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237 Cards in this Set
- Front
- Back
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What kind of drug is Diazepam?
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this a benzo
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How long does Diazepam last?
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this has a long half life
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What three things is diazepam used to treat?
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status epilepticus
muscle relaxant withdrawl tx |
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What receptor do ALL benzo's act on?
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GABA(a)
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What do ALL benzo's do to GABAa?
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these increase the duration of GABAa being open (and thus increase duration of Cl- flow)
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What drug affects diazepams metabolism?
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cimetidine (tagament)- lowers metabolism, and increases the half life
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What kind of drug is chlordiazepam?
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this is a benzo
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what is the half life of chlordiazepam like?
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this has a long half life
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What is chlordiazepam used to treat?
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this is used to taper withdrawal symptoms
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What kind of drug is Flurazepam?
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this is a benzo
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What does flurazepam treat?
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this treats insomnia
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What does chronic use of flurazepam cause?
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this causes metabolite accumulation because of its long action life
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How do you remember flurazepams action?
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long flu is bad, go to bed!
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what kind of drug is lorazepam?
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this is a benzo
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How is lorazepam broken down?
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this is directly inactivated
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What does lorazepam treat?
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this treats status epiliticus
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How long does lorazepam last?
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this has an intermediate duration
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How long does midazolam last?
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this is VERY short
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how is midazolam given?
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this is IV anestesia
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What is the main side effect of midazolam?
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anterograde amnesia
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What kind of drug is triazolam?
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benzo
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What does triazolam treat?
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short acting to treat insomnia
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What are the negative effects of triazolam?
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rebound insomnia
no chronic use |
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What kind of drug is Clonazepam
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this is a benzo
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what does clonazepam treat?
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absence seizures
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What receptor do all barbituates act on?
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GABA (A)
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What do all barbituates do to GABA (A)
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they increase the duration of action of GABA
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What is the general effect of all barbituates
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CNS depression
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What kind of drug is thiopental ?
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barbituate
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what is thiopental used for?
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this is a short acting anestesia agent
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What is phenobarbital used for?
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this is an anticonvulsant barbituate
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What do all barbituates induce?
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p450 enzymes, and porphyrin synthesis
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What are the blood effects of barbituates?
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induce porphyrin synthesis
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What receptor do all benzo's use
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GABA(A)
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What do you used to treat OCD
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SSRI's
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What do you used to treat agorophobia/panic disorders
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SSRI
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What od you used to treat PTSD
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antidepressants
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What do you used to treat anxiety in kids
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antidepressants
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what are the effects of ALL benzo's on the elderly?**
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very sensitive= MEMORY LOSS, confusion
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Who should not take benzos
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preggers
kids sleep apnea |
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What kind of drug is Flumazenil
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this is a benzodiazepine antagonist
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What are the possible negative effects of flumazenil?
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this can induce withdrawal seizures
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What type of drug is Zolpidem
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this is a short term non-benzo sleep aid
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what type of drug is zalephon
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this is a short term non-benzo sleep aid
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What drug is approved for long term treatment of insomnia
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eszopiclone
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Do the non-benzo sleep aids effect GABAa?
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no these all act on BZ1
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What sleep aid causes withdrawl symptoms?
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eszopiclone (lunesta)
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What receptors does ramelteon act on?
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MT1 and MT2- it is a melatonin agonist
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What is the contraindication for ramelteon?
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severe liver disease
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What kind of drug is promethazine?
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this is a antihistamine
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What does promethazine treat?
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occasional insomnia
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What receptor does chloral hydrate act on?
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GABAa
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Who usually gets chloral hydrate?
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pediactric dental
nursing home pts |
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What is chloral hydrate used for?
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sedation
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What kind of drug is Buspirone?
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this is an anti anxiety drug
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What receptor does buspirone act one
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5-HT1a
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Why is buspirones action special**
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this relives anxiety without sedation**
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Is buspirone addictive?
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No it is not
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Who should be treated with buspirone
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anxious alcoholics addicts or elderly
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What drug should NOT be combined with buspirone?
