Term
| Examples of live vaccines |
|
Definition
MMR (all 3)
Varicella (Varivax)
Influenza (Flumist)
Rotavirus (Rotateq and Rotarix) |
|
|
Term
| Examples of killed/inactivated/portion vaccines |
|
Definition
Hepatitis A
Hepatitis B
Meningococcal conjugate
Pertussis
Influenza (Fluarix)
HPV (Gardasil) |
|
|
Term
| Vaccines that require boosters |
|
Definition
Tdap
Meningococcal conjugate |
|
|
Term
| Examples of conjugated vaccines |
|
Definition
Haemophilus influenza B
Pneumococcal (Prevnar 13, Pneumovax 23)
Meningococcal |
|
|
Term
| Which vaccines are given SubQ? |
|
Definition
|
|
Term
| Which vaccines are given IM? |
|
Definition
DTaP
HIB
Hepatitis A and B
Pneumococcal conjugate
Meningococcal conjugate
Fluarix
Gardasil
Cervarix |
|
|
Term
| Which vaccine is given via nasal spray? |
|
Definition
|
|
Term
| Which vaccine is given PO? |
|
Definition
|
|
Term
| Which 3 bacteria are encapsulated and can cause meningitis? |
|
Definition
Streptococcus pneumoniae
Haemophilus influenzae
Neisseria meningitidis |
|
|
Term
| Populations at risk for adverse effects of vaccines? |
|
Definition
Immunocompromised children
Congenital immunodeficiency patients
HIV
Leukemia
Lymphoma
Generalized malignancy
Therapy with radiation
Cytotoxic anticancer drugs
High-dose glucocorticoids |
|
|
Term
| Name the mode of transmission for measles, mumps, and rubella viruses? |
|
Definition
| Nasopharyngeal secretions |
|
|
Term
| Precaution for MMR vaccine |
|
Definition
|
|
Term
| Corynebacterium diphtheriae |
|
Definition
Gram negative
In Nasopharynx
Toxin damages heart and nerves
Spread by secretions |
|
|
Term
|
Definition
Gram positive
In soil, dust, feces
Spread by puncture
Paralysis of all skeletal muscle
Treat with antitioxin AND antibiotic |
|
|
Term
|
Definition
Gram positive
In nasopharynx droplets
Persistent cough
Incidence is increasing
Treat with azithromycin |
|
|
Term
|
Definition
|
|
Term
| One thing you should cautiously watch for for 3 days after DTAP vaccination? |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
Gram negative
Causes meningitis, pneumonia, ear/throat infection
Successfully treated with antibiotics |
|
|
Term
| Nontypable Haemophilus influenzae |
|
Definition
Less virulent than type B
No capsule
No vaccine |
|
|
Term
| Possible conjugations for HIB in vaccine? |
|
Definition
Tetanus toxoid
OMP protein from Neisseria meningitides |
|
|
Term
|
Definition
|
|
Term
| Who is the varicella vaccine contraindicated for? |
|
Definition
Pregnant women
Leukemia/lymphoma patients
Hypersensitivity to neomycin or gelatin |
|
|
Term
| # of varicella vaccine doses |
|
Definition
|
|
Term
| # of doses of Hepatitis B vaccine |
|
Definition
|
|
Term
| # of doses of Hepatitis A |
|
Definition
|
|
Term
|
Definition
Microbe involved in pneumococcal infections
Leading bacterial cause of childhood meningitis, sepsis, pneumonia, otitis media |
|
|
Term
|
Definition
Microbe of meningococcal infection
Spread by respiratory secretions
Conjugated with diphtheria toxoid in vaccine |
|
|
Term
| # doses of meningococcal vaccine? |
|
Definition
| 2; booster based on age and risk (i.e. close living conditions) |
|
|
Term
| Rotavirus gastroenteritis |
|
Definition
Most common cause of diarrhea in infants and young children
Spread fecal-oral
Virtually all children become infected repeatedly before they turn 5
First episode is the worst |
|
|
Term
| Possible adverse effect of rotavirus vaccine |
|
Definition
| Intussusception: rare bowel obstruction |
|
|
Term
| Who should not receive the rotavirus vaccine? |
|
Definition
SCID patients
Infants with uncorrected GI malformation |
|
|
Term
|
Definition
16, 18: cancer
6, 11: warts |
|
|
Term
| Which vaccines can pregnant women not get? |
|
Definition
|
|
Term
|
Definition
Cervarix only protects against HPV 16 and 18, NOT 6 and 11
May provide longer protection |
|
|
Term
| What are the 2 major/general groups of antifungal agents? |
|
Definition
Drugs that treat systemic mycoses
Drugs that treat superficial mycoses |
