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Week 12 flashcards
Week 12
149
Pharmacology
Graduate
04/25/2013

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Term
MIRTAZAPINE
Definition
Antidepressant with tetracyclic structure. ADR include weight gain, constipation, xerostomia, dizziness, increased serum triglycerides. Has less sexual side effects compared to other antidepressants.
Term
Phenelzine
Definition
Type of Monoamine Oxidase Inhibitor (MAOIs). Rarely used in clinical practice because of toxicity and potentially lethal food and drug interactions. Primarily used now for the treatment of depression unresponsive to other antidepressants. Can be used also to treat anxiety states, including social anxiety and panic disorder.
Term
MOA: Phenelzine
Definition
A type of hydrazine derivative. Bind irreversibly and nonselectively with MAO-A and MAO-B.
Term
Adverse Effects of Phenelzine
Definition
Very slow elimination. Can cause hypotension, insomnia. Drug to drug interactions: can cause hypertensive crisis when combined with tyramine in the diet, or other indirect sympathomimetics. Can cause serotonin syndrome with serotonergic agents, along with some analgesic agents such as meperidine.
Term
Chlorpromazine
Definition
CLASS: antipsychotic MOA: antagonizes dopamine D2 receptors in brain USES: Schizophrenia, N/V, Preoperative apprehension, Intraoperative sedation, intractable hiccups, acute intermittent porphyria, Migraine (off label). ADR: extrapyramidal sx, anticholinergic effects, sedation, weight gain, ED, oligomenorrhea or amenorrhea. Metabolism: Cleared by the liver MANY D/D interatctions!
Term
Diazepam MOA
Definition
Benzodiazepine, anxiolytic, reduces neuronal depolarization resulting in decreased action potentials. Enhances the action of GABA by tightly binding to A-type GABA receptors, opening the membrane channels and allowing the entry of chloride ions.
Term
Diazepam Uses
Definition
Antianxiety, muscle relaxants, procedural sedation agents, and sedative-hypnotics to treat withdrawal states (ex ETOH) and treat many hyperadrenergic/stimulated conditions (ex seizures, serotonin syndrome, neuroleptic malignant syndrome, sympathomimetic overdose, psychiatric conditions)
Term
Diazepam Toxicity
Definition
CNS depression, take note of other medications that may increase this when administered together
Term
Venlafaxine (Effexor)
Definition
A heterocyclic or SNRI used in depression. Venlafaxine increases both serotonin and NE but mostly serotonin. May be more effective than other agents but must use larger doses. Do not use in combination with an SSRI or MAO inhibitors as this will substantially increase the patient's risk for serotonin syndrome. ADR include increased HR, BP, and CNS activation. Because of the increased CNS activation, patients may not sleep well if they take this medication too late in the day. Withdrawal syndrome is also a risk. May also see anticholinergic effects as well as sexual dysfunction.
Term
bupropion
Definition
MOA not fully understood- inhibitors of norepinephrine and dopamine reuptake in animals. Increases presynaptic availability of catecholamine’s. No direct effect on serotonin. Unicyclic.
Term
bupropion
Definition
May be 5ht1 agonist
Term
bupropion
Definition
May be noradrenergic and/or dopaminergic
Term
bupropion
Definition
Huge first pass metabolism

Long halflife, once a day dosing.

.
Term
bupropion
Definition
Not thought to be effective for anxiety Major use for SAD, depression, used withother antidepressants to augment responses

Smoking cessation-
buproprion, seems to mimic nicotines effect on dopamine and norepinephrine
receptors.

.

least number of sexual side effects
no anti-cholinergic side effects and no weight gain
Term
bupropion
Definition
ADR: Nausea, agitation, insomnia, seizures with OD.


Contrindicated in pts with seizure hisotry.