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MOAI's (both work on 5HT)
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What is the one side effect of buspirone?
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restlessness
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How do the receptors in the brain change with chronic alcohol use?
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GABA decreases, NMDA increases
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What do high doses of alcohol inhibit?
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inhibits glutamate- which leads to blackouts
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What does fomepizole do?
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this inhibits ADH- given for methanol toxicity
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What does disulfram inhibit?
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this inhibits aldehyde dehydrogenase
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What does Naltrexone do?
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this is an opioid receptor antagonist-
blocks alcohols reward pathway |
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What does Acomprosate do?
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this restores normal GABA/glutamate balance in alcoholics
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What enzyme is induced in alcoholics
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CYP2E1
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What happens when alcoholics take tylenol?
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their CYP2E1 breaks it down really fast creating toxic byproducts quickly!
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What are the major side effects of Naltrexone?
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Liver damage and nausea
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What does disulfram do?
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this blocks aldehyde dehydrogenase
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How long does disulfram last?
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very long duration, 3-4 days**
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What microsmal enzyme does disulfam inhibit?
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P450
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What are the signs of disulfram doing its job?
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flushing, intense headaches, nausea confusion
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What kind of drug is Topiramate?
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this is an anticonvulsant drug
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How does topiramate help in alcoholism?
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this reduces cravings
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What does reserpine do?
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this depletes neurons of NE and 5HT- leading to depression
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How do all antidepressants work?
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these affect uptake or metabolism of NE and 5HT
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What receptors of ALL TCA's affect? (not NT's)
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M, alpha, and histamine- these are responsible for the side effects
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What are the half life for TCA's like?
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these all have long half lifes
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What type of TCA's are the most sedating?
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the tertiary amines, they have more 5-HT effect
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How do TCA's affect the heart? **
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these can lead to torsade de points
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What are the endocrine effects of TCA's?**
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WEIGHT GAIN, SIADH
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What are the vascular effects of TCAs?**
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Postural hypotensions (alpha block)
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What is the major side effect of TCA overdose?
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suicidal behavior
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How do TCA"s affect seziures?
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these are BAD for seizure pts
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What drug treats TCA overdose?
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give Pheyntoin
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What does Phenelzine do?
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this IRREVERSIBLE inhibits MAO-A and MAO-B
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Who do you give Phenelzine to?
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people who havent responded to other antidepressants
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What are the major side effects of MAOI's?
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alpha block
Weight Gain* M block |
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Do SSRI's have autonomic effects?
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NO they do not, no alpha, M, or H blocks
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What are the DOC's for depression?
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SSRI's
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What enzymes do SSRI's inhibit?**
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CYP2D6 AND CYP3A4
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What is the half life of Fluoxetine?
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this has a half life of 2-3 days, and its metabolite lasts 7-9 days
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What are the main side effects of SSRI use?**
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CNS stimulation
SIADH**-> hyponatremia GI Sexual dysfunction |
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What does Paroxetine treat best?
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this SSRI treats OCD and Anxiety best (and depression)
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What age group gets Paroxetine?
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The elderly
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Who does NOT take Paroxetine?
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pregnant women
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What are the main side effects of SNRIs?
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increased BP
SIADH (seems like most antidepressants do this..) |
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What type of drug is Venlafaxine (effexor)
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this is a SNRI
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What type of drug is Desvenlafaxine (pritiq)
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this is a SNRI
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What type of drug is Duloxetine?
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this is a SNRI
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What is Duloxetine good for treating?**
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depression and the PHYSICAL symptoms of it
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What is the contraindication of Duloxetine?**
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this is hepatoxic
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What does Bupropion do?**
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this inhibits dopamine reuptake (antidepressant)
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What side effects do SSRI's have, that Burpropion does NOT have?
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this has NO sexual side effects, and can actually correct side effects from TCA's
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What two conditions does bupropion treat?
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ADHD, and addiction recovery
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What are the unique side effects of bupropion?
