Term
| Difference between GABAa and GABAb channels |
|
Definition
GABAa- ligand gated Cl- influx (Barb/Benzo)
GABAb- G protein K+ efflux |
|
|
Term
| short acting Benzo's and major use |
|
Definition
Triazolam
Oxazepam
Midazolam
Insomnia |
|
|
Term
|
Definition
Diazepam
Lorazepam
Triazolam
Temazepam
Midazolam
Alprazolam
Chlordiazepoxide (only weird name) |
|
|
Term
|
Definition
| Increase frequency of Cl- channel opening at GABAa |
|
|
Term
|
Definition
1st line- Static epileptics
1st line - Alcohol withdrawal (delirium tremens)
Anxiety (long acting)
Insomnia (short acting) |
|
|
Term
| BZ1 non -benzo agonist drugs and use |
|
Definition
Zolpidem
Zaleplon
Sleep disorders, loses the cognitive effects and less tolerance than BZ2 receptors |
|
|
Term
| Use for overdose of Benzo's |
|
Definition
|
|
Term
| 2 Major Barbiturates and their use |
|
Definition
Phenobarbital- seizures in pregnancy
Thiopental- induction of anesthesia (very short) |
|
|
Term
| Barbiturates Contraindicated in |
|
Definition
| Porphyria due to being a P450 inhibitor |
|
|
Term
| Ethylene glycol (antifreeze) broken down to____and major toxicity |
|
Definition
Glyceraldehyde-->Glycetic acid--->Oxalic acid
Nephrotoxic |
|
|
Term
| Methenol broken down to____and major toxicity |
|
Definition
Formaldehyde--->Formic Acid
Neurotoxic:ocular blindness |
|
|
Term
| Treatment of Ethylene and Methenol overdose |
|
Definition
|
|
Term
| Ethenol broken down to____and toxicity |
|
Definition
Acetaldehyde--->Acetic Acid
N/V, Hypotension,
Chronic: Hypoglycemia
Acetaldehyde soaks up Thiamine B1 (Karsakoff) |
|
|
Term
| Treatment of Ethenal abuse |
|
Definition
| Antiabuse (AA), Disulfaram |
|
|
Term
| Anticonvulsants that prevent Na+ influx of fast INACTIVE channels (inhibit propagation) |
|
Definition
Carbamezapine
Phenytoin
Valproic Acid (also works on T-type GABA channels) |
|
|
Term
| Anticonvulsants that increase inhibition of GABA |
|
Definition
Benzodiazapines (increase frequency)
Barbiturates (increase duration) |
|
|
Term
| Anticonvulsants that decreases the effects of glutamic acid (NMDA) |
|
Definition
| Felbamate and Lemotrigine |
|
|
Term
| Anticonvulsants that decrease Ca2+ influx through T type channels in thalamic neurons |
|
Definition
|
|
Term
| Partial (simple or complex) use___ |
|
Definition
Valproic acid
Phenytoin
Carbamazepine |
|
|
Term
|
Definition
Valproic acid
Phenytoin
Carbamazepine |
|
|
Term
| General Absent seizures use |
|
Definition
Ethosuximide
Valproic acid is second line |
|
|
Term
| Status epilepticus seizure use (emergency) |
|
Definition
Lorazepam or diazepam (Benzo's)
Phenytoin or Fosphenytoin |
|
|
Term
| Anticonvulsants especially Phenytoin decrease the efficacy of this which is really bad news |
|
Definition
|
|
Term
| Halothane and NO (has Anesthetics) which has the highest potency and which has the highest rate of induction |
|
Definition
Potency= Halothane (inverse to MAC)
Rate of induction= NO (inverse to Blood/Gas ratio) |
|
|
Term
| Major side effect of Halothane |
|
Definition
|
|
Term
|
Definition
Ketamine (Prototype)-NMDA receptor antagonist
Thiopental- short barbituate
Propfol- induce antiemetic
Fentanyl- opiate and antipain
Midazolom-anterograde amnesia |
|
|
Term
| Local Anesthetic kinetics |
|
Definition
| weak bases, non-ionized form get in nerve, and ionized form does blocking |
|
|
Term
| 3 each of the local anesthetic esters and amides and how they are metabolized |
|
Definition
Esters are metabolized by plasma esterases
Procain
Cocain
Benzocain
Amides (I before -cane) are liver metabolized
