Pharmacology of Bipolar and Epilepsy Treatment
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Questions and Answers

Which adverse effect is associated with Ethosuximide use for epilepsy?

  • Dizziness (correct)
  • Hypersensitivity reactions
  • Weight gain
  • Hair loss

    • What is a potential risk of using Valproate during pregnancy?

  • Transient hypertension
  • Increased metabolism
  • Increased seizure frequency
  • Neural tube defects (correct)

    • Which medication is indicated for the treatment of bipolar disorder?

  • Carbamazepine (correct)
  • Phenytoin
  • Ethosuximide
  • Bupropion

    • What is a common neurological side effect of the medication Ethosuximide?

    <p>Nausea</p> Signup and view all the answers

    Which of the following conditions is contraindicated with the use of Phenytoin?

    <p>Fetal malformations</p> Signup and view all the answers

    Which condition might indicate the use of Valproate for treatment?

    <p>Bipolar disorder</p> Signup and view all the answers

    What is the primary mechanism of action for Carbamazepine?

    <p>Sodium channel stabilization</p> Signup and view all the answers

    Which of these side effects is NOT typically associated with Valproate treatment?

    <p>Migraine relief</p> Signup and view all the answers

    What is a significant concern when discontinuing Carbamazepine suddenly?

    <p>Seizure recurrence</p> Signup and view all the answers

    Which patient group should be monitored closely when prescribed Ethosuximide?

    <p>Older adults</p> Signup and view all the answers

    Which medication is associated with migraine prophylaxis?

    <p>Pregabalin</p> Signup and view all the answers

    What condition is primarily treated with Gabapentin?

    <p>Seizure disorders</p> Signup and view all the answers

    Which of the following is NOT typically a use for Pregabalin?

    <p>Bipolar disorder management</p> Signup and view all the answers

    What is a characteristic of medications used in seizure management?

    <p>They have little effect on mood disorders.</p> Signup and view all the answers

    Which drug has a partial agonist indication in seizure treatment?

    <p>Pregabalin</p> Signup and view all the answers

    Which drug is classified as an α1 agonist for nasal decongestion?

    <p>Phenylephrine</p> Signup and view all the answers

    Which medication primarily acts on β1 receptors and is used in cases of cardiogenic shock?

    <p>Dobutamine</p> Signup and view all the answers

    Which category of drug commonly used for allergic rhinitis is known for having both oral and topical administration routes?

    <p>Ephedrine</p> Signup and view all the answers

    What is the mechanism of action for Clonidine in managing blood pressure?

    <p>α2 agonist</p> Signup and view all the answers

    Which medication is indicated primarily for treating hyperadrenergic states?

    <p>Phentolamine</p> Signup and view all the answers

    Identify the α1 antagonist used primarily to manage hypertension.

    <p>Prazosin</p> Signup and view all the answers

    Which drug is specifically utilized for its selective β2 agonist properties in asthmatic patients?

    <p>Salbutamol</p> Signup and view all the answers

    Which medication would be prescribed to reduce the hyperactive sympathetic response in patients experiencing pheochromocytoma?

    <p>Phenoxybenzamine</p> Signup and view all the answers

    Which drug acts as a mixed-action sympathomimetic indicated for ADHD?

    <p>Amphetamine</p> Signup and view all the answers

    Which α2 agonist is often used for its sedative effects in managing opioid withdrawal?

    <p>Clonidine</p> Signup and view all the answers

    What differentiates the action of Ritodrine from typical β agonists?

    <p>It acts on β2 receptors to induce uterine relaxation.</p> Signup and view all the answers

    Which drug listed has been widely used for treating acute hypotensive states?

    <p>Phenylephrine</p> Signup and view all the answers

    Identify the primary action of Doxazosin when treating urinary symptoms in benign prostatic hyperplasia.

    <p>Selective α1 antagonism</p> Signup and view all the answers

    What effect does epinephrine have at high doses?

    <p>Increases heart rate and systolic blood pressure</p> Signup and view all the answers

    Which receptor is primarily stimulated by dopamine at small doses?

    <p>Dopamine D1</p> Signup and view all the answers

    What is a potential consequence of using norepinephrine in the treatment of shock?

    <p>Vasoconstriction leading to potential tissue necrosis</p> Signup and view all the answers

    What role does epinephrine play in anaphylaxis management?

    <p>Inhibits the bronchial smooth muscle contraction</p> Signup and view all the answers

    Which action does beta-2 adrenergic stimulation NOT contribute to?

    <p>Decreased heart rate</p> Signup and view all the answers

    In what situation might the administration of nasal decongestants pose a risk?

    <p>In patients experiencing high blood pressure due to vasoconstriction</p> Signup and view all the answers

    What mechanism is primarily involved in the action of catecholamines on cardiac tissue?

    <p>Increased myocardial contractility via β1 adrenergic receptors</p> Signup and view all the answers

    What is a typical side effect of adrenergic agonists like epinephrine?