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anxiety
weight loss |
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Who should NOT get Bupropion?**
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people with seizure or head trauma hx*
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What receptors does Mirtazapine (Remeron) acto on?
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this BLOCKs presynaptic alpha 2's
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What is Trazdone used for?
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this is a sleep aid, used for pain management
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What type of drug is Trazdone?
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this is an antidepressant
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What are the hilarious side effects of trazdone?**
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priapism,
sedation |
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What receptors does trazdone act on?
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5-HT1a, blocks 5-HT2a
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What do classical antipsychotics do?
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these block D2, and affect positive symptoms
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what do new antipsychotics do?
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these block 5HT2a, and affect the negative symptoms
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As a whole, what receptors do antipsychotics block- causing side effects?
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alpha, histamine, M
so you get hypotension, sedation, and anticholinergic |
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What are the serious CNS side effects of taking antipsychotics?
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extrapyramidal effects
Tardive Dyskenisa** akathisia dystonia parkinsons symptoms |
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How do you treat extrapyramidal effects ?
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anticholinergic drugs
(so ach is bad in this case, for causing these symptoms) |
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What do you treat neuroleptic syndrome with?**
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dantrolene
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What receptors do Procholopromazine affect?
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D2 (classic)
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How do antipsychotics affect seizures?**
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these INDUCE seizures
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What types of drugs cause neroleptic malignant syndrome?
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antipsychotics
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What is prochlopromazine usually used to treat?
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schizophrenia
nausea and vomiting hallucinations |
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What are the unique side effects of Phenothiazines like compazine, and thorazine? (3 of em)***
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LONG Q-T
Jaundice Renal Deposits |
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What mental condition does Thorazine treat?
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schizophrenia (this is an antipsychotic)
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What receptors does Haldol affect?**
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BLOCKS D2 selectively
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What antipsychotic is MOST likely to cause extrapyramidal symptoms?***
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Haldol
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What type of drug is Clozapine?
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this is an atypical antipsychotic
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What receptors does Clozapine act on?
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D4, 5-HT2a
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In general, what side effects do atypicals NOT have?
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these low rates of Extrapyrmidal side effects
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What is the serious side effect specific to Clozapine?**
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agraunlocytosis
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What group of pts is clozapine unique in being able to treat?
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psychos with parkinsons, due to is lack of extrapyramidal effects
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What receptors do atypicals block as side effects?
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M, H, and alpha 1- just like most other mental drugs- same side effect profiles
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What kind of drug is olanzapine?
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this is an aytpical antipsychotic
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What receptors does Olanzapine block?
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D4 and 5HT (atypicals tend to affect D4 and 5-HT)
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What type of schizophrenia symptoms does Olanzapine treat?
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this, like all atypicals, treats the negative symptoms best
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How is Olanzapine different than clozapine?
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this does NOT cause agraunlocytosis
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What is Olanzapiens unique side effects ***
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Weight GAIN- most likely to cause this of all antipsychotics****
hyperglycemia and type 2 diabetes |
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What is the first line drug from treating psychosis?
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risperidone
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What receptors does risperidone block? ***
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D2, 5-HT, and alpha**
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Does risperidone have extrapymaidal effects?
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No it does not
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What are the two MAJOR side effects of risperidone?**
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Postural hypotension (alpha block)
Long QT- MOST Likely to cause this**** |
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What receptors does Ziprasidone (geodon) block?
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D2, and 5-HT
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what type of drug is Ziprasidone?
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antipsychotic
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What are the MAJOR side effects of Ziprasidone (geodon)
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LONG QT
hyperprolactinemia** unique!! |
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What pts should NOT get ziprasidone?
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ones with Hx of seizures
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What are the unique side effects of Quetiapine (seorquel)?
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xerostomia**
weight gain |
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What type of drug is Pimazide (Orap)
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this is an antipsychotic
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What is pimazide (Orap) used to treat?
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Tourettes
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what are the serious side effects of pimazide (orap)
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HIGH extrapyramidal effects
ECG changes |
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What type of drug is Aripiprazole?
