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215 Cards in this Set
- Front
- Back
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Penicillin (MOA)
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bind pbps, block transpeptidase cross-linking of cell wall, bacteria autolysin activity
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Methicillin (toxicity)
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interstitial nephritis
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Ampicillin, Amoxicillin (clinical use)
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Gram + and H. influenza, E. coli, Listeria, Proteus, Salmonella and enterococci
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Ampicillin (toxicity)
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pseudomembranous colitis
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Ticarcillin, carbenicillin, pipercillin (clinical use)
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Pseudomonas and gram - rods
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B-lactamase inhibitors
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clavulanic acid, sulbactam, tazobactam
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Bacteriostatic
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Erthromycin, Clindamycin, Sulfamethoxazole, Trimethoprim, Tetracyclines, Chloramphenicol
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Bacteriocidal
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Vancomycin, Fluoroquinolones, Pencillin, Aminoglycosides, Cephalsporins, Metronidazole
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Cephalosporins (MOA)
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B-lactam drugs that inhibit cell wall synthesis but less suspectible to penicillins
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1st generation Cephs (names and clinical use)
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Cefazolin, Cephalexin
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2nd generation Cephs (names)
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Cefaclor, Cefoxitin, Cefuroxime, Cefamandole
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2nd generation Cephs (clinical use)
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HEN PEcKS
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3rd generation Cephs
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Ceftriaxone, Cefotaxime, Ceftazidine
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4th generation Cephs
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Cefepime
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Cephs (toxicity)
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Nephrotoxicity with aminoglycosides
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Aztrenam (clinical use)
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Gram - rods
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Imipenem/cilastatin (MAO)
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B-lactamase resistant carbapenem.
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Imipenem and Meropenem (clinical use)
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Broadest spectrum
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Vancomycin (MAO and clinical use)
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inhibits cell wall mucopeptide formation by binding D-ala D-ala
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Vancomycin (Resistance)
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amino acid change from D-ala to D-lac
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Vancomycin (Toxicity)
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Nephrotoxicity, Ototoxicity, Thrombophlebitis, RED MAN SYNDROME
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30S inhibitors
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Aminoglycosides
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50S Inhibitors
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Chloramphenicol, Clindamycin
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Aminoglycosides (names and MAO)
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Gentamicin, Neomycin, Amikacin, Tobramycin, Streptomycin
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Aminoglycosides (clinical use and toxicity)
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MUST HAVE OXYGEN--> ineffective against anaerobes
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Aminoglycosides (resistance)
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transferase enzyme or enzymes that inactivate by adenylation, acetylation, and phosphorylation
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Tetracyclines (MAO)
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prevent attachment of aminoacyl tRNA
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Tetracyclines (clinical use)
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Vibrio chlorea, acne, Chlamydia, Ureaplasma, Mycoplasma, H. Pylori, Borrelia, Rickettsia
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Tetracylcine (toxicity)
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teeth discoloration, inhibition of bone growth, photosensitivity
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Macrolides (names and MAO)
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ACE (azithromycin, clarithromycin, erythromycin)
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Macrolides (clinical use)
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Mycoplasma, Legionalla, Chlamydia, Neisseria
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Macrolides (toxicity)
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Prolonged QT interval, GI discomfort, acute cholestatic hepatitis
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Chloramphenicol (MAO and clinical use)
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inhibits 50S peptidyltransferase
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Chloramphenicol (toxicity)
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Aplastic anemia
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Clindamycin (MAO)
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blocks peptide bond formation at 50S ribosomal subunit
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Drugs used for VRSA
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Streptogramins (quinupristin/dalfopristin)
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Sulfonamides (MAO)
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PABA antimetabolite
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Sulfonamides (toxicity)
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hemolysis in G6PD deficiency
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Trimethoprim (MAO and toxicity)
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inhibits bacterial dihydrofolate reductase
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Polymyxins (MAO)
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bind to cell membranes of bacteria and disrupt their osmotic properties
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Polymyxins (clinical use and toxicity)
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used for resistant gram - infections
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Ethambutol (MAO)
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inhibits arabinosyl transferase which polymerizes arabinose into arabinoglactan
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Ethambutol (toxicity)
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red green color blindness
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Rifampin (MAO)
