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166 Cards in this Set
- Front
- Back
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Methylphenidate
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stimulant
may block DA and NE reuptake tx ADHD and PD |
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Fluphenazine
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antipsychotic
D1 and D2 antagonist available in depot formulation |
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Haloperidol
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antipsychotic, 1st generation
D2 antagonist available in depot formulation biggest TI tx HD, Tourette's (DOC) |
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Phenytoin (dilantin)
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anticonvulsant
promotes efflux of Na+ out of motor neurons |
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Ondansetron
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antiemetic
5HT3 antagonist (peripheral and central but mostly GI) |
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Metoclopramide
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antiemetic
prokinetic DA antagonist in CTZ sensitizes tissues to ACh increases upper GI motility increases LES tone |
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Prochlorperazine
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antiemetic
antipsychotic DA antagonist in CTZ +block vagus nn in GI tract DA antagonist in mesolimbic too |
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Apomorphine
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DA agonist
induce vomiting tx PD |
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Syrup of Ipecac
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DA agonist
induce vomiting |
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Selegiline
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selective MAOB inhibitor
tx PD (supports environmental toxin hypothesis) converted into amphetamine |
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Codeine and morphine
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opioid analgesics
mu receptor agonist |
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heroin
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opiod narcotic
mu, delta, kappa activity |
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amphetamine/methamphetamine
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stimulant
sympathomimetic amine promotes release of DA and NE |
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st John's wort
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like an SSRI
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reserpine
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DA depletor
(antihypertensive) tx severe dystonia and dyskinesias |
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Chlordiazepoxide
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benzodiazepine, anxiolytic
^GABA |
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triazolam
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benzodiazepine, anxiolytic
^affinity of receptor for GABA inhibit adenosine (potentiates inhibitory pathway in pedunculopontine pathway) |
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alprazolam
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benzodiazepine, anxiolytic
^GABA has anxiopreferring dose |
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temazepam
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benzodiazepine, anxiolytic
^GABA conjugated outside liver |
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oxazepam
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benzodiazepine, anxiolytic
^GABA conjugated outside liver |
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Lorazepam
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benzodiazepine, anxiolytic
^GABA conjugated outside liver |
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Flurazepam
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benzodiazepine, anxiolytic
^GABA |
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Midazolam
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benzodiazepine, anxiolytic
^GABA |
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Estazolam
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benzodiazepine, anxiolytic
^GABA |
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Flumazenil
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benzo antagonist
reverse overdose |
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amobarbital
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barbiturate sedative
inc amt of time Cl- ionophore open in presence of GABA depress cortical and cerebellar func |
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secobarbital
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barbiturate sedative
inc amt of time Cl- ionophore open in presence of GABA depress cortical and cerebellar func |
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pentobarbital
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barbiturate sedative
inc amt of time Cl- ionophore open in presence of GABA depress cortical and cerebellar func |
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phenobarbital
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barbiturate sedative
inc amt of time Cl- ionophore open in presence of GABA depress cortical and cerebellar func |
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thiopental
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barbiturate sedative
inc amt of time Cl- ionophore open in presence of GABA depress cortical and cerebellar func |
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Zolpidem
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sedative hypnotic
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meprobamate
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sedative hypnotic
carbamate derivative |
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chloral hydrate
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sedative hypnotic
synergystic w/ etOH = Mickey Finn (competes for alcohol dehydrogenase + active metabolite is trichloroethanol) |
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paraldehyde
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sedative hypnotic
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eszopcilone
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sedative hypnotic
BZD-like |
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remelteon
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sedative hypnotic
melatonin agonist (MT1 and MT2) |
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zeleplon
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sedative hypnotic
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buspirone
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selective anxiolytic
high affinity for 5HT1 receptor some DA partial agonist properties |
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propanolol
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block NE (reduce locus ceruleus activation of central nucleus of amygdala)
DOC for situational anxiety also tx essential tremor |
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imipramine
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TCA
NE and 5HT reuptake inhibitor |
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amitriptyline
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TCA
NE and 5HT reuptake inhibitor |
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clomipramine
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TCA
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desipramine
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TCA
selective NE reuptake inhibitor |
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amoxapine
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heterocyclic
NE reuptake inhibitor (some D2 antagonist activity too) |
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trazodone
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heterocyclic
weak but selective SERT inhibitor |
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fluoxetine
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SSRI prototype
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paroxetine
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SSRI
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sertraline
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SSRI
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fluvoxamine
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SSRI
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Phenelzine
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MAOI
inc NE and 5HT via suicide inhibition (more effect on 5HT cuz NE has COMT) |
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Tranylcypromine
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MAOI
inc NE and 5HT via suicide inhibition (more effect on 5HT cuz NE has COMT) |
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Lithium carbonate
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antimanic
Block enzyme myo-inositol-1 phosphatase Reduces cycling of DAG and IP3 Stabilizes production of 5HT and DA (less mood swings) |
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carbamazepine
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antimanic
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valproate
