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;
91 Cards in this Set
- Front
- Back
|
Lithium
|
Bipolar
|
|
|
Valproic Acid
|
Depakote
-Bipolar (rapid cyclers, mixed episodes) |
|
|
Carbamazepine
|
Tegretol
-Bipolar (rapid cyclers, mixed episodes) |
|
|
Lamotrigine
|
Lamictal
-maintenance of Bipolar II |
|
|
Atypical Antipsychotics
|
Bipolar
|
|
|
Tacrine
|
Cognex
-Alzheimers -anti-AchE (help ^ACH) -not used b/c of liver toxicity -SE:^LFTs, salivation, sweating, lacrimation (SLUD) -intx:1A2,2D6 |
|
|
Donepezil
|
Aricept
-Alzheimers (mild-severe) -anti-AchE (help ^Ach) -SE: insomina -inhibit CYP2D6,3A4 |
|
|
Rivastigmine
|
Exelon
-Alzheimers (mild-mod.sev.) -anti-AchE (help ^Ach) -food delays abs. -SE:dizziness, HA -no CYP intx. |
|
|
Galantamine
|
Razadyne
-Alzheimers -dual action: 1)anti-AchE 2)stim N rec. to ^Ach prod. -it you stop tx, must restart titration -SE:agitation, anorexia, sleep probs. -intx: 2D6, 3A4 -food delays abs. -has ER form |
|
|
Estrogen
|
-Alzheimers
-prevention?? |
|
|
NSAIDS
|
-Alzheimers
-?dec. inflammation that causes plaques -not used (GI risks) |
|
|
Vitamin E
|
-Alzheimers
-anti-oxidant -delays deterioration |
|
|
Ginkgo Biloba
|
-Alzheimers
-anti-oxidant -unproved, ok to try |
|
|
Huperzine A
|
-Alzheimers
-anti-oxidant, neuroprotection -don't know efficacy |
|
|
Statins
|
-Alzheimers
-anti-lipid -cholesterol is factor in plaque formation |
|
|
Memantine
|
Namenda
-Alzheimers (vascular) -NMDA antag. -blocks glutamate -SE:agitation,confusion, dizziness,constipation,HA -can use w/Anti-AchE |
|
|
Haloperidol
Atypical Anti-psych Benzos |
Delirium (from Alz.)
|
|
|
Levodopa/Carbidopa
|
Sinemet
-Parkinsons -Dop precursor/dopa-decarboxylase inhibitor -dose: Lev:300-1000mg/day in 3-8 divided doses Carb:75-100 mg/day -SE: hallucin./confusion, anorexia, nausea, orthostatic hypotension, dyskinesias -start low, go slow -issues: wearing off, on-off phenomena, peak dose dyskinesias, slow onset of response -CR form (dose:same but in 2-4 divided doses) |
|
|
Bromocriptine
|
Parlodel
-Parkinsons -Dopamine Ag. -older -SE:orthostatic hypotension, constipation, pleuropulmonary fibrosis (BAD-use other drug!) |
|
|
Pergolide
|
Permax
-Parkinsons -Dopamine Ag. -older -SE:orthostatic hypotension, mental changes, dyskinesias |
|
|
Ropinirole
|
Requip
-Parkinsons, Restless legs -Dopamine Ag. -newer -SE: sleep attacks!,insomnia, constipation, dizziness, HA |
|
|
Pramipexole
|
Mirapex
-Parkinsons -Dopamine Ag. -newer -SE: sleep attacks!,insomnia, constipation, dizziness, HA |
|
|
Tolcapone
|
Tasmar
-Parkinsons -COMT inhibitor (block deg. of dopamine and levodopa) -liver failure! (Bad-use entacapone) -monitor LFTs -must be taken w/ levo/carb. |
|
|
Entacapone
|
Comtan
-Parkinsons -COMT inhibitor (block deg. or dopamine and levodopa) -must be taken w/ levo/carb. -works peripherally -^"on" time, dec. "off" time -SE: diarrhea, dyskinesias |
|
|
Levodopa/Carbidopa/Entacapone
|
Stalevo
-Parkinsons -combined mechanisms |
|
|
Benztropine
|
-Parkinsons
-Anticholinergic -early PD, for tremor -avoid in elderly -SE: dry mouth, constipation, urinary retention,confusion |
|
|
Amantadine
|
Symmetrel
-Parkinsons -MOA? -caution in elderly (^^confusion) SE:confusion, convulsions, GI, livedo reticularis (leg spots) -adjust for renal dys. |
|
|
Selegiline
|
Eldepryl
-Parkinsons -MAO-B inhibitor -doesn't cause HT crisis -?neuroprotective- likely not |
|
|
Apomorphine
|
Apokyn
-Parkinsons -D1/D2 Ag. -SQ inj. (mL, NOT mg) -for "off" periods w/ sev. motor fluctuations -SE: **N**/V, low BP, fainting, hallucination, sleepy -must pretreat w/antiemetic (ONLY Tigan) - |
