HPRS 2300 Exam 6

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cotypatricia
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84812
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HPRS 2300 Exam 6
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2011-05-09 16:28:30
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Neuropathy Psychiatric RX therapy
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Exam 6 review drugs
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  1. phenylzine

    MOA:
    1) inhibits the enzyme responsible for the breakdown of NE & 5-HT
    2) results in increased NE, 5-HT, & Dopamine (DA)
    Monoamine Oxidase Inhibitor (MAOI)
  2. tranylcypromine

    MOA:
    1) inhibits the enzyme responsible for the breakdown of NE & 5-HT
    2) results in increased NE, 5-HT, & Dopamine (DA)
    Monoamine Oxidase Inhibitor (MAOI)
  3. Sinequan

    MOA:
    1) inhibit the reuptake of NE & h-HT into the neuronal nerve endings

    (results upone admin, peaking @ 4-6 weeks, lasting through 2 wks after d/c)
    doxepin

    Tricyclic Antidepressants (TCAs)

    * not 1st line due to toxicity
  4. Tofranil

    MOA:
    1) inhibit the reuptake of NE & h-HT into the neuronal nerve endings

    (results upone admin, peaking @ 4-6 weeks, lasting through 2 wks after d/c)
    imipramine

    Tricyclic Antidepressants (TCAs)

    * not 1st line due to toxicity
  5. Pamelor

    MOA:
    1) inhibit the reuptake of NE & h-HT into the neuronal nerve endings

    (results upone admin, peaking @ 4-6 weeks, lasting through 2 wks after d/c)
    nortipyline

    Tricyclic Antidepressants (TCAs)

    * not 1st line due to toxicity
  6. Ascendin

    MOA:
    1) inhibit the reuptake of NE & h-HT into the neuronal nerve endings

    (results upone admin, peaking @ 4-6 weeks, lasting through 2 wks after d/c)
    amoxapine

    Tricyclic Antidepressants (TCAs)

    * not 1st line due to toxicity
  7. Elavil

    MOA:works on neuropathic pain
    1) inhibit the reuptake of NE & h-HT into the neuronal nerve endings

    (results upone admin, peaking @ 4-6 weeks, lasting through 2 wks after d/c)
    amitriptyline

    Tricyclic Antidepressants (TCAs)

    * not 1st line due to toxicity
  8. Prozac

    MOA: selective only to 5-HT
    1) inhibits the reuptake of serotonin
    fluoxetine

    Selective Serotonin Reuptake Inhibitors (SSRIs)

    *1st line for MDD & anxiety due to efficacy, tolerability (safer than TCA in OD)
  9. Paxil

    MOA: selective only to 5-HT
    1) inhibits the reuptake of serotonin
    paroxetine

    Selective Serotonin Reuptake Inhibitors (SSRIs)

    *1st line for MDD & anxiety due to efficacy, tolerability (safer than TCA in OD)
  10. Zoloft

    MOA: selective only to 5-HT
    1) inhibits the reuptake of serotonin
    sertaline

    Selective Serotonin Reuptake Inhibitors (SSRIs)

    *1st line for MDD & anxiety due to efficacy, tolerability (safer than TCA in OD)
  11. Celexa

    MOA: selective only to 5-HT
    1) inhibits the reuptake of serotonin
    citalopram

    Selective Serotonin Reuptake Inhibitors (SSRIs)

    *1st line for MDD & anxiety due to efficacy, tolerability (safer than TCA in OD)
  12. Lexapro

    MOA: selective only to 5-HT
    1) inhibits the reuptake of serotonin
    escitalopram

    Selective Serotonin Reuptake Inhibitors (SSRIs)

    *1st line for MDD & anxiety due to efficacy, tolerability (safer than TCA in OD)
  13. Effexor

    MOA:
    1) inhibits both 5-HT & NE reuptake
    venlafaxine

    Serotonin & Norepinephrine Reuptake Inhibitors (SNRIs)
  14. Prestiq

    MOA:
    1) inhibits both 5-HT & NE reuptake
    desvenlafaxine

    Serotonin & Norepinephrine Reuptake Inhibitors (SNRIs)
  15. Cymbalta

    MOA:
    1) inhibits both 5-HT & NE reuptake

    *indicated for fibromyalgia, but still prescribed for depression*
    dulocetine

    Serotonin & Norepinephrine Reuptake Inhibitors (SNRIs)