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inhibits DNA-dependent RNA polymerase
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Rifampin (toxicity)
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hepatotoxicity, P-450 inducers, orange body fluids
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Tetracycline (resistance)
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PUMP
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Macrolides (resistance)
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methylation of rRNA
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Azoles (MAO)
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inhibit fungal sterol synthesis (blocks 14-alpha-demethylase)
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Flucytosine (MAO and toxicity)
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inhibits DNA synthesis by conversion to 5-fluorouracil
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Caspofugin (MAO and clinical use)
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inhibits cell wall synthesis by inhibiting synthesis of B-glucan
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Terbinafine (MAO and clinical use)
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inhibits squalene epoxidase
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Griseofulvin (MAO)
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interferes microtubule function; disrupts mitosis
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Griseofulvin (clinical use and toxicity)
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dermatophytoses (oral treatment)
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Amantadine (MAO)
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blocks viral penetration/uncoating
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Amantadine (clinical use and toxicity)
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Influenza A and Parkinson's disease
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Zanamivir, Oseltamivir (MAO)
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inhibit influenza neuraminidase
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Acyclovir (MAO)
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Inhibits DNA synthesis in HSV, VZV, and EBV. Activated by viral thymidine kinase (TK- strains are resistant).
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Acyclovir (toxicity)
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crystalline nephropathy
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Ganciclovir (MAO)
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Inhibits DNA synthesis. Effective against herpes viruses CMV and HSV; for CMV requires bioactivation via viral phosphotransferase.
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Ganiciclovir (toxicity)
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leukopenia, neutropenia, thrombocytopenia, renal toxicity
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Foscarnet (MAO)
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Viral DNA polymerase inhibitor that binds to the pyrophosphate-binding site of the enzyme. Does not require activation by viral kinase.
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Foscarnet (clinical use and toxicity)
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Uses: CMV retinitis in immunocomp pts. when gancyclovir fails. Tox: Nephrotoxicity
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Protease Inhibitors (-navir) (MAO)
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inhibit maturation of new virus by blocking protease in progeny virus
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Protease Inhibitors (toxicity)
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GI intolerance, hyperglycemia, kidney stones, thrombocytopenia
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NRTI (names)
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Zidovudine, Abacavir, Didanosine (ddI), Lamivudine (3TC), Stavudine (d4T), and Zalcitabine (ddC
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NNRTI (names)
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Efavirenz, Declaviridine, Nevirapine
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Reverse transcriptase inhibitors (MAO)
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inhibit reverse transcriptase of HIV
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Reverse transcriptase inhibitors (toxicity)
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bone marrow suppression, peripheral neuropathy, lactic acidosis (NRTI), rash (NNRTI)
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Enfuviritide (MAO)
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bind viral gp41 subunit
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Maraviroc (MAO)
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blocks CCR5 protein on T-cell surface to prevent viral entry
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Interferons (MAO)
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Glycoproteins synthesized by virus-infected cells block replication of both RNA and DNA viruses
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Interferon alpha
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used in hep B and C, kaposi's sarcoma
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interferon beta
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Multiple sclerosis
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interferon gamma
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NADPH oxidase deficiency
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Praziquantel (MAO and clinical use)
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Increases membrane permeability to Ca2+ causing muscle contraction followed by paralysis.
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Ivermectin (MAO)
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Intensifies GABA-mediated neurotransmission in nematodes, but no access to CNS in humans.
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Mebendazole (MAO)
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Inhibits microtubule synthesis and glucose uptake in
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Sodium Stibogluconate (MAO)
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Inhibits glycolysis at PFK reaction. Used against LESHMANIA DONOVANI.
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Nifurtimox (MAO and clinical use)
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Forms intracellular oxygen radicals, which are toxic to the organism. Used against TRYPANOSOMA CRUZI.
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Cyclosporine (MAO)
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inhibits calcineurin --> prevents production of IL-2 and its receptor
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Cyclosporine (toxicity)
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nephrotoxic, gingival hyperplasia, hirtuism
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Tacrolimus (FK506) MAO
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binds to FK-binding protein --> inhibiting secretion of IL-2
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Azathioprine (MAO)
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precursor of 6-mercaptopurine
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Muromonab-CD3 (OKT3) MAO
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monoclonoal antibody that binds to CD3 on the surface of T cells
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Sirolimus (MAO
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blocks tyrosine kinase. binds to mTOR.