Term
fluoxetine MOA
Definition
Prototype SSRI. MOA= block reuptake of serotonin, keeping higher serotonin levels at it's receptor site. Has a very long half life- does not need taper when d/c. Very minimal effect on other neurotransmitters
Term
fluoxetine ADRs
Definition
Nausea and GI upset most common. Sexual dysfunction, decreased libido big disatisfier for pts. Can increase headaches and either insomnia or hypersomnia. Risk for serotonin syndrome, espeically in combo with other drugs that increase serotonin levels (ie: MAOIs).
Term
Buspirone
Definition
anxiolytic psychoactive drug of the azapirone chemical class and is primarily
used to treat generalized anxiety disorder (GAD).
Term
Buspirone
MOA
Definition
functions as a serotonin 5-HT1A receptor partial agonist. It
is this action that is thought to mediate its anxiolytic and antidepressant
effects. Additionally, it functions as a presynaptic dopamine agonist D2, D3,
dopamine antagonist D4, as well as a partial α1 receptor agonist.
Term
Buspirone
side effects
Definition
Most common adverse effects: drowsiness, upset stomach, vomiting, constipation, diarrhea, stomach pain, headache, dry mouth, depression, excitement, fatigue, nervousness, insomnia, lightheadedness, weakness, numbness.
Term
Buspirone
contraindications
Definition
Hypersensitivity to buspirone, metabolic
acidosis, as in diabetes, should not be used with MAO inhibitors, severely
compromised liver and/or renal function. Buspirone has been assigned to
pregnancy category B by the FDA.
Term
Zolpidem MOA
Definition
Binds selectively to GABA receptors to enhance membrane hyperpolarization.
Term
Zolpidem clinical effects and usage
Definition
Rapid onset of hypnosis with few amnesties effects or day after psychomotor depression or somnolence. Used in treatment of sleep disorders.
Term
Chlopromazine MOA
Definition
blockade of D2 receptor, histamine and alpha
Term
Chlopromazine Clinical Uses
Definition
One of the oldest antipsycotics; used to treat schizophrenia, bipolar disorder, used more infrequently now d/t newer agents with less side effects
Term
Chlopromazine Pharmakinetics
Definition
given orally in 10-200mg tablets, can be given rectally and parenteral as well; systemic availability of 25-30%, undergoes significant first pass metabolism
Term
Chlopromazine Adverse Effects
Definition
very sedating, akathisia, dystonia, hyperprolactinemia, weight gain
Term
Ramelteon - Rozerem
Definition
Used for Insomnia - It is a melatonin receptor agonist acting in vitro in cells expressing high selectivity for human MT1 & MT2 receptors compared to MT3 receptor, contributing to the sleep promoting properties. The receptors are thought to be part of the circadian rhythm maintenance underlying the sleep-wake cycle.
Term
Ramelteon - Rozerem - Pharm.
Definition
Absorption - 1/2 - 1 hour, Bioavailability - 1st Pass metabolism, Food delays absorption by 45 mins., High Fat meal increases AUC and Decreases Cmax, Distribution - Protein Binding, Metabolism - Liver, Excretion - Renal, 1/2 Life= 1 - 2.6 hours
Term
Ramelteon - Adverse Effects
Definition
Nausea, Dizziness, Fatigue, exacerbated Insomnia, Somnolence, worsen Depression, Hallucinations, Mania
Term
Diazepam MOA
Definition
Binds to GABA receptor subunits in the central nervous system. This enhances membrane hyperpolarizaion and leads to a reduction in muscle spasticity.
Term
Diazepam Clinical Uses
Definition
Treat chronic spasms from: cerebral palsy, stroke, spinal chord injury. Treatment of acute spams from a muscle injury. Treatment for anxiety, insomnia, or ETOH withdrawal. Given before procedures like cardiac catheterization or EGD to prevent spasms in coronary arteries or esophagus during the procedure.
Term
Diazepam Side Effects
Definition
Sedation, dizziness, nausea, depression, reflex tachycardia, suppression of REM sleep
Term
Diazepam Pharm.