    *FDA approved to treat Fibromyalgia (1/3)
  16. Sevella

    MOA: 1) inhibits both 5-HT & NE reuptake

    *indicated for fibromyalgia, not depression, but still prescribed for depression*
    milnacipran

    Serotonin & Norepinephrine Reuptake Inhibitors (SNRIs)

    *FDA approved to treat Fibromyalgia (1/3)
  17. Lyrica

    MOA:
    1) unknown, but modifies ionic factors
    Neuropathic Pain Agent

    *FDA approved to treat Fibromyalgia (1/3)
  18. Wellbutrin

    MOA:
    1) inhibits NE & Dopamine (DA) reuptake
    2) lowers seizure threshold

    *also used for smoking cessation
    buproprion

    Atypical Antidepressant
  19. Remeron

    MOA:
    1) Alpha2-Adrenergic Antagonist
    2) increases 5-HT & NE release

    *used for sedation @ low dose
    mirtazapine

    Atypical Antidepressant

    *avoid use with clonidine to avoid rebound HTN
  20. Serzone

    MOA: unkown
    1) inhibits serotonin & NE reuptake
    2) also acts on 5-HT receptor
    nefazadone

    Atypical Antidepressant

    * BBW: liver failure
  21. Desyrel

    MOA: unknown
    1) potentiates serotenergic activity in CNS
    2) Adjunct to AD for insomnia
    trazodone

    Atypical Antidepressant

    *may cause prolonged priapism
  22. St. John's Wart

    MOA:
    1) natural antidepressant activity
    Herbal Suppliment

    • DDIs:
    • 1) Warfarin
    • 2) SSRIs
    • 3) TCAs
  23. lithium

    MOA:
    1) decreases excitability of nerve tissue
    2) decreases release of NE @ nerve endings
    2) increases reuptake of NE & 5-HT
    Antimanic

    *similar to Na (sodium), so body uses Lithium instead of Sodium - increase NA intake
  24. Lithium: 0.6 - 0.8 Meq/L
    normal levels
  25. Litium: <1.5 Meq/L
    • fine hand tremors
    • GI upset
    • polydipsia
    • muscle weakness
  26. Lithium: 1.5 - 1.5 Meq/L
    • slurred speech
    • confusion
    • sedation
    • dizziness
  27. Lithium: >2.5 Meq/L
    • seizures
    • coma
    • cardiovascular collapse
    • DEATH
  28. divalproex sodium

    MOA: unkown
    1) works with GABA
    Class: Valporic Acid

    • anti-convulsant
    • anti-migrain
    • eanti-manic

    *BBW: hepatotoxicity
  29. Tegretol

    MOA: unknown for mania
    1) sodium channel blocker
    2) auto-induction & enzyme INDUCER
    carbamazepine

    • Antiepileptic (AED) & Antimanic
    • --> complex partial seizures
    • --> partial seizures secondarily generalized
    • --> tonic-clonic seizures

    *BBW: Steven Johnson Syndrome
  30. Lamictal

    MOA:
    1) bloacks Na (sodium) dependant channels
    2) unknown for mania, but may decrease glutamate release
    lamotrigene

    Anticonvulsant & Antimanic

    *start slow & low
  31. Thorazine

    MOA: based on dopamine hypothesis
    1) bloackade of CNS dopamine receptors
    2) results in inhibition of dopamine-mediated effects associated with schizophrenia
    chlorpromazine

    1st generation (Typical) Antipsychotics
  32. Mellaril

    MOA: based on dopamine hypothesis
    1) bloackade of CNS dopamine receptors
    2) results in inhibition of dopamine-mediated effects associated with schizophrenia
    thioridazine

    1st generation (Typical) Antipsychotics
  33. Haldol

    MOA: based on dopamine hypothesis
    1) bloackade of CNS dopamine receptors
    2) results in inhibition of dopamine-mediated effects associated with schizophrenia
    haloperidol

    1st generation (Typical) Antipsychotics
  34. Navane

    MOA: based on dopamine hypothesis
    1) bloackade of CNS dopamine receptors
    2) results in inhibition of dopamine-mediated effects associated with schizophrenia
    thiothixene