Lidocain
Bupivacain
Mepivacain |
|
|
Term
| What is given with a local Anesthetic to provide constriction of the vessels |
|
Definition
| a1 receptor agonists (not needed with cocain) |
|
|
Term
| 3 non-depolarizing (competitive inhibitors) of skeletal muscle |
|
Definition
D-tubocurarine
Atracurium
Mivacurium |
|
|
Term
| How is mivacurium metabolized: |
|
Definition
| Plasma cholinesterases (can negate this effect with an anti AChE) |
|
|
Term
| Atracurium breaks down to this metabolite which causes what side effect |
|
Definition
| Laudanosine causing seizures |
|
|
Term
| Progression of Paralysis of Competitive Skeletal muscle relaxants |
|
Definition
|
|
Term
| The only depolarizing (noncompetitive) skeletal muscle relaxant and describe the two phases |
|
Definition
Susccinylcholine
-Phase 1- Depolarization, Fasciculation, Prolong Depolarization and Flaccid Paralysis (AChE inhibitors increase phase 1)
-Phase 2 Desensitization (AChE don't work) |
|
|
Term
| Drugs causing malignant HTN and treatment |
|
Definition
Succinylcholine, Halothane
Tx: Dantrolene |
|
|
Term
| What is the MOA of malignant HTN |
|
Definition
| mutation in ryanodine receptors, a component of L type Ca2+ channels, causing increase release of Ca2+ |
|
|
Term
| Active metabolite of Opioids which is highly active |
|
Definition
|
|
Term
| Opioid acute triad side effects |
|
Definition
Miosis
Respiratory depression
coma
also know:
Constricts circular muscle (sphincters)
Relaxes longitudinal smooth muscle
increase biliary pressure (bad for biliary colic)
Also increases histamine release and behaves as a Hapten |
|
|
Term
| Opioid used in cough management |
|
Definition
|
|
Term
|
Definition
|
|
Term
| Full Agonist Opioid that has antimuscarinic characteristics, metabolized by cyt P450, and is a serotonin reuptake inhibitor (causing seizures) |
|
Definition
|
|
Term
| Full Agonist Opioid with very long HALF LIFE, so it can be used in maintenance of opiate addicts |
|
Definition
|
|
Term
| Two Opioid partial agonists which cause precipitation of withdrawal when used with a full agonist |
|
Definition
| Buprenorphine and Pentazocine |
|
|
Term
| Opioid mixed agonist at K and u recepetors |
|
Definition
|
|
Term
| Used for Opioid respiratory depression |
|
Definition
Naloxone
DO NOT GIVE VENTILATOR O2 |
|
|
Term
| Opioid used for both alcohol and opiate addiction |
|
Definition
|
|
Term
| Symptoms of withdrawal of Opioids |
|
Definition
Yawning
Lacrimation
Rhinorrhea
Salivation
Sweat |
|
|
Term
| Only effects of Opioids which don't have tolerance |
|
Definition
|
|
Term
| 4 Dopaminergic Neural Pathways and Results |
|
Definition
Nigrastriatal (D2a) - increase Movement
Mesolimbic-Mesocortical (D2c)-increase Reward
Tuberoinfundibular - Inhibits prolactin
Chemoreceptors - Increase emesis |
|
|
Term
Side Effects of Phenytoin (6)
(seizures + 1B antiarrhythmic) |
|
Definition
1. Osteomalacia- decrease Vit D
2. Teratogenic - Cleft Lip/palate
3. Megaloblastic anemia - decreases Folate
4. Gingivial Hyperplasia
5. SLE like syndrome
6. Hirsutism |
|
|
Term
| Side Effects of Carbamezapine (6) |
|
Definition
1. Osteomalacia - decrease vit D
2. Teratogenic - Cleft lip and Spina Bifida
3. SIADH
4. Megaloblastic Anemia
5. Aplastic Anemia
6. Steven Johnson |
|
|
Term
| Non-antiseizure use of Carbamezapine |
|
Definition
|
|
Term
| Side Effects of Valproic Acid |
|
Definition
1. Hepatotoxic
2. Spina Bifida
3. Thrombocytopenia
4. Alopecia
5. Pancreatitis |
|
|
Term
|
Definition
Facilitate GABAa action by increasing DURATION of Cl- channel opening.
