Psych, Neuro, Pain & Eye Pharmacology Review

A set of 100 vocabulary-style flashcards covering drug names, mechanisms, side effects, contraindications, therapeutic ranges, and helpful mnemonics from the lecture notes.

Amitriptyline

Tricyclic antidepressant used for depression, neuropathy, fibromyalgia, anxiety, and insomnia.

Imipramine

Tricyclic antidepressant indicated for depression and related disorders, shares profile with amitriptyline.

TCA Mechanism of Action

Increases the effect of serotonin and norepinephrine in the central nervous system.

Anticholinergic Effects

Typical TCA side effects: dry mouth, urinary retention, constipation, tachycardia, photophobia.

Orthostatic Hypotension

Drop in blood pressure when standing; common adverse effect of TCAs and several other drugs.

Diazepam

Benzodiazepine used for anxiety, seizures, muscle spasms, alcohol withdrawal, and anesthesia adjunct.

Lorazepam

Short-acting benzodiazepine for anxiety, status epilepticus, and pre-procedure sedation.

Midazolam

Benzodiazepine frequently used for procedural sedation and induction of anesthesia.

Chlordiazepoxide

Long-acting benzodiazepine especially useful in alcohol withdrawal management.

Benzodiazepine Mechanism

Enhances the inhibitory effect of GABA in the central nervous system.

Flumazenil

Competitive benzodiazepine receptor antagonist that reverses benzo overdose.

Duloxetine

SNRI used for depression, anxiety, and neuropathic pain; memory aid: “deluxe apartment.”

Venlafaxine

SNRI that inhibits reuptake of serotonin and norepinephrine to treat depression and anxiety.

SNRI Mechanism

Blocks reuptake of serotonin and norepinephrine, boosting their levels in the synapse.

St. John’s Wort Interaction

Herbal supplement that increases risk of serotonin syndrome when combined with SSRIs or SNRIs.

Paroxetine

SSRI prescribed for depression, anxiety disorders, OCD, and PTSD.

Sertraline

SSRI commonly used for depression and anxiety; marketed as Zoloft.

Fluoxetine

Long-acting SSRI; mnemonic: parents of teens might need it for stress.

SSRI Mechanism

Inhibits reuptake of serotonin, increasing synaptic serotonin levels.

Serotonin Syndrome

Potentially fatal condition with agitation, fever, tremors, and diaphoresis due to excess serotonin.

SSRI Onset

Full therapeutic effect typically requires two or more weeks of continuous use.

Acetaminophen

Analgesic and antipyretic that inhibits prostaglandin synthesis but lacks anti-inflammatory action.

Acetylcysteine

Antidote for acetaminophen overdose; replenishes hepatic glutathione.

Hepatotoxicity

Liver damage risk seen with high-dose acetaminophen, valproic acid, and other drugs.

Donepezil

Cholinesterase inhibitor used to improve memory and cognition in Alzheimer’s disease.

Cholinesterase Inhibitor Mechanism

Raises acetylcholine levels by preventing its breakdown, enhancing neuronal communication.

Bedtime Dosing of Donepezil

Administer at night to minimize daytime nausea and enhance adherence.

Carbidopa/Levodopa

Combination drug that increases central dopamine to treat Parkinson’s tremors and rigidity.

High-Protein Meal Interaction

Protein competes with levodopa for absorption and transport, reducing effectiveness.

Dyskinesias

Involuntary movements or tics often occurring with long-term levodopa therapy.

Memantine

NMDA receptor antagonist used to slow cognitive decline in Alzheimer’s disease.

NMDA Receptor Antagonist Mechanism

Blocks glutamate binding to NMDA receptors, reducing excitotoxic neuronal damage.

Phenytoin

Classic antiepileptic that stabilizes neuronal membranes by blocking sodium channels.

Fosphenytoin

Water-soluble prodrug of phenytoin given IV/IM for seizure control.

Therapeutic Phenytoin Range

Serum level of 10–20 mcg/mL required for seizure prophylaxis without toxicity.

Gingival Hyperplasia

Overgrowth of gum tissue, notable adverse effect of chronic phenytoin therapy.

Phenytoin–Contraceptive Interaction

Drug induces hepatic enzymes, decreasing effectiveness of oral contraceptives.

Sumatriptan

Serotonin 5-HT1 agonist that causes intracranial vasoconstriction to abort migraine attacks.

Triptan Contraindications

Avoid in CAD, peripheral vascular disease, or uncontrolled hypertension due to vasoconstriction.

Fentanyl

Potent opioid analgesic used for severe pain and anesthesia adjunct.

Morphine

Prototype opioid for moderate to severe pain, significant respiratory depression risk.

Hydromorphone

Semi-synthetic opioid stronger than morphine; brand name Dilaudid.

Oxycodone

Oral opioid often combined with acetaminophen for moderate to severe pain.

Hydrocodone

Moderate-strength opioid frequently formulated with acetaminophen for outpatient pain control.

Opioid Mechanism

Binds to mu and kappa receptors in CNS to alter perception of and response to pain.

Naloxone

Opioid antagonist that rapidly reverses respiratory depression and analgesia.

RUSH Naloxone Mnemonic

Indications to administer: Respiratory depression, Urinary retention, Sedation, Hypotension.

Aspirin

Irreversible COX inhibitor used for pain, fever, inflammation, and antiplatelet effects.

Reye’s Syndrome

Serious hepatic encephalopathy risk when aspirin is given to children with viral illness.

Salicylism

Toxic aspirin state with tinnitus, nausea, vomiting, and respiratory alkalosis.

Celecoxib

Selective COX-2 inhibitor for osteoarthritis and rheumatoid arthritis pain relief.

