Amit Narayan- B&B Pharmacology 2013 Indirect-Acting Sympathomimetic Agents - What should you avoid with these and

why? 1. Cocaine a. 3 MoAs? b. Specific effect on the transporters? 2. Amphetamine a. 3 MoAs 3. Methamphetamine a. Compare to amphetamine? 4. Methylphenidate a. Note about the isoform? b. MoA? c. 1 adverse effect? 5. Pseudoephedrine a. MoA? 6. Tyramine 7. Modafinil a. Used to alleviate Sx of what? 8. Atomoxetine a. Is it a stimulant? b. Special note about MoA? c. Addictive? d. 1 adverse effect? 9. Dexmethylphenidate a. Isoform? b. MoA? 10. Dextroamphetamine a. Isoform? b. MoA? c. 1 adverse effect? 11. Lysdexamfetamine a. Relationship to dextroamphetamine? 12. Amphetamine (Adderall) a. Note about its isoform 13. Phenylpropanolamine a. MoA?

Amit Narayan- B&B Pharmacology 2013 Drugs Used to Treat Affective Disorders - SSRIs o 6 diseases these treat? o Avoid what along with SSRIs? o Describe AE as compared to other antidepressants. o Metabolism? 2 exceptions? 1. Fluoxetine a. What is its metabolite? What is special about its metabolism? 2. Sertraline 3. Citalopram 4. Paroxetine 5. Fluvoxamine 6. Escitalopram - SNRIs o 4 diseases they treat? o 2 aspects of MoA? o Compare to TCAs. 1. Venlafaxine a. Describe MoA in terms of potency/weakness. b. Drug interaction risk? 2. Desvenlafaxine 3. Duloxetine a. Sedation severity? b. Contraindicated in what? - TCAs o Consequence of overdose? o 5 receptors blocked? o Effect on dementia Sx? o 2 cardiac AE? Desipramine a. Note about MoA i.e. which R is not blocked? Imipramine Amitriptyline a. Prophylaxis for what? Nortriptyline

1. 2. 3. 4.

- 5-HT2A R Antagonists 1. Trazodone a. Also used as what? b. 1 unique AE? 2. Nefazodone a. Note about AE? What is the implication on compliance? b. Note about REM suppression?

Amit Narayan- B&B Pharmacology 2013 - Tetracyclics/Unicyclics 1. Buproprion a. Tetracyclic or unicyclic? What are the rest? b. Describe the elimination? c. MoA? d. Used for what? e. Reverses what? f. Contraindicated in patients with what? 2. Mirtazapine a. Blocks what R? b. Effect on weight gain? c. Note about REM suppression? 3. Amoxapine a. Used to treat depression in what patient population? b. 2 unique AE? 4. Maprotiline a. Special note about MoA? - MAOIs o MoA? o 2 AE? o Why is it contraindicated with tyramine? o Why is it contraindicated with SSRIs, cocaine, MDMA, etc.? o Why is it contraindicated with opioids? o First line drug for what? 1. Phenelzine 2. Isocarboxazid 3. Tranylcypromine 4. Selegeline - Other 1. St. Johns Wort

Amit Narayan- B&B Pharmacology 2013 Antipsychotic Agents (Major Tranquilizers) a. Treat which Sx of schizophrenia? b. Strong MoA? c. Extrapyramidal effect of? d. AE with long Tx course? e. 4 unique AE? f. Contraindication? g. Endocrine related AE? h. What relieves Parkinsonian Sx? - Phenothiazines o 4 receptors blocked 1. Chlorpromazine 2. Thioridizine 3. Fluphenazine --4. Thiothixene 5. Haloperidol a. Potency and relative AE (autonomic vs extrapyramidal) as compared to phenothiazines? Atypical antipsychotics o General MoA? o Tx for what 2 diseases? o Reduce DA where, and increase DA where? o Block 5-HT release where? Implication? o Why do they have less extrapyramidal effects? o What rare AE to watch for? 6. Risperidone 7. Clozapine a. 1 unique AE? 8. Olanzapine a. 1 unique AE? 9. Quetiapine 10. Ziprasidone a. 1 unique AE? 11. Aripiprazole a. Note about its MoA? b. Note about the AE?

