Neuro Pharm

Front 1

Treatment Strategy for Parkinson's (BALSA)

Back 1

Bromocriptine (partial dopamine agonist)
Amantidine (causes Dopamine release)
Levodopa (converted to dopamine)
Selegiline (blocks Dopamine breakdown)
Antimuscarinics (benztropine- lowers ACh to relieve rigidity and tremor)

Front 2

L-Dopa/Carbidopa
1)MOA
2)Use
3)Toxicity

Back 2

1)L-Dopa crosses BBB and can be converted to Dopamine in the brain by dopa decarboxylase

2) Parkinson's

3) Arrhythmias if converted in periphery, which is blocked by administrating the Carbidopa (blocks peripheral decarboxylase)
Also can have dyskinesia after administration and akinesia between doses after long term use

Front 3

Selegiline
1)MOA
2)Use
3)Toxicity

Back 3

1) Selectively inhibits MAO-B due decrease breakdown of Dopamine

2)Adjuvant to L-Dopa

3)Can worsen side effects of L-Dopa

Front 4

Sumatriptan
1)MOA
2)Use
3)Toxicity

Back 4

1) 5-HT agonist which causes vasoconstriction (very acute with short half life)

2) Acute migraines, cluster headaches

3) Coronary vasospasm, mild tingling. Can't use in Prinzmetal's angina or CAD

Front 5

Seizure Treatments
1) Partial Seizures
2)Tonic Clonic Seziures
3)Absence Seizures
4)Status Epilepticus

Back 5

1) All drugs are useful
2)First line is Phenytoin, Carbamazepine, or Valproic Acid
3)First line is Ethosuximide, Valproic Acid will work
4) Prophylaxis is Phenytoin, Acute trt is Benzodiazepines (Diazepam, Lorazaepam)

Front 6

Phenytoin
1)MOA
2)Use
3)Toxicity

Back 6

1) Use dependent blockade of Na+ channels, and blocks glutamate release from Excitatory presynaptic terminals

2)Tonic Clonic Seizures, and Class IB antiarrhythmic

3) Diplopia, Ataxia, Nystagmus, SLE-like, induction of p450, gingival hyperplasia, hirsutism, blocks folate absorption (megaloblastic anemia), teratogenic, malignant hyperthermia

Front 7

Carbamazepine
1)MOA
2)Use
3)Toxicity

Back 7

1) Blocks Na+ channels
2) Tonic Clonic seizures, Trigeminal Neuralgia

3)Diplopia, Ataxia, induces p450, Agranulocytosis, teratogenic, liver toxicity

Front 8

Gabapentin
1)MOA
2)Use
3)Toxicity

Back 8

1)Causes GABA release
2)Tonic Clonic, and peripheral neuropathy

3) Sedation, ataxia

Front 9

Lamotrigine
1)MOA
2)Use
3)Toxicity

Back 9

1) Blocks voltage gated Na+ channels
2)Everything but Absence, and Status Epilepticus

3) STEVEN-JOHNSONS RASH

Front 10

Ethosuximide
1)MOA
2)Use
3)Toxicity

Back 10

1) Blocks T-type Ca+ Channels
2) Absence seizures
3) Lethargy, Uticaria, Steven Johnsons Rash

Front 11

Valproic Acid
1)MOA
2)Use
3)Toxicity

Back 11

1)Inactivates Na+ channels, increases GABA release
2)Everything but Status Epilepticus, and it works in Myoclonic Seizures

3) Hepatotoxic, GI, Spina Bifida, Tremor, Weight Gain

Front 12

Barbituates-Phenobarbital, Pentobarbital, Thiopental
1)MOA
2)Use
3)Toxicity
4)Trt of overdose

Back 12

1)increase the duration that the GABA Cl- channel is open --> decrease neuron firing

2) Sedative for anxiety, seizures, insomnia, induction of anesthesia (thiopental)

3) Addictive via dependence, additive CNS depression with EtOH, Respiratory Depression (death), Induction of p450

4) Respiratory Support, BP support

Front 13

Benzodiazepines- Diazepam, Lorazepam, all end in -epam
1)MOA
2)Use
3)Toxicity
4)Trt overdose

Back 13

1) Increase frequency of the GABA Cl- channel being open and usually have long half lives (Triazolam, Oxazepam, Midazolam are short TOM)

2)Anxiety, Spasticity, Status Epilepticus, Detox from EtOH, Night Terrors, Sleep Walking (Stage 4 sleep)

