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120 Cards in this Set

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amantadine
tx Parkinson's
antiviral drug for influenza -> who would have thought?
enhances synthesis, release and re-uptake of DA unless DA release is already at a maximum
less efficacious than levodopa
tolerance develops faster
good for rigidity and bradykinesia
antimuscarinic agents
benztropine
trihexyphenidyl
biperiden
tx Parkinson's
blocking cholinergic transmission -> effects similar to augmentation of DA transmission (creates an imbalance in DA/ACh ratio)
bromocriptine
tx Parkinson's
DA agonist
used w/ levodopa
must be built up slowly over 2-3 mo, serious side effects include:
hallucinations, confusion, delirium, nausea, orthostatic hypotension, worsens MI and ulcers
carbidopa
tx Parkinson's
DOPA decarboxylase inhibitor that doesn't cross BBB
it increases the action of levodopa and diminishes its side effects
deprenyl (selegiline)
tx Parkinson's
inhibits MAOB -> dec metabolism of DA -> inc levels

may prolong the period before severe symptoms set in
levodopa
tx Parkinson's
DA precursor that enters CNS and is decarboxylated to DA
also greatly decarboxylated in periphery unless co-administered w/ carbidopa
side effects -> nausea, vomiting, arrhythmias, hypotension
pramipexole
tx Parkinson's
non-ergot DA agonists
alleviate the motor deficitis in levodopa-naive patients and patients taking levodopa
less side effects
ropinirole
tx Parkinson's
non-ergot DA agonist
alleviate the motor deficits in levodopa-naive patients and patietns taking levodopa
less side effects
tolcapone
tx Parkinson's
nitrocatechol derivative-
selectively and reversibly inhibits both peripheral and central COMT
reduces the on-off phenomenon
excitatory pathways
excitatory neuron releases NE or ACh ->
bind to receptor on post-synaptic membrane ->
transient inc in Na permeability ->
Na influx ->
slight depolarization or EPSP
inhibitory pathways
inhibitory neuron releases GABA or glycine ->
binds to receptor on post-synaptic membrane ->
transient inc in K and Cl permeability ->
Cl influx and K efflux ->
slight hyperpolarization or IPSP
pyridoxine
B6
increases peripheral breakdown of levodopa
MAOIs and levodopa
hypertensive crisis
levodopa and glaucoma
can make glaucoma worse
levodopa and anti-psychotics
have opposing actions -> don't give them to the same patient
aprazolam
benzo anxiolytic-
when GABA binds its receptor -> opens Cl channel -> Cl influx -> hyperpolarization

the benzos bind a separate receptor that enhances GABA's affinity for its receptor
chlordiazepoxide
benzo anxiolytic
tx alcohol withdrawal
long acting
clonazepam
benzo anxiolytic
tx epilepsy
clorazepate
benzo anxiolytic
tx alcohol withdrawal
long acting
diazepam
benzo anxiolytic
tx grand mal seizures, alcohol withdrawal
lorazepam
benzo anxiolytic
quazepam
benzo hypnotic
long acting
midazolam
benzo hypnotic
estazolam
benzo hypnotic
flurazopam
benzo hypnotic
tx sleep disorder- long acting
temazepam
benzo hypnotic
tx sleep disorder- int acting- inability to stay asleep
triazolam
benzo hypnotic
tx sleep disorder- short acting- difficulty in getting to sleep
buspirone
anxiolytic
tx GAD
affinity for D2 and serotonin receptors
no anticonvulsant or muscle relaxant properties
hydroxyzine
anxiolytic
anti-histamine w/ antiemetic activity
great for drug addicts and for sedation before dental work or surgery
zolpidem
anxiolytic
acts on bezo receptors
- has no muscle relaxing or anticonvulsant properties

side effects include nightmares
flumazenil
benzo antagonist
GABA receptor antagonist
admin may precipitate withdrawal in dependent patients
amobarbital
barbituate
short acting
phenobarital
barbituate
long term management of tonic-clonic seizures
long acting
pentobarbital
barbituate
short acting
secobarbital
barbituate
short acting
thiopental
barbituate
short acting- good to induce anesthesia
antihistamines
diphenhydramine
doxylamine
sedatives
good for very mild insomnia
chloral hydrate
sedative
derivative of acetaldehyde -> converted to trichloroethanol
induces sleep in 30 minutes and lasts about 6 hours
ethanol
sedative
disulfiram
inhibit aldehyde dehydrogenase
(antabuse)
amphetamine
psychomotor stimulant
riases intracellular stores of catecholamines and blocks MAO
major actions due to release of DA, not NE
tx ADD