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antimanic
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aripiprazole
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antimanic
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buproprion
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new heterocyclic
stop smoking aid, 'wellbutrin' NET and DAT inhibitor facilitates release of catecholamines inc sz risk |
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venlafaxine
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new heterocyclic
SNRI affinity for SERT>NET |
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mertazapine
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new heterocyclic
stimulates NE and 5HT release (5-HT2 & 5-HT3 receptors) also alpha 2 antagonist |
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amantadine
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(flu drug)
DA reuptake inhibitor and releaser maybe some antimuscarinic probs hit glutamate receptors too |
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benztropine
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potent antimuscarinic + DA reuptake inhibitor
tx PD |
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rasagiline
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new MAOB inhibitor
not converted to amphetamine can produce tyramine effect |
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tolcapone
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peripheral and central Total COMT inhibitor
liver toxicity |
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entacapone
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peripheral COMT inhibitor
prolong levodopa T1/2 to reduce motor fluctuations |
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stalevo
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entacapone/levodopa/carbidopa
(DA+COMT inhibitor) |
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trihexylphenidyl
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antimuscarinic (very low inhibition of DAT)
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domperidone
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peripheral DA antagonist
tx epigastric distress and vomiting from levodopa |
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pramipexole
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D2 and D3 agonist
D3 = antidepressant, neuroprotective approved as monotherapy for PD |
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ropinerole
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DA agonist
approved as monotherapy |
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cabergoline
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direct-acting DA agonist
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clozapine and olanzapine
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2nd generation antipsychotic
DA antagonist not much affinity for D2 (so can reduce hallucinations in PD w/o worsening motor sx) |
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orphenadrine
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skeletal mm relaxant
anticholinergic in the brain stem tx mm pain, PD |
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benedryl (diphenhydramine)
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antihistamine
anticholinergic effects improve PD sx |
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tetrabenazine
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DA depletor
tx severe dystonia and dyskinesia |
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pimozide
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strong antimuscarinic
tx tourettes (better for the young ppl) |
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risperidone
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antipsychotic
tx tourettes |
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ziprasidone
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antipsychotic
tx tourettes |
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clonidine and guanfacine
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alpha agonists
tx ADHD w/ tourettes (doesnt inc DA) |
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Pemoline
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stimulant
tx ADHD |
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Adderall
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stimulant
amphetamine + dextroamphetamine |
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Atomoxetine
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very selective NET inhibitor
may become new DOC for ADHD |
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Chlorpromazine
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prototypical antipsychotic
D2 antagonist |
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thioridazine
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antipsychotic
direct DA antagonist D2 |
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quetiapine
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2nd generation antipsychotic
Reduces positive & negative symptoms via D2 & 5-HT2 antagonism |
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halothane
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prototype gas anesthetic
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enflurane
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gas anesthetic
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isoflurane
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gas anesthetic
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desflurane
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gas anesthetic
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sevoflurane
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gas anesthetics
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N2O
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gas anesthetic
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ether
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gas anesthetic
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chloroform
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gas anesthetic
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Thiopental
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IV anesthetic barbiturate
truth serum |
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etomidate
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IV anesthetic - non barbiturate
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propofol
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IV anesthetic
potentiate GABA |
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ketamine
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dissociative anesthetic
indirectly inhibit NMDA glutamate receptor cause bizzare recollections inc SANS -- good for procedures where hypovolemia is a concern |
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fentanyl
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opioid analgesic
not for opioid naive pts! |
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fentanyl/droperidol
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anesthetic combo
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droperidol/N2O
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anesthetic combo
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procaine
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ester local anesthetic
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cocaine
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ester local anesthetic
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benzocaine
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ester local anesthetic
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tetracaine
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ester local anesthetic
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lidocaine
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amide local anesthetic
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mepivacaine
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amide local anesthetic
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bupivacaine
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amide local anesthetic
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ropivacaine
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amide local anesthetic
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articaine
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amide local anesthetic
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Baclofen
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GABA B agonist
tx spasticity |
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Serotonin Syndrome
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MAOI +SSRI
SSRI + St John's Wort SSRI+ tramadol MAOI+merperidine sx : hyperthermia, rigidity, myoclonus, fluctuations in vitals |
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TCA toxicity
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#1 cause of toxic overdose
sx: tachy/brady, conduction block, fibrillation, asystole, htn/hypotension, long qt CNS agitation, disorientation, dystonia, myoclonus, sz's antimuscarinic effects tx- alkalinize blood |
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pickled herring, chianti wine, and cheese effect
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MAOIs
tyramine effect- htn crisis, ortho hypo tyramine -->octopamine |