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Clinical use for Aldesleukin (interleukin2)
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renal cell carcinoma
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Clinical use for erythropoietin
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Anemia esp in renal failure
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alpha 1 receptor
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increase vascular smooth muscle contraction, pupil dilator muscle (mydriasis), increase intestinal and bladder sphincter muscle contraction, decrease renin release
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alpha 2 receptor
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decrease insulin release, decrease sympathetic outflow
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Beta 1 receptor (heart and kidney)
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increase HR, contractility, renin release
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Beta 2 receptor
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vasodilation, bronchodilation, increase heart rate and contractility, increase insulin release, decrease uterine tone
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M1
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CNS
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M2 (heart)
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decrease HR and contractility of atria
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M3 (peripheral)
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increase exocrine gland secretions, miosis, accommodation
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Bethanechol
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Cholinomimetic. Activates bowel and bladder smooth muscle. Resistant to AChE. Uses: Postoperative and neurogenic ileus and urinary retention
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Carbachol
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Cholinomimetic. ACh analog. Uses: Glaucoma, pupillary constriction, and relief of intraocular pressure.
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Pilocarpine
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Cholinomimetic. Contracts ciliary muscle of eye (open angle), pupillary sphincter (narrow angle). Resistant to AChE. Uses: Glaucoma, Sjoren, Stimulator of tears, sweat, and saliva.
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Neostigmine
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Cholinesterase inhibitor. Increase endogenous ACh. Little CNS effect. Uses: Postoperative ileus and urinary retention, MG, reversal of neuromuscular blockade.
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Physostigmine
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Glaucoma, crosses BBB. atropine overdose
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DUMBBELSS
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Diarrhea, Urination, Miosis, Bronchospasm, Bradycardia, Excitation of skeletal muscle and CNS, Lacrimation, Sweating, Salivation.
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Muscarnic antagonists
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Atropine, Benztropine, Scopolamine, Ipratropium, Oxybutyin, Methscopalamine
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Atropine
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Blocks DUMBBELSS
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Don't use Atropine in ...
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acute angle glaucoma in elderly
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Hexamethonium
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Nicotinic antagonist (blocks para and sympathetic). Uses: Ganglionic blocker. In experimental models, prevents vagal reflex responses to changes in blood pressure - prevents reflex brady.
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Hexamethonium (toxicity)
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Tox: Orthostatic Hypotension, Blurred vision, constipation, sex dysfunction
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Epinephrine (MAO)
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Direct sympathomimetics. affinity for all receptors. low doses (B1), high doses (alpha1).
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Epinephrine (clinical use)
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anaphylaxis, glaucoma (open angle), asthma, hypotension
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Epinephrine (toxicity)
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tachycardia, hypertension, MI, pulmonary edema and hemorrhage
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Norepinephrine (MAO)
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Adrenoceptor agonist prototype: acts at B1- and all A adrenoceptors
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Norepinephrine (clincal use and toxicity)
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hypotension
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Isopropterenol (low dose epi)
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B1 and B2 agonist catecholamine prototype: bronchodilator, cardiac stimulant. Always causes tachycardia because both direct and reflex actions increase HR. Tox: arrhythmias, tremor, angina.
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Dopamine
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Neurotransmitter and agonist drug at dopamine receptors: used in shock to increase renal blood flow (low dose) and positive inotropic effects (moderate dose).
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Dobutamine
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b1>b2
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Dobutamine (clinical use)
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shock, heart failure, cardiogenic shock
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Phenylephrine
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A1 > A2. Uses: Pupillary dilation, vasoconstriction, nasal decongestion
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B2 selective agonist
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Metaproterenol, Albuterol, Salmeterol, Terbutaline
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Nonselective alpha blockers
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Phenoxybenzamine (irreversible)
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Prazosin, Terazosin, "-osins"
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Alpha1-selective blocker prototype: used in HTN and benign prostatic hyperplasia. Tox: first-dose orthostatic hypotension but less reflex tachycardia than nonselective a blockers.
