Term
| name all 6 drugs that are SSRI |
|
Definition
| Fluoxetine, Paroxetine, Sertraline, Fluvoxamine, Escitaloprm, & Citalopram |
|
|
Term
|
Definition
| Major depression, anxiety disorders, obsessive-compulsive disorder, eating disorders, & premenstrual dysmorphic disorder |
|
|
Term
| what is the main SE of SSRI? |
|
Definition
sexual dysfunction, GI upset, loss of appetite and weight loss, tremor.
Serotonin syndrome |
|
|
Term
| Fluoxetine is unique and could enhance effects of other drugs by inhibiting what |
|
Definition
|
|
Term
|
Definition
| Tranylcypromine, phenelzine, & isocarboxazid |
|
|
Term
| what three thing monominase oxidase metobolize |
|
Definition
| NE, Serotonin, and dopamine |
|
|
Term
| what is a DOC for atypical depression? |
|
Definition
| Tranylcypromine, phenelzine, & isocarboxazid |
|
|
Term
| pt has agoraphobia and stays home all day. what drug would you give him to cope with his condition? |
|
Definition
| MOIs: Tranylcypromine, phenelzine, & isocarboxazid |
|
|
Term
| what could be used for panic disorder? |
|
Definition
tricyclic anti-depressant,
MOIs
or benzodiazepines |
|
|
Term
| why do pt on MOIs get hypertensive crisis? |
|
Definition
| they eat tyramine-containing food. inhibition of M. oxidase also prevents tyramine metabolizism. so tyramine builds up in the gut and stimulates rlz of epi and NE causes HTN crisis. |
|
|
Term
| what is the name of drug that inhibits monoaminase oxidase B? what is it used for? |
|
Definition
| Selegiline. it inc level of dapamine -- used as adjunct tx for parkinson |
|
|
Term
| give 4 drugs that are heterocyclic anti-depressant? |
|
Definition
• Heterocyclic Anti-Depressants
o Drugs: Nefazodone, Mirtazapine, Venalfaxine, & Maprotiline |
|
|
Term
waht two neurotransmitter reuptake are blocked by heterocyclic anti-depressant?
which heterocylic doesnt block the reuptake but works differently? |
|
Definition
NE and Serotonin - Nefazodone, maprotiline, & venlafaxine
--> Mirtazapine: Inhibits activation at a2-adrenergic receptors & at 5HT2 receptors thereby increasing the release of norepinephrine & serotonin |
|
|
Term
| what two durgs are used for generalized anxiety disorder? |
|
Definition
Heteroxyclic anti-depressant (4drugs)
and
Buspirone |
|
|
Term
| if i put pt on effaxor (venlafaxine), what is the SE that i would tell him/her to watch for. |
|
Definition
|
|
Term
| what are 1st gen tricyclic? 2nd gen |
|
Definition
o Drugs:
1st Generation: Desipramine, Nortriptyline, Imipramine, Amitriptyline, & Doxepin
2nd Generation: Amoxapine, Trazodone, & Bupropion |
|
|
Term
| tricyclic anti depressants blocks what two neurotrnas.. |
|
Definition
sero and NE
also inhibit muscarinic, histamine, & a-adrenergic receptorsm |
|
|
Term
| 12 yo boy is bedwetting more than 3 times a week. he also seems depress. what medication would he be given? |
|
Definition
| tricyclic anti-depressant |
|
|
Term
| if i want to give pt one who is depressed and suffer from insomnia, which tricyclic would be appropriate. what would you tell that pt to watch for as a SE. |
|
Definition
|
|
Term
| what class drug are good for chronic pain syndrome? |
|
Definition
|
|
Term
| what are SE of tricyclic anti-depressant |
|
Definition
| sedation, cardiac arrhythmias postural hypotension, urinary retention, dry mouth, constipation, blurred vision |
|
|
Term
| with MOIs what two class drug should not be used? |
|
Definition
|
|
Term
| what drug is used as mood stabilizer and bipolar disorder? |
|
Definition
| Lithium (ppt: first line agent for acute mania and contination tx.) |
|
|
Term
| young female very sexually active and not on BC is suffering from bipolar disorder. what medication is good for her condition? |
|
Definition
| Atypical anti-psychotics -- becz what if she becomes pregnant and she is on Lithium and valporic acid -- then u got a big problem |
|
|
Term
| schizoaffective is tx with only one drug from our list which one is that |
|
Definition
|
|
Term
| schizophrenia is tx with 3 drugs from our list what are they |
|
Definition
Lithium
typical anti-psychotics (haloperidol and fluphenazine)
atypical anti-psychotics |
|
|
Term
| what 4 main SE of lithium? which one is most common |
|
Definition
Tremor(most common), hypothyroidism
nephrogenic diabetes insipidus
leukocytosis |
|
|
Term
| what should be done to avoid lithium intoxication? |
|
Definition
check therapeutic drug level every month..