    <p>Tachycardia</p> Signup and view all the answers

    What physiological effect does norepinephrine have on blood vessels?

    <p>Increases peripheral resistance through vasoconstriction</p> Signup and view all the answers

    What is the result of excessive alpha-1 adrenergic receptor stimulation?

    <p>Increased vascular resistance</p> Signup and view all the answers

    How do beta-2 agonists typically affect the gastrointestinal tract?

    <p>Cause relaxation of smooth muscle</p> Signup and view all the answers

    What complication can arise from the use of high-dose epinephrine in cardiac arrest?

    <p>Decreased peripheral blood flow</p> Signup and view all the answers

    What is one of the primary therapeutic purposes of catecholamines in emergency medicine?

    <p>Stabilizing blood pressure</p> Signup and view all the answers

    Which neurotransmitter does Mirtaapine primarily antagonize?

    <p>Serotonin</p> Signup and view all the answers

    What is a common side effect associated with Lithium?

    <p>Thyroid dysfunction</p> Signup and view all the answers

    Oxcarbazepine affects what receptor to exert its antidepressant effects?

    <p>GABA receptor</p> Signup and view all the answers

    What type of drug is Agomelatine?

    <p>Melatonergic Antidepressant</p> Signup and view all the answers

    Which receptor does Olanzapine predominantly antagonize?

    <p>5HT2A</p> Signup and view all the answers

    What mechanism do Benzodiazepines primarily use to enhance their effects?

    <p>Binding selectively to GABA receptors</p> Signup and view all the answers

    Which of the following is noted as a side effect of Valproate?

    <p>Spina bifida</p> Signup and view all the answers

    What is the main clinical use of Lithium?

    <p>Bipolar disorder management</p> Signup and view all the answers

    Which drug class does Trazoone belong to?

    <p>Antidepressants</p> Signup and view all the answers

    What mechanism does Lamotrigine utilize in epilepsy treatment?

    <p>Sodium channel blockade</p> Signup and view all the answers

    What is one effect associated with the use of Agomelatine?

    <p>Insomnia</p> Signup and view all the answers

    Risperidone is primarily used to treat which of the following disorders?

    <p>Schizophrenia</p> Signup and view all the answers

    Which of the following drugs is most associated with hepatotoxicity?

    <p>Valproate</p> Signup and view all the answers

    Which medication is known to induce metabolic side effects such as weight gain and diabetes?

    <p>Olanzapine</p> Signup and view all the answers

    Study Notes

    Bipolar (Carb a) / Mania c-depressive

    • Drug: Lithium
    • Route: Oral
    • Dosing: 6 months if >2 years of treatment
    • Side Effects:
      • Neuropathic pain
      • Hirsutism, megaloblastic anemia, fetal malformation, hypersensitivity
    • Stopping Treatment:
      • If no seizures, stop treatment
      • If seizures, Stop treatment for 6 months, then continue therapy

    Epilepsy (Ø seizure)

    • Drug: Ethosuximide
    • Route: Oral
    • Mechanism of Action: Inhibits CA2+ channel
    • Side Effects:
      • Nausea
      • Anorexia, Lethargy, Dizziness, Hypersensitivity

    Epilepsy (infantile/tonic-clonic/myodes)

    • Drug: Valproate, Depakine
    • Route: Oral
    • Duration: 15h
    • Side Effects:
      • Nausea, hair loss, weight gain, fetal weakness
      • Pregnant = spina bifida!!

    Adrenaline / Epinephrine

    • Route: IV, SC, IM, inhalation,
    • Mechanism of Action: Catecholamine; adrenergic
      • β1: Cardiovasc; vasoconstriction (high doses)
      • α: (high doses)
      • β2: (low doses)
    • Side Effects:
      • Panic, anxiety, tremor, cerebrovascular
      • Arrhythmias (haemorrhages)
      • ↑ HR, BP, systolic contraction
    • Contraindications:
      • Heart block
      • Anaesthesia
      • Angio-edema (allergy)

    NA / NE

    • Route: IV, IM
    • Mechanism of Action: Agonist
      • α: vasoconstriction
      • β:
    • Side Effects:
      • Tachycardia
      • Arrhythmias (necrosis/bleeding)
      • Hyperthermia (necrosis/bleeding)
      • Topical nasal decongestant
    • Contraindications:
      • Local bleeding
      • HypoT
      • Anaphylactic shock
      • ↓ GI motility

    Dopamine

    • Mechanism of Action: Small doses = D1 receptor
    • Side Effects:
      • Vasodilation

    Alpha 1 Adrenergic Agonists

    • Naphfazoline - Used for topical vasoconstriction of the eye and nose.
    • Phenylephrine - Used for nasal decongestion, cold symptoms, and topical vasoconstriction of the eye and nose.
    • Pseudoephedrine - Used for cold symptoms, allergic rhinitis, and as a component in combination antihistamine/antitussive/NSAID formulations.
    • Oxymetazoline - Used for nasal decongestion.
    • Xylometazoline - Used for nasal decongestion and cough relief.
    • Phenylephrine - Used for hypotensive shock, sinusitis, and as a component in combination antihistamine/antitussive/NSAID formulations.