|
|
Term
| Candidiasis, aspergillosis, cryptococcosis (meningitis), mucormycosis |
|
Definition
|
|
Term
| Sporotrichosis, blastomycosis, histoplasmosis, coccidioidomycosis |
|
Definition
|
|
Term
| 4 classes of antifungal drugs |
|
Definition
1. polyene antibiotics
2. azoles
3. echinocandins
4. pyrimidine analogs |
|
|
Term
| Most broad-spectrum antifungal agent? |
|
Definition
|
|
Term
| Drug of choice for systemic mycoses? |
|
Definition
|
|
Term
| Toxicity/ADE of amphotericin B |
|
Definition
| Infusion reaction and renal damage in all patients to varying degrees (always given IV), hypokalemia |
|
|
Term
|
Definition
| Binds to ergosterol much more than cholesterol in fungal cell membrane to increase permeability; fungistatic or fungicidal |
|
|
Term
|
Definition
| Fever, chills, rigors, hypotension, thrombophlebitis, anaphylaxis caused by release of proinflammatory cytokines 1-3 hours after start of infusion; severe to life threatening. |
|
|
Term
| How can Amphotericin B be made less toxic? |
|
Definition
|
|
Term
| Treatment for infusion reaction? |
|
Definition
| Pretreat with diphenhydramine and acetaminophen. Aspirin can help but may increase renal damage. |
|
|
Term
| Nephrotoxicity of Amphotericin B |
|
Definition
Extent of damage depends on total dose administered over full course of treatment. More common when treatments >2 weeks.
Avoid exacerbating by concurrently taking aminoglycosides or cyclosporines, NSAIDs.
Monitor serum creatinine every 3-4 days |
|
|
Term
| What are the advantages of azoles compared to amphotericin B? Disadvantages? |
|
Definition
| Azoles have lower toxicity and can be given PO, but they have many drug interactions. |
|
|
Term
|
Definition
| Inhibit synthesis of ergosterol via enzymes (which humans also have) |
|
|
Term
Itraconazole:
Used for?
ADE? |
|
Definition
For: systemic mycoses
ADE: Cardiosuppression (QTc prolongation)
Liver damage (watch for elevated liver enzymes)
Inhibition of drug-metabolizing enzymes
N/V/D |
|
|
Term
Fluconazole:
Static or cidal?
Used for?
ADE? |
|
Definition
Fungistatic
For candida albicans but not candida gradate
ADE: increased liver enzymes (LFT) |
|
|
Term
|
Definition
Uses: Candidemia, invasive aspergillosis, esophageal candidiasis
ADE: Hepatotoxicity, drug interactions |
|
|
Term
|
Definition
Uses: Mainly used as topical treatment; more toxic than other azoles if used any other way
ADE: Hepatotoxicity (fatal necrosis if used other-than-topical) |
|
|
Term
Echinocandins (newest class of antifungals):
MOA?
Route of administration?
Who can prescribe?
3 drugs? |
|
Definition
MOA: disrupt cell wall
Administered PO
Only infectious disease doctors can prescribe
Drugs: Caspofungin, Micafungin, Anidulafungin |
|
|
Term
| Pyrimidine Analog drug and MOA? |
|
Definition
Drug: Flucytosine
MOA: Converted to 5-fluorouracil in fungal cells |
|
|
Term
|
Definition
Serious infection with susceptible* strains of Candida and Cryptococcus neoformans (meningitis)
(*Resistance is common, so it's often used with ampho B) |
|
|
Term
|
Definition
Hematologic: GI bacteria can convert it to t-fluorouracil which causes bone marrow suppression.
Hepatotoxic: Inhibits drug-metabolizing enzymes |
|
|
Term
| Which two fungi cause superficial mycoses? |
|
Definition
Candida species, usually in mucus membranes and moist skin
Dermatophytes, usually in skin, hair and nails |
|
|
Term
|
Definition
Oral (thrush)
Vulvovaginal (75% of women)
Onychomycosis (nails) |
|
|
Term
|
Definition
Epidermophyton
Trichophyton
Microsporum |
|
|
Term
| Drugs for dermatophytic infections |
|
Definition
Clotrimazole/ketoconazole
Tribinafine (Lamisil)
Nystatin
Itraconazole
Griseofulvin |
|
|
Term
| Drugs for vulvovaginal candidiasis |
|
Definition
Miconazole (1-3 days topical)
Fluconazole (single dose) |
|
|
Term
| Drugs for oral candidiasis |
|
Definition
|
|
Term
|
Definition
Oral: Lamisil and itraconazole
Topical: Ciclopirox |
|
|
Term
| Topical DOC for superficial mycoses |
|
Definition
|
|
Term
Griseofulvin:
Uses?