Unlike Benzodiazepines, they can open receptors independent of GABA |
|
|
Term
| Barbiturates Inhibit what complex of the ETC |
|
Definition
|
|
Term
|
Definition
| Moves across BBB and is converted to Dopamine in the CNS by aromatic amino acid Decarboxylase. |
|
|
Term
| Carbidopa (used with Levodopa) MOA |
|
Definition
| inhibitis Aromatic Amino acid Decarboxylase in the peripheral to increase CNS availability |
|
|
Term
|
Definition
| Inhibit COMT which breaks down L-dopa into 3-O-methyl dopa. Allows for higher uptake and efficacy |
|
|
Term
|
Definition
| MAOb selective inhibitor to decrease breakdown of Dopamine in the CNS |
|
|
Term
| Name 3 Dopamine receptor Agonists and there use |
|
Definition
Bromocriptine
Pergolide
Pramipexole
For hyperprolactinemia and acromegaly |
|
|
Term
| Anti-ACh drugs used in Parkinsons (3) |
|
Definition
Benzotropine
Trihexypenidyl
Diphenhydramine |
|
|
Term
| Antiviral for Parkinson's/MOA/ and its major side |
|
Definition
Amantidine
Blocks muscarinic receptors
Livedo Reticularis- Purpilish blood vessels around ankles |
|
|
Term
| 5 Antipsychotic Drugs and MOA |
|
Definition
Haloperidol
Triflouroparazine
Fluphenazine
Thioridazine
Chlorpromazine
Block D2 receptors |
|
|
Term
| The 3 antipsychotics with higher neuro sides. Also the extrapyramidal timing sequence |
|
Definition
Haloperidol
Trifluoroperazine
Fluphenazine
4 hours- Acute dystonia
4 days - Akinesia
4 weeks- Alkathisia
4 months- Tardive Dyskinesia |
|
|
Term
| Side affects of antipsychotics thioradazine/Chlorpromazine |
|
Definition
Thioradazine- Retinal Deposits
Chlorpromazine- Corneal Deposits (CC) |
|
|
Term
| Sides effects of Antipsychotics |
|
Definition
1. Extrapyramido sides (high potency- haloperidol, trifluoroparazine, and fluphenazine
2. Endocrine- hyperprolactinemia/galactorrhea
3. Block alpha, histamine, muscarinic blocks
4. Neuroleptic malignant syndrome (use dantrolene)
5. Tardive Dyskinesia |
|
|
Term
| Atypical Antipsychotics (6) |
|
Definition
Atypical for Old CLOSets to QUIETly RESPIRE f/ A to Z
Olanzapine
Clozapine
Quetiapine
Resperidone
Aripiprazole (Partial Agonist of D2)
Ziprasidine |
|
|
Term
|
Definition
|
|
Term
| Uses of Antipsychotics and Atypical Antipsychotics |
|
Definition
Schizophrenia, Psychosis, acute manic, Tourrette's
Atypicals improve negative symptoms and also used in OCD, anxiety, and depression. Also fewer extrapyramidal sides |
|
|
Term
|
Definition
| Blockage of some part of the phosphoinositol cascade. Decreasing PIP2, DAG, IP3 |
|
|
Term
|
Definition
Hypothyroid
Teratogenic
Diabetes Insipidus |
|
|
Term
|
Definition
DOC for BIpolar Disorder
Manic Relapse
SIADH |
|
|
Term
|
Definition
Stimulates 5HT1a, takes 1/2 weeks for effects
Generalized Anxiety Disorder (Im ANXIOUS for the BUS)
Does not interact with Alcohol |
|
|
Term
| Tricyclic Antidepressants (3) |
|
Definition
Amitriptyline
Imipramine
Clonipramine
(Any -triptyline, -pramine) |
|
|
Term
| MOA of Tricyclic Antidepressants |
|
Definition
Block reuptake of NE and Serotonin
also block muscarinic and alpha |
|
|
Term
| Use of Tricyclin antidepressants |
|
Definition
Major Depression
Bedwetting
OCD
Fibromyalgia |
|
|
Term
| Side Effects of Tricyclic antidepressants ( |
|
Definition
1. Triad: Convulsion, Cardio, Coma
2. Alpha Blockade (think anti-HTN meds)
3. Anti muscarinic
4. Hypertensive crisis with other NE increasing drugs
5. Seritonin Syndrome with other increasers |
|
|
Term
|
Definition
Fluoxetine
Paroxetine
Sertaline |
|
|
Term
|
Definition
| Serotonin Reuptake inhibitors which take 4-8 weeks to take effect |
|
|
Term
|
Definition
Depression
OCD
Bulimia
Social Phobia
Premenstrual Dysmorphic Disoreder |
|
|
Term
|
Definition
1. Sexual Dysfunction (Older men)
2. Serotonin Syndrome
3. Bruxism- teeth grinding |
|
|
Term
|
Definition
| Inhibit serotonin and NE reuptake (Nonselective and devoid of ANS side effects) |
|
|
Term
| what are 4 MAO inhibitors |
|
Definition
Tranylcypromine
Phenelzine
Isocarboxazide
Selegiline |
|
|
Term
|
Definition
Atypical depression
Anxiety
Hypochondriasis |
|
|
Term
|
Definition
1. Hypertensive Crisis w/ increases of NE
