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65 Cards in this Set
- Front
- Back
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What is memantadine used to treat?
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Alzheimer's
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What is the MOA of memantadine?
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It blocks the NMDA receptor (glutamate receptor involved in controlling memory); helps prevent exitotoxicity
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What are the side effects for:
1) Memantadine 2) Donepezil, galantamine, rivastigmine |
1) Diziness, confusion, hallucinations (generally good drug)
2) Nausea, dizziness, insomnia (maybe CNS or GI effects of increase AcH- more motility?) |
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What is the mechanism of action of donepezil, galantamine, rivastigmine?
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They are acetylcholinesterase inhibitors.
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Name the high potency neuroleptic (antipsychotic drugs). (2/3)
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Haloperidol, trifluoperazine (possibly moderate), fluphenazine
"High Frequency Tripping" |
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Name the low potency neuroleptic drugs (2)
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thioridazine, chlorpromazine
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What is different between high potency and low potency neuroleptics?
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High- have more extrapyramidal side effects
Low- have more anticholinergic side effects |
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What is the mechanism of action of neuroleptic drugs?
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They block dopamine (D2) receptors which leads to increased cAMP (via Gi)
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Name 3-4 indications for the use of neuroleptics.
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1) schizophrenia (too much dopamine)
2) Acute mania (too much dopamine) *3) Tourette's (didn't talk about neuro.) 4) Acute agitation (like someone messed up on PCP) |
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Describe the general categories of side effects from neuroleptic drugs (5)
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Extra-pyramidal SE
Endocrine SE (dopamine antagonism --> hyperprolactinemia & galactorrhea) Anti-muscarinic (anti-cholinergic) Anti-alpha (hypotension) Anti-histamine (sedation, weight gain) |
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What is acute dystonia and how long does it take to appear after giving a neuroleptic?
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Muscle spasm, stiffness, oculogyric crisis, tortacollis
4 hours after giving medicine |
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What is akinesia and how long does it take to appear after giving a neuroleptic?
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Parkinsonian symptoms
4 days after giving drug |
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What is akathisia and how long does it take to appear after giving a neuroleptic?
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Restlessness
4 weeks after giving drug |
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What is tardive dyskinesia and how long does it take to appear after giving a neuroleptic?
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stereotypic oral-facial movements due to long-term antipsychotic use, often irreversible
4 months + |
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What is the treatment for acute dystonia?
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Give additional drug that will increase anti-cholinergic side effects (like diphenhydramine).
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What is it called when you get rigidity, myoglobinuria, autonomic instability, and hyperpyrexia after taking a neuroleptic?
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Neuroleptic Malignant Syndrome
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What is the treatment for neuroleptic malignant syndrome and why? (2 drugs)
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Dantrolene (blocks calcium release and reduces muscle contraction)
Bromocriptine (dopamine agonist, reverse drug action) |
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Olanzapine, clozapine, quetiapine, risperidone, aripiprazole, ziprasidone are in what drug category?
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Atypical anti-psychotics
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What makes the atypical anti-psychotics different from the "typical" ones? (mechanism and side effects)
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Atypical blocks serotonin receptors as well as dopamine R.
Atypical have less extrapyramidal and anticholinergic side effects |
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Which atypical anti-psychotics are known for causing weight gain?
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Olanzepine, Clozapine, Quetiapine
Notice they all start with round letters like round fat people... |
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What is the side effect associated with clozapine?
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Agranulocytosis
FA says "must watch clozapine clozely" |
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What is the proposed mechanism of action for lithium?
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Possibly related to phosphoinositol cascade (2nd messenger system)
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Describe the side effects of lithium
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Lithium
Movement (tremor) Nephrogenic diabetes insipidus O (hypOthyroidism) Pregnancy problems (cardiac defects like Ebstein anomaly and malformation of great vessels) |
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Lithium is used to treat? (2)
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Bipolar disorder and SIADH
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What are the drugs used to treat bipolar disorder? (4)
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1) Lithium
2) Valproic Acid 3) Carbemazapine 4) Atypical antipsychotics (olanzepine, arapiprazole) |
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Imipramine, amitriptyline, desipramine, nortriptyline, clomipramine, doxepin, and amoxapine are in what category of drugs?
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Tri-cyclic anti-depressents
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Which TCA would you use for an elderly patient to avoid anti-cholinergic side effects?