3) Dependence, additive depressent with EtOH, but less risk of Respiratory Depression

4)Flumazenil (blocks GABA)

Front 14

Antipsychotics/Neuroleptics - Thioridazine, Haloperidol, Fluphenazine, Chlorpromazine

1)MOA
2)Use

Back 14

1)Blocks Dopamine D2 receptors (excess Dopamine implicated in Psychosis and schizophrenia)

2) Schizophrenia,Pychosis, Mania, Tourette's

Front 15

Antipsychotics/Neuroleptics

1)EPS side effects
2)Neuroleptic Malignant Syndrome
3)Tardive Dyskinesia

Back 15

1)Blockage of Dopamine in the Basal Ganglia causes the symptoms of
-acute dystonia
-akinesia
-askathisia
-tardive dyskinesia (after 4 mo of therapy
Blockage of Dopamine also removes the inhibition of Prolactin --> gynecomastia
Muscarinic Block (dry mouth), Hypotension, and sedation (histamine block)

2) Causes rigidity, myoglobinuria, autonomic instability, and hyperexia --> trt with Dantrolene

3) stereotypical oral facial mvmts after long term use

Front 16

Atypical Antipsychotics- Clozipine, Olanzapine, Risperidone
1)MOA
2)Use
3)Toxicity

Back 16

1) Blocks Dopamine and 5-HT in diff't tissues

2) Szhizophrenia (both positive and negative symptoms)
Olanzapine --> OCD, anxiety, depression, Tourette's mania

3) Few EPS and anticholingergic side effects.
Clozapine has Agranulocytosis

Front 17

Lithium
1)MOA
2)Use
3)Toxicity

Back 17

1) Completely unknown
2)Mood stabalizer, blocks relapse of manic effects

3)LMNOP
Lithium causes
Movement problems (tremor)
Nephrogenic Diabetes Insipidus
hypOthyroidism
Pregnancy Problems

Front 18

SSRI's - Fluoxetine, Sertraline, Paroxetine

1)MOA
2)Use
3)Toxicity

Back 18

1) Blocks re-uptake of Seratonin
Takes 2-3 weeks to have effect

2) Depression, OCD

3) GI distress, sexual dysfxn (no orgasm)
Seratonin Syndrome- happens if on SSRI and MAOi --> hyperthermia, rigid muscles, cardiovascular collapse

Front 19

Tricyclics- imipramine, amitryptaline, desipramine, nortryptiline, clomipramine, doxepin

1)MOA
2)Use
3)Side Effects
4)Toxicity

Back 19

1) Block reuptake of NE and Seratonin

2)Major depression, bedwetting (imipramine), OCD (clomipramine)

3)Sedation, Hypotension, Anticholinergic symptoms (amitryptiline)
Desipramine is least sedating

4) Tri-C's --> convulsions, Coma, Cardiotoxic
May also hallucinate from early anticholinergic side effects

Front 20

Bupoprion
1)Use
2)Toxicity

Back 20

1)Depression, Smoking cessation

2) Stimulatory (tachy, insomnia), seizures, no sexual side effects

Front 21

Venlafaxine
1)MOA
2)Use
3)Toxicity

Back 21

1)Block Seratonin, NE, and Dopamine reuptake

2) Generalized anxiety, depression

3) Stimulation, nausea, constipation

Front 22

Mirtazapine
1)MOA
2)Use
3)Toxicity

Back 22

1)alpha2 blocker --> excess release of NE and Seratonin

2)Depression

3)Sedation, increased appetite, weight gain, increase blood pressure

Front 23

Maprotiline
1)MOA
2)Use
3)Toxicity

Back 23

1)Blocks NE reuptake
2)Depression
3)sedation

Front 24

Trazodone
1)MOA
2)Use
3)Toxicity

Back 24

1)Blocks 5-HT reuptake
2)Depression
3)Sedation, priapism, hypotension

Front 25

MAOi's - Phenelzine, Tranylcypromine

1)MOA
2)Use
3)Toxicity

Back 25

1) Nonselective blockade of MAO --> increases all amine neurotranmitters (Epi, Dopamine, NE)

2)Atypical Depression (with pyschosis), anxiety, hypochondriasis

3) Hypertensive crisis with Tyramine ingestion (Cheese, wine)
CNS stimulation,
Can't combine with SSRI's or Beta Agonists (Seratonin Syndrome)