2. Serotonin Syndrome |
|
|
Term
| Serotonin Syndrome symptoms and Drugs |
|
Definition
sweating, rigidity, myoclonus, hyperthermia, ANS instability, seizures
SSRI
TCA
MAO inhibitors
Meperidine |
|
|
Term
| Hypertensive Crisis symptoms and Drugs |
|
Definition
Increase BP, arrhythmia, excitation, hyperthermia
Tyramine (wine and cheese parties)
MAO (-)
TCA's
ephedrines
Amphetamines
Levodopa
alpha agonist |
|
|
Term
|
Definition
Increase NE and dopamine by unknown mech (dopamine>NE)
Smoking cessation |
|
|
Term
|
Definition
alpha 2 antagonist
serotonin 5 HT2-3 antagonist |
|
|
Term
|
Definition
|
|
Term
|
Definition
Inhibits Serotonin re-uptake (SSRI like) and strong alpha blockade
Insomnia |
|
|
Term
| 4 Serotonin Receptors, where they are found, and Drugs that work at each |
|
Definition
5HT1-CNS(inhibitory), smooth muscle
Buspirone (General Anxiety Disorder)
Sumatriptin (Migrains)
5HT2- CNS (excitatory), smooth muscle, uterine, platelets
Olanzapine (Atypical Antidepressent) (schizo)
Cyproheptadine (carcinoid, Gi tumors, anorexia nervosa)
5HT3- Area Postrema and peripheral sensory/enteric nerves
Ondansetron (antiemetic)
5HT4- GI and myenteric nerves
Tegaserod (IBS with constipation) |
|
|
Term
| *TCA Antidepressents w/ NE> serotonin activity? Which two can be used for ADHD? |
|
Definition
Amytriptyline, imipramine, desipramine.
#1 is Desipramine (metabolite of Imipramine) |
|
|
Term
| *Two most commonly used TCAs for ADHD |
|
Definition
|
|
Term
| *TCA w/ predominantly serotonin> NE and has less anti cholinergic effects than the others? |
|
Definition
|
|
Term
| *Which TCA associated w/ Sudden Cardiac Death in kids A(also low seizure threshold)? |
|
Definition
|
|
Term
| *This TCA is used to control bed wetting? |
|
Definition
|
|
Term
| *This TCA can be used for OCD and depression |
|
Definition
|
|
Term
| TCA, sometimes used for migrane, many anti cholinergic effects, heavily sedating |
|
Definition
|
|
Term
| Atomoxetine indirectly increases some dopamine in the prefrontal cortex but has not been found to have abuse potential, trigger mania, or seizures since dopamine is not elevated in the ______ |
|
Definition
| nucleus accumbens, straitu |
|
|
Term
|
Definition
| Increased suicidal thoughts; LIVER |
|
|
Term
| Bupropion indicaitons/ contraindications |
|
Definition
I: General depression, smoking cessation, off label: ADHD refractive to stimulants
C: seizure disoders/bulemia (electrolyte abnor. -> seizure) |
|
|
Term
| Guanfacine MOA and indication |
|
Definition
| A2 agonist; approved for ADHD |
|
|
Term
| Injury to frontal cortex and *hippocampus* involved with |
|
Definition
| cognitive aspects of depression like memory impairment, worthlessness, hopelessness, guilt, doom suicide |
|
|
Term
| Injury to *ventral striatum, nucleus accumbens, amygdala* involved w/ |
|
Definition
| losses to emotional stimuli . Anhedonia, anxiety, amotiviation |
|
|
Term
| Loss of appetite, sleep problems, loss of interest in sex |
|
Definition
|
|
Term
| Corticosteroids decrease BDNF expression but _____ increase it |
|
Definition
|
|
Term
| Contraindications of TCAS |
|
Definition
1) severe hyperpyretic crisis, convulsions, death if used within two weeks of *MAOI* therapy
2)lower SEIZURE threshold
3) CHF/ARRYTHMIAS
4) recovery from MI (depress fast Na channels)
5) potentiate CNS depressants |
|
|
Term
Indications include OCD, Depression , Autism and Premature ejaculation.
Highly Sedative Most selective for Serotonin |
|
Definition
|
|
Term
| TCA that can be used as adjunct for COPD and sleep apnea due to stimulation of central respiratory centers |
|
Definition
|
|
Term
| Nortriptyline vs. Amitriptyline |
|
Definition
| Nortriptyline (a metaboliste of amitriptyline) is less sedating and has less muscarinic activity |
|
|
Term
| Acute intermittant porphyria can be exacerbated by this class of antidepressants |
|
Definition
|
|
Term
| High plasma protein binding, half life long, can increase levels of other drugs |
|
Definition
|
|
Term
| Thioridazine can be increased by SSRIs leading to it's black box warning of |
|
Definition
| QT prolongation/arrythmias |
|
|