    1st generation (Typical) Antipsychotics
  35. clozapine

    MOA:
    1) Moderate - high D2 antagonist (blocker)
    2) High 5-HT2a antagonist (blocker)
    3) Also affects other receptors to work on the negative sxs of schizophrenia
    2nd Generation Antipsychotics

    *1st line agents in tx of schizophrenia
  36. Risperidone

    MOA:
    1) Moderate - high D2 antagonist (blocker)
    2) High 5-HT2a antagonist (blocker)
    3) Also affects other receptors to work on the negative sxs of schizophrenia
    2nd Generation Antipsychotics

    *1st line agents in tx of schizophrenia

    Effective as monotherapy/adjuct with lithium/valporic acid in txof acute mania*
  37. Olanzapine

    MOA:
    1) Moderate - high D2 antagonist (blocker)
    2) High 5-HT2a antagonist (blocker)
    3) Also affects other receptors to work on the negative sxs of schizophrenia
    2nd Generation Antipsychotics

    *1st line agents in tx of schizophrenia

    Effective as monotherapy/adjuct with lithium/valporic acid in txof acute mania*
  38. Quetiapine

    MOA:
    1) Moderate - high D2 antagonist (blocker)
    2) High 5-HT2a antagonist (blocker)3) Also affects other receptors to work
    on the negative sxs of schizophrenia
    2nd Generation Antipsychotics

    *1st line agents in tx of schizophrenia

    Effective as monotherapy/adjuct with lithium/valporic acid in txof acute mania*
  39. Ziprasidone

    MOA:
    1) Moderate - high D2 antagonist (blocker)
    2) High 5-HT2a antagonist (blocker)
    3) Also affects other receptors to work on the negative sxs of schizophrenia
    2nd Generation Antipsychotics

    *1st line agents in tx of schizophrenia

    Effective as monotherapy/adjuct with lithium/valporic acid in txof acute mania*
  40. Aripiprazole *

    MOA:
    1) Moderate - high D2 antagonist (blocker)
    2) High 5-HT2a antagonist (blocker)
    3) Also affects other receptors to work on the negative sxs of schizophrenia
    2nd Generation Antipsychotics

    *1st line agents in tx of schizophrenia

    Effective as monotherapy/adjuct with lithium/valporic acid in txof acute mania*
  41. Paliperidone

    MOA:
    1) Moderate - high D2 antagonist (blocker)
    2) High 5-HT2a antagonist (blocker)
    3) Also affects other receptors to work on the negative sxs of schizophrenia
    2nd Generation Antipsychotics

    *1st line agents in tx of schizophrenia
  42. Iloperidone

    MOA:
    1) Moderate - high D2 antagonist (blocker)
    2) High 5-HT2a antagonist (blocker)
    3) Also affects other receptors to work on the negative sxs of schizophrenia
    2nd Generation Antipsychotics

    *1st line agents in tx of schizophrenia
  43. Safrus

    MOA:
    1) Moderate - high D2 antagonist (blocker)
    2) High 5-HT2a antagonist (blocker)
    3) Also affects other receptors to work on the negative sxs of schizophrenia
    asenapine

    2nd Generation Antipsychotics

    *1st line agents in tx of schizophrenia
  44. Lurasidone *

    MOA:
    1) Moderate - high D2 antagonist (blocker)
    2) High 5-HT2a antagonist (blocker)
    3) Also affects other receptors to work on the negative sxs of schizophrenia
    2nd Generation Antipsychotics

    *1st line agents in tx of schizophrenia
  45. Xanax

    MOA:
    1) inhibits enzyme responsible for GABA breakdown
    2) reduces neuronal excitability
    alprazolam

    Benzodiazepine: SHORT-ACTING
  46. Ativan

    MOA:
    1) inhibits enzyme responsible for GABA breakdown
    2) reduces neuronal excitability
    lorazepam

    Benzodiazepine: SHORT-ACTING
  47. Restoril

    MOA:
    1) inhibits enzyme responsible for GABA breakdown
    2) reduces neuronal excitability
    temazepam

    Benzodiazepine: SHORT-ACTING
  48. Halcion

    MOA:
    1) inhibits enzyme responsible for GABA breakdown
    2) reduces neuronal excitability
    triazolam

    Benzodiazepine: SHORT-ACTING
  49. Librium

    MOA:
    1) inhibits enzyme responsible for GABA breakdown
    2) reduces neuronal excitability
    chlordiazepoxide

