NR 565 Pharm Midterm Exam with
Complete Solutions
CYP2D6 - ANS-Need to increase doses of SSRI, beta blockers etc.
Codeine can be deadly
CYP2C9 - ANS-Decrease warfarin dose
Test for gene VCORC1 mutation
CYP3A4 - ANS-Decreases elimination
Increase toxicity of Amio
Schedule I - ANS-no accepted medical use in the US it may not be prescribed.
heroin,various opium derivatives,hallucinogenic substances
Schedule II - ANS-No refills, no telephone orders
Narcotics, Stimulants, Depressants
Benzodiazepines - ANS-The most common group of antianxiety drugs, increases GABA
and decreases neuronal excitation
do not mix with cns depressive agents
Valium, xanax, ativan
Serotonergic anxiolytics - ANS-Enhances serotonin to relieve anxiety
No CNS depression, no anticonvulsant properties, very mild SE
Buspirone, ipsapirone, gepirone
Barbiturates - ANS-drugs that depress the activity of the central nervous system,
reducing anxiety but impairing memory and judgment, treat epilepsy, seizures, insomnia
do not suddenly discontinue, CNS depression does occur, decreases many other
medications such as beta blockers
pentobarbital, -barbital etc
, sedative-hypnotics - ANS-Drugs that can act in the body either as sedatives or as
hypnotics, depress the CNS
Benzodiazepine hypnotics - ANS-Diazepam, Midazolam, Zolazepam
Potentiates the inhibitory action of GABA. Activation of the receptor causes an influx of
Cl- ion movement into the neuron and hyperpolarization and inhibition of membrane
depolarization
addicting
Nonbenzodiazepine hypnotics - ANS-Zolpidem, Zaleplon, exZopiclone. "ALL ZZZs put
you to sleep."
MOA: act via BZ1 subtype of GABA receptor. Effects reversed by flumazemnil
Use: insomnia
SE: ataxia, headaches, confusion. Short duration. Decreased depdence risnk like
bneozs and only modest daf-after pscyhomoter depression
mood stabilizers - ANS-drugs used to control mood swings in patients with bipolar mood
disorders
Lithium - ANS-Inhibits IP3 second messenger cascade, mood stabilizer for bipolar
therapeutic range 0.6 to 1.5
causes congenital malformations
Valproates - ANS-Blocks GABA uptake, treats seizures, mania, bipolar, manic
depressive
SE: alopecia, drosiness, heartburn
Valproic acid or V P A, Depakote, Depakene
nonclassified mood stabilizers - ANS-nonbenzodiazepine gaba-ergics that help treat
epilepsy and bipolar, all effect GABA somehow
risk for kidney stones and steens-johnson syndrome (rash)
lamotrigine (Lamictal, gabapentin (Nuerontin) and topiramate (Topamax)
Centrally acting muscle relaxants - ANS-Relieves skeletal muscle spasm in: spinal cord
injury, multiple sclerosis, cerebral palsy
Complete Solutions
CYP2D6 - ANS-Need to increase doses of SSRI, beta blockers etc.
Codeine can be deadly
CYP2C9 - ANS-Decrease warfarin dose
Test for gene VCORC1 mutation
CYP3A4 - ANS-Decreases elimination
Increase toxicity of Amio
Schedule I - ANS-no accepted medical use in the US it may not be prescribed.
heroin,various opium derivatives,hallucinogenic substances
Schedule II - ANS-No refills, no telephone orders
Narcotics, Stimulants, Depressants
Benzodiazepines - ANS-The most common group of antianxiety drugs, increases GABA
and decreases neuronal excitation
do not mix with cns depressive agents
Valium, xanax, ativan
Serotonergic anxiolytics - ANS-Enhances serotonin to relieve anxiety
No CNS depression, no anticonvulsant properties, very mild SE
Buspirone, ipsapirone, gepirone
Barbiturates - ANS-drugs that depress the activity of the central nervous system,
reducing anxiety but impairing memory and judgment, treat epilepsy, seizures, insomnia
do not suddenly discontinue, CNS depression does occur, decreases many other
medications such as beta blockers
pentobarbital, -barbital etc
, sedative-hypnotics - ANS-Drugs that can act in the body either as sedatives or as
hypnotics, depress the CNS
Benzodiazepine hypnotics - ANS-Diazepam, Midazolam, Zolazepam
Potentiates the inhibitory action of GABA. Activation of the receptor causes an influx of
Cl- ion movement into the neuron and hyperpolarization and inhibition of membrane
depolarization
addicting
Nonbenzodiazepine hypnotics - ANS-Zolpidem, Zaleplon, exZopiclone. "ALL ZZZs put
you to sleep."
MOA: act via BZ1 subtype of GABA receptor. Effects reversed by flumazemnil
Use: insomnia
SE: ataxia, headaches, confusion. Short duration. Decreased depdence risnk like
bneozs and only modest daf-after pscyhomoter depression
mood stabilizers - ANS-drugs used to control mood swings in patients with bipolar mood
disorders
Lithium - ANS-Inhibits IP3 second messenger cascade, mood stabilizer for bipolar
therapeutic range 0.6 to 1.5
causes congenital malformations
Valproates - ANS-Blocks GABA uptake, treats seizures, mania, bipolar, manic
depressive
SE: alopecia, drosiness, heartburn
Valproic acid or V P A, Depakote, Depakene
nonclassified mood stabilizers - ANS-nonbenzodiazepine gaba-ergics that help treat
epilepsy and bipolar, all effect GABA somehow
risk for kidney stones and steens-johnson syndrome (rash)
lamotrigine (Lamictal, gabapentin (Nuerontin) and topiramate (Topamax)
Centrally acting muscle relaxants - ANS-Relieves skeletal muscle spasm in: spinal cord
injury, multiple sclerosis, cerebral palsy