|
|
Trimethobenzamide
|
Tigan
-Parkinsons -antiemetic -used before Apomorphine to control nausea -started 3 days before initial dose of Apomorphine, continued 2mo.+ |
|
|
Biperiden
|
Akineton
-Parkinsons -Anticholinergic -SE: anti-cholinergic |
|
|
Estazolam
|
Prosom
-Sleep (DFA,DMS,EMA) -Benzo -longer onset, moderate duration (7-9hrs.) -SE: sedation, psychomotor retartdation, falls, anterograde amnesia, rebound insomnia |
|
|
Temazepam
|
Restoril
-Sleep (DMS,EMA) -Benzo -longer onset, moderate duration (7-9hrs.) -SE: sedation, psychomotor retartdation, falls, anterograde amnesia, rebound insomnia |
|
|
Flurazepam
|
Dalmane
-sleep: not used though -Benzo -super long t1/2 (100hrs.) -rapid onset, long duration |
|
|
Quazepam
|
Doral
-sleep: not used though -Benzo -super long t1/2 (100hrs.) -rapid onset, long duration |
|
|
Triazolam
|
Halicon
-Sleep:DFA (not used much) -Benzo -fast onset, short duration -SE: bizzard behavior, daytime anxiety, rebound insomnia, anterograde amnesia |
|
|
Zolpidem
|
Ambien
-sleep: IR:DFA CR:DMS,EMA -Benzo-rec. ag. -little effect on sleep stages -tk on empty stomach -no tol/rebound insom./w/d -safe w/ preg.- others are not |
|
|
Eszopiclone
|
Lunesta
-sleep (Chronic insomnia) -Benzo-rec. ag. -effective up to 6 mo. |
|
|
Ramelton
|
Rozerem
-sleep: DFA -Melatonin rec.ag.(MT1,MT2) -not controlled (good for pt. w/ abuse) -can be used for long time -active met. (caution w/liver) -intx:fluvoxamine, 1A2 |
|
|
Antidepressants (Sleep)
|
-Sleep
1)TCAs SE:antichol., CV 2)Trazodone SE:priapism 3)Mirtazapine (Remron) SE:EDS,wt.gain -not for the elderly |
|
|
Antihistamines (Sleep)
|
-Sleep
1)Diphenhydramine -not as effective as BZDs -SE:sedation, antichol., CV, glaucoma -avoid in late preg.and elderly 2)Doxylamine- not avail. anymore |
|
|
Valerian Root
|
-sleep
-^GABA -intx: barbiturates, benzos, ethanol, opioid analgesics |
|
|
CNS Stimulants
|
-Narcolepsy (EDS)
-CIIs 1)Methylphenidate 2)Dextroamphetamine 3)Methamphetamine' SE:^BP,^HR, CNS effects |
|
|
Modafinil
|
Provigil
-Narcolepsy (EDS) -CIV -induces 2C19, 3A4(OC) |
|
|
Antidepressants (Narcolepsy)
|
-Narcolepsy (Cataplexy)
1)SSRI (fluoxetine, venlafaxine) 2)TCA (protriptyline, imipramine, clomipramine) 3)MAOI (selegiline) SE:anticholinergic |
|
|
Sodium oxybate
|
Xyrem
-Narcolepsy (Cataplexy) -date rape drug -CIII, ONLY for narc., otherwise illegal -potent -intx:alcohol, CNS dep. |
|
|
Dopamine Agonists (RLS)
|
-Restless legs
-1st line: Requip -long half lives, flexible dosing SE: sleep attacks, edema, nausea, drowsiness |
|
|
Gabapentin
|
Neurontin
-Restless legs -usefull in painful RLS w/ neuropathy -no intx. |
|
|
Hypnotics (RLS)
|
-Restless legs
1)clonazepam* -long half-life- hangover 2)temazepam 3)zolpidem 4)eszopiclone -disad:tolerance, confusion, ^snoring |
|
|
Levodopa/Carbidopa (RLS)
|
Sinemet
-Restless legs -good for short term -bad-^augmentation (sx earlier and req. ^dose) |
|
|
Opioids (RLS)
|
-Resless legs
ex)propoxyphene, hydrocodone, oxycodone, etc. -at bedtime -good for painful RLS -SE:tolerance, constipation |
|
|
Iron supplement
|
-Restless legs
|
|
|
Melatonin
|
-Circadian Rhythm Disorder
-caution w/ epilepsy, warfarin |
|
|
Clonazepam
|
-REM Behavior Disorder
|
|
|
Antidepressants (Neuropathic pain)
|
-Neuropathic pain
-inhibit descending NE/5HT opiate receptors 1)SSRI 2)SNRI 3)TCAs -Amitriptyline -Clomipramine -Desipramine -Nortriptyline SE: sedation, anti-chol, hypotension, CV, sz., wt. gain |