    Benzodiazepine: LONG-ACTING
  50. Klonopin

    MOA:
    1) inhibits enzyme responsible for GABA breakdown
    2) reduces neuronal excitability
    clonazepam

    Benzodiazepine: LONG-ACTING
  51. Valium

    MOA:
    1) inhibits enzyme responsible for GABA breakdown
    2) reduces neuronal excitability
    diazepam

    Benzodiazepine: LONG-ACTING
  52. Dalmane

    MOA:
    1) inhibits enzyme responsible for GABA breakdown
    2) reduces neuronal excitability
    flurazepam

    Benzodiazepine: LONG-ACTING
  53. Buspar

    MOA:
    1) supresses serotonergic activity
    2) enhances noradrenergi & dopaminergic cell firing
    3) relieves sxs associated with GAD (motor tension, autonomic hyperactivity)
    buspirone

    • Azapirone
    • -similar in efficacy to benzodiazepines
  54. Valerian

    MOA: similar to benzodiazepine
    1) inhibits the breakdown of GABA
    herbal supplement

    TX: insomnia & anxiety

    DDIs: MAOIs
  55. TCA - OTC

    MOA:
    1) atagonists (blocker) at histamine receptor sites
    amitriptyline & doxepine

    OTC Antipressants

    Histamine Antagonist (Blocker)
  56. mirtazapine

    MOA:
    1) atagonists (blocker) at histamine receptor sites
    OTC Antipressants

    Histamine Antagonist (Blocker)
  57. trazodone

    MOA:
    1) atagonists (blocker) at histamine receptor sites
    OTC Antipressants

    Histamine Antagonist (Blocker)
  58. Rozerem

    MOA:
    1) stimulates melatonin receptor to normalize physiologic & behavioral sleep patterns
    ramelton - RX only

    Melatonin Recpetor Agonist
  59. Melatonin

    MOA:
    1) normalizes physiologic & behavioral sleep patterns
    OTC supplement

    Melatonin Receptor Agonist
  60. Ambien

    MOA:
    1) binds to GABA receptor complex sites
    2) enhances GABA activity in CNS
    zolpidem

    • GABA Agonist: Nonbenzodiazepine
    • "Z drugs"
  61. Lunesta

    MOA:
    1) binds to GABA receptor complex sites
    2) enhances GABA activity in CNS
    eszopiclone

    • GABA Agonist: Nonbenzodiazepine
    • "Z drugs"
  62. Sonata

    MOA:
    1) binds to GABA receptor complex sites
    2) enhances GABA activity in CNS
    zaleplon

    • GABA Agonist: Nonbenzodiazepine
    • "Z drugs"
  63. Adderall

    MOA:
    1) effective in tx of ADHD
    stimulant
  64. Concerta

    MOA:
    1) effective in tx of ADHD
    Ritalin

    stimulant
  65. Focalin

    MOA:
    1) effective in tx of ADHD
    stimulant
  66. Vyvanse

    MOA:
    1) effective in tx of ADHD
    stimulant
  67. Daytrana - patch

    MOA:
    1) effective in tx of ADHD
    topical (trasdermal) stimulant

    * total wear time should not exceed 9 hrs
  68. Strattera

    MOA:
    1) non-stimulant tx for ADHD
    NRI (norepinephrine reuptake inhibitor)
  69. Dilantin

    MOA:
    1) Inhibits Na (sodium) channels
    2) decreases hyperexcitability of the nerve cells
    *enzyme inducer
    phenytoin

    • Hydantoins (AEDs)
    • --> complex partial seizures
    • --> patial seizures 2ndarily generalized
    • --> tonic-clonic seizures
  70. Zarontin

    MOA:
    1) antiepilectic action with very narrow spectrum
    ethosuximide

    • Antiepileptic Drug (Misc AED)
    • --> absence seizures
  71. Depakene

    MOA:
    1) unknown, but elevates GABA
    Side Effects:
    - Thrombocytopenia
    - Weight gain & GI Upset
    BBW: Hepatic Failure*
    valporic acid

    • Antiepileptic Drug (Misc AED)
    • --> tonic-clonic seizures
    • --> absence seizures
  72. Neurontin

