Anti-parkinsons
-Benztropine
-Trihexyphenidil
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-Decrease tremor and rigidity in PD
-Less effect on bradykinesia
-Decreased EPS dysfunction caused by DA antagonist
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-Tremor
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-Exacerbation of tardive dyskinesias
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Anti-parkinsons
-Amantadine
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-Weak actions possibly via M block
-Atropine like side effects and livedo reticularis (edema and skin mottling)
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Antipsychotic
-Negative SS: amotivation, social withdrawal, flat affect, poverty of speech
-Positive SS: disorders, delusions, hallucinations, bizarre behavior
-Dopamine blockade may cause an increase in prolactin secretion
-Increased prolactin may cause amenorrhea and galactorrhea, gynecomastia
-Neuroleptic/malignant syndrome: muscle rigidity and hyperthermia associated with anti-muscarinic effects associated with older anti-psychotics. Dantroline or DA agonist may be useful for this disorder.
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Antipsychotics
-Chlorpromazine
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-Block D2 receptor, an older antipsychotic
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-Antipsychotic
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-Increased EPS dysfunction
-Ocular dysfunction
-Sedating
-Alpha blockade
-Lower seizure threshold
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Antipsychotics
-Haloperidol
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-High potency
-Inexpensive
-D2 blockade
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-Antipsychotic
-Chemical restraint
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-Major EPS side effects
-Less alpha and M block
-Tardive dyskinesia
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Antipsychotics
-Clozapine
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-Blocks D2 and 5HT receptors
-Newer antipsychotic
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-Antispychotic
-No EP dysfunction or tardive dyskinesia
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-Watch for agranulocytosis
-Requirement for weekly bloodtest
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Antipsychotic
-Olanazapine
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-Blocks 5HT2 receptors, improves negative symptoms
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-Antispsychotic
-No tardive dyskinesia
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-Improves negative symptoms, may cause alpha blockade
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Antidepressants / MAO
-Phenelzine
-Tranulcypromine
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-Inhibition of MAO type A and type B. Type B MAO metabolizes DA
-Theory is that via inhibition of metabolism, more catecholamines will be available in the brain
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-Depression
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-HTN crisis with tyramine, Neuptakeblockers, alpha agonists, and L dopa
-Hyperthermia, HTN, seizures with meperidine or dextromethorphan
-Serotonin sundrome
-Hypertension with wine and cheese consumption
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Antidepressants/SSRI
-Prozac
-Zoloft
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-5HT receptor antagonists. These drugs may also have a small amount of action at norepinepherine receptors. The first novel drugs for depression
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-Depression
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-Relatively safe
-Some may have p450 reactions
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Antidepressant/Heterocyclic
-Buproprion (DA inhibitor)
-Nefazodone
-Trazodone
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-Amoxapine and maprotiline block NE reuptake
-Nefazodone (Serzone) and trazodone block 5HT reuptake, but both drugs also act as antagonists at certain serotonin receptor subtypes
-Buproprion has minimal effects on NE or 5HT systems but may affect DA neurotransmission
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-Depression
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-Priapasm as a side effect of trazodone
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Antipsychotic
-Lithium
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-Cross blood brain barrier
-Inhibits dephosphorylation from IP to inositol
-Mood stabilizer
-Lithium may also cause decrease in camp
-May affect vasopressin receptors
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Mood stabilization
Manic disorder
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-Tremor, ataxia, choreoarthrosis
-Visual dysfunction, seizures, goiter
-Nephrogenic diabetes insipidus via uncoupling of vasopressin V2 receptors
-Neonatal toxicity
-Teratogenicity
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Some drugs of abuse
-PCP: hallucinations and paranoia. Horizontal and vertical nystagmus. Seizures, amnesia. Symptomatic tx
-MDMA: ecstasy.. amphetamine like with strong 5HT pharmacologyand therefore hallucinogenic and generally neurotoxic.
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ANTIMICROBIALS AND MECHANISM OF ACTION
1. Inhibition of bacterial cell wall synthesis: PCN, Ceph, Vanc
2. Inhibition of bacterial protein synth: aminoglycosides, CHPC, macrolides, TCN
3. Inhibition of nucleic synthesis: fluoroquinolones, rifampin
4. Inhibition of folic acid synthesis: SMX/TMP, pyrimethamne
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