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this is a dopamine system stabilizer, used as an antipsychotic
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What is Aripirazole excellent for treating?
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drug resistant depression (ask your doctor if adding abilify is right for you!)
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What are the unique side effects of Aripirazole?
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Diabeties inducer
ESOPHAGEAL DYSMOTILITY** |
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How do you dose Lithium?
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you must use blood tests to monitor serum levels
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What are the side effects of Lithium tox?
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Nausea, vomiting, tremor
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What things increase serum levels of Lithium? (AKA drug interactions)
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low Na+
NSIADS thiazides |
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What are the side effects of regular Lithium use?***
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Diabetes insipidus (polyuria, polydypsia)
decreased thyroid function Weight gain |
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How do you treat Lithium induced diabetes insipidis?
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Amiloride (a potassium sparring diuretic)
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What kind of drug is Valproic acid?
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this is an anticonvulsant
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Though valproic acid is an anticonvuslant, what is it widely used for?
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as a mood stabilizer
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What needs to be monitored while taking Valproic Acid?
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liver enzymes need to be monitored
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What are the side effects of Valproic acid?
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weight gain
GI upset |
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Who is Carbamazepine used to treat?
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this treats pts who do not respond to lithium
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What kind of drug is carbamazepine?
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this is an antipsychotic
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What are the major effects of Carbamazepine?***
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CNS tox
Hematologic disorders** requires blood monitoring**** SJS |
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What genetic phenotype needs to be careful when taking Carbamazepine so they dont get SJS?
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HLA-B1502
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What is Gabapentin used to treat?
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Neurological pain
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What type of drug is Gabapentin?
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an anticonvulsant
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What is the basis for seizures, based upon receptor activity?
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Under activity of GABA
over activity of glutamate |
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What whole CLASS of drugs requires monitoring plasma drug levels?
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All anticonvulsants
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How does phenytoin work?
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this blocks sustained high frequency firing, by Prolonging the inactivation of Na+ channels***
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What types of seizures does Phenytoin treat?
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partial seizures, tonic-clonic seizures
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What is the elimination of phenytoin like?
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dose dependent
1st order low zero order high |
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What are the side effects of Phenytoin?
|
Gingival hyperplasia
Hirsutism |
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How does Phenytoin affect enzymes?***
|
induces microsomal enzymes
(increases metabolism of oral contraceptives) |
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What increases the metabolism of phenytoin?
|
Carbamazepine
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How does pheyntoin interact with warfain?**
|
this increases warfarin concentration in the blood
|
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What kind of drug is Carbamazepine?
|
anticonvulsant
|
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What receptors does Carbamazepine work on?
|
this blocks Na+ channels to decrease NT release
|
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What diseases does Carbamazepine treat best?
|
Partial seizures
Tonic clonic* Trigerminal neuralgia BIPOLAR* |
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What does Carbamazepine do to enzymes? (3 things)
|
this INduces hepatic microsomal enzymes
increases oral contraceptive breakdown. AND**induces its OWN metabolism- FUN! |
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What two drugs inhibits carbamazepine metabolism?
|
Cimetidine (it affects everything)
fluoxetine |
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What are the Serious side effects of carbamazepine**
|
Blood dyscrasias
anemia, agranulocytosis (like Clozapine-an atypical antipsychotic) |
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What is Phenobarbitals method of action?
|
prolongs Cl- channel opening @ GABAa
|
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What does phenobarbital treat as an anticonvulsant?
|
this treats generalized clonic tonic seziures, and pratial seizures
|
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What kind of drug is Lamotrigine?
|
an anticonvulsant
|
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What does Lamotrigine treat?
|
absence seizures
bipolar parital seizures |
|
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What kind of drug is Topiramate?
|
this is an anticonvulsant
|
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How does topiramate work?
|
this blocks Na+ channels, enhances GABAa, limits glutamate activation
|
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What does Topiramate treat best?*
|
Broad spectrum- partial, generalized tonic clonic's
migraines |
|
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What will Topiramate decrease the effectiveness of?