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Alpha 2 blockers
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Mirtazapine (depression) and Yohimbine
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(Inducers) Queen Barb Steals Phen-phen and Refuses Greasy Carbs Chronically
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Quinidine, Barbiturates, St. John's wort, Phenytoin, Rifampin, Griseofulvin, Carbamazepine, Chronic alcohol use
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(Inhibitors) Inhibit yourself from drinking beer from a KEG because it makes you Acutely SICk
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Sulfonamides, Isoniazid, Cimetidine, Ketoconazole, Erythromycin, Grapefruit juice, Acute alcohol use
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HMG-CoA reductase inhibitors (MAO)
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inhibit cholesterol precursor, upregulates LDL receptors
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HMG-CoA reductase inhibitors (toxicity)
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hepatitis
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Niacin (MAO)
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inhibits lipolysis in adipose tissue.
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Niacin (toxicity)
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flushed skin (decresed by aspirin)
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Bile acid resins (cholestyramines)
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Prevent intestinal reabsorption of bile acids. Liver must use cholesterol to make more
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Bile acid resins (toxicity)
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GI discomfort, decrease absorption of fat-soluble vitamins. GALLSTONES
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Fibrates (MAO)
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upregulate LPL--> increase in TG clearance
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Fibrates (toxicity)
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myositis
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Hydralazine
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Antihypertensive. Arteriolar vasodilator, orally active. Uses: Severe HTN, CHF, HTN in preg (with Methyldopa). Metabolized by Acetylation. Tox: Tachycardia, Salt and H2O retention, Lupus like syndrome.
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Minoxidil
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K+ channel opener that hyperpolarizes and relaxes vascular smooth muscle. Uses: Severe HTN, baldness. Tox: Hypertrychosis, Pericadial effusion, Reflex tachy, Angina, Salt retention.
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Nifedipine
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Dyhydropiridine calcium channel blocker. Vasoselective (N>D>V). Uses: Hypertension, Angina, Printzmetal's angina, Reynaud's. Tox: Cardiac depression, AV block, edema, flushing, dizziness, constipation.Others: Amlodipine (HF), Nimodipine (subarachnoid hemmorhage), Nicardipine
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Fenoldopam
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D1 receptor antagonist. Relaxes smooth muscle. Powerful vasodilator. Uses: Hypertensive emergencies
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Digoxin
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Cardiac glycoside. Direct inhibitor of Na+/K+ pump leading to indirect inhibition of Na+/Ca++ exchanger and increasing intracellular calcium levels. Stim. vagus. T1/2 40hrs. Uses: CHF, A-fib. Tox: Calcium overload arrhythmias, GI upset.
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Quinidine, Procainamide, Disopyramide
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. Uses: Atrial and vetricular arrhythmias. Tox: Cinchonism - headache, tinnitus, Thrombocytopenia, Torsades. Others: Procainamide, Dysopyramide. Increase AP
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Lidocaine, Mexiletine, Tocainide
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Selectively affects ischemic or depolarized vent. tissue. Uses: Acute V-arrhythmias (post MI) and digoxin tox. Tox: Local anesthetic, CNS stim/ dep, cardiovascular depression. Others: Mixeiletine (Oral), Tocainide. Decrease AP
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Flecainide, Encainide, Propafenone
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Class 1C antiarrhythmic. No effect on AP. Uses: V-tach and rapid SVT with WPW. Tox: Proarrhythmic (post MI), Prolongs refractory period in AV. Others: Encainide, Propafenone
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Adenosine
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Unclassified antiarrhythmic. Parenteral only. Hyperpolarizes AV nodal tissue causing block for 10 - 15 secs. Very short acting. Uses: Drug of choice in abolishing/ diagnosing SVT. Tox: flushing, hypotension, chest pain
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Mg++
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Effective in torsades de pointes and digoxin toxicity.
