Shared Flashcard Set

Details

CNS PHARM
-
114
Agriculture
Kindergarten
04/10/2013

Additional Agriculture Flashcards

 


 

Cards

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
Benzo's (7) drugs
Definition
Diazepam
Lorazepam
Triazolam
Temazepam
Midazolam
Alprazolam
Chlordiazepoxide (only weird name)
Term
MOA of Benzo's
Definition
Increase frequency of Cl- channel opening at GABAa
Term
Uses for Benzo's
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
Flumazenil
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
Formepizal or ethenol
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
Ethosuximide
Term
Partial (simple or complex) use___
Definition
Valproic acid
Phenytoin
Carbamazepine
Term
General tonic clonic use
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
OC's
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
Malignant HTN
Term
IV anesthetics (5)
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
Face-limb-respiration
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
Morphine 6 glucuronidase
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
Dextromethorphan
Term
Opioid used in diarrhea
Definition
Loperamide
Term
Full Agonist Opioid that has antimuscarinic characteristics, metabolized by cyt P450, and is a serotonin reuptake inhibitor (causing seizures)
Definition
Meperidine
Term
Full Agonist Opioid with very long HALF LIFE, so it can be used in maintenance of opiate addicts
Definition
Methadone
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
Nalbuphine
Term
Used for Opioid respiratory depression
Definition
Naloxone

DO NOT GIVE VENTILATOR O2
Term
Opioid used for both alcohol and opiate addiction
Definition
Naltrexone
Term
Symptoms of withdrawal of Opioids
Definition
Yawning
Lacrimation
Rhinorrhea
Salivation
Sweat
Term
Only effects of Opioids which don't have tolerance
Definition
Miosis
Constipation
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
Trigeminal Neuralgia
Term
Side Effects of Valproic Acid
Definition
1. Hepatotoxic
2. Spina Bifida
3. Thrombocytopenia
4. Alopecia
5. Pancreatitis
Term
Barbiturates MOA
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
Complex 1
Term
Levodopa MOA
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
Talcapone MOA
Definition
Inhibit COMT which breaks down L-dopa into 3-O-methyl dopa. Allows for higher uptake and efficacy
Term
Selegiline MOA
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
Major side of Clozapine
Definition
Agranulocytosis
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
Lithium MOA
Definition
Blockage of some part of the phosphoinositol cascade. Decreasing PIP2, DAG, IP3
Term
SE's of Lithium
Definition
Hypothyroid
Teratogenic
Diabetes Insipidus
Term
Uses of Lithium
Definition
DOC for BIpolar Disorder
Manic Relapse
SIADH
Term
Buspirone MOA and USE
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
SSRI's (3)
Definition
Fluoxetine
Paroxetine
Sertaline
Term
SSRI MOA
Definition
Serotonin Reuptake inhibitors which take 4-8 weeks to take effect
Term
USE of SSRI
Definition
Depression
OCD
Bulimia
Social Phobia
Premenstrual Dysmorphic Disoreder
Term
SE of SSRI (3)
Definition
1. Sexual Dysfunction (Older men)
2. Serotonin Syndrome
3. Bruxism- teeth grinding
Term
SSNRI MOA
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
Use of MAO inhibitors
Definition
Atypical depression
Anxiety
Hypochondriasis
Term
SE of MAO inhibitors (2)
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
Bupropion MOA and USE
Definition
Increase NE and dopamine by unknown mech (dopamine>NE)

Smoking cessation
Term
Mirtazapine MOA
Definition
alpha 2 antagonist
serotonin 5 HT2-3 antagonist
Term
Maprotiline MOA
Definition
Blocks NE re-uptake
Term
Trazodone MOA and USE
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
Imipramine, Desipramine
Term
*TCA w/ predominantly serotonin> NE and has less anti cholinergic effects than the others?
Definition
Nortriptyline
Term
*Which TCA associated w/ Sudden Cardiac Death in kids A(also low seizure threshold)?
Definition
Desipramine
Term
*This TCA is used to control bed wetting?
Definition
Imipramine
Term
*This TCA can be used for OCD and depression
Definition
Clomipramine
Term
TCA, sometimes used for migrane, many anti cholinergic effects, heavily sedating
Definition
Amitryptyline
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
Atomoxetine toxicity
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
hypothalamus
Term
Corticosteroids decrease BDNF expression but _____ increase it
Definition
antidepressants
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
Clomipramine
Term
TCA that can be used as adjunct for COPD and sleep apnea due to stimulation of central respiratory centers
Definition
Protriptyline
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
TCA
Term
High plasma protein binding, half life long, can increase levels of other drugs
Definition
SSRIs
Term
Thioridazine can be increased by SSRIs leading to it's black box warning of
Definition
QT prolongation/arrythmias
Supporting users have an ad free experience!