it has narrow therapeutic window |
|
|
Term
|
Definition
| Typical anti-psychotics: Haloperidol & Fluphenazine (both high-potency drugs) & chlorpromazine & thioridazine (both low-potency drugs) |
|
|
Term
| what else is inhibited than D2 by haloperidol like drugs? |
|
Definition
| H1 receptor, cholinergic and adrenergic receptors. |
|
|
Term
| Pt with schizophrenia is having delusions and hallucination in the hospital bed. he has a long hx of this disease. what medication would you give |
|
Definition
Haloperidol/fluphenzine Chlorpromazine/thioridazine
o Uses: Positive symptoms of schizophrenia (eg delusions, hallucinations), Tourette syndrome, & delirium & agitation |
|
|
Term
| what are highlighted SE of haloperidol ..? |
|
Definition
SEdation (H1 inhibition )
extrapyramidal system SE (dystonia/akinesia)
galactorrhea/amenorrhea (no dopamine-inc prolactin) |
|
|
Term
| pt on what medication could develop neuroleptic malignant syndrome? what should be given to tx it? |
|
Definition
typical anti-psyc (fluphenazine, chloropromazine, thioridazine, halope..)
give Dantrolene or dopamine agonists |
|
|
Term
| Atypical anti-psyc agents are ...6 of them |
|
Definition
clozapine, olanzapine, quetiapine
risperidone, ziprasidone, aripriprazole |
|
|
Term
| this drugs block both Serotonin and dopamine receptors D2 in limbic system. |
|
Definition
| Atypical-anti psyc - ziprasidone, quetiapine, olanzapine, risperidone .. |
|
|
Term
| this pt shows sx of schizophrenia but now he demonstrates both neg and positive sx. he has been to your office before and you decide to change his meds from haloperidol to what drug? (give atleast one specific drug name) |
|
Definition
| quetipine, olanzapine, risperidone, clozapine, aripriprazole, ziprasidone |
|
|
Term
| this pt present with 2 days hx of delirium. he should be treat with what class and what drugs in that class. (3 drugs) |
|
Definition
Delirium: Atypical anti-psyc
olanzapine, risperidone, quetiapine |
|
|
Term
| which of the atypical anti-psyc would you not want to use as it requires weekly monitoring of WBC |
|
Definition
| Clozapine - causes leukopenia and agranulocytosis |
|
|
Term
| what is the difference between atypical and typical anti-psyc? |
|
Definition
fewer extrapyramidal and anticholinergic SE than typical.
use: typical for + schizophrenia
atypical both + and neg sx for schizophrenia |
|
|
Term
| benzo enhance which receptors by bind with them. |
|
Definition
| GABAa receptors. -- they hyperplorize the cell membrane --> dec activity of the neurons of the limbic thalamic and hypothalamic regions of CNS. |
|
|
Term
| alcoholic comes in to hospital and goes thrw withdraw..what drug would you give? give me atleast 2 drugs from each subclass of benzo |
|
Definition
midazolam and triazolam
lorazepam, temazepam, oxazepam, alprazolam, chlordiazepoxide
Diazepam, prazepam, clonzapem, and flurazepam |
|
|
Term
| what r some uses of benzo? |
|
Definition
anxiety, seizures and status epilepticus, alcohol withdraw, mucle spasm, insomnia, panic do,
midozolam (versed) and Diazepam are also used as anesthetics |
|
|
Term
| this class of drug should not withdrawn abruptly because it could cause withdrawal sx. |
|
Definition
|
|
Term
| what is the reversal for benzos? |
|
Definition
| flumazenil -- competitive antagonist |
|
|
Term
| what 5 drugs for barbituates? |
|
Definition
| phenobarbital, thiopental, secobarbital, amobarbital, phentobarbital |
|
|
Term
| indirectly potentiate GABA receptors activity in brain. it inc Cl- ion flow making membrane hyperpolorized..which dec activity of CNS neurons. |
|
Definition
|
|
Term
| thiopental is used for what? |
|
Definition
|
|
Term
| tx for neonatal seizures and hyperbilirubinemia. |
|
Definition
|
|
Term
| can you give phenobarbital in preg. |
|
Definition
|
|
Term
| which drugs inhibits p450 and which on induces it |
|
Definition
barbituates and pheytoin induces p450 -- secretes the drugs