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Lispro, Aspart, Regular Insulin
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Short acting insulin analogs. Bind insulin receptor (TK). Liver - Increase glucose stored as glycogen. Muscle - Increase glycogen and protein synthesis, K+ uptake. Fat - Aids TG storage. Uses: DM1, DM2, Hyper K+. Tox: Hypoglycemia
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NPH
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Intermediate acting insulin analog. Bind insulin receptor (TK). Liver - Increase glucose stored as glycogen. Muscle - Increase glycogen and protein synthesis, K+ uptake. Fat - Aids TG storage. Uses: DM1, DM2, Hyper K+. Tox: Hypoglycemia
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Glargine, Detemir
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Long acting insulin analogs. Bind insulin receptor (TK). Liver - Increase glucose stored as glycogen. Muscle - Increase glycogen and protein synthesis, K+ uptake. Fat - Aids TG storage. Uses: DM1, DM2, Hyper K+. Tox: Hypoglycemia
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Sulfonlyureas
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Blocks K+ channels in pancreatic B cells, causing depolarization and release of insulin. Uses: Only DM2. Tox: hypoglycemia, weight gain, cholestatic jaundice
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Metfomin
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Oral biguanide hypoglycemic. Decreases hepatic gluconeogenesis, Increase Glycolysis, and peripheral glucose uptake (insulin sensitivity). Uses: Oral, can be used in DM1. Minimal hypoglycemia or weight gain. Tox: Lactic acidosis. DON'T use in renal failure
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Pioglitazone, Rosiglitazone
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peroxisome proliferator-activator receptors (PPARs) enhances target tissue sensitivity to insulin.
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Acarbose, Miglitol
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Alpha-glucosidase inhibitors. Delayed sugar hydrolysis and glucose absorption leads to decreased postprandial hyperglycemia. Uses: DM2. Tox: GI disturbances.
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Pramlintide
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Mimetic.(amylin analog) Decreases glucagon release. Uses: DM2. Tox: Hypoglycemia, nausea, diarrhea
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Exenatide
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GLP-1 analog. Increased insulin, decreased glucagon release. Uses: DM2. Tox: Nausea vomiting, pancreatitis, weight loss
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Propylthiouracil, Methimazole
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Antithyroid drug. Inhibits tyrosine iodination and coupling reactions. Orally active. Uses: Hyperthyroidism. Tox: Rash, agranulocytosis (rare). Methimazole is a possible teratogen
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Levothyroxine, triodothyronine
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Thyroid replacement. Uses: Hypothyrodism, myxedema. Tox: Tachycardia, heat intolerance, tremors, arrhythmias.
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Glucocorticoids
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Decrease production of leukotrienes and prostaglandins by inhibiting phospholipase A2 and expression of COX2. Uses: Addisons disease, inflammation, immune suppression, asthma. Tox: Cushing's syndrome. Adrenal insufficiency when drug is stopped after chronic use.
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Bismuth, Sulfralfate
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Binds to ulcer base, provides physical protection, and allows HCO3- secretion to establish pH gradient in mucous layer. Uses: Ulcer healing and traveler's diarrhea.
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Misoprostol
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PGE1 analog. Increased production of mucus and decreased acid secretion
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Antacids
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Can affect absorption, bioavailability, or excretion of other drugs due to alteration of gastric/ urine pH. Tox: Aluminum Hyd.- conspitation, Mag Hyd. - Diarrhea, Cacium Carb - Hypercalcemia. All can cause hypokalemia.
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Sulfasalazine
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A combination of Sulfapyridine (antibacterial) and 5-aminosalicylic acid (anti-inflammatory). Activated by colonic bacteria. Uses: UC, Crohn's. Tox: Malaise, nausea, sulfonamide toxicity, reversible oligospermia.
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Metaclopramide
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D2 receptor antagonist. Increase resting tone, contractility, LES tone, motility. Uses: Diabetic and post-surgery gastroparesis. Tox: Parkinsonian effects, Restlessness, Drowsiness, Drug interactions with Digoxin and diabetic agents.
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Dimercaprol
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chelating agent used in treatment of arsenic poisoning by displacing arsenic ions from sulfhydryl
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Streptokinase
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Thrombolytic. Protein from streptococci that accelerates
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Alteplase
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Thrombolytic. Human recombinant tissue plasminogen
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Clopidogrel
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Blocks platelet ADP receptors irreversibly and inhibits platelet
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Brimonidine
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Alpha agonist used in Glaucoma. Decrease aqueous humor synthesis. No pupillary or visual changes.