overdose tx w/ chlorpromazine
caffeine
psychomotor stimulant
a methylxanthine
cocaine
psychomotor stimulant
prolongation of DA action produces intense euphoria
used therapeutically as topical anesthetic (blocks voltage gated Na channels)
vasoconstriction causes necrosis and perforation of nasal septum
methylphenidate
psychomotor stimulant
tx narcolepsy (an amphetamine)
nicotine
psychomotor stimulant
2nd to caffeine as most widely used stimulant
2nd to alcohol as most widely abused drug
theobromine
psychomotor stimulant
a methylxanthine found in coco
theophylline
psychomotor stimulant
a methylxanthine found in tea
Lysergic acid diethylamide (LSD)
psychotomimetic
acts at presynaptic 5-HT receptors
haloperidol can shorten its action
phencyclidine (PCP)
psychotomimetic
inhibits reuptake of DA, serotonin and NE
also anticholinergic (yet it causes salivation)
an analog of ketamine
produces dissociative anesthesia (insensitivity to pain, without loss of consciousness) and analgesia
tetrahydrocannabinol (THC)
dronabinol
psychotomimetic
high dose may lead to psychosis
tx severe emesis in cancer patients
anticholinergics
scopolamine
preanesthetic medication
prevent bradycardia and secretion of fluids into respiratory tract
antiemetics
dropendol
preanesthetic medication
antihistamines
preanesthetic medication
prevention of allergic reactions (diphenhydramine)
or to decrease gastric acidity (cimetidine)
barbituates
phenobarbital
preanesthetic medication
for sedation

thiopental (fast acting short lived barbituate) helps avoid stage II of anesthesia
benzodiazepines
diazepam
preanesthetic medication
relieves anxiety and facilitates amnesia
opiods
fentanyl
preanesthetic medication
for analgesia
atracurium
mm relaxant
succinylcholine
mm relaxant
vecuronium
mm relaxant
enflurane
inhaled anesthetic
halothane
inhaled anesthetic
best agent in pediatrics, bronchial sm mm relaxation good for patients w/ asthma
reduces hepatic and renal blood flow, lowers BP, sensitizes myocardium to actions of catecholamines, hepatic toxicity and arrhythmias
isoflurane
inhaled anesthetic
good mm relaxant, rapid recovery, stability of CO, does no raise intracranial pressure, no sensitization of myocardium
methoxyflurone
inhaled anesthetic
nitrous oxide
inhaled anesthetic
good analgesia, rapid onset/recovery, safe, nonirritating
incomplete anesthesia, no mm relaxation
sevoflurane
inhaled anesthetic
amitriptyline
TCA
amoxapine
TCA- 2nd gen
desipramine
TCA
doxepine
TCA
imipramine
TCA
maprotiline
TCA- 2nd gen
nortriptyline
TCA
protriptyline
TCA
trimipramine
TCA
fluoxetine
SSRI
fluvoxamine
SSRI
nefazodone
SSRI
paroxetine
SSRI
sertraline
SSRI
trazodone
SSRI
venlafaxine
SSRI
isocarboxazid
MAOI
phenelzine
MAOI
tranylcypromine
MAOI
lithium salts
drugs used to treat mania
chlorpromazine
phenothiazine (neuroleptic)<br />lots of adverse effects

tx hiccups
fluphenazine
phenothiazine (neuroleptic)
available as slow release
prochlorperazine
phenothiazine (neuroleptic)
promethazine
phenothiazine (neuroleptic)
thioridazine
phenothiazine (neuroleptic)<br />strong muscarinic antagonist

good anti-emetic
risperidone
benzisoxazole (neuroleptic)
clozapine
dibenzodiazepine (neuroleptic)
agranulocytosis
haloperidol
butyrophernone (neuroleptic)
little adrenergic or muscarinic activity; available as slow release
thiothixene
thioxanthene (neuroleptic)
fentanyl
opiod agonist
80x analgesic potential of morphine, short duration of action
(anesthesiologists get addicted to this stuff)
heroin
opiod agonist
meperidine
opiod agonist
tx acute pain
methadone
opiod agonist
morphine
opiod agonist<br /><br />miosis via Edinger-Westphal<br />emesis via trigger zone<br /><br />not for asthmatics (releases histamine)
morphine-6-glucoronide = potent
morphine-3-glucoronide = not potent
sufentanil
opiod agonist
even more potent than fentanyl
codeine
opiod agonist (moderate)
(** in most new cough medicines, codeine has been replaced w/ detromethorphan)
propoxyphene
opiod agonist (moderate)
dextro-isomer -> for pain
levo isomer -> antitussive
(VERY bad when taken w/ alcohol and even naloxone can't overcome the cardiotoxicity)
buprenorphine
mixed opiod agonist/antagonist
pentazocine
mixed opiod agonist/antagonist

can induce withdrawal in morphine addicts
naloxone
opiod antagonist
tx overdose (works within 30 seconds! to relieve respiratory depression and coma)
may produce withdrawal sx in morphine or heroin abusers
naltrexone
opiod antagonist
blocks the effect of injected heroin for up to 48 hours
-> used to tx opiate-dependence
carbamazepine
anti-epileptic<br /><br />partial simple<br />partial complex<br />tonic clonic

can cause bone marrow suppression
clonazepam
anti-epileptic

myoclonic
corazepate
anti-epileptic
diazepam
anti-epileptic

status epilepticus
ethosuximide
anti-epileptic<br /><br />absence

can cause Stevens-Johnson
gabapentin
anti-epileptic
lamotrigine
anti-epileptic (new)
inhibits glutamate and aspartate release
bloks Na channels
phenobarbital
anti-epileptic<br /><br />febrile seizures in children

causes sedation
phenytoin
anti-epileptic
partial simple
partial complex
grand mal
status epilepticus
primidone
anti-epileptic

phenobarbital is its metabolite
tiagabine
anti-epileptic
topiramate
anti-epileptic
valproic acid
anti-epileptic

myoclonic
viagabatrin
anti-epileptic