MOA?
ADE? |
|
Definition
Uses: superficial mycoses
MOA: Inhibits fungal mitosis
ADE: Transient headache, rash, GI effects, insomnia/tiredness |
|
|
Term
|
Definition
|
|
Term
|
Definition
| Similar to ampho B; binds sterols and causes cell leakage |
|
|
Term
|
Definition
ONLY for candidiasis
DOC for intestinal candidiasis
ONLY orally or topically; too toxic for IV |
|
|
Term
| Terbinifine classification? |
|
Definition
| Allylamine: Inhibits ergosterol synthesis enzyme |
|
|
Term
|
Definition
| Same cell secretes and receives hormones for local and short-lived effects |
|
|
Term
|
Definition
| Secreting cell and neighbors receive hormone for nearby and long-lived effects |
|
|
Term
|
Definition
| Gland secretes hormone that travels via blood to distant target cells for systemic and long-lived effects |
|
|
Term
|
Definition
At base of brain
Anterior and posterior lobes
Portal venous system: stalk of neurosecretory fibers and blood vessels that allow for hormone transport from hypothalamus to anterior pituitary |
|
|
Term
| Pituitary gland overall function |
|
Definition
| Controls metabolism, growth, and reproduction via neural and endocrine systems |
|
|
Term
| Growth Hormone (GH, Somatotropin) |
|
Definition
| From anterior pituitary. Targets liver, bone, muscles, and kidneys to secrete IGF-1. Required for childhood/adolescence normal growth and development. |
|
|
Term
| Important effects of Growth Hormone |
|
Definition
Lipid/carb metabolism
Lean body bass
Bone density |
|
|
Term
|
Definition
| Released by hypothalamus to inhibit growth hormone |
|
|
Term
|
Definition
| In case of sulfonylurea OD, this drug reduces stimulation of pancreatic beta cells to release insulin, thereby mimicking somatostatin. Its main use, however, is for esophogeal varices. |
|
|
Term
| Thyroid Stimulating Hormone |
|
Definition
| Causes thyroid to secrete thyroxine (T4) and triiodothyronine (T3); normalizes growth and development, body temperature, and energy levels in a negative feedback system. |
|
|
Term
| Secretion pathway Growth Hormone is involved in |
|
Definition
Hypothalamus: Growth Hormone Releasing Hormone-->
Anterior pituitary: Growth Hormone |
|
|
Term
| Secretion pathway of Thyroid Stimulating Hormone |
|
Definition
Hypothalamus: Thyrotropin-releasing hormone -->
Anterior pituitary: Thyroid stimulating hormone -->
Thyroid: thyroxine/triiodothyronine |
|
|
Term
| Secretion pathway of follicle stimulating hormone and luteinizing hormone |
|
Definition
Hypothalamus: Gonadotropin-releasing hormone (GnRH)-->
Anterior pituitary: FSH/LH-->
Gonads: estrogen, progesterone, testosterone |
|
|
Term
| Secretion pathway of adrenocorticotropin (ACTH) |
|
Definition
Hypothalamus: Corticotropin-releasing hormone -->
Anterior pituitary: Adrenocorticotropin-->
Adrenal cortex: Cortisol (hydrocortisone) |
|
|
Term
| Function of Adrenocorticotropin |
|
Definition
| Regulation of intermediary metabolism, cardiovascular function, growth, and immunity |
|
|
Term
| Physiologic effects of glucocorticoids (Cortisol) (endogenous) |
|
Definition
Improves responsiveness of vascular and bronchial tissue to catecholamines
Anti-inflammatory/immunosuppressive |
|
|
Term
| Metabolic effects of glucocorticoids (Cortisol) |
|
Definition
Dose-related effects
Increase serum glucose and stimulates insuline release
Inhibits uptake of glucose by muscle cells
Stimulates lipogenesis (more fat deposition and increased fats in circulation) |
|
|
Term
| Dose-dependent physiologic effects of glucocorticoid DRUGS (exogenous) |
|
Definition
Low dose: modulation of glucose metabolism in adrenocortical insufficiency
High dose: Suppression of inflammation |
|
|
Term
|
Definition
Glucocorticoids
Mineralocorticoids
Produced by adrenal cortex |
|
|
Term
|
Definition
Hydrocortisone
Potent anti-inflammatory |
|
|
Term
|
Definition
Aldosterone
Controls water balance primarily in kidneys during stress |
|
|
Term
| Regulation of corticosteroids |
|
Definition
| Tightly regulated by negative feedback loop involving hypothalamus, anterior pituitary, and adrenal cortex (Shut down hydrocortisone production in adrenal cortex when there is enough around) |
|
|
Term
