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59 Cards in this Set
- Front
- Back
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Hallucination and delusions are o Positive symptoms of schizophrenia |
Typical anti psychotic drugs Phenothiazines Haloperidol |
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Atypical antisychotics |
Clozapine Rispiridone Olanzapine Quetiapine Sertindole
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Phenothiazines(anti psychotics) |
Piperidine Piperazine |
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Phenothiazine |
Antagonist at D1 and D2 receptor Muscarinic Adrenergic Serotonin (less |
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Acute dystonia (side of effect of anti psychotics)
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antagonist Use muscarinic antagonistBenztropine or diphenhydramine Benztropine and diphenhydramine |
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Peri oral tremor rabbit syndrome |
Is a side effect of anti psychotics |
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Piperazine are more potent anti emetic than others |
Side effect of phenothiazines Include its anti muscarinic,adrenergic and serotonergic effect |
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Anti psychotics also cause depression of temp regulating area and vasomotor mechanism |
Leading to poikilothermic effect |
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Anti psychotic side effect of being an anti histamine are |
Sedation weight gain confusion disturbed concentration |
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Thioridazine |
A piperadine phenothiazines that causes toxic retinopathy |
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Molidone(anti psychotics ) |
Least agent that cause weight gain |
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Leucocutosis is also a side effect of |
Antipsychotics |
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Drug drug interaction with anti psychotics(phenothiazines) |
1 inhibit alcohol metabolism 2 potentiate cns depressant 3additive anti cholinergic effect 4 affect the effect of anti hyper tensive drug guanethidine(blocks d reuptake mech) 5 thioridazine have quinidine like effect and can cause nephrotoxicity Inhibit phenytoin metabolism |
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Eps side effect are more common |
With haloperidol |
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Haloperidol is a potent D2 antagonist |
Fewer ANS effect Particularly effective for acute amnia No anticholinergic effect It causes orthostatic hyootension |
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Clozapine |
Have affinity for d4 receptor Potent anticholinergic effect Has no anti anti pakinson effect Lower affinity for serotonin receptor Minimal eps |
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Agranulocytosiz |
Side effect of clozapine |
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Lithium is an anti maniac agent |
It takes time for lithium to achieve effective brain level There is delayed onset of (like 7 days or longer) |
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Thiazides interfere with lithium excretion |
Lithium use can lead to nephrotoxicity (nephrogenic di) Hydrate properly |
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Clinical effect of Tca and Mao inhibitor |
Takes weeks to manifest |
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TCA |
1st generation imipramine aminotriptyline 2nd generation(heterocyclics) amoxapine maprotiline(resemble the normal tca) But bupropion and trazodone dont 3rd generation venlafaxine mirtazapine nefazodone (developed on basis of trazodone) |
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TCA also bock |
Alpha receptor histamine and muscarinic receptor |
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SSRI That is use in depression are |
Fluoxetine Paroxetine Sertraline Fluvoxamine Citalopram |
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Mao inhibitors |
They are either hydrazides: phenelzine tranylcypromine. Or non hydrazides:tranylcypromine.Tranylcypromine retain some of it sympathetic characteristics (of the amphitamines Tranylcypromine retain some of it sympathetic characteristics (of the amphitamines |
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Chemically |
Tca resemble phenothiazine |
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Tca undergo 1st pass metabolism Vd is large |
Trazodone And venlafaxine have short half lifes |
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Fluxetine can be given once weekly (has A very long halflife |
Mao inhibitor persist even after the drug is not present |
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TCA are also use for enuresis |
Venlafazine and duloxetine are use for pain However SSRI are not effective for chronic pain |
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TCA can cause ejaculatory problem |
Some anti depressant causes inhibition of cyp450 enzyme |
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Digitoxin |
Is more lipophilic |
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Indirect action of digoxin |
On SA And AV Node (it slows down conducting tissues generation and propagation of velocity So it has negative chronotropic effect Enhancement of vagal activity(parasympathetic tone |
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Digoxin |
Pronlong the av refractory period |
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In contrast to b4 |