|
|
Opioids (Neuropathic Pain)
|
-Neuropathic pain
-inhibit descending NE/5HT opiate receptors -2nd line SE: sedation, constipation |
|
|
Carbamazepine (Neuropathic Pain)
|
Tegretol
-Neuropathic Pain -MOA: in PNS & CNS PNS-Na channel blocker CNS-modifies L-type Ca channels -SE: sleepy, hyponatremia, rash |
|
|
Oxcarbazepine (Neuropathic Pain)
|
Trileptal
-Neuropathic Pain -MOA: PNS & CNS PNS- Na channel blocker CNS- modulates N, P type Ca channels SE: like CBZ, but worse |
|
|
Lamotrigine (Trigeminal Neuralgia)
|
Lamictal
-Trigeminal Neuralgia -blocks Na channels |
|
|
Topiramate (Neuropathic Pain)
|
Topamax
-Neuropathic pain -blocks Na channels -blocks glutamate -^GABA -pts. won't tk: bad SE SE:cog. eff., slowing, word finding |
|
|
Gabapentin (Neuropathic pain)
|
Neuropentin
-Neuropathic Pain -1st line* -^GABA -fast onset (days-wks) -few SE (sed, dizz) |
|
|
Pregabalin
|
-neuropathic pain
-try gabapentin 1st, then switch to pregab. if needed |
|
|
Mexiletine
|
-neuropathic pain
-only for pt. who do not respond to other meds |
|
|
Lidocaine
|
-neuropathic pain
-patch -no CNS effect |
|
|
Capsaicin
|
-neuropathic pain
-cream |
|
|
Betaseron
|
-Multiple Sclerosis-RR
-INF beta 1b -SC inj./qod -SE: inj. site rxn, cutaneous necrosis, flu-like, menstrual irreg., abortion pot., CNS (more dep., confusion) |
|
|
Avonex
|
-multiple sclerosis -relapsing
-INF beta 1a -IM inj./wk SE: flu-like, similar to bateseron |
|
|
Rebif
|
-multiple sclerosis
-INF beta 1a -SC inj. -SE: flu, HA, inj. site rxn, sz. |
|
|
Glatiramer
|
Copaxone-RR
-multiple sclerosis -SC inj./d -SE: inj. pain, chest pain (tightness, tk w/ someone 1st time) |
|
|
Mitoxantone
|
Novatrone
-multiple sclerosis -for very progressive, relapsing MS -IV inf. -CAN CAUSE CHF! -SE:alopecia, leukopenia, menstural probs (like a chemo drug) |
|
|
Beta Blockers
|
-Glaucoma- 1st line
-ex)"-olol" 1)Betaxolol 2)Carteolol 3)Levobunolol 4)Metipranolol 5)Timolol -MOA: dec. aq. humor production by ciliary body -SE:hypotension, syncope, bradycardia, bronchospasm, CNS effects -caution w/:asthma, HF,DM |
|
|
Prostaglandin Analogs
|
-glaucoma-1st line
1)Latanoprost (Zalatan)-frige 2)Brimatoprost (Lumigan) 3)Travoprost (Travitan) MOA-^trabecular outflow, ^uveoscleral outflow SE:muscle/joint pain, brown iris, hypertrichosis (^eye lashes), edema of retina -Caution w/:macular edema, inflammatory conditions |
|
|
Alpha-2 Adrenergic Agonists
|
-glaucoma
1)apraclonidine 2)brimondidine (Alphagan)-1st line MOA:dec. aq. humor production, ^uveoscleral outflow SE: hypotension, dizziness, fatigue, dry mouth, allergic rxn. Caution w/: infants, MAOIs, TCAs, CV DM, renal |
|
|
Carbonic Anhydrase Inhibitors (CAIs)- Topical
|
-glaucoma
1)brinzolamide (Azopt) 2)dorzolamide (Trusopt) -MOA:dec. aq. humor production -SE:local discomfort (stinging, blurred vision, tearing) -Caution w/:sulfa allergy, renal/hepatic |
|
|
Carbonic Anhydrase Inhibitors (CAIs)- Systemic
|
-glaucoma
1)acetazolamide 2)dichlorphenamide 3)methazolamide MOA: dec. aq. humor production SE:acidosis (fatigue, wt. loss, depression), metallic taste, GI Caution w/:TONS!!! (sulfa, sickle-cell....) |
|
|
Cholinergic Agonists
|
-glaucoma
1)pilocarpine 2)carbachol MOA:^aq. humor outflow SE: miosis, HA, cataracts Caution: night driving, pulmonary disease *at high doses, systemic SE |
|
|
Cholinesterase Inhibitors
|
-glaucoma
1)Echothiophate -MOA:^ aq. humor outflow -SE: like Chol. Ag. but more severe, more systemic -caution: w/ artificial lens (b/c of cataracts risk) |
|
|
Non-specific Adrenergic Ag.