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lithium tox
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side effects- fine tremor, polydypsia, polyuria
tox: confusion, dysphoria,gross tremor, dysarthria, N/V,sz |
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phenytoin
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1ary tx sz
interfere w/ Na channel's switch from 'closed and not ready' to 'closed and ready' induce p450 but not autoinducer |
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phenobarbital
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1ary tx sz
inc duration of GABA Cl- channel open autoinducer concentrate in sz focus via ion trapping |
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carbamazepine
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1ary tx sz
interfere w/ Na channel's switch from 'closed and not ready' to 'closed and ready' autoinducer antimanic |
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valproate
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1ary tx sz
increases GABA (dec Glu) broad activity (also antimanic) |
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clonazepam
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benzo
1ary tx sz tx myoclonic sz |
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ethosuximide
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DOC for 1ary tx absence sz
block T type Ca channels (thalamus) |
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side effects of phenytoin
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hirsuitism
gingival hyperplasia peripheral neuropathy inc vit D metabolism (osteomalacia) inc bleeding |
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carbamazepine unique side effects
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diplopia
resp depression |
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valproate tox
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need high doses = heavy molecular burden= fulminant hepatitis
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vigabatrin
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GABA transaminase inhibitor
tx partial sz |
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lamotrigine
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adjunctive tx sz
block N and P/Q Ca channels dec Glu |
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gabapentin
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adjunctive tx sz
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topiramate
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adjunctive tx sz
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zonisamide
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adjunctive tx sz
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tiagabine
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adjunctive tx sz
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levetiracetam
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adjunctive tx sz
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status epilepticus
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1- benzos (cuz can give high dose)= lorazepam
2- phenytoin 3- pentobarbital coma if doesn't respond |
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fetal hydantoin syndrome
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microcephaly
mental retardation growth/developmental delay craniofacial dysmorphic features arene epoxides (phenytoin metabolite)= teratogen |
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ethosuximide side effects
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gastric irritation, N&V
restlessness anxiety photosensitivity parkinsonian sx |
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side effects common to all AEDs
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cerebellar: intention tremor, nystagmus, ataxic gait, diplopia, hyperreflexia
sz:high dose induction, development of absence sz withdrawal: sz |
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primidone
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converted to PEMA and phenobarbital
all 3 are antisz |
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ergotamine
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induce vasoconstriction
tx migraine |
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sumatriptan
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prevent release of CGRP (sterile inflammatory response)
5HT1d and 5HT1b agonist |
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verapamil
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Ca channel antagonist
tx migraine |
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methysergide
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prophylaxis for migraines
nonspecific 5HT antagonist/partial agonist |
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propanolol
(migraine) |
migraine prophylaxis DOC
hit beta receptors on astrocytes and prevents K+ buildup |
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amitriptyline
(migraine) |
TCA
5HT reuptake inhibitor in pfc breaks 'cycle of tension' to tx migraine |
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metoclopramide
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DA antagonist
prokinetic tx gastric stasis assoc w/ migraines |
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ondansetron
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5HT antagonist
tx gasric stasis assoc w/ migraines |
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prochlorperazine
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phenothiazine
tx gasric stasis assoc w/ migraines |
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cyclobenzaprine
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flexoril
tx tension headache |
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triptans adverse effects
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pain at injection site
chest tightness (contraindicated in pt w/ hx of CAD) |
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methysergide side effect
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retroperitoneal fibrosis
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codeine
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full opioid agonist
converted to morphine codeine-6-glucuorinide metabolite responsible for analgesia |
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heroin
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full opioid agonist
diacetlymorphine |
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hydromorphone
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dilaudid
full opioid agonist |
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hydrocodone
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full opioid agonist
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oxycodone
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full opioid agonist
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meperidine
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full opioid agonist
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fentanyl
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full opioid agonist
derivative of meperidine (demerol) |
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methadone
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full opioid agonist
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propoxyphene
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full opioid agonist
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pentazocine
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partial opioid agonist/anatagonist
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buprenorphine
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partial opioid agonist/anatagonist
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naloxone
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opioid antagonist
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naltrexone
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opioid antagonist
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dextromethorphan
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non narcotic
central antitussive raises cough threshold robitussin |
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diphenoxylate w/ atropine
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tx diarrhea
merperidine congener |
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loperamide
|
imodium
abused = morphine-like effects resembles meperidine |
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meperidine
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synthetic opiate-like drug
analgesia, euphoria, resp depression etc like morphine 1/10 potency of morphine |
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meperidine + MAOI
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serotonin syndrome
(meperidine normally has mild 5HT reuptake inhibition) |
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opioid withdrawal tx
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clonidine
(tx anxiety and dysautonomia) |
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CNS depressants
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ethanol
chloral hydrate methanol disulfriam |
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anorexients
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phenteramine
benzphentamine phendimetrazine fenfluramine phenylpropanolamine |