COX-2 Inhibitor Mechanism

Blocks COX-2 enzyme to reduce prostaglandins, decreasing pain and inflammation with less GI risk.

Cardiovascular Thrombotic Risk

Increased MI and stroke potential associated with selective COX-2 inhibitors like celecoxib.

Timolol (Eye Drops)

Nonselective beta blocker that decreases aqueous humor production to lower IOP in glaucoma.

Eye-Drop Occlusion Technique

Hold lacrimal duct 1 minute post-instillation to limit systemic beta-blocker absorption.

Normal Intraocular Pressure

Physiologic range of 10–21 mm Hg inside the eye.

Pilocarpine

Cholinergic agonist that increases aqueous humor outflow, treating open-angle glaucoma.

Aqueous Humor Outflow

Drainage of intraocular fluid; enhanced by miotics like pilocarpine to reduce IOP.

Chlorpromazine

First-generation antipsychotic effective against positive symptoms of schizophrenia.

Haloperidol

High-potency typical antipsychotic often used for acute agitation and psychosis.

Extrapyramidal Symptoms

Drug-induced movement disorders: dystonia, akathisia, Parkinsonism, tardive dyskinesia.

Neuroleptic Malignant Syndrome

Life-threatening reaction with fever, rigidity, and autonomic instability from antipsychotics.

Benztropine

Anticholinergic used to treat EPS secondary to antipsychotic therapy.

Dantrolene

Muscle relaxant administered IV to treat neuroleptic malignant syndrome.

Valproic Acid

Broad-spectrum anticonvulsant and mood stabilizer that increases CNS GABA levels.

Thrombocytopenia

Low platelet count; notable adverse effect of valproic acid therapy.

Pancreatitis (Valproic)

Severe abdominal pain and elevated amylase/lipase can signal valproate-induced pancreatitis.

Lithium

Mood stabilizer affecting sodium transport; first-line for bipolar disorder.

Therapeutic Lithium Range

Serum concentration of 0.6–1.2 mEq/L required for efficacy with minimal toxicity.

Lithium Toxicity Signs

Coarse tremor, confusion, seizures, hypotension, and tinnitus when >1.5 mEq/L.

Sodium Intake and Lithium

Low dietary sodium elevates lithium levels; maintain consistent salt and fluid intake.

"Amy Tripped" Mnemonic

Helps recall anticholinergic dryness of tricyclic amitriptyline (tripping over a tricycle in the desert).

Benzodiazepine Withdrawal

Abrupt cessation causes insomnia, irritability, tremors, and possible seizures.

Neonatal Opioid Withdrawal

Syndrome of irritability and diarrhea in infants born to mothers using opioids chronically.

Tachycardia (Anticholinergic)

Fast heart rate due to vagal inhibition associated with anticholinergic drugs.

Repeat Orthostatic Hypotension

Blood-pressure drop common to TCAs, carbidopa/levodopa, and antipsychotics.

Opioid-Induced Constipation

Decreased bowel motility requiring increased fluid and fiber intake in patients on opioids.

Photophobia

Light sensitivity often stemming from anticholinergic pupil dilation.

Muscle Spasm Use of Benzos

Benzodiazepines relax skeletal muscle by enhancing GABA effects.

Alcohol Withdrawal Treatment

Benzodiazepines like chlordiazepoxide prevent seizures and delirium tremens.

Cluster Headache

Severe unilateral headache type effectively aborted by subcutaneous sumatriptan.

Kawasaki Disease

Pediatric vasculitis for which high-dose aspirin is a cornerstone therapy.

Osteoarthritis Indication

Degenerative joint disease pain relieved by celecoxib or other NSAIDs.

Systemic Beta-Blocker Effects

Bradycardia and bronchospasm risk if timolol eye drops enter systemic circulation.

Open-Angle Glaucoma

Chronic eye condition treated with timolol or pilocarpine to lower IOP.

Positive Symptoms of Schizophrenia

Hallucinations and delusions targeted by typical antipsychotics like haloperidol.

Benzodiazepine Abuse Potential

Risk of dependence, tolerance, and addiction necessitating short-term use only.

Aspirin in Pregnancy

Contraindicated due to potential maternal and fetal bleeding and premature ductus closure.

Renal Disease & Lithium

Kidney impairment contraindicates lithium because drug is excreted unchanged renally.

Lithium-Induced Polyuria

Excessive urination from nephrogenic diabetes insipidus associated with lithium therapy.

Lithium-Associated Weight Gain

Common metabolic side effect; advise diet and exercise monitoring.

Lithium-Induced Hypothyroidism

Thyroid hormone suppression presenting with fatigue and weight gain during therapy.

Parent-of-Teen SSRI Mnemonic

Phrase referencing paroxetine/fluoxetine for coping with teenage stress.

"Deluxe Apartment" Mnemonic

Memory aid linking duloxetine to improved mood without material needs.

"Sumo Wrestler" Mnemonic

Visualization of a sumo causing head pressure to remember sumatriptan vasoconstriction.

"Car-Bid" Mnemonic

Carbidopa is the car delivering levodopa to the brain to raise dopamine.

Acetaminophen Non-Anti-Inflammatory

Unlike NSAIDs, it reduces pain and fever but not tissue inflammation.

Tim Stuck Finger in Eye Mnemonic

Helps recall timolol eye drops for glaucoma (Tim + LOL).

"Celebrate" Celecoxib Mnemonic

Phrase linking pain-free celebration with celecoxib use for arthritis.

RUSH Naloxone Mnemonic Explained

Respiratory depression, Urinary retention, Sedation, Hypotension prompt naloxone administration.