|
-glaucoma
1)epinephrine 2)dipivefrin -MOA:^outflow SE:HA, faintness,^BP, ^HR Caution:CV, aphakia (no lens), CAG |
|
|
Oxybutynin
|
Ditropan
-incontinence -anti-cholinergic -MOA: inhibits invol. contractions of bladder -^capacity of bladder (relaxes it) -delay the initial urge to void SE:anti-chol, tachycardia, confusion* (HIGH CNS penetration) -also patch -CYP3A4 inhibitor |
|
|
Tolerodine
|
Detrol
-incontinence -start w/ low dose in elderly -avoid w/ 3A4, 2D6 inhibitors |
|
|
Trospium
|
Sanctura
-incontinence -anti-chol -MOA: inhibits invol. contractions of bladder -^capacity of bladder (relaxes it) -delay the initial urge to void SE:anti-chol, tachycardia, confusion |
|
|
Solifenacin
|
VESIcare
-incontinenece -anti-chol (M3 selective) -MOA: inhibits invol. contractions of bladder -^capacity of bladder (relaxes it) -delay the initial urge to void SE:anti-chol, tachycardia, confusion -CYP 3A4 inhibitor |
|
|
Darifenacin
|
Enablex
-incontinence -anti-chol (M3 selective) -MOA: inhibits invol. contractions of bladder -^capacity of bladder (relaxes it) -delay the initial urge to void SE:anti-chol, tachycardia, confusion -avoid w/3A4, 2D6 inhibitors |
|
|
Hyoscyamine
|
Urispas
-incontinence -AVOID in elderly |
|
|
Estrogen
|
-incontinence
-ring/cream -poor evidence-but can help atrophic vaginitis |
|
|
Alpha Blockers
|
-BPH
1)Terazosin (Hytrin) 2)Doxazosin (Cardura) 3)Alfuzosin (UroXatral) 4)Tamsulosin (Flomax) MOA-dec. smooth muscle tone leading to dec. urethral resistance -titrate slow! -SE:orthostatic hypotension (GIVE AT BED) -also used for high BP (except Tamulosin) -days-wks for benefit -more common than 5-alpha inh. b/c of cost and quick effect |
|
|
5-Alpha Reductase Inhibitors
|
-BPH
1)Finasteride (Proscar) 2)Dutasteride (Avodart) -MOA:inhibit 5-alpha reductase blocking the conversion of testosterone to active dihydrotestosterone, which interferes w/ prostate enlargement -SE:sex.dys, breast tenderness/enlargement -takes 3-6mo. -dec. PSA -start low, titrate up -teratogenic, women avoid exposure |
|
|
Pseudoephedrine
|
-incontinence (stress)
-sympathomimetic -strengthen smooth muscle responsible for opening and closing the bladder's internal sphincter SE:agitation, insomnia, anxiety, tachycardia |
|
|
Sildenafil
|
Viagra
-ED -phosphdiesterase inhibitors MOA: ^cGMP levels producing smooth muscle relaxation leading to ^blood flow to penis SE:HA, flushing, dyspepsia, diarrhea, rhinitis, nausea, blue tinged vision, dizziness, rash -tk on empty stomach -30-60 min. onset -4 hr. duration -caution w/ nitrates, antihypertensives |
|
|
Tadalafil
|
Cialas
-ED -phosphdiesterase inhibitors MOA: ^cGMP levels producing smooth muscle relaxation leading to ^blood flow to penis SE:HA,dyspepsia, back/limb pain, myalgias, rhinitis, flushing -30 min onset 24-36 hr duration!!! -caution w/ nitrates, antihypertensives |
|
|
Vardenafil
|
Levitra
-ED -phosphdiesterase inhibitors MOA: ^cGMP levels producing smooth muscle relaxation leading to ^blood flow to penis SE:HA,dyspepsia, back/limb pain, myalgias, rhinitis, flushing -caution w/ nitrates, antihypertensives |