    Alpha 1 Adrenergic Antagonists

    • Phenoxybenzamine - Used for treatment of pheochromocytoma (tumor of the adrenal medulla) and as a α-adrenergic antagonist to control blood pressure.
    • Phentolamine - Used to treat hypertensive crisis, particularly in patients with pheochromocytoma.
    • Prazosin - Used for hypertension and can cause orthostatic hypotension and tachycardia.
    • Doxazosin - Used for severe hypertension.
    • Terazosin - Used for hypertension.
    • Tamsulosin - Used for benign prostatic hypertrophy and can impair ejaculation.
    • Yohimbine - Used as a selective α2-adrenergic antagonist.
    • Idazoxan - Used as a selective α2-adrenergic antagonist.

    Alpha 2 Adrenergic Agonists

    • Clonidine - Used for opioid/alcohol withdrawal, hypertension, and as an antihypertensive agent. It can cause orthostatic hypotension, bradycardia, dry mouth, and drowsiness.
    • Ergot amines - Used as α2-adrenergic receptor blockers for migraines and cluster headaches.

    Beta 1 Adrenergic Agonists

    • Dobutamine - Used to treat cardiogenic shock.

    Beta 2 Adrenergic Agonists

    • Salbutamol - A short-acting (2-6 hours) β2-adrenergic agonist used for bronchial asthma.
    • Terbutaline - A β2-adrenergic agonist that can be used for asthma and preterm labor.
    • Salmeterol - A long-acting β2-adrenergic agonist used for asthma.
    • Ritonodrine - A β2-adrenergic agonist that can be used for preterm labor and uterine relaxation.
    • Mirabegron - A β2-adrenergic agonist for bladder relaxation.
    • Ephedrine - A mixed acting α/β agonist used as a nasal decongestant (in combination with other medications) and for allergic rhinitis. It has a high rate of CNS effects and can cause tachycardia, hypertension, and can interact with MAOIs.

    Mixed Acting Alpha/Beta Agonists

    • Amphetamine - Used for ADHD, narcolepsy, and epilepsy. It can cause euphoria, talkativeness, and increased physical activity. It is also used as a performance enhancer and has a high potential for abuse.

    Other Drugs

    • Phentanolamine - An ergot derivative, used as an α-adrenergic antagonist and can cause orthostatic hypotension.

    Medications for Psychiatric Disorders

    • St. John's Wort is used for anxiety, depression, and hyperforin is the active ingredient.
    • St. John's Wort inhibits the reuptake of serotonin, dopamine, norepinephrine, GABA, and glutamate.
    • Mirtazapine is an antidepressant that blocks alpha-2 adrenergic, 5HT2C, and H1 receptors.
    • Trazodone is an antidepressant. It blocks 5-HT2A, 5-HT2C, and does not affect serotonin reuptake.
    • Agomelatine is an antidepressant used for severe depression, circadian disturbances, and is a melatonin agonist.
    • Agomelatine is an antagonist of MT1 and MT2 receptors.
    • Lithium salts are used for bipolar disorder, Alzheimer’s disease, and are commonly prescribed to reduce the incidence of suicidal behavior.
    • Lithium salts increase the release of norepinephrine and serotonin.
    • Lithium salts are associated with gastrointestinal discomfort, nausea, vomiting, diarrhea, anorexia, weight gain, polyuria, and tremor.
    • Lithium salts can cause thyroid/kidney disorders or fetal malformations.
    • Oxcarbazepine is used for bipolar depression, epilepsy, and is an enzyme inducer that reduces side effects.
    • Valproate is used for epilepsy and is a teratogen.
    • Lamotrigine is used for Epilepsy and is also a teratogen which prevents recurrence of seizures.
    • Olanzapine is an anti-psychotic which functions as an antagonist of D2 and 5HT2A receptors.
    • Risperidone is an anti-psychotic which functions as an antagonist of D2 and 5HT2A receptors.
    • Quetiapine is an anti-psychotic used for schizophrenia, bipolar disorder.
    • Aripiprazole is an anti-psychotic used for mania and bipolar disorder.
    • Fluoxetine (SSRI) is an anti-psychotic used for mania and bipolar disorder.
    • Haloperidol is used as a prophylactic for manic depression and anxiety disorders.
    • Benzodiazepines (BZD) are used for anxiety, epilepsy, and are lipophilic, GABA-A receptor selective, and reduce anxiety but can be fatal.
    • Gabapentin is used for epilepsy and is a GABA analogue, but does not interact with GABA receptors.
    • Gabapentin is a teratogen.

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    Description

    This quiz covers the pharmacological treatments for bipolar disorder and various types of epilepsy. It includes information on medications such as Lithium, Ethosuximide, and Valproate, along with their routes of administration, side effects, and mechanisms of action. Test your knowledge on these essential psychiatric and neurological drugs.

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