Definition
Hepatic metabolism. Long half-life with a duration of 12-24 hours. However, short duration of action due to redistribution of lipophilic sites.
Term
Buspirone Clinical Use
Definition
A nonbenzodiazapine that is FDA approved for use as an anxiolytic. Also used off-label for Depression
Term
Buspirone MOA
Definition
Exact MOA unclear. Chemically unrelated to other psychotropic medications. Buspirone appears to produce anxiolytic effects via serotonergic and dopaminergic effects. The drug lacks the anticonvulsant, sedative, and muscle relaxant effect of benzodiazepines, and has been termed "anxioselective". Buspirone does not bind to the benzodiazepine-GABA-chloride ion receptor complex in vitro. It has a significant effect on the dopaminergic system, interacting with dopamine receptors in vitro and acting pharmacologically as an agonist, antagonist, or both (in vivo and in vitro).
Term
Buspirone MOA Cont.
Definition
Buspirone appears to block presynaptic dopamine receptors selectively and causes an increased firing rate in midbrain dopamine neurons. Lowers acetylcholine in selected parts of the brain, whereas benzodiazepines increase brain acetylcholine. It has been felt that the interaction of buspirone with dopaminergic pathways may account for its anxiolytic effects
Term
Buspirone ADR
Definition
Appears generally well tolerated. Serious side-effects include CVA, CHF, and/or MI occurring in 0.1% of users. Dizziness appears to be most common occurring in 12% of users.
Term
Zolpidem
Definition
Newer hypnotic that produces drowsiness, pronounced depression of CNS, and encourages the onset and maintenance of sleep
Term
Zolpidem pharmacokinetics
Definition
Oral; peak plasma concentration in 1.6hrs, half-life 1.5-3.5hrs. Rapidly metabolized. Excreted by kidney. Clearance is decreased in elderly
Term
Zolpidem clinical use
Definition
Sleep disorders
Term
Zolpidem MOA
Definition
Selectively binds to molecular components of GABA alpha 1 subunit receptors in the neuronal membranes in the CNS
Term
Zolpidem action
Definition
Decreases REM sleep with little effect on slow-wave sleep. No anticonvulsant activity
Term
Zolpidem special considerations
Definition
Tolerance can occur with extended use. Withdrawl symptoms may occur with abrupt cessation
Term
Phenelzine MOA
Definition
MAOIs act by lessening the action of monoamine oxidase in the neuron and increases monoamine content. There are 2 forms of MAO: MAO-A (present in dopamine and norepinephrine found in the brain, gut, placenta, and liver; acts on norepinephrine, epinephrine, & serotonin) and MAO-B (found in serotonergic and histaminergic neurons located in the brain, liver, and platelets; acts on tyramine, phenylethylamine, & benzylamine).Blocks MAO-A and MAO-B irreversibly and non-selective
Term
Phenelzine Clinical Indications
Definition
Major depression unresponsive to other drugs
Term
Phenelzine ADR
Definition
Orthostatic Hypotension and weight gain, Anorgasmia, insomnia, restlessness, Confusion
Term
Phenelzine Interactions
Definition
Hypertensive crisis with tyramine and other indirect sympathomimetics
Serotonin syndrome with serotonergic agents
Term
Venlafaxine MOA
Definition