SSRI inhibits p450--keeps the drugs |
|
|
Term
| overdose of barbituates does what to pt. |
|
Definition
| cardiac and resp arrest.--tx with hemodialysis and alkalinization of urine |
|
|
Term
| barbituates should not be given to pt with.. |
|
Definition
| porphyria, alcoholics, preg, liver disease |
|
|
Term
| 1st line tx for depression |
|
Definition
|
|
Term
| what should you give for malignant hyperthermia caused by succinylcholine? |
|
Definition
|
|
Term
| what are the four seizure type that phenytoin is used for? |
|
Definition
| Simple and complex partial sezire, tonic-clonic and status epilepticus |
|
|
Term
| if pt present with trigeminal neuralgia, and while waiting in the exam room goes in to torsades de pointe...what medication would tx both? |
|
Definition
| Phenytoin. treat trigeminal neuralgia and torsades de pointe |
|
|
Term
| pt has been on this drug for 3 yrs to seizure and shows sign of SLE. pt blood work come positive for anti-histone abs. |
|
Definition
| Phenytoin: durg-induce lupus |
|
|
Term
| if preg female is given phenytoin what would happen to fetus? |
|
Definition
| Fetal hyantoin syndrome. prenatal growth deficiency and congenital cardiac and palate malformation |
|
|
Term
| this drug dec Ca++ currents across neuronal cells and inhibits GABA metabolism. what is it used for and name the drug? |
|
Definition
| Ethosuximide: Absence seizures |
|
|
Term
| inhibits GABA metabolism and modulates Na-K pump thus hyperpolorizing the neuronal cell membrane. what drug is this? |
|
Definition
|
|
Term
| pt is bipolar and has episodes of mania. he also suffers from myoclonic seizures. what drug is good for him? |
|
Definition
Valporic acid:
o Uses: Generalized tonic-clonic seizures, myoclonic seizures, & absence seizures. Also has been used in the treatment of mania assoc with bipolar disorder & in the prevention of migraines |
|
|
Term
| female pt finds out that she is preg after 30days. pt was on valporic acid but upon finding out that she is preg PCP stop the drug. what is the fetus at risk of having? |
|
Definition
|
|
Term
| what are is major SE of valporic acid? |
|
Definition
| hepatoxicity, thrombocytopenia, teratogen, |
|
|
Term
|
Definition
| simple and complex partial seizure |
|
|
Term
| what two drug would tx trigeminal neuralgia? |
|
Definition
| Carbamazepine and phenytoin |
|
|
Term
| only one drug from our list causes aplastic anemia? |
|
Definition
| Carbamazepine: SE: hepatotoxicity and agranulocytosis |
|
|
Term
| tiagabine and vigabatrin is used for what kind of seizures? |
|
Definition
|
|
Term
| how does succinylcholine works? |
|
Definition
| Depolarizing neuromuscular blocker that competes with acetylcholine to reversibly bind to the nicotinic receptors |
|
|
Term
| what medication given with succinycholine could result in malignant hyperthermia? |
|
Definition
| Halothane - tx with dantrolene |
|
|
Term
| what is MOA of pancuronium? |
|
Definition
| : Nondepolarizing neuromuscular blocker that acts to competitively bind nicotinic receptors at the neuromuscular junction |
|
|
Term
| pt is being intubated by it is starting to be a difficult intubation as pt cant relax his skeletal muscles. pt is fighting even with the sedation and starting to develop cyanosis. what drug adjunct to general anesthesia would give? |
|
Definition
|
|
Term
| pt is still paralyzed from pancuronium. what drug is given to reverse its effects? |
|
Definition
| Neostigmine - cholinesterase inhibitor. |
|
|
Term
|
Definition
| by blocking Na+ channels on neuronal cell membrane. thereby dec activation of these neurons |
|
|
Term
| what is the main SE that needs to be monitor with local anesthetics like procaine, cociane, tetracaine... |
|
Definition
| Seizure, neurotoxicity, myocardial depression and hypotension. |
|
|
Term
| which one has longer half life? Esters or Amides - local anesthetics. what are two amides? |
|
Definition
Amides have longer half-life than esters.
