Antidepressants
What 2 classes of antidepressants increase BOTH serotonin and norepinephrine?
SNRI and TCA
Name 2 first generation antipsychotics
Haloperidol and Chlorpromazine
What is the beta2 target organ?
Lungs
Which class of CNS depressants is considered safer; benzodiazepines or barbiturates?
Benzodiazepines
Finite amount of CNS depression (Ceiling)
What is the role of acetylcholinesterase?
Breaks down acetylcholine (specifically into acetate and choline
Bupropion as brand-name Zyban is indicated for what?
Smoking cessation
What class of antipsychotics have a higher risk of extrapyramidal side effects?
1st generation or typical
Doxazosin is an alpha1 antagonist. What is this medication indicated for?
Benign prostatic hyperplasia (BPH)
What benzodiazepine-like drug helps with both DFS and DMS?
Ambien CR (Zolpidem)
What is the role of the blood brain barrier?
Protects toxic substances from getting into brain (Good and bad)
Name 3 SSRIs.
fluoxetine (Prozac), paroxetine (Paxil), sertraline (Zoloft), citalopram (Celexa), escitalopram (Lexapro), fluvoxamine (Luvox)
2nd generation or atypical antipsychotics are associated with metabolic effects. What are these metabolic effects?
Hyperlipidemia, hyperglycemia --> diabetes, weight gain
What is the effect of alpha1 agonism?
Vasoconstriction
What is a non-controlled alternative to benzos to treat anxiety?
Buspirone (Buspar)
What is role of carbidopa in carbidopa/levodopa combination?
Blocks the breakdown of levodopa before it reaches the brain
A patient is taking isocarboxazid. Food rich in what should be eaten in moderation?
Tyramine (aged cheeses, wine, chocolate)
A patient taking a FGA has been experiencing parkinsonism like side effects? What treatment should be recommended?
Administer anticholinergic (diphenhydramine)
Name 2 therapeutic applications for beta1 agonism
Heart failure, shock, AV heart block, cardiac arrest
A patient experiences severe anxiety a few times a year when she needs to speak in front of people for her company's meetings. She is reluctant to start chronic therapy for her anxiety. What class of medications is best for her situation?
Benzodiazepines (lorazepam, alprazolam, clonazepam, etc.)
What causes first dose syncope with alpha1 antagonists?
Causes vasodilation (give first dose at bedtime to treat)
A patient is started on an SSRI but doesn't notice much improvement in symptoms after one week. How soon will full effect of medication be seen?
Could take up to 4-8 weeks to see full effect of SSRI
What are 2 examples of both positive and negative symptoms seen in schizophrenia?
Positive: hallucinations, dellusions, agitation, tension, paranoia
Negative: withdrawal, depression, lack of motivation, poor self-care
What does beta2 activation cause hyperglycemia in diabetic patients?
Beta2 receptor activation in liver and skeletal muscle promotes glycogenolysis --> hyperglycemia
What is the difference between traditional and newer anti-epileptics?
Traditional agents - know they're efficacious (been studied for a long time), many side effects, difficult pharmacokinetics, DDI
Newer - safer in pregnancy, more-tolerable side effects,
What are the common anticholinergic side effects? (Hint: ABDUCT)
Anhydrosis, blurry vision, dry mouth, urinary retention, constipation, tachycardia