provides moderately selective blockade of both norepinephrine transporter (NET) and serotonin transporter (SERT), resulting in an acute increase in serotonergic and adrenergic synaptic activity
Term
Venlafaxine Clinical Uses
Definition
*major depression*, chronic pain disorders, fibromyalgia, generalized anxiety, stress urinary incontinence, vasomotor symptoms of menopause
Term
Venlafaxine ADR
Definition
anticholinergic effects, sedation, hypertension
Term
Bupropion MOA
Definition
Increased norepinephrine and dopamine activity. Presynaptic release of catecholamines but no effect on 5-HT
Term
Bupropion Clinical Uses
Definition
Major depression, smoking cessation
Term
Bupropion ADR
Definition
lowers seizure threshold, suicidal thoughts/behavior, agitation, HA, dry mouth, N/V, tremor
Term
Mirtazapine MOA
Definition
Antagonist of the presynaptic alpha 2 autoreceptors and enhances the release of both norepinephrine and 5-HT
Term
Mirtazapine Clinical Uses
Definition
Used for major depression; insomnia
Term
Mirazapine ADR
Definition
sedation(potent H1 antagonist wihc is associated with drugs sedative effects), weight gain, dizziness,not associated with sexual side effects like many of other drugs used for depression
Term
Fluoxetine Subclass
Definition
SSRI
Term
Fluoxetine MOA
Definition
selectively inhibits serotonin reuptake, therefore increasing the effects of serotonin at its receptor. Fluoxetine is metabolized to norfluoxetine its active product
Term
Fluoxetine Clinical Uses
Definition
Depression, anxiety, OCD, bulimia nervosa, panic disorder
Term
Fluoxetine ADRs
Definition
GI, nausea, sexual dysfunction, seratonin syndrome
Term
Fluoxetine Kinetics
Definition
Long 1/2 life (48-72 hours) Protein binding (95%), inhibits CYP3A4
Term
Venlafaxine
(effexor)
MOA
Definition
SNRI= serotonin-norepinephrine reuptake inhibitor
Stronger inhibitor of serotonin transporter (SERT) than norepinephrine transporter (NET).
Term
Venlafaxine
Clinical Uses
Definition
Depression
Generalized Anxiety Disorder
Term
Venlafaxine
ADR
Definition
Increased: heart rate, BP, CNS excitation
Withdrawal Syndrome

NEVER MIX VENLAFAXINE w/ SSRI- high risk for Serotonin Syndrome

(require high dose- >225mg/day... need to titrate)
Term
SNRIs vs TCAs
Definition
SNRIs differ from TCAs in that SNRIs lack antihistamine, anti-adrenergic or anticholinergic effects of TCAs

(therefore SNRIs have less S/E and are better tolerated than TCAs)
Term
Zolpidem (MOA/Use)
Definition
(newer hyponotic) Selectively binds to BZ1 receptors, acting like benzodiazepines to enhance membrane hyperpolarization.
uses: sleep disorders
Term
Zolpidem (clinical considerations)
Definition
Rapid onset, short duration
Miminal muscle relaxation and anticonvulsant effects
Lacks rebound insomnia
Term
Zolpidem (ADR)
Definition
CNS depression
depression liability
Interactions with ethanol and other drugs - additive CNS depression
Term
Buspirone (MOA/Use)
Definition
Is a serotoin agonist at the 5-HT receptor and likes to bind to the D2 receptor sites.
It's primary use is in generalized anxiety states (not good for painic attacks) and it does not cause sedation or hypnotic or euphoric effects.
May take over a week before effectiveness noted.
Term
Buspirone (ADR)
Definition
Common: Nausea, dizziness, headache, somnolence, nervousness sensation.
