Pharm Exam 4

Front 1

Procaine

Back 1

Ester
Local anesthetic
Used for minor surgical procedures, spinal, topical

Front 2

Lidocaine

Back 2

Amide. Local anesthetic.
Used for epidural blockades, antiarrythmic if given IV

Front 3

Benzocaine

Back 3

Ester. Local anesthetic.
Topical for cold sores.

Front 4

Cocaine

Back 4

Ester. Local anesthetic.

Front 5

Nitrous Oxide

Back 5

Inhaled anesthetic. Very high MAC (low potency), risk of suffocation.
Good analgesia
no malignant hyperthermia

Front 6

Halothane

Back 6

Inhaled anesthetic.
Most potent - lowest MAC.
Poor analgesia, smells good (induction in children)
Tox: arrhythmias, malignant hyperthermia

Front 7

Isoflurane

Back 7

Inhaled anesthetic - widely used for maintenance.
Moderate analgesia
Not toxic because it's not metabolized (except malignant hyperthermia)

Front 8

Enflurane

Back 8

Inhaled anesthetic.
similar to halothane
malignant hyperthermia

Front 9

Desflurane

Back 9

Inhaled anesthetic - most widely used in outpatient settings - rapid recovery/induction.
Tox: bronchial irritant

Front 10

Sevoflurane

Back 10

Inhaled anesthetic - outpatient surgery. Low blood gas coeff (lambda) so it induces anesthesia rapidly

Front 11

Thiopental

Back 11

Barbiturate - intravenous
facilitates GABAa by increasing duration of Cl channel opening.
Rapid onset/high potency, highly lipid soluble, short duration.
Not analgesic.
Respiratory and CV depression

Front 12

Ketamine

Back 12

IV anesthetic.
Causes dissociated anesthesia - awake but not aware. Good for ppl with CV problems.
Dis: emergence rxns, respiratory suppression

Front 13

Etomidate

Back 13

IV anesthetic
Short acting - modulates GABAa rec. Good for ppl with CV problems.

Front 14

Droperidol

Back 14

IV anesthetic (analgesia and sedation)
Targets opioid receptors
Sedation for minor procedures

Front 15

Propofol

Back 15

IV anesthetic
Potentiates GABAa, no analgesia
Rapid, often outpatient, short procedures. anti-emetic.

Front 16

Midazolam

Back 16

IV anesthetic
Benzodiazepine - facilitates GABA action by increasing the frequency of Cl channel opening.
No analgesia.
Anti-anxiety, sedation.

Front 17

Fentanyl

Back 17

IV anesthetic
Opioid - 100x more potent than morphine. Mu receptor agonist
Analgesia used with inhalation anesthetics

Front 18

Sufentanil

Back 18

IV anesthetic
1000x more potent than morphine. Much like fentanyl.

Front 19

morphine

Back 19

Opioid analgesic
Strong mu agonist
Chronic and acute pain, t1/2 4 hrs
Can cause resp depression, n/v, itching, tolerance, euphoria

Front 20

Methadone

Back 20

Opioid analgesic. Long acting mu agonist.
Chronic pain, maintenance in addicts.
Little euphoria. T1/2 24 hrs

Front 21

Meperidine

Back 21

Opioid analgesic.
Mu receptor agonist (also K and D)
T1/2 = 2 hrs

Front 22

Fentanyl

Back 22

Opioid analgesic. 100x more potent than morphine at mu.
Anesthetic, acute pain.
T1/2 5-45 min

Front 23

Codeine

Back 23

Opioid analgesic.
Moderate agonist against all receptors (mu, delta, kappa)
Used for mild pain, cough.
Greater oral bioavailability than morphine

Front 24

Sufentanil

Back 24

Like fentanyl - but 1000 more potent than morphine
Opioid analgesic. Also anesthetic

Front 25

Pentazocine

Back 25

Opioid analgesic.
Mixed agonist-antagonist at Kappa
Weak antagonist at Mu, Delta
For acute pain, but may cause morphine withdrawal sx due to antagonist activity

Front 26

Propoxyphene

Back 26

Opioid analgesic
Moderate agonist at all receptors.