    MOA:
    1) inhibit Ca (calcium) channel
    2) increases GABA
    gabapentin

    • Antiepileptic Drug (Misc AED)
    • --> complex partial seizures
  73. Topamax

    MOA:
    1) Affects voltage dependent Na (sodium)
    2) effects GABA receptors
    topiramate

    • Antiepileptic Drug (Misc AED)
    • --> complex partial seizures
    • --> tonic-clonic seizures
  74. Vimpat

    MOA:
    1) decreases hyperexcitability of neurons
    lacosamide

    Antiepileptic Drug (Misc AED)
  75. Trileptal

    MOA:
    1) antiepileptic activity
    Side Effects:
    - Ocular (diplopia, nystagmus)
    - N/V
    oxcabazepine

    Antiepileptic Drug (Misc AED)

    * suspension only good for 7 weeks once opened
  76. Keppra

    MOA:
    1) antiepileptic activity
    Side Effects:
    - Sedation; fatigue
    levetiracetam

    Antiepileptic Drug (Misc AED)
  77. Sabril

    MOA:
    1) inhibits enzyme responsible for the breakdown of GABA
    *enzyme inhibitor*
    vigabatrin

    • Antiepileptic Drug (Misc AED)
    • --> complex partial seizures
  78. Zonegran

    MOA:
    1) Na (sodium) channel, T-type Ca inhibitor
    * enzyme inhibitor*
    zonisamide

    • Antiepileptic Drug (Misc AED)
    • --> absence seizures
  79. L-Dopa

    MOA:
    1) Precurser to Dopamine (DA)
    2) Crosses Blood/Brain Barrier
    3) Carbidopa adjunct: prevents peripheral conversion of L-Dopa to dopamine (prevents peripheral effects of N&V) & allows L-Dopa to enter CNS
    levodopa (&carbidopa)

    Antiparkinsonian
  80. Cogentin

    MOA:
    1) antichiloinergic activity similar to atropine
    benztropine

    Antiparkinsonian: ANTI-CHOLINERGIC
  81. Artane

    MOA:
    1) antichiloinergic activity similar to atropine
    trihexphenidyl

    Antiparkinsonian: ANTI-CHOLINERGIC
  82. Symmetrel

    MOA:
    1) interferes with viral trasmission into cell
    amantadine

    Antiparkinsonian: ANTI-VIRAL
  83. Benadryl

    MOA:
    1) competes at Histamine receptors
    diphenydramine

    Antiparkinsonian: ANTI-HISTAMINE
  84. Eldepryl

    MOA:
    1) inhibits the MAOB enzyme, which is responsible for Dopamine (DA) metabolism/breakdown
    selegeline

    • Antiparkinsonian: DOPAMINE CONSERVER
    • -->MAOB Inhibitor*
  85. Azilect

    MOA:
    1) inhibits the MAOB enzyme, which is responsible for Dopamine (DA) metabolism/breakdown
    rasagiline

    • Antiparkinsonian: DOPAMINE CONSERVER
    • -->MAOB Inhibitor*
  86. Parlodel

    MOA:
    1) binds to & stimulates dopamine receptors
    bromocriptine

    • Antiparkinsonian: DOPAMINE AGONIST
    • - less fluctuation & dyskinesia
  87. Mirapex

    MOA:
    1) binds to & stimulates dopamine receptors
    pramipexole

    • Antiparkinsonian: DOPAMINE AGONIST
    • - less fluctuation & dyskinesia
  88. Requip

    MOA:
    1) binds to & stimulates dopamine receptors
    ropinerole

    • Antiparkinsonian: DOPAMINE AGONIST
    • - less fluctuation & dyskinesia
  89. Apokyn

    MOA:
    1) binds to & stimulates dopamine receptors
    *USED FOR TEMP RELIEF DUR "OFF PERIODS"
    apomorphine

    • Antiparkinsonian: DOPAMINE AGONIST (potent)
    • - less fluctuation & dyskinesia
  90. Tasmar

    MOA:
    1) inhibits the enzyme primarily responsible for the metabolism of L-dopa
    tolcapone

    Antiparkinsonian: COMT INHIBITOR

    BBW: liver toxicity
  91. Comtan

    MOA:
    1) inhibits the enzyme primarily responsible for the metabolism of L-dopa
    entacapone

    Antiparkinsonian: COMT INHIBITOR

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