Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
199 Cards in this Set
- Front
- Back
|
Phenytoin:
- class |
- antiepileptic (antiarrhythmic 1b)
|
|
|
Phenytoin:
- mechanism of action |
- blocks Na+ channels, increases GABA inhibition, decreases Ca++ influx
|
|
|
Phenytoin:
- indications |
- generalized tonic-clonic seizures (grand mal) and partial seizures
|
|
|
Phenytoin:
- major side effects/ considerations |
- nystagmus, diplopia, ataxia, sedation
- gingival hyperplasia, hirsutism - status epilepticus with sudden withdrawal |
|
|
Carbamazepine:
- class? |
- antiepileptic
|
|
|
Carbamazepine:
- mechanism of action? |
- blocks Na+ channels
|
|
|
Carbamazepine:
- indications? |
- partial seizures and tonic-clonic seizures
|
|
|
Carbamazepine:
- side effects |
- diplopia, ataxia
- blood dyscrasias |
|
|
Abrupt withdrawal of phenytoin in epileptic patients may lead to ...?
|
status epilepticus
|
|
|
Phenobarbital:
- class |
- antiepileptic/ sedative
|
|
|
Phenobarbital:
- mechanism of action |
- potentiates GAVAnergic stimulus by increasing the duration of Cl-channel openings
- more generalized action than benzodiazepines |
|
|
Phenobarbital:
- indications |
- sedation, hypnosis, anesthesia, epilepsy
|
|
|
Phenobarbital:
- side effects |
- cardiopulmonary depression, DDIs, addiction
|
|
|
Ethosuximide:
- class |
antiepileptic
|
|
|
Ethosuximide:
|
blocks Ca++ channels
|
|
|
Ethosuximide:
|
absence (petit mal) seizures
|
|
|
Ethosuximide:
|
- headache, dizziness
- GI distress, Parkinsonism, bone marrow depression |
|
|
Valproate:
- class |
antiepileptic
|
|
|
Valproate:
|
enhances GABA-mediated inhibition, blocks Na+ channels, increases K+ current, blocks Ca++ channels
|
|
|
Valproate:
|
all seizure types
|
|
|
Valproate:
|
hair loss
|
|
|
Gabapentin
- class |
antiepileptic
|
|
|
Gabapentin
- mechanism of action |
unknown
|
|
|
Gabapentin
- indications |
partial seizures
|
|
|
Gabapentin
-side effects |
sedation, dizziness, unsteadiness, relatively benign
|
|
|
Diazepam (valium)
- class |
benzodiazepine, anxiolytic, antiepileptic
|
|
|
Diazepam (valium)
- mechanism of action |
enhances GABA, especially in limbic system, hypothalamus, thalamus
|
|
|
Diazepam
- indications |
continuous seizure activity, especially tonic-clonic status epilepticus
|
|
|
Diazepam
- side effects |
tolerance
drowsiness, fatigue, ataxia thrombosis/phlebitis at injection site |
|
|
Lorazepam (Ativan)
- class |
benzodiazepine, antiepileptic, anxiolytic-sedative
|
|
|
Lorazepam (Ativan)
- mechanism of action |
facilitates GABA
|
|
|
Lorazepam (Ativan)
- indications |
status epilepticus (more long-acting than Diazepam)
|
|
|
Lorazepam (Ativan)
- side effects |
drowsiness
contraindicated with myasthenia gravis and acute narrow angle glaucoma |
|
|
Lamotrigine
- side effects |
skin rashes (SJS), toxic epidermal necrosis (Lyell's syndrome)
|
|
|
Lamotrigine
- class |
antiepileptic
|
|
|
Lamotrigine
- mechanism of action |
blocks Na+ channels
|
|
|
Lamotrigine
- indications |
partial seizures and absence seizures
|
|
|
Caffeine
- class |
stimulant, methylxanthine
|
|
|
Caffeine
- mechanism of action |
adenosine receptor antagonist --> increased intracellular cAMP
|
|
|
Caffeine
- indications |
sleep retardant, migraine, apnea of prematurity
|
|
|
Caffeine
- side effects |
mild delirium, insomnia, diuresis, tachcardia, arrythmia
|
|
|
Nicotine
- class |
stimulant
|
|
|
Nicotine
- mechanism of action |
nicotinic agonist
low doses: mainly stimulant (locus ceruleus) high doses: reward effects (limbic) |
|
|
Nicotine
- indications |
aid to smoking cessation, nicotine withdrawal
|
|
|
Nicotine
- side effects |
overdose: pallor, cold sweat, nausea, sailvation, vomiting, abd pain, diarrhea, HA, dizziness, confusion, tremor, weakness, disturbed hearing and vision
