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37 Cards in this Set
- Front
- Back
What drug was historically used to treat hypertension and schizophrenia?
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Reserpine
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What is the method of action of reserpine?
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It inhibits the storage of amine neurotransmitters in the brain
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Levels of what neurotransmitters in the brain are thought to be the cause of depression?
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5-HT (Seratonin) and Norepinephrine
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What is depression ultimately caused by?
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Decreased amine-dependent synaptic transmission
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What is the prototypical agent for tricyclic antidepressents?
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Amitriptyline
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- What are the elimination half-lives?
- How many half lives does it take to reach a steady state? - How long does it take to see any clinical significance? - Why is this? |
- 12-76 hrs
- 5 half-lives - Weeks to months - Due to remodeling of neuronal networks |
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What is the method of action for Amitriptyline?
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Non-specifically inhibit storage of serotonin and norepinephrine in the CNS
Accounts for therapeutic effects |
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What other receptors does Amitriptyline bind too?
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Adrenergic
Histominergic Cholinergic |
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What are the adverse effects of using Amitriptyline?
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α-adrenergic - hypotension
Histaminergic - drowsiness Cholinergic - SLUD (Salivation, Lacrimation, Urination, Defacation) |
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What is Amitriptyline a secondary agent too?
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SSRI's (Selective Seratonin Reuptake Inhibitors)
SNRI's (Selective Norepinephrine Reuptake Inhibitors) |
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What is the method of action for Trazodone?
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- serotonin antagonist and reuptake inhibitor (SARI)
- more specific for serotonin than Tricyclic antidepressents |
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What is Trazodone used for?
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Depression and Insomnia
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What are the adverse reactions associated with using Trazodone?
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Less than Tricyclic antidepressents
Usually just drowsiness |
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What are the specific drugs that are SSRI's (Selective Seratonin Reuptake Inhibitors)?
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Fluoxetine (Prozac)
Paroxetine (Paxil) Citalopram (Celexa) Escitalopram (Lexapro) Sertraline (Zoloft) |
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What is the prototypical SSRI drug on which all others are based chemically?
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fluoxetine (Prozac)
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What is the method of action of SSRI's (Selective Seratonin Reuptake inhibitors)?
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Decreases Seratonin reuptake which increases Seratonin levels in the CNS
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What are the drugs of choice for initial treatment of depression?
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SSRI's
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What are the adverse effects of the SSRI's?
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Similar to Tricyclic Antidepressents but to a much lesser severity and frequency
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What are the SNRI (Selective Norepinephrine Reuptake Inhibitor) drugs?
Which one is the prototypical agent on which the other drugs are based? |
bupropion (Wellbutrin) – prototypical agent
venlafaxine (Effexor) duloxetine (Cymbalta) |
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What is the Mode of action for the SNRI's?
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Decreases the reuptake of both Seratonin and Norepinephrine at the synapse
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What is the greatest use of SNRI's?
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Most effective in treating antidepression along with anxiety
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What is the drug of choice for treating bipolar disorder?
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Lithium
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What are the ions that Lithium competes with?
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Mg++, K+, Na+, Ca++
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What is the Mode of action of Lithium in the CNS?
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Competes with overactivity of neurotransmitters thought to contribute to mania
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What are the adverse effects of Lithium in the CNS?
In the GI? In the Muscular system? |
Dizziness, Lethargy, and Memory loss
Metalic Taste Hand Tremors, Muscle Weakness |
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What are the implications for use of Antidepressents in regards to dentistry?
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Decreased compliance with oral hygiene
Be careful placing the patient back in the chair for treatment or x-rays |
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What are the positive symptoms of Schizophrenia?
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hallucinations
delusions thought disorders insomnia bizarre behavior |
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What are the negative symptoms of Schizophrenia?
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apathy
a motivation anhedonia (lack of pleasure from normal pleasurable experiences), asocial behavior |
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What is the prototypical antipsychotic agent?
What is its mode of action? |
chlorpromazine (Thorazine)
Non-specifically inhibit dopamine at the level of its D2 receptor |
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Of the adverse reactions that stem from Antipsychotics where do the extrapyramidal symptoms come from?
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Due to dopamine effects on tracts other than mesocorticolimbic
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What are the early onset Extrapyramidal symptoms that are caused by antipsychotics?
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- Dystonia : muscle spasms - limbs and facial muscles
- Pseudoparkinsonism More due to BLOCK of DA |
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What are the intermediate onset Extrapyramidal symptoms associated with antipsychotic drugs?
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Akathisia or Restlessness
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What are the newer generation antipsychotics?
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risperidone (Risperdal)
quetiapine (Geodon) olanzapine (Zyprexa) aripiprazole (Abilify) |
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What is the mode of action of the newer generation of antipsychotic drugs?
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- Inhibit serotonin at the level of its receptors (specifically)
- Also inhibit D2 receptors |
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What is the use of the newer generation of antipsychotic drugs?
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First line agents for treatment of psychosis
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What are the adverse effects of the newer generation antipsychotics?
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Same as the typical antipsychotics but less severe and frequent
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What are the implications for using antipsychotic drugs in dentistry?
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- Neuroleptic facial movements
- ↑ sedation when given with opioids - ↑ oral candidiasis (agranulocytosis, leukocytosis) - ↓ salivation - NSAIDs - interaction with lithium |