Serious (VERY RARE= less than 0.1%): CHF, CVA, & MI
Term
Diazepam
Definition
Benzodiazepine, skeletal mucscle relaxant, antianxiety, anticonvulsant, long half-life
Term
Diazepam (MOA)
Definition
binds to GABA receptors to increase GABA's actions, tranquilization caused by inhibition of the limbic system
Term
Diazapam (ADR)
Definition
Cardiac dysrthymias, confusion, respritory depression
Term
Diazapam (Clinical Uses)
Definition
ETOH withdrawl, anxiety, seizures
Term
phenelzine (MOA)
Definition
monoamine oxidase (MAO) inhibitor, hydrazine derivative binding irreversibly and nonselectively with MAO-A and -B
Term
phenelzine (ADR)
Definition
Orthostatic Hypotension, abdominal discomfort, constipation, hypertensive crisis (as a result of tyramine build-up)
Term
phenelzine (Clinical Uses)
Definition
Depression; Non-FDA Labeled: Agoraphobia, Bulimia nervosa, Panic disorder, Social phobia
Term
Chlorpromazine (Thorazine) MOA
Definition
Dopamine 2 receptor > 5 HT2A receptor blockade
Term
Chlorpromazine (thorazine) clinical indices
Definition
Oldest drug used for treatment of Schizophrenia
Also used for biopolar, antiemesis, preoperative sedation, pruritis
Term
Chlorpromazine (thorazine) ADR's
Definition
Alpha, muscarinic and H1 receptor antagonistic effects as well
-CNS depression and major sedation, lowered seizure threshold, extrapyramidal effects (movement disorders), tardive dyskinesias, urinary retention, hyperprolactenemia, amenorrhea/infertility, weight gain
Term
Ramelteon (MOA)
Definition
A selective MT1 and MT2, metatonin agonist used to treat insomnia in patients having difficulty with sleep onset. Ramelteon's binding to the MT1 and MT2 receptors, which are normally acted upon by endogenous melatonin, contributes to sleep-promotion and maintenance of the circadian rhythm underlying the normal sleep-wake cycle. It has no effect on GABA. It is not addictive and it is not a controlled substance. FDA pregnancy category C.
Term
Ramelteon (Drug Interactions and Precautions)
Definition
It is metabolized by the P450 enzyme and should not be used when taking CYP1A2 inhibitors (ciprofloxacin, fluvoxamine, tacrine, zileuton) or CYP2C9 (Fluconaxole) and should be used in caution with patients with liver dysfunction.
Term
Ramelteon (ADR)
Definition
Dizziness, somnolence, fatigue, hallucinations, angioedema (rare). It may decrease testosterone and increase prolactin. A worsening of insomnia and depression may occur.
Term
Mirtazapine dosing considerations
Definition
Administer dose in the evening due to sedating effect (T1/2 is 20-40 hours)
Term
Mirtazapine S/E
Definition
Weight gain very common, more of a sedative effect than other agents
Term
Mirtazapine MOA
Definition
Combination 5HT2 and alpha adrenoceptor antagonist. Also is a potent H1 antagonist which is where the sedating effects are associated from
Term
Mirtazapine Clinical Uses
Definition
Major depressive disorder, as an adjunct to increase appetite in patients with AIDS or cancer
Term
Bupropion
Definition
Atypical antidepressant/smoking cessation aid, MOA poorly understood, weakly inhibits reuptake of DA and NE; suicide warning under age 24; does not cause sexual dysfunction; ↓seizure threshold, weight loss common
Term
Bupropion drug class
Definition
antidepressant
Term
Bupropion MOA
Definition
MOA poorly understood: may increase presynaptic availablity of catecholamines by inhibiting their reuptake (NE > Dopamine), may be a 5-HT1 agonist
Term
Bupropion clinical uses
Definition
Major depression, adjunct in smoking cessation
Term
Bupropion ADR
Definition
Nausea, headache, agitation, insomnia, anorexia, tachycardia
Term
History of seizures (lowers seizure threshold)
Definition
What is a contraindication to bupropion?
Term
children
Definition
Bupriopion is not FDA approved for which population?
Term
C
Definition
Bupriopion is which pregnancy category?
Term
Phenelzine Class
Definition
Antidepresssant, Nonselective Monoamine Oxidase Inhibitor
Term
Phenelzine MOA
Definition
The exact mechanism of action has not been determined, it appears that the irreversible, nonselective inhibition of MAO by phenelzine relieves depressive symptoms by causing an increase in the levels of serotonin, norepinephrine, and dopamine in the neuron.
Term
Phenelzine Serious ADR
Definition
Seizures, suicidal thoughts, hypertensive crisis, worsening depression, hepatic necrosis
Term
Phenelzine Common ADR
Definition
orthostatic hypotension, weight gain, constipation, Increased liver aminotransferase level, dizziness, headache, fatigue
Term
Phenelzine Monitoring
Definition
reduced depression and associated symptoms, blood pressure, worsening of depression, suicidality, or unusual changes in behavior.