|
|
|
Cocaine
- class |
stimulant
|
|
|
Cocaine
- mechanism of action |
blocks monoamine reuptake transport; Na channel blocker
|
|
|
Cocaine
- side effects |
tachycardia, HTN, hyperthermia, mydriasis, cardiac arrythmia, seizure
ADDICTION |
|
|
Methylphenidate (Ritalin)
- class |
stimulant
|
|
|
Methylphenidate (Ritalin)
- mechanism of action |
blocks reuptake of dopamine
|
|
|
Methylphenidate (Ritalin)
- indications |
ADHD, narcolepsy
|
|
|
Methylphenidate (Ritalin)
- side effects |
nervousness, insomnia, HA, dizziness, drowsiness, chorea, nausea, anorexia, wt loss
|
|
|
Dextroamphetamine, methamphetamine
- class |
stimulant
|
|
|
Dextroamphetamine, methamphetamine
- mechanism of action |
increases release of monoamines (norepi, 5-HT, dopamine) from storage sites in nerve terminals
|
|
|
Dextroamphetamine, methamphetamine
- indications |
ADHD, narcolepsy
|
|
|
Dextroamphetamine, methamphetamine
- side effects |
nervousness, insomnia, palpitations, HTN, HA, dizziness, anorexia, dryness of mouth
|
|
|
MDMA (ecstasy)
- mechanism of action |
increases release of monoamines (5-HT, norepi, dopamine), distorted sense of time/ perception, sexual enhancer, facilitates interpersonal communication
|
|
|
MDMA (ecstasy)
- class |
stimulant, hallucinogen
|
|
|
MDMA (ecstasy)
- side effects |
long term neurotoxicity, tachycardia, HTN, mydriasis
|
|
|
LSD
- class |
hallucinogen
|
|
|
LSD
- mechanism of action |
agonist and/or antagonist of 5-HT receptors
|
|
|
LSD
- side effects |
sense of time and self may change, delusions, visual hallucinations, mydriasis, tachycardia, panic attacks
|
|
|
PCP
- class |
hallucinogen
|
|
|
PCP
- mechanism of action |
blocks NMDA-type glutamate receptors
|
|
|
PCP
- side effects |
acute psychosis, dissociation, disorientation, loss of proprioception, catatonic posturing, aggression
|
|
|
THC
- class |
hallucinogen, antiemetic, analgesic
|
|
|
THC
- mechanism of action |
cannabinoid receptor agonist at CB1 and CB2
|
|
|
THC
- indications |
cancer-related N/V, appetite stimulation among AIDS pts, chronic pain
|
|
|
THC
- side effects |
antimotivational syndrome with chronic use
|
|
|
Ethanol
- class |
depressant
|
|
|
Ethanol
- mechanism of action |
enhancement of GABA, inhibition of glutamate at NMDA receptors
|
|
|
Ethanol
- symptoms of abuse/poisoning |
ataxia, slurred speech, slow breathing, vomiting, stupor, coma, cirrhosis
|
|
|
Ethanol
- DDIs |
induction of cytP450 --> acetaminophen toxicity, inhibited metabolism of other drugs
physical and psychological dependence |
|
|
Disulfirim
- indication |
treatment of alcoholism
|
|
|
Disulfirim
- mechanism of action |
blocks acetaldehyde dehdrogenase (converts acetaldehyde to acetic acid) --> unpleasant effects (flushing, SOB, N/V, HA, postural fainting, etc)
|
|
|
Naltrexone
- class |
narcotic antagonist
|
|
|
Naltrexone
- mechanism of action |
blocks or reverses action of narcotic analgesics
|
|
|
Naltrexone
- indications |
alcohol dependence,
longer duration of action than Naloxone --> long-term treatment of opioid addiction |
|
|
Naltrexone
- side effects |
hepatocellular injury
|
|
|
Morphine
- class |
narcotic analgesic
|
|
|
Morphine
- mechanism of action |
opioid receptor agonist
|
|
|
Morphine
- mechanism of action |
pain relief
|
|
|
Morphine
- side effects |
constipation, N/V, dizziness, sedation, respiratory depression, circulatory depression, apnea, shock
addiction/ abuse |
|
|
Codeine
- class |
narcotic analgesic
|
|
|
Codeine
- mechanism of action |
opioid receptor agonist in CNS, bowel
|
|
|
Codeine
- indications |
mild to moderate pain relief
|
|
|
Codeine
- side effects |
constipation, N/V, sedation, sweating, dry mouth, respiratory depression
|
|
|
Dextromethorphan
