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54 Cards in this Set
- Front
- Back
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ethosuximide
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Calcium channel inhibitor (T-type)
Use = absence (petit mal) seizures Adverse effects Bone marrow suppression Lupus like syndrome SJS |
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valproic acid
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GABA transaminase inhibitor
Decresases GABA metabolism Increases potassium conductance Uses Myoclonic seizures Absence seizures Grand mal seizures Adverse effects Hepatotoxicity Inhibits P450 Alopecia |
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primadone
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Metabolized to phenobarbital
Uses (2nd line) Partial seizures Grand mal seizures Adverse effects Lupus like syndrome Bone marrow suppression |
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felbamate
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NMDA receptor antagonist
Uses Lennox-Gastraut syndrome (childhood onset epilepsy with frequent and varying seizures) Partial seizures Adverse effects Inhibits P450 Bone marrow suppression |
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gabapaentin
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GABA analog
Uses Partial seizures Grand mal seizures (adjunct) Adverse effects Fatigue Ataxia |
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lamotrigine
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Mechanism
Prolongs inactivation of sodium channels Inhibits glutamate and aspartate release Uses Partial seizures Grand mal seizures (adjunct) Adverse effects SJS |
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TOPIRAMATE
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Mechanism
Sodium channel inhibitor Potentiates GABA activity Blocks some glutamate receptors Uses Refractory partial seizures Grand mal seizures (adjunct) Adverse effects Confusion Kidney stones |
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MEPERIDINE CONTRAINDICATIONS?
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MAO inhibitors (will lead to hyperpyrexic coma)
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MEPERIDINE USES? ACTIONS?
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Analgesia
Increased heart rate Peripheral vasodilation Pupil dilation USE - Analgesia during labor |
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METHADONE use?
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therapeutic opiate withdrawal
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adverse effects of MORPHINE
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respiratory depression, homrmone alteration
- increase ADH< GH, proalctin - decrease GnRH, CRH |
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cotnraindications of morphine? 3
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1. brain injury (increase iCP )
2. asthamtics (histamine release) 3. BPH (increases urinary retnetion) |
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SIDE EFFECTS OF KETAMINE?
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1. post op nightmare and hallucinations (worst in kids and elderly)
2. icnreases intraocular pressure (can't give to glaucoma patients) increase blood pressure |
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contraindications for ketamine?
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HTN or stroke
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adverse effects of propofol?
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1. pain on injection
2. decrease BP 3. respiratory depression |
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adverse effects of etomidate?
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1.f hiccups
2. N/V 3. pain on injection 4. myoclonus |
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use of codeine? high or low abuse potential?
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- moderatem u agonist
- good oral absoprtion uses - 1. cough suppressant 2. moderate pain relief - low abuse potnetial |
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PENTAZOCINE
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adverse effects - increases work of heart (bad with CAD)
hallucinations |
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PROPOXYPHENE OFTEN GIVEN WITH OTHER DRUGS? WHICH ONES?
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NSAIDs or tyleno,l like codeine
used for cough suppression |
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NALOXONE use?
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rapiudly reverse acute intoxication
- preciptate withdrawal in abusers |
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HOW DOES NALTREXONE RWORK?
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comeptitve antagonsit at mu, kappa, elta recpetors
- long term treatment of opioid and alcohol dependence |
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PHENOBARBITAL MECHANISM?
USE? ADVERSE EFFECTS? |
1. increase duration of CL channel opening
2. decrease release of Ca dpeendent neurotransmitters use = febrile seizures in children adverse effects = induce P450 |
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DIAZEPAM MOA?
USE? |
icnrase FREQ of Cl channel opening
decrease releaes of Ca dependent neutrotransmitters USE 1. status epilepticus 2. alcohol withdrawal |
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CARBAMAZEPINE MOA?
use? adverse effects ? |
MOA
- Voltage gated sodium channel blocker Suppresses repetitive firing of neurons uses= grand mal seizures, trigeminal neuralgia adverse effects - induce P450 bone marrow suppression (worse iwht lithium) |
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PHENYTOIN MOA? euse? adverse effects?
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MOA
- voltage gated na channel blocker suppresses reptitive firing of neurons uses - grand mal seziures, status epilepticus adverse effects 1. induce P450 2. gingival hyperplasia 3. stevens johnson syndrome |
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TIAGABINE?