amides: bupivacaine and lidocaine |
|
|
Term
| how do inhaled anesthetics work? |
|
Definition
| they directly activate GABA throw out the brain. == leading to dec neuronal activity. |
|
|
Term
| what is main side effect of halothane? |
|
Definition
| causes fulminant hepatic necrosis. hypotension and cardiac arrhythmias |
|
|
Term
| in the list of inhaled anesthetics which two causes nephrotoxicity? |
|
Definition
| Methoxyflurane and enflurane |
|
|
Term
| which one causes chemical pancreatitis? |
|
Definition
|
|
Term
| which one is used for conscious sedation other tahn propofol? |
|
Definition
| etomidate: SE: myoclonus adrenal suppression |
|
|
Term
| what r some SE of ketamine which limits its use? |
|
Definition
| hallucination, cardiac and resp depressant |
|
|
Term
| first line tx for parkinson. |
|
Definition
| levodopa...it is converted to dopamine in brain. |
|
|
Term
| what are the SE of Levodopa? |
|
Definition
| Dyskinesia. Cardiac arrh*, hallucination and depression |
|
|
Term
| what is the drug that is given with levodapa? |
|
Definition
|
|
Term
| what is on off phenomenon? |
|
Definition
on period : marked dyskinesia
off periods: marked Akinesia (the inability to initiate movement due to difficulty selecting and/or activating motor programs) |
|
|
Term
| which drug is given to parkinson pt in off-period? |
|
Definition
|
|
Term
| if lithium fails in tx mania which one you should use? |
|
Definition
|
|
Term
|
Definition
haloperidol: most effective.
Clonidine could also be used |
|
|
Term
| to tx tremor which is a SE of lithium what drug could be used? |
|
Definition
|
|
Term
| which one is most selective SSRI? |
|
Definition
|
|
Term
| do intravenous anesthetics help with pain? |
|
Definition
|
|
Term
| most commonly used steroid muscle relaxants (part of Non-depo NMB) |
|
Definition
|
|
Term
| most commonly used inhaled anesthetics |
|
Definition
isoflurane
Desflurane
Sevoflurane |
|
|
Term
| which of the barbituates is commonly used for anesthesia induction? |
|
Definition
|
|
Term
| which is agent of choice for ambulatory surgery? |
|
Definition
|
|
Term
| good summary for C. Sedation |
|
Definition
BZDs: control anxiety, facilitate amnesia
Barbiturates: sedation
Antihistamines:
Diphenhydramine: prevention of allergic reactions
Ranitidine: reduce gastric acidity
Ondansetron: antiemetic
Opioids: analgesia
Anticholinergics: amnesia
Also used to prevent bradycardia and secretion of fluids into the respiratory tract |
|
|
Term
| which drug is partial dopamine receptor agonist? |
|
Definition
| bromocriptine --for parkinson and hyperprolactinemia |
|
|
Term
| which group of pt should not receive sumatriptan? |
|
Definition
| Cardiac - as it causes coronary vasospasm |
|
|
Term
| what is the main use of Sumatriptan? |
|
Definition
|
|
Term
| this drug is used for smoking cessation and antidepressant. |
|
Definition
|
|
Term
|
Definition
|
|
Term
| postherpetic neuralgia is tx with this medication |
|
Definition
|
|
Term
| what two drug are used in chronic neuropathic pain ? |
|
Definition
| gabapentin and pregabalin(fibromyaagia) |
|
|
Term
| peripheral edema could be caused by which seizure drug |
|
Definition
|
|
Term
| most commonly abused sedative hypnotics |
|
Definition
|
|
Term
| heroin addicts could be put on what drug? it is also used for opioid substitution |
|
Definition
|
|
Term
| FDA approved tx for opioid and alcohol addiction |
|
Definition
|
|
Term
| what two drugs causes agranulocytosis? |
|
Definition
| Clozapine and carbamazepine |
|
|
Term
|
Definition
|
|
Term
| works on S phase - cell cycle specific |
|
Definition
|
|
Term
| Vincristine and vinblastine works on which phase in cell cycle specific |
|
Definition
| VV - turn it upside down -^^ M |
|
|
Term
| what is the The treatment for CML |
|
Definition
|
|
Term
| pt present with neuropathic pain what agents would tx this... |
|
Definition
Amitriptyline
pregabalin/gabapentin
Levetiracetam
Ketamine |
|
|
Term
| pt present with neurolaptic pain and signs of depression. |
|
Definition
|
|
Term
| pt present with neurolaptic pain who has hx of seizure. |
|
Definition
|
|
Term
| what four drug causes weight gain? |
|
Definition
| MOI, heterocyclic, atypical, valporic acid |
|
|