Amit Narayan- B&B Pharmacology 2013 Mood Stabilizers 1. Lithium a. What does it treat? b. MoA (3 steps)? c. How is it cleared, and what two things could interfere with this? d. What should be avoided with this? Why? e. 3 unique adverse effects? f. 3 Sx of overdose? 2. Valproic acid 3. Carbamazepine Sedative-Hypnotics and Minor Tranquilizers - Benzodiazepines o What is their usual MoA? o How is BZ overdose reversed? o What CNS effects should be monitored? o Effect on sleep? (latency, slow wave sleep, stage 2 sleep, cycles, REM) 1. Chlordiazepoxide a. Length of action? 2. Diazepam a. Length of action? b. A unique effect on CNS and implication on skeletal musculature? c. Tx for what? 3. Desmethyldiazepam a. Length of action? 4. Oxazepam a. Length of action? b. Is it metabolized by liver? 5. Flurazepam a. Length of action? 6. Triazolam a. Length of action? 7. Alprazolam a. Length of action? 8. Lorazepam a. Length of action? b. Is it metabolized by liver? c. Tx for what? --9. Zolpidem a. What does it bind to, i.e. which site? b. What is the result of abrupt discontinuation? c. Effects on sleep? (REM, latency, slow wave sleep, total time in sleep) 10. Zaleplon a. Effects on sleep? (latency, total sleep time, REM/non-REM) b. Note about AE? 5

Amit Narayan- B&B Pharmacology 2013 11. Ramelteon a. MoA? b. Effects of stopping? c. Dont use with which drug? d. 2 adverse effects? 12. Eszopiclone a. Effects on sleep? (total sleep time, stage 2, REM (at high doses)) b. 2 aspects better than benzodiazepines? - Barbiturates o Bind to what, i.e. specific site? o Mainly used for what procedures? o Compare MoA at low concentration vs high concentration. o What CNS effects should be monitored? 13. Thiopental a. Used for what? 14. Secobarbital a. Used for what? b. 1 AE? 15. Phenobarbital --16. Buspirone a. 2 MoA? b. Abuse potential? 17. Flumazenil a. Tx for what? 18. Valerian root a. Advantage over benzodiazepines? Anesthetics o 4 stages of anesthesia? - Inhalational General Anesthetics o Drug needs to transfer from what to what to what? o Relationship between solubility and onset? o What is the MAC? o AE? o Contraindicated in what? 1. Halothane a. Low or high partition coefficient? b. 2 unique AE? 2. Enflurane a. Low or high partition coefficient? 3. Isoflurane 4. Sevoflurane 5. Nitrous oxide 6

Amit Narayan- B&B Pharmacology 2013 a. Low or high partition coefficient? b. 1 unique AE? - Intravenous Anesthetics and Anesthetic Adjuncts 1. Thiopental a. Class of drug? b. MoA? c. It is ok for patients with what condition? d. Dose-dependent decreases in what? 2. Midazolam a. Class of drug? b. MoA? c. When is it given? d. Describe its half life 3. Diazepam 4. Lorazepam 5. Ketamine a. MoA? b. What type of anesthesia does it cause? c. Describe onset rate. d. Contraindicated in patients with what condition? e. Useful in what 3 patient populations? 6. Propofol a. Used for what? b. Popular? Why? 7. Etomidate a. Used for what? b. Analgesic effects? 8. Fentanyl a. How is it given? b. Reduces what kind of changes? 9. Sufentanil a. How is it given? b. Reduces what kind of changes? 10. Droperidol

Amit Narayan- B&B Pharmacology 2013 Opioid Analgesics and Antagonists o 2 general uses? o Stimulation of which R causes dysphoric and negative psychological AE (like 'feeling ill or seeing spiders on the wall)? o What is the typical overdose triad of Sx? 1. Morphine a. Metabolism note? b. Which R is agonized? 2. Heroin a. Which R? b. Overdose Sx? c. Tx for withdrawal? 3. Methadone a. Which R? b. Compare to morphine. 4. Codeine a. Note about MoA? 5. Oxycodone 6. Hydrocodone 7. Hydromorphone 8. Oxymorphone 9. Fentanyl a. Also used for what? 10. Meperidine a. 3 MoAs? b. 2 AE? 11. Propoxyphene a. Describe analgesic activity. 12. Tramadol a. 4 MoA? b. Differentiate from meperidine. 13. Nalbuphine a. 2 MoA? 14. Pentazocine 15. Butorphanol a. 2 MoA; similar to which other drug? b. Note about metabolism? 16. Buprenorphine a. MoA? b. Also used in Tx of what? c. What do you combine with buprenorphine and why? 17. Dextromethorphan 18. Naloxone a. MoA? b. Treats what?