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B- blockers: Timolol, betaxolol, carteolol
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Decrease aqueous humor synthesis. No pupillary or visual changes.
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Latanoprost
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Prostaglandin used in Glaucoma. Increase outflow of aqueous humor. Tox: Darkens color of iris (browning)
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Opioid Analgesics (MAO)
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agonists at opoid receptors to modulate synaptic transmission-- open K+ channels, close Ca2+ channels --> decrease synaptic transmission
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Opioid Analgesics (Clinical use)
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Pain, cough suppression (dextromethorphan), diarrhea (loperamide and diphenoxylate), maintence program for addicts
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Opioid Analgesics (Toxicity)
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respiratory depression, pinpoint pupils, CNS depression
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Butorphanol
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Partial agonist at opioid mu receptors, agonist at kappa receptors. Uses: Pain, causes less resp. depression than full agonists. Tox: Causes withdrawal if on full opioid agonist.
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Tramadol (MOA)
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inhibits NE and serotonin reuptake (works at multiple receptors)
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Phenytoin (MAO)
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Anticonvulsant. Used for tonic-clonic and partial seizures;
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Phenytoin (toxicity)
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sedation, diplopia, gingival
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Barbiturates (MAO)
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Facilitate GABA by increasing DURATION of Cl- channel opening --> decrease neuron firing
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Barbiturate (clinical use)
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sedative for anxiety, seizures, insomia
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Barbiturate (toxicity)
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additive CNS depression with alcohol, respiratory and CV depression. Induction of P450
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Gabapentin
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Anticonvulsant: structural analog of GABA that facilitates its
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Lamotrgine
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Newer antiepiliptic drug for absence and partial seizures; also
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Carbamazepine
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Anticonvulsant: used for tonic-clonic and partial seizures;
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Valproic acid
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Anticonvulsant: primary drug in clonic-tonic, absence, and
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Ethosuximide
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Anticonvulsant: primary in absence seizures; may block T-type Ca2+ channels in thalamic neurons. Tox: GI distress; safe in
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Baclofen (MOA)
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binds to GABAb. increase K+ efflux. hyperpolarization
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Benzo's (MAO)
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Facilitate GABAa action by increasing FREQUENCY of Cl- channel opening. decrease REM sleep
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Benzo's (clinical use)
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anxiety, spastic, status epilepticus, detox, night terrors and sleepwalking
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Benzo's (toxicity)
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treat overdose with Flumazenil
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Vigabatrin
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Anticonvulsant. Irreversibly inhibits GABA transaminase - increase in GABA.
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Halothane
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General anestheti. Inhaled halogenated hydrocarbon. Tox: cardiovascular and respiratory depression and relaxation of skeletal and smooth muscle. Use is declining because of sensitization of heart to catecholamines and occurrence (rare) of hepatitis. Others: Fluranes + NO.
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Midazolam
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Most common drug used for endoscopy. Used adjuntively with gaseous anesthetics and narcotics. May cause severe postoperative respiratory depression, decrease in BP, and amnesia.
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Ketamine
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PCP analog that acts as dissociative anesthetic. Block NMDA receptors. Cardovascular stimulant. Cause disorientaion, hallucination, and bad dreams. Increase cerebral blood flow.
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Succinylcholine
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Depolarizing neuromuscular relaxant. Short duration
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Tubocurarine
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Nondepolarizing neuromuscular blocking agent. Competitive nicotinic blocker (ACh). Releases histamine and may cause hypotension. Analogs: pancuronium, atracurium, vecuronium, and other "-curiums" and "-oniums." Tox: respiratory paralysis. Antidote: cholinesterase inhibitor, eg, neostigmine.