Front 27

Naloxone

Back 27

Opiate antagonist
Rapidly displaces bound opioids.
Reverses respiratory depression & coma from overdose.
Short T1/2 - repeated doses

Front 28

Naltrexone

Back 28

Opiate antagonist
Same as Naloxone, but longer duration of action. Blocks effects of heroine for 48 hours

Front 29

Barbiturates

Back 29

Used for insomnia
GABAa receptor modulator - increases duration of Cl channel opening, decreasing neuron firing
Changes sleep architecture - withdrawal and rebound.
OD causes death!

Front 30

Benzodiazepines

Back 30

Used for insomnia - safer than barbiturates.
GABAa receptor modulater - increases the FREQUENCY of Cl channel opening.
Withdrawal common.
OD - light anesthetic, sleep. Safer.

Front 31

Examples of benzodiazepines

Back 31

triazolam, flurazepam

Front 32

Zolpidem

Back 32

"Ambien" Non-benzo.
Allosteric modulator of GABAa receptor. No change in sleep architecture.
Best for sleep onset insomnia. Minimal next day effects

Front 33

Eszopiclone

Back 33

"lunesta"
Non-benzo allosteric modulator of GABAa. Best for sleep onset insomnia - long term use.

Front 34

Zaleplon

Back 34

Non-benzo, allosteric modulator of GABAa receptor.
Insomnia

Front 35

Ramelteon

Back 35

Targets MT1 and MT2 receptors.
Sleep onset insomnia.
Can cause amenorrhea, galactorrhea, decreased libido.

Front 36

Dephenhydramine

Back 36

antihistamine - OTC sleep aid.
significant next day drowsiness

Front 37

Phenobarbital

Back 37

barbiturate
Anti-seizure
Increase GABAa by increasing DURATION of Cl channel opening.
1st line for pregnant women and children in partial and generalized tonic-clonic
Induces P450!

Front 38

Carbamazepine (Tegretol)

Back 38

Antiseizure
Prolongs inactivation of Na channels. Blocks T type Ca channels in Thalamus
1st line for Generalized tonic-clonic, trigeminal neuralgia, partial seizures.
Toxic: hyponatremia, drowsiness, liver tox, ataxia, many more!
Induces P450

Front 39

Phenytoin (Dilantin)

Back 39

Anti-seizure
Prolongs inactivation of Na channels.
Generalized tonic-clonic, status epilepticus.
Tox: hepatitis, gingival hyperplasia, hisutism, ataxia, and more.
Induces p450. Displaces other drugs from plasma proteins.

Front 40

Clonazepam (Klonopin)

Back 40

Anti-seizure
Benzodiazepine
Partial and generalized tonic-clonic
Contraindicated in absence and myoclonic!!
Tox: drowsiness, ataxia, personality changes

Front 41

Ethosuximide

Back 41

Anti-seizure.
Blocks T-type Ca channels in thalamus.
1st line for generalized absence.
AE: n/v, anorexia, drowsiness, euphoria.
Safe! no interactions

Front 42

Primidone

Back 42

Anti-seizure
Converted to phenobarbital
Partial and generalized tonic-clonic.

Front 43

Valproid Acid

Back 43

Anti-seizure
Against tonic-clonic - prolongs Na inactivation, increases GABA synthesis
Against absence - blocks T-type Ca
AE: anorexia, n/v fulminant hepatitis.
Competitive enzyme inhibition with other drugs.

Front 44

Felbamate

Back 44

Anti-seizure.
Prolongs inactivation of Na channels, inhibits NMDA glutamate receptors.
Used in Partial and secondarily generalized seizures.
AE: aplastic anemia, hepatic failure, GI upset, HA

Front 45

Diazepam

Back 45

Anti-seizure
Benzodiazepine
1st line: status epilepticus
AE: low acute tox, drowsiness, ataxia

Front 46

Gabapentin (Neurontin)

Back 46

Anti-seizure
Promotes GABA release
Add on for partial and generalized seizures.
Very low AE

Front 47

Lamotrigine

Back 47

Anti-seizure
Prolongs inactivation of Na channels.
Generalized and partial seizures

Front 48

Topiramate

Back 48

Anti-seizure
Prolongs inactivation of Na channels, enhances GABA
Add on for partial seizures.