- class |
nonnarcotic antitussive
|
|
|
Dextromethorphan
- mechanism of action |
cough suppression via medulla
|
|
|
Dextromethorphan
- indications |
nonproductive cough relief
|
|
|
Dextrmethorphan
- side effects |
dizziness, drowsiness
N/V, stomach pain |
|
|
Hydrocodone
- combined with acetaminophen = ? |
Vicodin
|
|
|
Hydrocodone
- class |
semisynthetic narcotic analgesic, antitussive
|
|
|
Hydrocodone
- mechanism of action |
opioid agonist, similar to codeine
|
|
|
Hydrocodone
- indications |
mild to moderate pain
|
|
|
Hydrocodone
- side effects |
lightheadedness, dizziness, sedation, N/V, additive w/ other depressants
|
|
|
Oxycodone
- combined with ASA = ? |
Percodan
|
|
|
Oxycodone
- class |
narcotic analgesic
|
|
|
Oxycodone
- mechanism of action |
semi-synthetic narcotic, similar to morphine
|
|
|
Oxycodone
- indications |
moderate to severe pain, mild sedation, MSK injury, cancer pain
|
|
|
Oxycodone
- side effects |
light headedness, dizziness, sedation, N/V
|
|
|
Tramadol
- class |
centrally acting analgesic (not chemically related to opioids)
|
|
|
Tramadol
- mechanism of action |
unknown:
- opioid receptor agonist? - inhibition of norepi and 5-HT reuptake? |
|
|
Tramadol
- indications |
moderate to moderately severe pain
|
|
|
Tramadol
- side effects |
dizziness, vertigo, HA, somnolence, CNS stimulation, anxiety, confusion, seizures
|
|
|
Tramadol
- increased risk of seizures with what drug? |
Naloxone (does not work to treat Tramadol overdose)
|
|
|
Meperidine (Demerol)
- class |
narcotic analgesic (synthetic)
|
|
|
Meperidine (Demerol)
- mechanism of action |
opiate receptor agonist
|
|
|
Meperidine (Demerol)
- indications |
analgesic for moderate to severe pain, especially minor surgeries and diagnostic procedures
|
|
|
Meperidine (Demerol)
- side effects |
transient hallucinations, transient hypotension, visual disturbances
|
|
|
Methadone
- class |
narcotic analgesic, morphine type (synthetic)
|
|
|
Methadone
- mechanism of action |
similar to morphine
only mild euphoria (less addictive) |
|
|
Methadone
- indications |
detox and maintenance of narcotic dependence
|
|
|
Methadone
- side effects |
constipation, sweating, pulmonary edema, chorea
|
|
|
Heroin
- class |
hallucinogen, opiate
|
|
|
Heroin
- mechanism of action |
- CNS depressant --> dreamlike state of warmth and well-being
|
|
|
Heroin
- intoxication Sx - withdrawal Sx |
intoxication: myosis, nausea, respiratory depression, euphoria
withdrawal: panic, nausea, muscle cramps, chills, insomnia, miscarriage, stillbirth |
|
|
Chlorpromazine
- Class |
typical antipsychotic
|
|
|
Chlorpromazine
- mechanism of action |
blocks alpha 1 & 5-Ht2 < D2 < D1 receptors
|
|
|
Chrlorpromazine
- side effects |
drowsiness, seizures, agranulocytosis, aplastic anemia, thrombocytopenia, tardive dyskinesia, neuroleptic malignant syndrome
|
|
|
Haloperidol
- class |
typical antipsychotic
|
|
|
Haloperidol
- mechanism of action |
blocks D2 > D1 predominantly
|
|
|
Haloperidol
- indications |
psychosis, Tourette's
|
|
|
Haloperidol
- side effects |
EPS, elevated serum prolactin, tardive dyskinesia
|
|
|
Risperidone
- class |
atypical antipsychotic
|
|
|
Risperidone
- mechanism of action |
blocks D2 & 5-HT2 receptors
|
|
|
Risperidone
- side effects |
minimal EPS, minimal prolactin elevation, less propensity to induce tardive dyskinesia
|
|
|
Clonazapine
- class |
atypical antipsychotic
|
|
|
Clonazapine
- mechanism of action |
blocks D4 & alpha 1 receptors
|
|
|
Clonazapine
- side effects |
minimal EPS, minimal prolactin elevation, less propensity to induce tardive dyskinesia
|
|
|
Olanzapine
- class |
atypical antipsychotic
|
|
|
Olanzapine
- mechanism of action |
blocks 5-HT2 > D1
|
|
|
Olanzapine
- side effects |
