Serotonin & Dopamine Drugs (8-24-15)

Question 1

5-HTP

Answer 1

• Indication: Depression

* MOA: 5-HT precursor

Question 2

Buspirone

Answer 2

• Indication: Depression, anxiety
• MOA: 5-HT1A partial agonist
• Side-effects: early increase in anxiety

Receptor location: Cortex, Hypothalamus
Effect: mood, cognitive function, neuroendocrine function

Question 3

Sumatriptan

Answer 3

(IMITREX)

• Indication: Migraine
• MOA: 5-HT1D agonist
• Side-effects: coronary vasoconstriction

Receptor location: Cerebral VSM
Effect: vasoconstriction

Question 4

Risperidone

Answer 4

• Indication: Depression, [schizophrenia w/] psychosis
• MOA: 5-HT2A/2C antagonist
• Side-effects: weight gain, akathisia (inability to sit still)

Receptor location: Straitum
Effect: hallucination

Question 5

Ondansetron

Answer 5

(ZOFRAN)

• Indication: Chemotherapy-induced emesis (vomiting)
• MOA: 5-HT3
• Side-effects: ???

Receptor location: Area Postrema, Emetic Center
Effect: nausea, vomiting

Question 6

Fluoxetine

Answer 6

(PROZAC)

• Indication: Depression, OCD, anxiety, panic disorder, PTSD, social phobia
• MOA: SSRI
• Side-effects: sexual dysfunction, insomnia

Receptor location: 5-HT nerve terminals
Effect: Removal of 5-HT from synapse

Question 7

Sertraline

Answer 7

(ZOLOFT)

• Indication: Depression, OCD, anxiety, panic disorder, PTSD, social phobia
• MOA: SSRI
• Side-effects: sexual dysfunction, insomnia

Receptor location: 5-HT nerve terminals
Effect: Removal of 5-HT from synapse

Question 8

L-DOPA

Answer 8

• Indication: Parkinson’s Disease
• MOA: Dopamine precursor (Increase DA in nigrostriatal pathway); D1 and 2 agonist
• Side-effects: arrhythmia, dyskinesia (impairment in movement control–spasmodic movements)

Question 9

Bromocriptine

Answer 9

• Indication: Parkinson’s Disease
• MOA: D2 agonist (post synaptic activation of basal ganglia)
• Side-effects: cardiac valvular fibrosis

Question 10

Carbidopa

Answer 10

• Indication: Parkinson’s Disease
• MOA: Aromatic acid decarboxylase inhibitor (inhibits conversion of L-DOPA to DA (can not cross BBB))
• Side-effects: same as L-DOPA since it increases DA (arrhythmia, dyskinesia)

Question 11

Selegiline

Answer 11

• Indication: Parkinson’s Disease
• MOA: MAO-B inhibitor (MAO-A: liver, GI tract; MAO-B: platlets (both CNS))
• Side-effects: low dose: hypotension (dizziness); high dose: hypertensive crisis
• Contraindications: use of indirect acting sympathomimetics

Question 12

Tolcapone

Answer 12

• Indication: Parkinson’s Disease
• MOA: COMT inhibitor (prolongs and increases effect of L-DOPA)
• Side-effects: dyskinesia
• Contraindications: liver failure (requires liver enzyme testing)

Question 13

Methylphenidate

Answer 13

(RITALIN)

• Indication: ADHD
• MOA: Dopamine re-uptake inhibitor (Increased DA release in frontal cortex)
• Side-effects: tachycardia
• Contraindications: Tricyclic Antidepressant

Question 14

Metoclopramide

Answer 14

• Indication: Nausea
• MOA: D2 antagonist
• Side-effects: akathisia (inability to sit still)

Question 15

Haloperidol

Answer 15

• Indication: psychosis
• MOA: D2 antagonist
• Side-effects: Extra-pyramidal motor disturbances

Question 16

Dopamine

Answer 16

• Indication: Shock, cardiac decompensation
• MOA: Dopamine and adrenergic receptor agonist
• Side-effects: HYPOtension (low dose), tachycardia

Long term Rx can cause tardive dyskinesia

Question 17

Trazadone

Answer 17

• Indication: Anxiety, depression
• MOA: 5-HT2A/2C antagonist + SSRI
• Side-effects: suicidality early after initiation

Receptor location: Frontal CTX
Effect: inhibits DA release