CNS

Question 1

Disulfiram (Antabuse)

Answer 1

Drug used for alcoholism
Inhibits aldehyde dehydrogenase: when the patient consumes alcohol, they experience severe HA, N/V, chest pain, weakness, etc.
Long duration of action (3-4 days)
Inhibits CYP450: lots of drug interactions
Dangerous, not recommended

Question 2

Diazepam (Valium)

Answer 2

Benzodiazepine
Used for alcohol withdrawal, to prevent seizures, delirium, and tremors; to relive anxiety, insomnia, to produce muscle relaxation; IV for status epilepticus.
Binds to a specific BZ receptor on the GABA-A complex and intensifies the actions of GABA by increasing binding affinity.
Long acting due to metabolite with a long half life

Question 3

Chlordiazepoxide (Librium)

Answer 3

Drug used for alcohol withdrawal

Long acting benzodiazepine: prevents seizures, delirium, and tremors

Question 4

Lorazepam (Ativan)

Answer 4

Drug used for alcohol withdrawal

Long acting benzodiazepine: used to treat seizures once they occur, used IV for status epilepticus.

Question 5

Phenytoin (Dilantin)

Answer 5

Drug used for alcohol withdrawal
Anticonvulsant: second line tx for seizures once they occur, used for partial seizures and generalized tonic-clonic seizures.

Question 6

Naltrexone (ReVia)

Answer 6

Drug used for alcoholism
Opioid receptor antagonist: blocks the beta-endorphin - opioid receptor - dopaminergic reward pathway in the brain which is stimulated by alcohol. Reduces alcohol cravings.
Side effect is nausea, and may cause liver damage in large doses.

Question 7

Nalmefene (ReVex)

Answer 7

Drug used for alcoholism
Opioid receptor antagonist: blocks the beta-endorphin - opioid receptor - dopaminergic reward pathway in the brain which is stimulated by alcohol. Reduces alcohol cravings.
Side effect is nausea, is less likely to cause liver damage than Naltrexone, and has a longer duration of action.

Question 8

Acamprosate (Campral EC)

Answer 8

Drug used for alcoholism
GABA analogue: restores the normal balance of GABA and glutamate transmission
Excreted by the kidneys, no liver toxicity.

Question 9

Fomepizole (Antizol)

Answer 9

Drug used for methanol or ethanol poisoning
Alcohol dehydrogenase inhibitor: prevents the conversion of methanol and ethylene glycol into aldehydes.
Used along with respiratory support, gastric lavage, alkalization, and dialysis)

Question 10

Carbamazepine (Tegretol)

Answer 10

Used in partial seizures and generalized tonic-clonic seizures.

Question 11

Phenobarbital

Answer 11

Used in partial seizures and generalized tonic-clonic seizures.

Question 12

Gabapentin (Neurontin)

Answer 12

Used in partial seizures and generalized tonic-clonic seizures.

Question 13

Lamotrigine (Lamictal)

Answer 13

Used in partial seizures and generalized tonic-clonic seizures.

Question 14

Topiramate (Topamax)

Answer 14

Used in partial seizures and generalized tonic-clonic seizures.

Question 15

Ethosuximide (Zarontin)

Answer 15

Used in absence seizures

Question 16

Valproic acids (Depakene)

Answer 16

Used in absence seizures