minimal EPS, minimal prolactin elevation, less propensity to induce tardive dyskinesia
|
|
|
Olanzapine
- indications |
psychosis, bipolar disorder
|
|
|
Amitryptiline, imipramine
- class |
tricyclic antidepressants (tertiary amines)
|
|
|
Amitryptiline, imipramine
- mechanism of action |
block reuptake of serotonin and norepinephrine
|
|
|
Amitryptiline, imipramine, desipramine, nortryptiline
- side effects |
arrythmia, orthostatic hypotension, fatal overdose, dizziness, dry mouth, urinary retention, conduction defects, sedation, weight gain, constipation
|
|
|
Desipramine, nortryptiline
- class |
tricyclic antidepressants (secondary amines)
|
|
|
desipramine, nortryptiline
- mechanism of action |
block reuptake of norepinephrine
|
|
|
Selegiline, phenelzine, isocarboxazid, tranylcypromine
- class |
MAOIs
|
|
|
Selegiline, phenelzine, isocarboxazid, tranylcypromine
- mechanism of action |
inhibit MAO-A and -B from deactivating monoamine NTs (epi, norepi, dopamine, serotonin)
|
|
|
Dietary consideration with MAOIs?
|
low tyramine (MAO-A metabolizes tyramine foods)
too much tyramine --> hypertensive crisis |
|
|
Selegiline, phenelzine, isocarboxazid, tranylcypromine
-side effects |
dizziness, dry mouth, weight gain, sexual dysfunction, headache, insomnia, constipation, blurred vision, urinary retention, LFT elevation, fainting, nausea, peripheral edema, myoclonic jerks
|
|
|
Fluoxetine, sertraline, paroxetine, citalopram
- class |
SSRIs
|
|
|
Fluoxetine, sertraline, paroxetine, citalopram
- side effects |
altered GI motility, nausea, agitation, anxiety, sleep disturbance, sexual dysfunction
|
|
|
Venlaxafine, duloxetine, buproprion
- class |
Norepinephrine and serotonin reuptake inhibitor (NSRI)
|
|
|
Venlaxafine, duloxetine, buproprion
- side effects |
idiopathic htn
|
|
|
Mirtazapine
-class |
NSRI
|
|
|
Mirtazapine
- mechanism of action |
increased release of norepi and serotonin, 5-HT2 and 3 antagonist, H1 antagonist --> net effect to upregulate 5-HT1
|
|
|
Mirtazapine
- side effects |
weight gain, sexual dysfunction
|
|
|
Trazodone
- class |
antidepressant
|
|
|
Trazodone
- mechanism of action |
mixed serotonin antagonist/ agonist
|
|
|
Trazadone
- side effects |
othostatic hypotension, sedation, priapism
|
|
|
Nefazodone
- class |
antidepressant
|
|
|
Nefadozone
- mechanism of action |
5-HT2 antagonist
|
|
|
Nefadozone
- side effects |
liver necrosis
|
|
|
Aripiprazole
- class |
antidepressant
|
|
|
Apriprazole
- mechanism of action |
D2 partial agonist (atypical antipsychotic)
|
|
|
Which antidepressants are used to treat depression and OCD in children?
|
Depression - Fluoxetine
OCD - Fluoxetine, fluvoxamine, sertaline, clomipramine |
|
|
Lithium
- indications |
mania, mood stabilizer
|
|
|
Lithium
- mechanism of action |
enhances serotonin neurotransmission, decreases neostriatal dopaminergic activity, facilitates norepi release
|
|
|
Lithium
- side effects |
narrow therapeutic index; tremor, diarrhea, weight gain, polyuria, excessive thirst, memory problems,
|
|
|
Valproate
- class |
anticonvulsant
|
|
|
Valproate
- indications |
acute mania in bipolar disorder
|
|
|
Valproate
- mechanism of action |
potentiates GABA
|
|
|
Valproate
- side effects |
hepatic failure, pancreatitis, thrombocytopenia
|
|
|
Lamotrigine
- indications |
maintenance of bipolar depression
|
|
|
Carbamazepine
- indications |
bipolar depression, tonic-clonic seizures, trigeminal neuralgia
|
|
|
DDI:
Lamotrigine and depakote |
Stevens-johnson syndrome
|
|
|
SSRI + St Johns Wort OR sumatriptan OR zolmitriptan -->
|
serotonin syndrome
|
|
|
SSRI +tricyclic -->
|
TCA excess, monitor anticholinergic excess
|
|
|
SSRI + MAOI -->
|
hypertensive crisis
|
|
|
What effects do benzodiazapine hypnotics have on various stages of sleep?