| What happens if you are taking high dose corticosteroids and then stop taking them abruptly? |
|
Definition
|
|
Term
| What is the effect of glucocorticoids on the immune system? |
|
Definition
Causes Neutrophils to migrate from bone marrow and inflammation sites into blood; net effect is increase in neutrophils
Causes all other WBCs to migrate from blood to lymphoid tissues; net effect is decrease in all other WBC's |
|
|
Term
| Target cells of mineralocorticoids |
|
Definition
Kidney
Salivary glands
Bladder |
|
|
Term
| Where do corticosteroids work at the cellular level? |
|
Definition
| Bind to transcription factors in nucleus; bind and "turn on" or "turn off" certain genes |
|
|
Term
| Major anti-inflammatory roles of corticosteroids |
|
Definition
Suppress synthesis of inflammatory mediators
Suppress infiltration of phagocytes
Suppress release of lysosomal enzymes
Suppress proliferation of lymphocytes |
|
|
Term
| Dosing strategies of corticosteroids |
|
Definition
Low doses treat endocrine disorders
High doses treat nonendocrine/inflammatory disorders (asthma, RA)
Normally dosed in the morning since cortisol levels are highest between 2-8 a.m. and the pituitary gland is less sensitive (less likely to cause adrenal suppression) at this time |
|
|
Term
| Corticosteroids for anti-inflammatory therapy |
|
Definition
Prednisone
Prednisolone
Methylprednisolone
Dexamethasone |
|
|
Term
| Corticosteroids for asthma emergencies |
|
Definition
Prednisone (PO)
Prednisolone (PO) |
|
|
Term
| Corticosteroids for asthma maintenance |
|
Definition
Fluticasone (inhaled with beta 2 agonists)
Budesonide (inhaled with beta 2 agonists) |
|
|
Term
| Other uses for corticosteroids (besides asthma, acute inflammation) |
|
Definition
RA/Osteoarthritis
Gout
Psoriasis
Allergies
Lupus
Septic shock (increase catecholamine responsiveness)
Late COPD
Inflammatory bowel diseases
Spinal cord injury |
|
|
Term
|
Definition
Glucose intolerance (caution in diabetics)
Oral thrus with oral inhalation agents
Fluid and electrolyte imbalance depending on drug's mineralocorticoid activity level
Osteoporosis with long-term treatment
HTN
Depression
Growth retardation with long-term therapy
Adrenal suppression (possible)
Increased susceptibility to infection |
|
|
Term
| Origin and purpose of follicle stimulating hormone |
|
Definition
Origin: pituitary gland
Purpose: convert androgen to estrogen |
|
|
Term
| Origin and purpose of luteinizing hormone |
|
Definition
Origin: pituitary gland
Purpose: ovulation; make cholesterol into progesterone and androgen |
|
|
Term
| Origin and purpose of estrogen |
|
Definition
Origin: ovaries
Purpose: Uterine growth, thicken vaginal mucosa, thin cervical mucus |
|
|
Term
| Origin and purpose of progesterone |
|
Definition
Origin: ovaries
Purpose: Prepare uterus for implantation, thicken cervical mucus, prevent uterine cancer by regulating estrogen |
|
|
Term
| 3 phases of the menstrual cycle |
|
Definition
1. Follicular phase
2. Ovulation
3. Luteal phase |
|
|
Term
| What is the main hormone of the follicular phase of menstrual cycle? |
|
Definition
|
|
Term
| What is the main hormone of the luteal phase of the menstrual cycle? |
|
Definition
|
|
Term
| What is happening during the follicular phase of the menstrual cycle? |
|
Definition
Egg development
Low E&P--> GNRH from hypothalamus-->FSH and LH from anterior pituitary
Follicles grow
Dominant follicle emerges and starts to secrete estrodiol and estrogen (negative feedback loop to decrease FSH) |
|
|
Term
| What is happening during ovulation? |
|
Definition
High enough estrogen causes LH surge prior to ovulation
Oocyte is released and travels down fallopian tube
Window of fertility (~3 days) begins |
|
|
Term
| What is happening during the luteal phase of the menstrual cycle? |
|
Definition
LH has caused follicle to change into corpus luteum
Corpus luteum produces progesterone (preparing for implantation)
LH/FSH decrease while estrogen increases
Egg travels to uterine cavity
Corpus luteum eventually degenerates and P&E will decrease |
|
|
Term
| Target cells of estrogens/progestins |
|
Definition
| Breasts, uterus, vagina, bone, CNS |
|
|
Term