Front 49

Tiagabine

Back 49

Anti-seizure
Inhibits GAT-1 (GABA reuptake transporter)
Add on for partial or sec gen tonic-clonic
Contraindicated in abscene

Front 50

Zonisamide

Back 50

Anti-seizure
Prolongs inactivation of Na channels
Add on for partial seizures

Front 51

Levetiracetam

Back 51

Anti-seizure, unknown mechanism
Add on for partial and sec gen tonic-clonic

Front 52

Triazolam

Back 52

Benzodiazepine
sedative, hypnotic

Front 53

Flurazepam

Back 53

Long acting benzo

Front 54

Estazolam

Back 54

Sedative, hypnotic, benzo

Front 55

Zolpidem

Back 55

Ambien!
an imidazopyridine
Acts via BZ1 receptor
AE: ataxia, HA, confusion, modest day after effects and amnesia

Front 56

Eszopiclone

Back 56

Lunesta
Sedative and hypnotic.
A Pyrazolopyridine.
Basically - long term ambien
AE: bad taste, dry mouth

Front 57

Zaleplon

Back 57

Sonata
A sedative and hypnotic, insomnia.
A Pyrazolopyrimidine.
Same as ambien

Front 58

Diazepam

Back 58

Valium
Anti-anxiety, benzodiazepine
anti-seizure

Front 59

Oxazepam

Back 59

Anti-anxiety
Benzodiazepine
Short acting

Front 60

Alprazolam

Back 60

Anti-anxiety
Benzodiazepine

Front 61

Midazolam

Back 61

Anti-anxiety
Benzodiazepine

Front 62

Clonazepam

Back 62

Anti-anxiety, anti seizure (absence, myoclonic, atonic)
Benzodiazepine
Enhances binding of GABA to receptor, increases

Front 63

Chlordiazeperoxide

Back 63

Anti-anxiety Anti-seizure
Benzodiazepine

Front 64

Lorazepam (ativan)

Back 64

Anti-anxiety, anti-seizure (status epilepticus)

Front 65

Buspirone

Back 65

Anti-anxiety, antidepressant
Serotonergic anxiolytic, partial 5HT agonist.
No dependence or withdrawal.

Front 66

Venlafaxine

Back 66

SNRI
Effexor
Anti-anxiety, antidepressant, chronic pain
Blocks reuptake for Ne and 5HT,
AE: HTN

Front 67

SSRIs

Back 67

Anti-anxiety
Selective serotonin reuptake inhibitor

Front 68

Desipramine

Back 68

Tricyclics
for Affective Disorders, or backup for depression
Block reuptake pumps for 5HT and NE.
AE: sedation, weight gain

Front 69

Imipramine

Back 69

Triclyclic
Affective disorders, backup for depression, chronic pain
Inhibits 5HT reuptake more than NE.

Front 70

Nortriptyline

Back 70

Tricyclics
For affective disorders, depression, chronic pain.
Inhibits more NE reuptake than 5HT

Front 71

Amitriptyline

Back 71

Tricyclics
Affective disorders, depression, chronic pain.
Inhibits 5HT reuptake more than NE

Front 72

Trazodone

Back 72

Heterocyclics
Affective disorder, depression,
Serotonin 2a antagonist, SSRI, results in increased 5HT1a stimulation.
AE: sedation, orthostatis hypotension

Front 73

Phenelzine

Back 73

Irreversible MAO inhibitor
Used in depression that doesn't respond to other drugs

Front 74

Tranylcypromine

Back 74

MAOI
Much like phenelzine
Used for depression not helped by other drugs.

Front 75

Lithium carbonate

Back 75

Used for Depression, mania, bipolar.
Mood stabilizer.
Long term prevention, slow onset.
Narrow therapeutic window.