Term
Phenelzine Contraindications
Definition
1. concomitant use, or use within 10 days, of dibenzazepine derivatives (carbamazepine, cyclobenzaprine, tricyclic or tetracyclic antidepressants) . 2. diabetes - may increase insulin sensitivity. 3. hypertensive crises, which can be fatal or result in intracranial bleed - may present as palpitations or frequent headaches during therapy. 4. Schizophrenia - may cuase hyperstimulation and/or agitation.
Term
Phenelzine Foods to Avoid
Definition
chocolate, certain aged cheeses, Chianti and other aged red wines, vermouth, avocado, pickled fish, broad beans, beers, liver, smoked or pickled meats, snails, and yeast extracts.
Term
Phenelzine and Serotonin Syndrome
Definition
Serotonin syndrome may develop in patients taking MAOIs and illicit drugs, dextromethorphan, SSRIs, meperidine, and herbal supplements such as St John's Wort.
Term
Mirtazapine class
Definition
Tetracyclic antidepressant (chemical structure and belongs to the piperazino-azepine group of compounds).
Term
Mirtazapine (Remeron) MOA
Definition
Increased release of norepinephrine, 5-HT
Term
Mirtazapine clinical indications
Definition
Major depressive disorder
Term
Mirtazapine ADR
Definition
Agranulocytosis, cirrhosis of liver, depression exacerbation, grand mal seizure, neuroleptic malignant syndrome, neutropenia, serotonin syndrome, status epilepticus, suicidal thoughts, suicide
Term
Mirtazapine advantages
Definition
One of the few antidepressants not commonly associated with sexual side effects.
Term
Mirtazapine kinetics
Definition
Extensive metabolism in liver.
Term
Mirtazapine toxicities
Definition
sedation and weight gain
Term
Mirtazapine pregnancy category
Definition
C
Term
Phenelzine Interactions
Definition
Many - need to monitor drug interactions and need to discontinue and flush these medications out of their system before therapy can begin.
Term
fluoxetine
Definition
prototype for selective serotonin re-uptake inhibitors (SSRIs); most commonly prescribed antidepressants in clinical use
Term
fluoxetine MOA
Definition
blocks reuptake of serotonin by selectively inhibiting SERT, the serotonin transporter, thus enhancing the effects of serotonin at its receptor
Term
fluoxetine ADR
Definition
most common: nausea & sexual dysfunction; most serious: serotonin syndrome
Term
serotonin syndrome
Definition
characterized by: HTN, hyperreflexia, tremor, clonus, hyperthermia, diarrhea, mydriasis, agitation, coma w/ onset within hours; predictable when SSRI in combo w/ other 5HT drugs, as well as antidepressants (i.e.: linezolid, ondansetron, St. John's Wort, tramadol)
Term
treat serotonin syndrome
Definition
d/c offending drug; sedate; & possibly a 5HT antagonist like cyproheptadine
Term
withdrawal syndrome
Definition
characterized by: mostly GI symptoms, but also anxiety & irritability; occurs with many SSRI's but less so with fluoxetine because of its long T 1/2
Term
fluoxetine
Definition
extremely safe as a single agent when considering suicide risk
Term
fluoxetine & SSRIs
Definition
preferred for maintenance therapy because of fewest serious side effects
Term
fluoxetine clinical effects
Definition
quickly increases serotonergic synaptic activity & more slowly changes signaling pathways & neurotropic activity
Term
SSRIs popularity
Definition
easy use; safe in OD; tolerable; cost/generic; broad use
Term
fluoxetine DDI
Definition
TCAs; MAOIs; theophyline; carbamazepine; cisapride; NSAIDs
Term
fluoxetine uses
Definition
major depression; social anxiety; panic disorder; PTSD; OCD; bulimia; premenstrual dysphoric disorder
Term
fluoxetine kinetics
Definition