| What are secondary sex characteristics caused by estrogens/progestins? |
|
Definition
Skin softening
Hair growth
Fat redistribution to hips
Breast growth |
|
|
Term
| What are the effects of estrogens/progestins on bone? |
|
Definition
Inhibit proliferation of osteoclasts (break-down)
Prevents apoptosis of osteoblasts |
|
|
Term
| CNS effects of estrogens/progestins |
|
Definition
|
|
Term
| Metabolic effects of estrogens |
|
Definition
Positive effect on bone mass
Increase HDL, lower LDL
Increases breakdown of fibrin (clotter)
Increases levels of coagulation factors
Decrease coagulation-suppressors |
|
|
Term
| What is estrogen replacement therapy used for? |
|
Definition
Treatment of moderate to severe vasomotor symptoms of menopause
Prevention of postmenopausal osteoporosis in high-risk patients |
|
|
Term
| ADE of estrogen replacement therapy? |
|
Definition
Increased risk of CV events
Increased risk of breast and endometrial cancer
*Not recommended as first line therapy; if necessary, use lowest dose for shortest time |
|
|
Term
| Estrogen replacement therapy agents? |
|
Definition
Conjugated estrogen
Conjugated estrogen + medroxyprogesterone |
|
|
Term
| Selective Estrogen Receptor Modulators: Examples of drugs |
|
Definition
Raloxifene (bone E agonist, breast/uterus E antagonist)
Tamoxifen (breast antagonist)
Clomiphene (ovulation induction) |
|
|
Term
| Uses of Selective Estrogen Receptor Modulators |
|
Definition
Prevent and treat postmenopausal osteoporosis
Ovulation induction
Breast cancer prophylaxis in high-risk postmenopausal women |
|
|
Term
| 2 types of oral contraceptives |
|
Definition
Progestin
Estrogen + progestin |
|
|
Term
| 2 types of estrogen + progestin OC's |
|
Definition
Monophasic: E&P levels the same throughout cycle
Multiphasic: E&P rise and fall throughout cycle |
|
|
Term
| MOA of oral contraceptives |
|
Definition
Estrogen: Suppresses FSH to prevent dominant follicle development; suppresses LH surge to prevent ovulation; stabilizes endometrial lining to prevent implantation
Progestin: Negative feedback inhibits LH and FSH to inhibit ovulation; thickening of cervical mucus makes it less permeable to sperm |
|
|
Term
|
Definition
Natural (innate)
Specific acquired |
|
|
Term
|
Definition
CD8 cells
Attack/kill target cells directly |
|
|
Term
|
Definition
CD4 cells
Promote delayed-type hypersensitivity
Activate CD8 cells |
|
|
Term
|
Definition
Monocytes that have moved into tissues
Principal scavengers
Activate T cells
Phagocytize antibody-tagged cells |
|
|
Term
|
Definition
| Basophils that have moved into tissues |
|
|
Term
|
Definition
| Phagocytize bacteria/foreign particles |
|
|
Term
|
Definition
| Attack and destroy foreign particles coated with IgE |
|
|
Term
|
Definition
|
|
Term
| Antigen binding site of antibodies |
|
Definition
| The variable regions of heavy and light chains |
|
|
Term
| Memory and time limitation of immune responses |
|
Definition
| After initial antigen exposure, antibody levels rise slowly, peak at a low level, and decline rapidly. AFter second exposure to the antigen, antibody levels rise rapidly to a higher peak, persist longer, and slowly decline. |
|
|
Term
| Characteristic features of immune response |
|
Definition
Specificity
Diversity
Memory
Time limitation
Selectivity for antigens of nonself origin |
|
|
Term
| Phases of Immune Response |
|
Definition
1. Recognition: antigen recognized by B and T cells
2. Activation: proliferation and differentiation of lymphocytes
3. Effector: elimination of antigen |
|
|
Term
|
Definition
APC's (macrophages or dendritic cells) activate CD4 cells.
CD4 cells (helper T) stimulate B cells
B cells make antibodies |
|
|
Term
| 2 types of cell-mediated immunity |
|
Definition
Delayed-type hypersensitivity
Cytolytic T lymphocytes |
|
|
Term
| Delayed type hypersensitivity |
|
Definition
Requires 2 cells: CD4 and infected macrophage.
CD4 cell binds to infected macrophage to activate itself and release interferon gamma and cytokines. Interferon gamma activates that macrophage. CD4 proliferates and differentiates into memory cells |
|
|
Term
|
Definition
Requires 3 cells: Cytotoxic T lymphocytes, APCs, CD4.