|
Induces sleep in alert and quiet wakefullness
Stage 1 & 2 - longer Stage 3 & 4 - shorter |
|
|
Barbituate hypnotics (Pentobarbital, secobarbital, amobarbital)
- mechanism of action |
enhance GABA-A receptor/chloride channel via prolonging duration of opening
|
|
|
Barbituate hypnotics (Pentobarbital, secobarbital, amobarbital)
- indication |
short-term basis for frequent awakenings/nightmares
|
|
|
Barbituate hypnotics (Pentobarbital, secobarbital, amobarbital)
- side effects |
drug hangover, respiratory depression, induction of CytP450, dependence
|
|
|
Benzodiazepine hypnotics (lorazepam, alprazolam, temazepam)
- mechanism of action |
enhance GABA-A receptor/chloride channel via allosteric site --> increases frequency of channel opening
Use SHORT ACTING benzo's for sleep |
|
|
In whom should doses of benzodiazepines be reduced
|
- elderly
- liver failure/ dysfunction (e.g. cirrhosis) |
|
|
Benzodiazepine hypnotics (lorazepam, alprazolam, temazepam)
- side effects |
decreased alertness, habituation, dependence, withdrawal (clonazepam lower), can cross placenta and breast milk, DDI with depressants
|
|
|
Flumazenil
- mechanism of action/ indication |
displaces benzodiazepines at binding site on GABA-A --> benzo antagonist for overdose
|
|
|
Zolpidem, Zalepon, Eszopiclone
- class |
short-acting hypnotics
|
|
|
Zolpidem, Zalepon, Eszoplicone
- mechanism of action/ advantages over benzodiazepines |
- bind to subset of GABA-A receptors allosterically in the CNS
- fast onset, short duration --> do not affect sleep architecture, minimal hangover, lower risk of dependence - Eszoplicone (Lunesta) is for longer use - little rebound insomnia, lower dependence |
|
|
Other treatments (non-barb, non-benzo) used for insomnia?
|
- chloral hydrate
- anti-histamines - antidepressants (Trazodone) - kava kava, valerian root, melatonin |
|
|
Ramelteon
- mechanism of action |
- selective melatonin MT1 & MT-2 receptor agonist in suprachiasmatic nucleus (SCN)
- no GABA-A action --> non-scheduled drug |
|
|
Ropinirole, Pramipexole
- mechanism of action - indication |
- non-ergot D2-receptor agonist
- RLS |
|
|
Which benzodiazepines are used for anxiety?
|
- long-acting: Diazepam (valium), alprazolam (xanax), lorazepam (ativan)
|
|
|
Which benzodiazepines are used for panic disorder?
|
alprazolam (xanax)
|
|
|
Aspirin (O-acetyl salicylic acid)
- mechanism of action |
irreversible nonspecific COX inhibitor
|
|
|
Aspirin (O-acetyl salicylic acid)
- side effects |
GI ulcers, platelet blockage, inhibition of PG-mediated renal fxn, hypersensitivity, HA, dizziness
Reye's syndrome in children w/ chicken pox or flu |
|
|
Ibuprofen (2-arylpropionic acids)
- indications |
arthritis, bursitis, tendonitis, dysmennorhea
|
|
|
Ibuprofen (2-arylpropionic acids)
- side effects |
GI ulcers, platelet blockage, inhibition of PG-mediated renal fxn, hypersensitivity, HA, dizziness
|
|
|
Ibuprofen (2-arylpropionic acids)
- mechanism of action |
nonspecific COX inhibitor
|
|
|
Celecoxib
- mechanism of action |
selective COX-2 inhibitor
|
|
|
Celecoxib
- side effects |
renal toxicity, increased thrombosis
|
|
|
Acetaminophen
- actions |
analgesic, antipyretic, NOT anti-inflammatory
|
|
|
Acetaminophen
-toxicity mechanism -exacerbated by... |
depletion of glutathione --> accumulation of toxic metabolite --> necrosis of liver and kidney tubules
exacerbated by phenobarbital or ethanol (P450 inducers) |
|
|
Triptans
- mechanism of action |
serotonin agonist selective for cranial vasculature receptors
|
|
|
Triptans
- side effects |
elevation of blood pressure, cardiac events
|
|
|
Dihydroergotamine
- indication - side effect |
- migraine
- nauseachart |