Amit Narayan- B&B Pharmacology 2013 What is neuroleptanalgesia? What is neuroleptanesthesia?

Migraine Headache Drugs o Activate what R on which nerve endings? o Vasodilation or vasoconstriction? 1. Sumatriptan a. Duration of action? b. Contraindicated in patients with what? And those using what? 2. Ergotamine a. When is it given? b. How do you increase its absorption? c. What to watch for when taken long term?

Amit Narayan- B&B Pharmacology 2013 Drugs of Abuse 1. Ethanol a. Withdrawal serious? How to manage? b. Long term Tx (3)? 2. Nicotine a. Tx for smoking? 3. Benzodiazepines a. Used to immediately treat what? What is long term maintenance for this disease? 4. Barbiturates 5. Cocaine a. MoA (3)? b. OD Sx in general? A few specific examples? c. What R should not be blocked in OD? An example of such a drug? d. What does it do when used as a topical anesthetic? 6. Methamphetamine a. MoA (3)? What does it do to the transporter? b. 1 Sx of amphetamines OD that differs from cocaine OD? Why? 7. 3,4-methylenedioxymethamphetamine a. MoA (3)? More importantly, difference from methamphetamine? 8. Opioids a. Two examples? b. Tx for withdrawal Sx? c. Two other Tx? Combine one of these with what? Why? 9. Marijuana a. What does it bind and where? 10. Inhalants 11. Ketamine a. Describe it. b. MoA? 12. Phencyclidine a. Describe it. b. MoA? 13. Dextromethorphan a. Describe it. b. MoA? 14. Lysergic acid diethylamide a. MoA (2)? b. 2 Sx caused by LSD abuse? 15. Mescaline 16. Psilocybin 17. Rohypnol a. MoA? 18. Gamma hydroxybutyrate a. MoA? 19. Clonidine 10

Amit Narayan- B&B Pharmacology 2013 20. Carenicline 21. Buproprion 22. Disulfuram 23. Naltrexone 24. Acamprosate 25. Methadone 26. Buprenorphine 27. Nitrites a. MoA? Lifestyle note? Alzheimers Drugs o MoA? o 3 AE? 1. Donazepil 2. Rivastigmine a. Also comes in what form? 3. Galantamine 4. Memantine a. Its MoA is different from above 3. MoA? b. Does it compete with glutamate? c. Better when administered with what?

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Amit Narayan- B&B Pharmacology 2013 Anticonvulsants o 3 AE of most antiepileptic drugs? 1. Carbamazepine a. What channels are blocked? b. Special note about its breakdown? c. Induces __ to interfere with MoA of what common thing? d. 3 adverse effects? e. What syndrome to watch out for? f. First line Tx for what? 2. Ethosuximide a. Inhibits what? b. Primary Tx for what kind of seizure? 3. Phenobarbital a. Contraindicated in patients with what kind of seizures? 4. Primidone a. What is its metabolite? 5. Valproic acid a. 3 MoAs? b. Why is it good for absence seizures? c. Avoid in whom? d. 2 AE? 6. Phenytoin a. MoA? b. Special note about low concentrations v higher concentrations? So what should we watch for at higher concentrations? c. A special adverse effect? d. Interferes with what common thing? 7. Diazepam a. MoA? b. What kind of modulator is it? c. What is needed for it to work? d. Especially useful for what state? e. Stop slowly to avoid what? 8. Clonazepam a. MoA? b. Who is this used for? c. Also used for Tx of what? 9. Gabapentin a. Which neurotransmitter does this protect? b. What enzyme is blocked? c. Also useful for what? d. Avoid in which people? 10. Pregabalin 11. Tiagabine a. MoA? b. Contraindicated in what? 12

Amit Narayan- B&B Pharmacology 2013 12. Topiramate a. 2 MoA? b. 3 unique side effects? 13. Lamotrigine a. 1 serious, rare AE? 14. Zonisamide a. Note about tolerance? Viral Encephalitis Drugs 1. Acyclovir 2. Rabies immune globulin Muscarinic Receptor Antagonists 1. Benztropine 2. Trihexyphenidyl

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