Recognize and kill virally-infected cells by binding and release of chemicals |
|
|
Term
| 1st Generation "Typical" Antipsychotics MOA |
|
Definition
| Block dopamine (DA2) in mesolimbic area of brain |
|
|
Term
| 1st Generation Antipsychotics ADE |
|
Definition
| Extrapyramidal symptoms (EPS): dystonia, Parkinsonism, akasthesia, tardive dyskinesia, neuroleptic malignant syndrome |
|
|
Term
| 1st Generation Antipsychotics drug interactions |
|
Definition
Anticholinergics (especially in elderly)
CNS depressants
Levodopa/DA agonists |
|
|
Term
| Toxicity of 1st Generation Antipsychotics |
|
Definition
OD deaths very rare
HTN
EPS
CNS depression |
|
|
Term
| Examples of low, medium, and high potency Typical Antipsychotics |
|
Definition
Low: Chlorpromazine HCl
Medium: Loxapine
High: Haloparidol |
|
|
Term
| Typical antipsychotics that come in depot preparations |
|
Definition
|
|
Term
Chlorpromazine
Fluphenazine
Haloperidol
Loxapine
Molindone
Perphenazine
Pimozide
Thioridazine
Thiothixine
Trifluoperazine |
|
Definition
| 1st Generation Antipsychotics |
|
|
Term
| 2nd Generation "Atypical" Antipsychotics MOA |
|
Definition
| Block serotonin > block dopamine |
|
|
Term
| Atypical antipsychotics ADE |
|
Definition
| Metabolic syndrome: Weight gain, dyslipidemia, diabetes |
|
|
Term
| Most effective atypical antipsychotic? |
|
Definition
Clozapine
Also most dangerous--causes agranulocytosis, myocarditis, and the most metabolic syndrome |
|
|
Term
Paliperidone
Asenapine
Lurasidone
Ziprasidone
Iloperidone
Aripiprazole
Quetiapine
Olanzapine
Risperidone
Clozapine |
|
Definition
| 2nd generation, atypical antipsychotics |
|
|
Term
|
Definition
atypical antipsychotic
If taken <8 mg/day, lower EPS risk |
|
|
Term
|
Definition
Tied with clozapine for highest risk of metabolic syndrome.
Can increase prolactin |
|
|
Term
|
Definition
Believed to block more than just 5HT and dopamine.
many anticholinergic-like side effects |
|
|
Term
|
Definition
| Bioavailability better with food |
|
|
Term
|
Definition
Least likely to cause metabolic syndrome
Long half life
One IM injection/month |
|
|
Term
|
Definition
Long half life
Can increase prolactin |
|
|
Term
| Which drug comes in a "ghost tablet"? |
|
Definition
| Paliperidone: 2nd generation/atypical antipsychotic |
|
|
Term
|
Definition
| Bioavailable ONLY if given sublingual. Do not take with food, drink, or smoke |
|
|
Term
| Diagnosing major depressive disorder |
|
Definition
Depressed mood + 4 or more of:
Sleep disturbance
Interest/pleasure loss
Guilt
Energy change
Concentration difficulty
Appetite changes
Psychomotor disturbances
Suicidal thoughts |
|
|
Term
| Which NT's can antidepressants modulate? |
|
Definition
|
|
Term
| What other conditions can antidepressants be used to treat? |
|
Definition
Smoking
Anxiety
Menopause symptoms |
|
|
Term
| Most commonly prescribed antidepressant class? |
|
Definition
|
|
Term
|
Definition
Weight gain
GI upset
Sedation and insomnia
Tremor
Dizziness
Headache
Sexual dysfunction
Increased risk of bleeding with anticoagulants |
|
|
Term
|
Definition
MAOI's (risk serotonin syndrome)
Other 5HT agents including Lithium and St. John's Wort
Warfarin
Pimozide |
|
|
Term
Citalopram
Escitalopram
Fluoxetine
Fluvoxamine
Paroxetine
Sertraline |
|
Definition
|
|
Term
| SSRI with highest affinity? |
|
Definition
|
|
Term
| SSRI that is better tolerated than citalopram and can be taken at a lower dose? |
|
Definition
|
|
Term
|
Definition
Fluoxetine; give it in the morning.
