48. In depression, Tricyclic antidepressants (TCAs)
are the drug of choice in severe depression because
of their high efficacy while the selective serotonin
reuptake inhibitors (SSRIs) are the drug of choice
in mild to moderate depression because of their high
safety.
The side effects of TCAs are:
T Tremors
C Cardiovascular side effects (arrhythmias esp.
in ischemic heart disease, postural hypotension)
A Anticholinergic side effects
S Sedation and Seizures
49. The side effects of SSRIs are:
S Serotonin syndrome
S Stimulate CNS
R Reproductive dysfunctions if male
I Insomnia
Serotonin syndrome is a very dangerous and fatal situation. It
is just like neuroleptic malignant syndrome and results from
interaction between serotonin enhancing drugs e.g. SSRIs,
MAO-Is, TCAs, etc.
Serotonin syndrome is characterized by (causes HARM):
H Hyperthermia
A Autonomic instability (delirium)
R Rigidity
M Myoclonus
53. 3 As of Buspirone
A - partial Agonist
A - 5 HT1 type A receptor
A - Anxiety disorders
ABCD of Sumatriptan
A - Acute migraine treatment / Asthenia as a side effect
B - Basoconstriction ("v") of cerebral vessels
C - Coronary vasospasm
D - 5 HT1 type D receptor
"SETRON"
SE - SEerotonin antagonist
T - 5 HT Three receptor
TR - TRigger zone
O - Ondansetron (MC drug)
N - No second messenger (ion channels)
99. Oncogenes. Gain of function
mutation in one allele -->
cancer.
K-ras: Kolon, panKreatic
H-ras: (Hematuria) - bladder
and kidney tumors
N-ras: melaNomas
101. Psammoma bodies - laminated,
concentric, "rings on a tree"
spherical calcifications:
P - Papillary (adenocarcinoma of
thyroid)
S - Serous (cystadenoma of ovary)
M - Meningioma
M - Mesothelioma (asbestos
exposure)
102. Metastases to brain (# metastases = #
primary brain tumors):
Lung, Breast, Skin (melanoma), Kidney
(RCC), GI
Typically, multiple well-circumcribed
tumors at gray-white border
103. Metastases to liver (metastases
>> primary liver tumors):
Colon, Stomach, Pancreas,
Breast, Lung.
*Think breast & lung, plus what
is drained by portal venous
system to liver.
104. Metastases to bone (metastases >>
primary):
Prostate, Thyroid, Breast, Lung,
Kidney
Lung = Lytic (IL-1)
Prostate = blastic
105. Drugs with zero order elimination
P - Phenytoin
E - Ethanol
A - Aspirin (at high or toxic
concentrations)
107. β’ G-protein linked 2nd messengers:
q - alpha 1 - vasoconstriction --> inc BP
i - alpha 2 - dec sympathetic outflow
s - beta 1 - inc HR, contractility, renin, lipolysis
s - beta 2 - vaso-/bronchodilation, inc HR
q - M1 - CNS, ENS
i - M2 - dec HR, dec contractility of atria
q - M3 - peristalsis, gastric acid,
bronchoconstriction, miosis, accommodation
108. β’ G-protein linked 2nd messengers:
s - D1 - relaxes renal vascular sm muscle
i - D2 - modulates NT release, esp in brain
q - H1 - (nasal, bronchial mucus production)
s - H2 (gastric acid secretion)
q - V1 - vasopressin (sm m contraction)
s - V2 - vasopressin (inc H2O permeability
109. β’ Receptors that use the Gq pathway:
H1, alpha-1, V1, M1, M3
Gq -> phospholipase C -> -> IP3 (-> Ca++ from
ER) + DAG (-> Protein Kinase C)
110. β’ Receptors that use the Gi pathway:
M2, alpha-2, D2
Gi --> inhibition of Adenylate cyclase --> dec
cAMP --> dec protein kinase A
111. OP
β’ Hot as a hare (inc body temp)
Dry as a bone (dry mouth, skin)
Red as a beet (flushed skin)
Blind as a bat (cycloplegia, mydriasis)
Mad as a hatter (delirium)
Bloated as a toad (constipation, urinary
retention)
112. β’ low doses of epinephrine are selective for
beta-1 receptors -->