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MOA
- block GABA uptake into presynaptic neurson prolonging time in synapse uses 1. refractory partial seizures 2. grandm al seizures (adjunct) adverse effects 1. fatigue |
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ZONISAMIDE
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MOA
- allosteric GABA binding decreaess GABA reuptake faster glutamate reuptake uses 1. partial seizures (adjunct) 2. resting tremor in parkinson's adverse effects 1. drowsiness 2. decreased appetitie |
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LEVETIRACETAM
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- binds SV2A (synaptic vesicle protein)
uses - partial seizures, grand mal seizures adverse effects - muscle weakness |
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what does SIGECAPS stand for?
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S-sleep disturbance
I-loss of interest G-feelings of guilt or worthlessness E-loss of energy C-loss of concentration A-change in appetite/weight P-psychomotor symptoms S-suicidal ideations Depressed mood |
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adverse effects of TCA?
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Sedation
Postural hypotension Weight gain 1st degree heart block Lower seizure threshold |
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uses of TCA?
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major depression, anxiety
Elevate mood, increase alertness |
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mechanism of tCAs?
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Mechanism: block reuptake of NE and serotonin
Decrease receptor levels at post-synaptic membrane |
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what are the 2 tertiary amines (TCAs)?
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eimipramine , amitriptyline
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what are the 2 2ndary amines?
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desipramine, nortriptyline
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use of imiprmamine?
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2nd line therapy for bedwetting
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unortriptyline is used for depression in elderly why?
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less confusion - less anticholinergic effects
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adverse effects of MAOi?
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Hypertensive crisis with tyramine (wine and cheese) or Beta agonists (asthma), or L-dopa (Parkinson’s)
Serotonin syndrome with meperidine and SSRIs |
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MAOi has serotonin syndrome with what drugs?
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1. meperidine
2. SSRIs |
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uses of mAOi?
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atypical depression (mood reactivity, sensitivity to rejection, excessive sleepiness, anxiety)
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trazodone mechanism?
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heterocyclic antidepressant
Primarily inhibits serotonin reuptake Also reduces NE and serotonin reuptake |
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use of trazodone?
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major depression (does not cause weight gain)
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adverse effects of trazodone? (4)
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Priapism (painful, sustained erection)
Sexual dysfunction Orthostatic hypotension Sedation |
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adverse effects of SSRIs?
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Sexual dysfunction (decreased arousal, anorgasmia)
Weight gain |
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what are the SSRIs? FOR PETE'S SAKE, CREATE ENTHUSIASM AND FUN
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fluoxetine, paroxetine, sertraline, ctialopram, escitalopram, fluvoxamine
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emechansim of lithium? use? adverse effects?
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Mechanism: Inhibits phosphoinositide cascade
Decreases PIP2 (precursor of IP3 and DAG) Serotonergic activity Uses: bipolar disorder Adverse Effects Nephrogenic diabetes insipidus Teratogen: cardiac defects Tremor |
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what are the 3 phenothaizine antipysychotics?
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1. chlorpromazine
2. thioridiazine 3. fluphenazine |
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CHLORPROMAZINE
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low potency
treats hiccups, nausea autnonomic effects |
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thioridazine
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PIGEMNTARY RETINOPATHY at high doses
autonomic effects e |
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fluphenazine side effects? (antipsychotic)
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lenticular deposits on cornea
EPS sypmtoms |
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mechanism of 2nd gen antipsychotics?
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Serotonin-2 and D2 antagonists
Treats negative symptoms as well Fewer EPS |
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RISPERIDONE?
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minimal sedation
low potential for EPS prolonged QT interval! |
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OLANZAPINE
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Low potential for EPS
Lots of anticholinergic effects Weight gain Also treats tic disorders, OCD |
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QUETIAPINE - SEROQUEL USE? WHAT CATEGORY OF DRUG IS THIS? adverse effects!?
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Low potential for EPS
Moderate sedation Orthostatic hypotension No weight gain No anticholinergic effects |
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ST JOHNS WORT, GINSENING, GARLIC, GINGKO, GREEN TEA, (these do what to P450)?
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St. John’s Wort - Inducer
Ginseng - Inhibitor Garlic - Inhibitor (with warfarin) Gingko - Inhibitor Green tea |
