Sedation, antimuscarinic (Amitriptyline >Desipramine), orthostatic hypotension, Convulsions, Coma, Cardiotoxicity (arrhythmias), respiratory depression

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11
Q

Phenelzine

A

MAOI

Atypical depression, anxeity

SE: Hypertensive crisis (tyramine), CNS stimulation, Serotonin syndrome

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12
Q

Fluoxetine

A

SSRI

Block SERT

SE: Hypertension, anxeity, nausea, withdrawal symptoms (lower risk with fluox), sexual dys., sedation

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13
Q

Selegiline

A

MAOI Parkinson’s SE: Hypertensive crisis (tyramine), CNS stimulation, Serotonin syndrome

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14
Q

Lithium

A

mechanism unknown (inhibition of phosphoinositol cascade)

Mood stabilizer for bipolar blocks relapse and acute manic events

SE: narrow therapeutic index (monitoring)

LMNOP Movement (tremor) Nephrogenic Diabetes Insipitus O-hypOthyroid Pregnancy problems (Ebstein anomaly) polyuria (diabetes insipitus),

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15
Q

Alprazolam

A

Benzodiazepine agonist intensify GABA effects (binding alpha 1 and 2-5)

Increase freq. of Cl- channel opening

short acting, high potency

acute management of anxiety. (situational anxiety) ,

SE: Dependence, additive depressant effects w/ EtOH, anterograde amnesia, abuse

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16
Q

Flurazepam

A

Benzodiazepine agonist intensify GABA effects (binding alpha 1 and 2-5)

Increase freq. of Cl- channel opening

Anxiety, spasticity, detox, night terrors, sleepwalking, general anesthetic (amnesia, muscle relaxant), insomnia

SE: Dependence, additive depressant effects w/ EtOH, anterograde amnesia, abuse

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17
Q

Diazepam

A

Benzodiazepine agonist intensify GABA effects (binding alpha 1 and 2-5) Increase freq. of Cl- channel opening

longer half life

acute management of anxiety. (situational anxiety), status epileticus

SE: Dependence, additive depressant effects w/ EtOH, anterograde amnesia, abuse

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18
Q

Oxazepam

A

Benzodiazepine agonist intensify GABA effects (binding alpha 1 and 2-5)

Increase freq. of Cl- channel opening; short acting

anxiety, insomnia, withdraw from EtOH

SE: Dependence, additive depressant effects w/ EtOH, anterograde amnesia, abuse

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19
Q

Triazolam

A

Benzodiazepine agonist intensify GABA effects (binding alpha 1 and 2-5)

Increase freq. of Cl- channel opening; short acting

Insomnia

SE: Dependence, additive depressant effects w/ EtOH, anterograde amnesia, abuse

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20
Q

Lorazepam

A

Benzodiazepine agonist intensify GABA effects (binding alpha 1 and 2-5)

Increase freq. of Cl- channel opening short half life, high potency

acute management of anxiety. (situational anxiety) good for elderly, status epilepticus

SE: Dependence, additive depressant effects w/ EtOH, anterograde amnesia, abuse

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21
Q

Midazolam

A

Benzodiazepine agonist intensify GABA effects (binding alpha 1 and 2-5) Increase freq. of Cl- channel opening; short acting

anesthesia (adjunct), anxiety, insomnia

SE: Dependence, additive depressant effects w/ EtOH, anterograde amnesia, abuse

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22
Q

Temazepam

A

Benzodiazepine agonist intensify GABA effects (binding alpha 1 and 2-5) Increase freq. of Cl- channel opening

insomnia, anxiolytic, anticonvulsant, muscle relaxant

SE: Dependence, additive depressant effects w/ EtOH, anterograde amnesia, abuse

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23
Q

Flumazenil

A

Benzodiazepine receptor ANTagonist used for OD of Benzo

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24
Q

Zolpidem

A

Non-BDZ Activate BZ1 subtype of GABA receptor

Insomnia

SE: Ataxia, headache, confusion less dependence risk, less amnesia

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25
Q

Eszopiclone

A

Non-BDZ Activate BZ1 subtype of GABA receptor

Insomnia

SE: Ataxia, headache, confusion less dependence risk, less amnesia

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26
Q

Zaleplon

A

Non-BDZ Activate BZ1 subtype of GABA receptor (GABA Cl- channel)

Insomnia

SE: Ataxia, headache, confusion less dependence risk, less amnesia

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27
Q

Phenobarbital

A

Barbiturates increase *duration* of GABA CL- channel opening

Anxiety, seizures, insomnia, anesthesia (thiopental)

Seizures: partial and generalized tonic-clonic

SE: Respiratory and CV depression! Sedation!

CNS depression (worse w/ EtOH), dependence, DDI (P-450 inducer)

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28
Q

Ramelteon

A

Melatonin Receptor Agonist

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29
Q

Buspirone

A

5HT1A partial agonist (D2 antagonist)

Anxiety

30
Q

Cocaine

A

DAT (+SERT, NET) Stimulant

31
Q

Amphetamines

A

DAT (+SERT, NET) stimulant

32
Q

Nicotine

A

nicotinic receptor Stimulants

33
Q

Stimulants

A

Nicotine Cocaine Meth MDMA (ecstasy)

34
Q

Depressants

A

Alcohol Barbiturates Benzodiazepines

35
Q

Barbiturates

A

increase GABA-A, decrease NMDA

36
Q

Benzos

A

Increase GABA-A only antagonist: flumazenil

37
Q

Dissociative Anesthetics

A

Phencyclidine (PCP) Ketamine

38
Q

Opioid analgesics

A

Morphine heroin fentanyl meperidine

39
Q

Heroin

A

Mu-opioid receptor (Gi/o) agonist treat w/ naloxone

40
Q

Cannabinoids

A

CB-1 receptor (Gi/o) agonist

41
Q

Hallucinogens

A

Lysergic acid diethyl amide (LSD) Mescaline (peyote)