|
birth control pills
|
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What is the first choice drug for Absence seizures?**
|
Ethosuximide
|
|
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How does Ethosuximide work?**
|
this reduces low threshold Ca2+ currents in thalamus**
|
|
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What kind of seizures does valproic acid treat?
|
absence seizures
tonic-clonic myoclonic basically most seizure types |
|
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What are the toxicities of Valproic acid?
|
weight gain
hepatotoxicity teratogenic |
|
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What receptor does Baclofen act on?
|
GABAb agonist**
|
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How is Baclofen administered?
|
Intrathecal route**
|
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What is Baclofen used for?
|
this is a muscle relaxant
|
|
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What type of drug is Tizanidine?
|
muscle relaxant
|
|
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What receptor does tizanidine act on?
|
alpha 2 agonist**- like clonidine
|
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What does Tizanidine treat?
|
chronic muscle spasms
|
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What kind of drug is Cyclobenzaprine?
|
this is a muscle relaxant
|
|
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How does cyclobenzaprine work?
|
this is a sedative on the brain stem
also has anticholinergic activity |
|
|
What are the serious side effects of cyclobenzaprine?**
|
this causes confusion, hallucinations
|
|
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What two diseases is Dantrolene used to treat?
|
malignant hyperthermia
neruoleptic malignant syndrome |
|
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How does dantrolene work?
|
this blocks Ca2+ release
|
|
|
What kind of drug is Modafinil?
|
this is provigil, and CNS stimulant
|
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Why is Modafinil better than ritalin?
|
this is less addictive, no withdrawals
|
|
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What enzymes does Modafinil induce?
|
CYP3A4- eats up oral contraceptives
|
|
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What kind of drug is Atomoxetine?
|
this is a SNRI
|
|
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What does Atomoxetine treat?
|
this treats ADHD
with NO abuse potential |
|
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How does caffeine work?
|
this blocks adenosine receptors
increases cAMP by inhibits phosphodiesterase |
|
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How can caffeine treat a headache?
|
it constricts cerebral blood vessels
|
|
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What is the root cause of parkinsons?
|
low dopamine in the nigrastriatal pathway
|
|
|
What are the side effects of L-dopa/carbidopa (sinemet)
|
nausea
vomiting hypotension psychosis* |
|
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What kind of drug is Selegiline?
|
this is a parkinsons drug
|
|
|
How does selegiline work?
|
this inhibits MAO-B
|
|
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What kind of drug is Bromocriptine?
|
this s a dopamine receptor agonist for parkinsons
|
|
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Does bromocriptines effectiveness decrease over time?
|
nope it sure doesnt
|
|
|
What is the sweet side effect of Bromocriptine?**
|
Erythromelalgia (red swollen feet)
hypotension GI problems |
|
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What do Pramipexole and Ropinirole treat?
|
parkinsons disease
|
|
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what is the one side effect of pramipexole and ropinirole?
|
daytime sleep
|
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What does apomorphine treat?
|
parkinsons
|
|
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what is the major side effect of apomorphine?
|
severe nausea
|
|
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What kind of drug is Benztropine?
|
this is an anticholinergic drug for parkinsons
|
|
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How does benztropine work?
|
this decreases the affects of Ach, to match the dopamine loss
|
|
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What is the root cause is alzheimers?
|
low ACH
|
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What does rivastigimine treat?
|
alzheimers disease
|
|
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What does rivaastigmine do?
|
this is a cholinesterase inhibitor
|
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What does Tacrine treat?
|
alzheimers
|
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How does tacrine work?
|
this is a cholinesterase inhibitor
|
|
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What is the toxic effect of tacrine?
|
liver toxicity
|
|
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What does Memantine treat?
|
alzheimers
|
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How does memantine work?
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this is an NMDA receptor antagonist
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What are the beneficial side effects of memantine?
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this protects the brain from glutamnine toxicity
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What are the general side effects of memantine
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mostly urinary effects
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