Front 76

Fluoxetine

Back 76

SSRI for depression
Selective and more potent than TCAs, fewer AE
AE: sexual dysfunction, suicide
Half life: days

Front 77

Paroxetine

Back 77

SSRI for depression

Front 78

Sertraline

Back 78

SSRI for depression

Front 79

Citalopram

Back 79

SSRI for depression

Front 80

Escitalopram

Back 80

SSRI for depression

Front 81

Fluvoxamine

Back 81

SSRI for depression

Front 82

Chlorpromazine

Back 82

a Phenothiazine
antipsychotic
Dopamine inhibitor

Front 83

Thioridazine

Back 83

a Phenothiazine
Blocks D2 receptors, decreasing + Sx for schizophrenia
AE: amenorrhea, gynecomastia, arrythmia, stroke

Front 84

Fluphenazine

Back 84

A phenothiazine
much like thioridazine
antipsychotic, dopamine antagonist, too many AE for use in most pts

Front 85

Haloperidol

Back 85

a Butryphenone
antipsychotic
antidopaminergic
Helps delusions and hallucinations
AE: extrapyramidal: pseudoparkinsonism, dystonias

Front 86

Pimozide

Back 86

a butyrophenone
For tourette syndrome and tics
extrapyramidal side effects

Front 87

Olanzapine

Back 87

2nd gen antipsychotic, mood stabilizer.
Schizophrenia, depression, mania, PTSD

Front 88

Risperidone

Back 88

2nd gen antipsychotic/mood stabilizer
similar to olanzapine

Front 89

Quetiapine

Back 89

2nd gen antipsychotic/mood stabilizer
typical schizophrenia, psychosis, depression, mania, bipolar

Front 90

Aripiprazole

Back 90

2nd generation antipsychotics mood stabiliers
Major depression

Front 91

Ziprasidone

Back 91

2nd gen antipsychotic mood stabilizer
AE QT prolongation

Front 92

Paliperidone

Back 92

2nd generation antipsychotic/mood stabilizer

Front 93

Lysergic acid diethylamide LSD

Back 93

Psychotomimetic
5HT1 and 5HT2 agonist
Produces hallucinations, delusions, paranoia
Most potent hallucinogenic

Front 94

Mescaline

Back 94

Psychotomimetics
Hallucinogen with amphetamine like properties

Front 95

Methylenedioxymethamphetamine
MDMA

Back 95

Strong psychedelic effects
Hallucinations, delusions, paranoia
Neurotoxicity and degeneration of serotonergic neurons

Front 96

Psilocybin

Back 96

Psychotomimetics
metabolized to psilocin - partial agonist to 5HT2A and 1A
Mushrooms

Front 97

Phenylcyclidine PCP

Back 97

Psychomimetics
Blocks NMDA type glutamate receptors
Anesthetic, impairs consciousness, delirium and hallucinations

Front 98

Methamphetamine

Back 98

CNS stimulant
Stimulates release of dopamin, inhibits catecholamine reuptake pump
AE: cardiac arrhythmia, involuntary motor activity, anorexia, paranoia

Front 99

Amphetamines

Back 99

same as methamphetamines

Front 100

Cocaine

Back 100

CNS stimulant
inhibits catecholamine and serotonin reuptake pumps

Front 101

Opiates:

Back 101

Heroin
Methadone
Buprenorphine
Morphine

Front 102

Ephedrine

Back 102

Sympthomimetic
released stored NE
for asthma, cough, congestion

Front 103

Nicotine

Back 103

sympathomimetic
Binds to nicotinic ACh, excites neurons. Release of DA from nucleus accumbens

Front 104

Ethanol

Back 104

CNS depressant
Binds to ACh, GABA, 5HT, and NMDA receptors.
Euphoria, relaxation, vomiting, impaired motor and sesory function

Front 105

Marijuana THC

Back 105

Cannabinoid
GPCR inhibit adenylate cyclase
Relaxation, impairs cognition and motor fxns, tox causes memory distortion and hallucinations
Decreases sperm count and testosterone in males

Front 106

St. John's Wort

Back 106

Herbal compound
CYP450 interactions
Used for depression
AE: photosensitivity, serotonin syndrome

Front 107

Ginseng

Back 107

aphrodisiac, stimulant, sexual dysfunction type II DM
Interacts with warfarin

Front 108

Garlic

Back 108

alters pharmacokinetic variables of acetaminophin, decreases warfarin concentration, interacts with aids drugs

Front 109

Gingko

Back 109

Possible antagonist of GABA activity
Can cause hemorrhages when mixed with NSAIDs and aspirin

Front 110

Green Tea

Back 110

Procoagulant
opposite of warfarin