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Nortriptyline
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Which TCA might you use for bed-wedding?
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Imipramine (Think that an IMmature kid would wet the bed- IMipramine)
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Which TCA would you use for OCD?
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Clomipramine (notice it has an "O" and a "C" in it)
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Why would you use TCAs for fibromyalgia?
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For their sedating effects
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Describe the side effects of TCAs
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Tri-Cs
Convulsions Coma Cardiotoxicity (arrhythmias) Also- respiratory depression and hyperpyrexia Confusion and hallucinations in elderly (anti-cholinergic) |
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What would you give to treat cardiotoxicity from a TCA?
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Sodium Bicarbonate
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Fluoxetine, paroxetine, sertraline, and citalopram are part of what family of drugs?
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SSRIs
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What is the mechanism of action of SSRIs?
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Serotonin-specific reuptake inhibitors
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Clinical uses for SSRIs? (lots)
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Depression, *OCD, bulimia (NOT anorexia), social phobias, DIT says anxiety
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What are the main side effects of SSRIs?
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GI side effects and sexual dysfunction
Think "SSri = Sex & Stomach problems" |
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What happens when you combine SSRIs with another drug that increases serotonin?
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Serotonin syndrome, which is characterized by hyperthermia, muscle rigidity, cardiovascular collapse, flushing, diarrhea, and seizures
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What is the treatment for serotonin syndrome?
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First- cooling and benzodiazepines
Cyproheptadine (a 5-HT2 receptor antagonist) |
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Venlafaxine, duloxetine, desvenlafaxine, nefazodone, milnacipran, and subtramine are part of which drug class?
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SNRIs
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What can duloxetine be used for in addition to depression?
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Peripheral neuropathy (has a greater effect on NE)
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Which neurotransmitter does duloxetine have a greater effect on?
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NE
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What are the side effects of SNRIs?
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Increased BP is the most common
Can also get stimulant effects, sedation, and nausea. |
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Phenelzine, tranylcypromine, isocarboxacid, selegiline are members of what family of drugs?
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MAO inhibitors
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What is the unique mechanism of seligiline?
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It is an MAO-B inhibitor only; used to treat Parkinson's
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What is the mechanism of action of MAOIs?
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To increase the levels of amine neurotransmitters (NE, serotonine, dopamine)
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What are the uses for MAOIs (3)?
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Atypical depression, *anxiety, *hypochondriasis
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What is the major side effect of taking MAOIs?
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hypertensive crisis with tyramine ingestion (can't eat cheese, wine, etc.), also hypertensive crisis with beta blockers
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Why is tyramine bad when taking MAOIs?
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Because it normally gets broken down in gut by MAO, but since they are inhibited, the tyramine gets into the system and causes NE release and CNS stimulationg, hypertension, etc.
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What is the mechanism of action of buproprion?
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It increases NE and dopamine via an unknown mechanism.
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What would be a good drug to give alongside buproprion?
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SSRI, because it addresses serotonin and the buproprion addresses NE & and dopamine.
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Name three side effects of buprioprion.
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Stimulant effects, headache, lowers seizure threshold.
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What is the mechanism of action of mirtazapine?
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alpha2 antagonist which leads to increased release of NE and serotonin.
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What is buproprion used to treat?
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Depression
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What is mirtazapine used to treat?
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Depression
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What does mirtazapine antagonize?
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5HT2 and 5HT3 receptors
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What are the side effects of mirtazapine?
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Sedation, increased appetite, weight gain, dry mouth
Think of a little old lady called "mirta" with depression who you''d give this to to help her sleep & help her gain weight |
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What is maprotiline used to treat?
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Depression
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What is the MOA of maprotiline?
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Blocks NE reuptake
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What are the side effects of maprotiline?
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Sedation, orthostatic hypotension
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What is trazodone used to treat?
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Low dose- insomnia
High dose- antidepressant |
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What is the mechanism of action of trazodone?
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Primarily inhibits serotonin reuptake
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What are the side effects of trazodone (4)?
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sedation, nausea, priapism, postural hypOtension
"trazoBONE" |
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What drug is used to treat generalized anxiety disorder?
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Buspirone
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What is the mechanism of action of buspirone?
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It stimulates 5 HT-4 receptors.
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What are the side effects of buspirone?
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Very few side effect, doesn't cause addiction or interact with alcohol
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