*Also, less likely weight gain and NO withdrawal because of long half life |
|
|
Term
|
Definition
|
|
Term
| Most anticholinergic SSRI that also causes the most weight gain? |
|
Definition
|
|
Term
| New formulation of which SSRI can treat menopause hot flashes? |
|
Definition
|
|
Term
| SSRI that causes more GI ADE |
|
Definition
|
|
Term
Venlafaxine
Desvenlafaxine
Duloxetine
Milnacipran
Levomilnacipran |
|
Definition
|
|
Term
| Which NT's does venlafaxine inhibit reuptake of? |
|
Definition
|
|
Term
| Active metabolite of venlafaxine? |
|
Definition
| Desvenlafaxine; also a SNRI |
|
|
Term
| SNRI for Depression AND Fibromyalgia? |
|
Definition
Duloxetine
*Need baseline LFT because of high hepatotoxicity risk |
|
|
Term
| Which SNRI treats only fibromyalgia? |
|
Definition
|
|
Term
| Which SNRI treats only depression? |
|
Definition
|
|
Term
| Tricyclic antidepressants' MOA |
|
Definition
Block reuptake of serotonin and norepinephrine
Also directly block alpha 1, histamine, and acetylcholine receptors |
|
|
Term
|
Definition
Sedation (H1)
Anticholinergic (ACh)
Cardiotoxicity
Seizures
Orthostatic HoTN
Yawngasm with clomipramine |
|
|
Term
|
Definition
MAOI's
Sympathomimetics
Anticholinergics
CNS depressants |
|
|
Term
|
Definition
Mainly from anticholinergic and cardiotoxic actions
Treat with physostigimine, propranolol, lidocaine, phenytoin
Only 7-day supply can be written because of possible suicide |
|
|
Term
Desipramine
Doxepin
Imipramine
Clomipramine
Amitriptyline
Nortriptyline
Protriptylin |
|
Definition
| Tricyclic antidepressants |
|
|
Term
|
Definition
| MAO enzyme in neurons and liver |
|
|
Term
|
Definition
Weight gain
Sedation
GI upset
Orthostatic HoTN
Sexual dysfunction |
|
|
Term
|
Definition
Sympathomimetics
TCAs
SSRIs
Anti-HTN
Meperidine
Tyramine (foods) |
|
|
Term
| Result of MAOI + Tyramine |
|
Definition
| HTN crisis: When liver MAO's are inhibited, tyramine gets to neurons and NT's rise even higher |
|
|
Term
Phenelzine
Tranylcypromine
Isocarboxazid
Selegeline: first transdermal; less HTN risk |
|
Definition
|
|
Term
Reboxetine
Amoxapine
Nefazodone
Mirtazapine
Vortioxetine
Vilazodone
Trazadone
Bupropion |
|
Definition
|
|
Term
|
Definition
Inhibit reuptake of NE and DA
(NERI and DARI) |
|
|
Term
| Additional benefits of Buproprion |
|
Definition
Stimulant actions suppress appetite (no weight gain)
No sexual dysfunction
Smoking cessation |
|
|
Term
|
Definition
|
|
Term
|
Definition
Sedation (use as sleep agent at low dose)
Priapism (at high dose) |
|
|
Term
|
Definition
| SSRI + partial 5HT agonist |
|
|
Term
|
Definition
| More GI effects (take with food) |
|
|
Term
|
Definition
| SSRI and 5HT agonist/antagonist |
|
|
Term
| Vortioxetine ADE and drug interactions |
|
Definition
Interactions with linezolid and methylene blue
ADE: N/V, constipation |
|
|
Term
|
Definition
|
|
Term
| Which atypical antidepressants can be used as sleep agents at low doses? |
|
Definition
|
|
Term
| Mainstay therapies for bipolar disorder |
|
Definition
Lithium
Valproic acid
Lamotrigine |
|
|
Term
|
Definition
Alters distribution of certain ions
Synthesis and release of NE, 5HT, DA
Intracellular responses to NT's
Facilitates regeneration of damaged optic nerve
Can increase gray matter in regions known to atrophy in BPD. |
|
|
Term
|
Definition
Depends on length of treatment:
Early: Dry mouth, polydipsia, polyuria, GI, hand tremor
Late: Hypothyroidism, acne, cardiac
Birth defect: Epstein's anomaly |
|
|
Term
| Drugs that can decrease Li effects |
|
Definition
Caffeine
Theophylline
Carbonic anhydrase inhibitors
Sodium |
|
|
Term
|
Definition
|
|
Term
|
Definition
N/V
Increased appetite and weight gain
Hepatic dysfunction
Increased ammonia
Teratogenic
Tremor
Sedation
Alopecia
Platelet dysfunction |
|
|
Term
| Antiepileptics that can be used for bipolar disorder? (BPD) |
|
Definition
Carbamazepine
Lamotrigine
Topiramate |
|
|
Term
| Topiramate (anticonvulsant) side effects |
|
Definition
weight loss