Vd=12-97%; highly protein bound= 95% ; bioavailability= 70%; available as isomers & formulated in racemic forms; longest 1/2 life= 48-72 hrs; active metabolite (norfluoxetine) w/ T 1/2=180 hrs; highly lipophilic; P450 interactions
Term
fluoxetine consideration
Definition
long T 1/2, so d/c 4-5 weeks before administer any MAOI to decrease risk of serotonin syndrome
Term
Advantages of bupropion
Definition
Few sexual side effects, no anticholinergic side effects, no weight gain
Term
Zolpidem Class
Definition
Sedative Hypnotic
Term
Zolpidem MOA
Definition
Bind selectively to a subgroup of GABA(A) receptors, acting like benzodiazepines to enhance membrane hyperpolarization
Term
Zolpidem Clinical Applications
Definition
Sleep disorders, especially those categorized by difficulty falling asleep
Term
Zolpidem Effects
Definition
Rapid onset of hypnosis with few amnestic effects or day after psychomotor depression or somnolence
Term
Who should doses of Zolpidem be decreased in?
Definition
Patients with hepatic impairment and elderly
Term
What can develop with extended use of zolpidem?
Definition
Tolerance
Term
Zolpidem Drug Interactions
Definition
Any CNS depressants, alcoholic beverages, opoid analgesics, and phenothiazines-which can lead to additive effects. Less obvious are the antihistamines, some antihypertensions and TCA’s (antidepressant class), d/t enhanced CNS depression
Term
Venlafaxine (Effexor) Drug Class
Definition
Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs)
Term
Venlafaxine MOA
Definition
Moderately selective blockade of NET and SERT to increase serotonergic and adrenergic activity
Term
Venlafaxine Clinical Uses
Definition
Depression. Also approved for treatment of neuropathy, fibromyalgia, generalized anxiety, stress urinary incontinence, and vasomotor symptoms of menopause
Term
Venlafaxine Adverse Reactions
Definition
Increased blood pressure and heart rate, GI symptoms, and CNS activation such as insomnia, anxiety, and agitation
Term
Venlafaxine Drug Interactions
Definition
Never mix with a SSRI drug as this can greatly increase risk of serotonin syndrome
Term
Chlorpromazine MOA
Definition
Phenothiazine derivative; exact MOA is unknown. Chlorpromazine has strong anti-adrenergic activity (D2-receptor blockade) and weak anti-cholinergic activity (muscarinic-receptor blockade). Also a weak blocker of serotonin (5HT2A) and H1 receptors.
Term
Chlorpromazine Toxicities
Definition
Toxic effects result from the anticholinergic properties of this drug (excessive sedation), as well as the alpha-blocking effects (hypotension) and mild sodium channel blocking effects (QRS prolongation and dysrhythmias).
Term
Chlorpromazine Pharmacokinetics
Definition
Up to 99% bound to protein, metabolized by liver, excreted by kidneys. Very long T1/2.
Term
Clinical Uses of Chlorpromazine
Definition
Antipsychotic agent used for schizophrenia and bipolar disorder (produces CNS depression). Also used as an antiemetic (due to dopamine-receptor blockade) and for itching (due to H1-receptor blockade).
Term
Chlorpromazine ADE's
Definition
Extrapyramidal effects such as dystonia, tardive dyskinesia, akathisia, and Parkinson’s syndrome (tremor). Also dry mouth, urinary retention.
Term
Buspirone brand name
Definition
Buspar
Term
Buspirone drug class
Definition
Anxiolytix, miscellaneous
Term
Buspirone clincal use
Definition
generalized anxiety disorder. Off label: augments anti depressants
Term
Buspirone MOA
Definition
Unknown, Buspirone is a serotonin 5-HT1A and 5-HT2 agonist, without affecting GABA receptors
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