42
Q

Methadone

A

Treat opioid dependence binds Mu receptor agonist and NMDA antagonist

43
Q

Buprenorphine

A

partial mu agonist (avoid respiratory depression) Treat opioid addiction

44
Q

Clonidine

A

Alpha 2 agonist

treat withdrawal from EtOH, Opioids, smoking

45
Q

Disulfiram

A

Antabuse blocks enzyme acetaldehyde dehydrogenase treat alcoholism SE: metallic taste, headache, drowsiness, optic neuritis, peripheral neuropathy, hepatitis Contraindications: Risk MI, CVA, pregnant or if cognitively

46
Q

Naltrexone

A

antagonists at μ-opioid receptor, the κ-opioid receptor (KOR) to a lesser extent reverses effects of opioids and EtOH SE: Nausea, Headaches, anxiety, sedation If on opiates or heroin will go into withdrawal

47
Q

d-Amphetamine

A

Adderall

Inhibits or reverses the transporter proteins for the monoamine Increases releases of monoamines Inhibits breakdown of monoamines

48
Q

Methylphenidate

A

Ritalin

Blocks the dopamine transporter and norepinephrine transporter more remains in synaptic cleft

49
Q

-ipramine

A

TCA

50
Q

-etine

A

SSRI

51
Q

-triptyline

A

TCA

52
Q

-zepam

A

Benzo

53
Q

-zolam

A

Benzo

54
Q

-barbital

A

Barbiturate

55
Q

-azine

A

Typical antipsychotics

56
Q

Nitrous Oxide

A

Gaseous anesthetics low potency, good analgesic

paired with barbiturates or opioids

rapid onset and recovery

Problems: Concentration effect (faster uptake) Diffusion hypoxia (not enough O2) Second gas effect (more of paired GA)

57
Q

Volatile anesthetics

A

Desflurane Enflurane Halothane Isoflurane Sevoflurane

58
Q

Halothane

A

Volatile anesthetics mod to high potency; poor analgesic

Three issues: -Respiratory and CV failure -Hepatotoxicity (metabolized in liver) -Malignant Hyperthermia

59
Q

IV anesthetics

A

Propofol Etomidate Thiopental

60
Q

IV adjuncts for GA

A

Diazepam Ondansteron (anti-emetic) Fentanyl (analgesic) Glycopyrrolate (Anticholinergic) Ketamine (NMDA antagonist) Morphine Neuromuscular blocking agents Dantrolene (Ca2+ channel blocker)

61
Q

Dantrolene

A

prevents release of Ca2+ from sarcoplasmic reticulum of skeletal muscle

Malignant hyperthermia and neuroleptic malignant syndrome

62
Q

Ethosuximide

A

Blocks thalamic T-type Ca2+ channels

Absence seizures

SE: EFGHIJ

Ethosuximide causes

Fatigue

GI distress

Headache

Itching

steven-Johnson syndrome

63
Q

Diazepam

A

Benzodiazepime

Increased GABA-A action–increased frequency of Cl- channel opening

Status Epliepticus

SE:Sedation, tolerance dependence, respiratory depression

64
Q

Lorazepam

A

Benzodiazepime

Increased GABA-A action–increased frequency of Cl- channel opening

Status Epliepticus

SE:Sedation, tolerance dependence, respiratory depression

65
Q

Midazolam

A

Benzodiazepime

Increased GABA-A action–increased frequency of Cl- channel opening

Status Epliepticus

SE:Sedation, tolerance dependence, respiratory depression

66
Q

Phenytoin

A

increase Na+ channel inactivation

zero order kinetics, Induction of P450

Not as popular anymore but used for Partial seizures and generalized tonic-clonic seizures

Prophylaxis for status epilepticus

SE: Nystagmus, diplopia, ataxia, sedation (high dose), rash, gingival hyperplasia, hirsutism, megaloblastic anemia, peripheral neuropathy

67
Q

Carbamazepine

A

Increase Na+ channel inactivation

First line for Partial and Tonic clonic (also trigeminal neuralgia)

SE: diplopia, ataxia, blood dyscrasias (agranuloctosis and aplastic anemia), teratogenesis

Induction of P450

SIADH, Steven-Johnson syndrome

68
Q

Valproic Acid

A

Inhibits GABA transminase (increasing [GABA]) (Increases Na+ channel inactivation)

Use: first line in Generalized Tonic-Clonic

also for absance and partial

SE: GI destress, possible hepatotoxicity, neural tube defects, tremor, weight gain, bad for pregnancy

DDI: alcohol/CNS depressants, anticonvulsants, aspirin/warfarin

69
Q

Phenobarbital

A

Increase GABA-A action

CYP450 inducer (many DDI)

Partial seizures and generalized tonic-clonic

  • excessive sedation limits use*
  • S*E:sedation, tolerance, dependence, cardiorespiratory depression
70
Q

Levetiracetam

A

unknown MOA

First line for Tonic-clonic

SE: somnolence, dizziness, fatigue

NO P450 effect

71
Q

Lamotrigine

A

Blocks VSSC

partial, generalized and absance

SE: dizziness, ataxia, diplopia, sedation, rashes, nausea

(less than phenytoin)

72
Q

Divalproex

A

Inhibits GABA transminase (increasing [GABA]) (Increases Na+ channel inactivation)

Use: first line in Generalized Tonic-Clonic

also for absance and partial

SE: GI destress, possible hepatotoxicity, neural tube defects, tremor, weight gain, bad for pregnancy

DDI: alcohol/CNS depressants, anticonvulsants, aspirin/warfarin

Neuro IV pharm (3 decks)

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