decreased cognition |
|
|
Term
|
Definition
| Spontaneous occurrence/brief episodes of loss/distrubance of consciousness with excessive EEG discharges and usually also body movements |
|
|
Term
|
Definition
| Transient behavior alteration due to disordered, synchronous, rhythmic firing of a population of brain neurons (focus) |
|
|
Term
Simple
Complex
Secondary generalized |
|
Definition
|
|
Term
Absence (petit mal)
Tonic-clonic (grand mal)
Atonic
Myoclonic
Status epilepticus
Febrile |
|
Definition
|
|
Term
Ethosuxamide
Rufinamide
Zonisamide
Topiramate
Tiagabine
Levetiracetam
Lamotrigine
Pregablin
Vigabatrin
Lacosamide
Gabapentin
Phenobarbital
Valproic acid
Carbamazepine
Phenytoin
Fosphenytoin |
|
Definition
|
|
Term
|
Definition
MOA: Selective Na channel inhibition
Use: Partial and tonic-clonic |
|
|
Term
|
Definition
| Prodrug injection of phenytoin (selective Na channel inhibition for partial and tonic-clonic) |
|
|
Term
|
Definition
| Prolongs inactivation state of Na channels |
|
|
Term
|
Definition
| Inhibits Na and Ca channels and increases GABA |
|
|
Term
| Valproic Acid uses (seizure types) |
|
Definition
Absence
Partial
Generalized
Bipolar disorder
Migraines |
|
|
Term
|
Definition
Hepatotoxic
Pancreatitis
Teratogenic |
|
|
Term
| Valproic acid drug interactions |
|
Definition
Phenobarbital
Carbamazepine
Phenytoin |
|
|
Term
|
Definition
|
|
Term
|
Definition
ONLY used for absence
*Drug of choice for absence |
|
|
Term
|
Definition
|
|
Term
| Uses for phenobarbital (seizure types) |
|
Definition
|
|
Term
| Prodrug of phenobarbital? |
|
Definition
|
|
Term
|
Definition
| Increases GABA, decreases calcium influx |
|
|
Term
|
Definition
Partial seizures
Neuropathic pain
Migraines |
|
|
Term
| Drugs for partial-onset seizures |
|
Definition
Lacosamide
Lamotrigine
Levetiracetam
Tiagabine
Topiraate
Zonisamide
Rufinamide
Valproic Acid
Phenobarbital
Gabapentin |
|
|
Term
| Drugs for partial onset seizures AND tonic clonic? |
|
Definition
Phenobarbital
Tiagabine
Topiramate |
|
|
Term
| Drug for refractory seizure patients? |
|
Definition
|
|
Term
|
Definition
| Continuous series of 20-30 minute tonic clonic seizures |
|
|
Term
| Treatment of Status Epilepticus |
|
Definition
Maintain ventillation
Correct hypoglycemia
Terminate seizures with IV lorazepam or diazepam
Long-term suppression drugs |
|
|
Term
|
Definition
| Enhance excitation or decrease inhibition |
|
|
Term
|
Definition
Amphetamines
Methylphenidate and Dexmethylphenidate
Methylxanthines
Miscellaneous |
|
|
Term
|
Definition
| Release norepinephrine and dopamine in cortex, striatum, and RAS |
|
|
Term
|
Definition
CNS stimulation
Weight loss
Cardiovascular effects
Psychosis |
|
|
Term
|
Definition
Arrhythmias
HTN
Palpitations
Dizziness, confusion, hallucinations, delusions
Convulsions
Coma
Cerebral Hemorrhage |
|
|
Term
Lisdexamphetamine
Methamphetamine
Amphetamine
dextraomphetamine |
|
Definition
|
|
Term
| Which amphetamine has a built-in abuse blocker? |
|
Definition
| Lisdexamphetamine: It is a prodrug turned on by liver so you must take it PO |
|
|
Term
| Which drugs are in the methylphenidate/dexmethylphenidate class of stimulants? |
|
Definition
Ritalin
Concerta
Daytrana: 9 hour patch |
|
|
Term
|
Definition
| Reversible blockade of adenosine, calcium permeability, cyclic AMP buildup |
|
|
Term
| Which stimulants are used for neonatal apnea? |
|
Definition
|
|
Term
| Where do methylxanthines come from? |
|
Definition
| Derivatines of xanthine (caffeine, theophylline) |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| What is Modafinil prescribed for? |
|
Definition
Night shift disorder
Narcolepsy |
|
|
Term
| Modafinil drug interactions? |
|
Definition
Oral contraceptives
Cyclosporins |
|
|
Term
Atomexetine
Clonidine
Guanfacine |
|
Definition
|
|
Term
|
Definition
| Nonstimulant selective NERI |
|
|
Term
|
Definition
| Nonstimulant alpha 2 agonist (adjunct in ADHD) |
|
|
Term
|
Definition
| Nonstimulant alpha 2 agonist (ADHD adjunct) |
|
|
