Anti-seizure, Anesthetics, Muscle Relaxants

Question 1

Drugs for absence seizures

Answer 1

Clonazepam
Ethosuximide
Valproic acid

Question 2

Drugs for myoclonic seizures

Answer 2

Clonazepam
Lamotrigine
Valproic acid

Question 3

Sudden, brief, shock-like contractions

Answer 3

Myoclonic seizures

Question 4

MOA of phenytoin

Answer 4

Blocks voltage-gated sodium channels

Similar drugs: fosyphenytoin, mephenytoin, ethotoin

Question 5

Fetal hydantoin syndrome

Answer 5

Upturned nose
Mild midfacial hypoplasia
Long upper lip with thin vermillion border
Lower distal digital hypoplasia

Question 6

MOA of carbamazepine

Answer 6

Blocks voltage-gated sodium channels and decreases glutamate release
Tricyclics

Question 7

Teratogenic side effects of valproic acid

Answer 7

Neural tube defects
Spina bifida
“Valproate ate the folate”

Question 8

MOA of ethosuximide

Answer 8

Decreases calcium currents (T type) in thalamus

Similar drugs: phensuximide, methsuximide

Question 9

MOA of gabapentin and pregabalin

Answer 9

Blocks calcium channels
Increases GABA release
Inhibits neuronal discharge from seizure foci

Question 10

MOA of lamotrigine

Answer 10

Blocks sodium and calcium channels

Decreases glutamate

Question 11

MOA of levetiracetam and piracetam

Answer 11

Selectively binds synaptic vesicular protein SV2A
Modifies synaptic release of glutamate and GABA
Not metabolized by cytochrome P450

Question 12

Antiseizure drug with the most number of MOA

Answer 12

Topiramate (monosaccharide derivative)

Multiple actions on synaptic function, probably via sodium, calcium, GABA, AMPA-glutamate, carbonic anhydrase

Question 13

Used in Lennox-Gastaut syndrome (difficult form of epilepsy, 2-6 y/o)

Answer 13

Topiramate

Question 14

First line drug for mania

Answer 14

Valproic acid

Question 15

DOC for trigeminal neuralgia

Answer 15

Carbamazepine

Question 16

Can be used for migraine

Answer 16

Gabapentin
Phenytoin
Topiramate

Question 17

Drugs for tonic-clonic seizures

Answer 17

Carbamazepine
Lamotrigine
Phenytoin
Valproic acid

Question 18

Stages of anesthesia

Answer 18

Analgesia
Disinhibition
Surgical anesthesia
Medullary depression

Question 19

Inhalational anesthetics

Answer 19

Nitrous oxide 
Desflurane
Sevoflurane
Isoflurane
Enflurane
Halothane
Methoxyflurane

Question 20

SE include megaloblastic anemia and euphoria, lowest potency, highest MAC

Answer 20

Nitrous oxide

Question 21

Pulmonary irritant, pungent, poor induction agent

Answer 21

Desflurane

Question 22

SE include renal insufficiency

Answer 22

Sevoflurane

Metabolite is nephrotoxic

Question 23

Associated with coronary steal syndrome

Answer 23

Isoflurane

Question 24

SE include spike-and-wave activity, muscle twitching, breath holding

Answer 24

Enflurane

Question 25

Can cause post operative hepatitis and malignant hyperthermia when mixed with succinylcholine

Answer 25

Halothane

Question 26

Highest potency and lowest MAC, obsolete

Answer 26

Methoxyflurane

Question 27

Antidote to benzodiazepines

Answer 27

Flumazenil

Question 28

Dissociative anesthetic, MOA?

Answer 28

Ketamine | Blocks excitation of glutamate at NMDA receptors

Question 29

IV anesthetic with minimal effects on CV and respiratory functions, no analgesic properties

Answer 29

Etomidate

Question 30

Opioid analgesics

Answer 30

Fentanyl Morphine Alfentanil Remofentanil

Question 31

Antidote to fentanyl

Answer 31

Naloxone- antidote for opioids

Question 32

Milk of amnesia, MOA?

Answer 32

Propofol | Potentiates GABA-alpha receptors, blocks sodium channels

Question 33

Local anesthetics

Answer 33

Esters, 1 i: tetracaine, procaine, benzocaine | Amides, 2 i's: bupivacaine, ropivacaine, lidocaine

Question 34

MOA of local anesthetics

Answer 34

Block voltage-dependent sodium channels, reducing influx of sodium, thereby preventing depolarization

Question 35

All local anesthetics are vasodilators except...

Answer 35

Cocaine

Question 36

Shortest half life among local anesthetics

Answer 36

Procaine | Novocaine

Question 37

Prevents reuptake of epinephrine and norepinephrine

Answer 37

Cocaine

Question 38

Topical ophthalmic anesthesia, with most allergenic potential

Answer 38

Tetracaine

Question 39

Local anesthetic with group 1B antiarrhythmic activity

Answer 39

Lidocaine

Question 40

Toxic dose of lidocaine

Answer 40

5 mg/kg | 1%=10 mg/ml

Question 41

Used in dental anesthesia, can cause methemoglobinemia

Answer 41

Prilocaine

Question 42

Used in epidural anesthesia

Answer 42

Bupivacaine | Ropivacaine

Question 43

Treatment for cardiotoxicity of bupivacaine

Answer 43

INTRALIPID (fat emulsion used in TPN)

Question 44

MOA of succinylcholine

Answer 44

Agonist at Ach-N receptors causing initial twitch then persistent depolarization.

Question 45

Nondepolarizing neuromuscular blockers

Answer 45

``` Tubocurarine Mivacurium Atracurium Vecuronium Rocuronium Pancuronium ```

Question 46

Long acting nondepolarizing neuromuscular blocker

Answer 46

Tubocurarine

Question 47

Used in strychnine poisoning, lethal injection

Answer 47

Pancuronium

Question 48

Undergoes Hofman elimination (rapid spontaneous breakdown)

Answer 48

Atracurium

Question 49

Drugs used in lethal injection

Answer 49

Thiopental Pancuronium Potassium chloride

Question 50

Metabolized by pseudocholinesterase

Answer 50

Mivacurium | Succinylcholine

Question 51

Undergoes elimination in bile

Answer 51

Vecuronium

Question 52

Can cause malignant hyperthermia

Answer 52

Succinylcholine interaction with halothane and possibly tubocurarine Treatment includes rapid cooling and administration of dantrolene