Digoxin increases the automacity of his purkinje conducting system |
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Digoxin causes visual disturbances |
Yellow (xanthopsia) Red of green vision Photophobia Blurring |
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Gynecomastia is a side effect of digoxin bcos |
It resembles estrogen |
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CRF causes reduction in volume of distribution and clearance of digoxin |
Digibind as a digoxin specific fab fragment use for digoxin overdose |
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After depolarization activity |
Normal ap triggers abnormal ap |
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Type I na channel blockers |
Have little effect on normal tissue it slows conduction primarily in depolarized tissue |
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Concerning the na channel blockers lidocaine |
1 not effective against atrial or av nodal reentrant arrythmia 2 1st line for VT with defect in LV 3 Polymorphic ventricular arrythmia(torsedes de pointes) borderline efficacy 2nd line for ventricular fibrillation and pulseless tachycardia
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Lidocaine is known to cause seizure |
Lidocaine is not effective orally bcos of 1st pass metabolism |
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Flecainide has a slow time of recovery from block |
Lidocaine has rapid time constant recovery from block |
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ECG when using lidocaine has no clear changes cos it has little effect on normal tissue |
Flecainide cause prolongation of PR and qrs interval but has little effect on qt interval ( little effect on ventricular repolarizatn) |
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Lidocaine is contraindicated for peri mi ventricular arrythmia |
Flecainide can only be used when LV fxn is normal and there is no structural abnormality |
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Flecainide is used majorly for atrial problems |
Atrial fibrillation Atrial tachycardia contraindicated in ventricular tachycardia |
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Flecainide is orally active with 90% bioavialbility |
Flecainide can increase the level of digoxin when given concurrently |
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Digoxin has a long half-life and it is highly protein bound |
Eliminated via renal route Oral antacid inhibit d absorption of digoxin Amiodarone and flecainide increases the level of digoxin Adenosine act on av nodal re entry(acute) |
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Methylxanthines (eg theophylline can competitively ) block the effect of digoxin Dipyridamole can block adenosine degredation |
Hypokalemia causes after depolarization and ectopic beat in non pace maker cell Hyerkalemia slows down conduction velocity |
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Dofetilide |
Prototype of class iii anti arrythmia drug Others ate sotalol and amiodarone |
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Di hydropyridine ca channel blocker only block vascular smooth muscle ca channel nifedipine amlodipine |
Dialtiazem and verapamil are used for ca channel in the heart |
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Verapamil have anti hypertensive anti arrhythmic and anti anti anginal property |
No MD |
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There is prolonged PR interval by verapamil |
Use for atrial fibrillation and flutter (acute and chronic use ) 1st line |
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Verapamil undergo extensive 1st pass metabolism |
Oral verapamil causes more activity than iv verapamil |
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Diltiazem and verapamil are rarely use ventricular tachycardia |
Diltiazem is also extensively metabolised by 1st pass met. Diltiazem increases the level of cyclosporine and thus nephtotoxicity |
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Dofetilide |
Inhibit only the rapid component of delayed rectifier of potassium currency On the ECG there is prolongation of qt interval |
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Unlike class I agent dofetilide can be use for congestive heart failure |
Dofetilide should not be use in pregnant woman and breast feeding woman |
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Drugs that prevent cationic kidney secretion |
Verapamil Ketoconazole Cimetidine Can increase level of digoxij |
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Amiodarone has d activity as a class I class 2 3 4 anti arrhythmic agent |
It blosks na K Non competitive inhibitor of b adrenergic receptor Ca Non competitive inhibitor of b adrenergic receptor Amiodarone causes prolongation of qt interval and PR interval Ca Non competitive inhibitor of b adrenergic receptor Amiodarone causes prolongation of qt interval and PR interval Amiodarone causes prolongation of qt interval and PR interval |
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The most common adverse effect of amiodarone would be pneumonitis leading to pulmonary fibrosis Can also cause hypotension and hyperthyroidism bcos of it resemblance with iodine |
Liver dysfunction can also occur with amiodarone Amiodarone has a long half-life of 50 days |
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Amiodarone increases the blood level of warfarin |
Dronedarone is less toxic than amiodarone |