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Dantrolene (clinical use)
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used in treatment of malignant hyperthermia and to treat neuroleptic malignant syndrome
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Dantrolene (MAO)
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prevents the release of Ca2+ from the sarcoplasmic reticulum of skeletal muscle by blocking ryanodine receptors
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Agonize dopamine receptors
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Bromocriptine, pergolide, pramipexole, ropinirole
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Prevent dopamine breakdown
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Selegine (MAO type b inhibitor)
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l-dopa
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Dopamine precursor: used in parkinsonism, usually combined
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Memantine
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Alzheimers drug. NMDA receptor antagonist; Helps prevent excitotoxicity (mediated by Ca++). Tox: Dizziness, confusion, hallucinations
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Donepezil
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Alzheimers drug. Acetylcholinesterase inhibitors. Tox: Nausea, vomiting, insomnia.
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Huntington drugs
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Reserpine + tetrabenazine - amine depleting. Haloperidol - dopamine receptor antagonist. Dz - Increase dopamine, decrease GABA + ACh.
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Sumatriptan
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5-HT1D receptor agonist: used to abort migraine attacks. Tox:
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Haloperidol + azines
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Antipsychotic: blocks brain dopamine D2 receptors (Increase cAMP). Uses: Schizophrenia, Psychosis, Acute mania, Tourette's. Tox: marked EPS dysfunction (Hal, Flu drugs), hyperprolactinemia; neuroleptic malignant syndrome, tardive dyskinesia
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NMS
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FEVER
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Tardive dyskinesia
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Sterotypic oral-facial movements due to long-term antipsychotic use. Often irreversible
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Olanzapine
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Atypical antipsychotic; high-affinity antagonist at 5-HT2 receptors with minimal extrapyramidal side effects; improves
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Clozapine
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Atypical antipsychotic: low affinity for dopamine D2 receptors, higher for D4 and 5-HT2A receptors; fewer EPS adverse
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Lithium
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Antimanic prototype: a primary drug in mania and bipolar affective disorders; blocks recycling of the phosphatidylinositol
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Buspirone
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Anxiolytic: partial agonist that interacts with 5-HT1A receptors; slow onset (1-2 weeks). Uses: GAD. Minimal potentiation of CNS depressants, including ethanol; negligible abuse liability.
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TCAs (Imipramine, Amytriptyline, Clomipramine, Doxepin)
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blocks reuptake of norepinephrine and serotonin. Uses: Major depression, bedwetting (Imi), OCD (Clop), fibromylagia.
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TCAs (toxicity)
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atropine-like, postural hypotension, sedation, cardiac arrhythmias in overdose, additive effects with other CNS depressants. 3-C: Convulsions, Coma, and Cardiotox.
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SSRIs (Fluoxitine, Paroxitine, Sertaline, Citalopram) (MAO and clinical use)
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selective serotonin reuptake inhibitor
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SSRI (toxicity)
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Tox: CNS stimulation, sexual dysfunction, seizures
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Venlafaxine, Duloxetine
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Serotonin and NE reputake inhibitors. Uses: Depression. Venla - GAD. Dulo - Diabetic peripheral neruopathy. Tox: Hypertension
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Phenelzine, Tranylcypromine, Isocarboxazid (MAO and clinical use)
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Irreversible nonselective monoamine oxidase (MAO) inhibitor. Increases level of neurotransmitters. Uses: backup drug for atypical depression, hypochondrias
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Phenelzine, Tranylcypromine, Isocarboxazid (toxicity)
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Tox: malignant hypertension with indirect-acting sympathomimetics and tyramine, serotonin syndrome with serotonergic drugs.
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Selegiline
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MAO-B inhibitor: selective inhibitor of the enzyme that metabolizes dopamine (no tyramine interactions). Uses: Parkinson's disease. Tox: GI distress, CNS stimulation, dyskinesias, serotonin syndrome if used with selective serotonin reuptake inhibitors.
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Bupropion
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Atypical antidepressant. Used in smoking cessation. Increases NE and dopamine via unknown mech. Tox: Stimulant effect, headache, seizure in bulemic patients.
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Mirtazapine
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Atypical antidepressant. Alpha 2 agonist (increase release of NE + Ser) and potent Serotonin receptor antagonist. Used in anorexia. Tox: Sedation, Increased appetite, weight gain, ortho hypotension.
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Trazodone
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Atypical antidpressant. Primarily inhibits serotonin reuptake. Used for insomnia, as high doses are needed for anti-depressant effects. Tox: Sedation, nausea, priapism, postural hypotension
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