Final Exam Mat.

Question 1

Abortive migraine therapy.

5HT1 receptor agonist

Answer 1

Sumatriptan (a SUMo wrestler TRIPs ANd falls on your HEAD)

Question 2

For initial treatment of Parkinson’s disease:

Answer 2

Bromocriptine (dopamine agonist): Ropinirole, Pramipexole, Rotigotine are D2 agonists

Question 3

PD drug, crosses BBB, direct precursor of dopamine, mainstay of treatment

Answer 3

L-dopa

Question 4

PD drug, peripheral decarboxylase inhibitor, increases bioavailability of L-dopa in brain and limits peripheral side effects (orthostatic htn, nausea)

Answer 4

Carbidopa

Question 5

PD drug, MAO-B inhibitors in the brain, increases availability of dopamine

Answer 5

Selegiline, rasagiline

Question 6

PD drug, blocks muscarinic receptors, improves tremor and rigidity in early stages of disease

Answer 6

Benztropine, trihexyphenidyl

Question 7

PD drug, COMT inhibitor, prevents methylation of L-DOPA by COMT (in periphery)

Answer 7

Entacapone

Question 8

AD drug, acetylecholinesterase inhibitors

Answer 8

Donezpezil, rivastigmine, galantamine

Question 9

AD drug, NMDA receptor antagonist, may slow progression of disease

Answer 9

Memantine

Question 10

Stimulant, displaces monoamines

Answer 10

D-amphetamine

Question 11

Stimulant, inhibits reuptake of NE and DA

Answer 11

Methylphenidate

Question 12

Stimulant, inhibits NE and DA transports, Increases free 5-HT and glutamate, dec. GABA, low abuse potential

Answer 12

Modafinil

Question 13

Seizure type: preservation of consciousness, sensory auras or limited unilateral motor convulsions, 20-60 seconds

Answer 13

Simple Partial Seizure

Question 14

Seizure type: impaired consciousness, automatisms, post-ictal confusion, most common refractory seizure in adults (30s-2min)

Answer 14

Complex partial seizure

Question 15

Seizure type: LOC, major convulsions, tonic spasm, followed by clonic jerking, prolonged post-ictal stupor, 1-2 min

Answer 15

Grand mal or Tonic Clonic seizures

Question 16

Seizure type: abrupt interruptions of consciousness associated with staring and cessation of activities; lack of poast-ictal abnormalities (less than 30 sec).

Answer 16

Absence (petit mal) seizures

Question 17

List the general mechanisms of Anti-seizure drugs:

Answer 17

Change ion channels, increase seizure threshold, increase GABA or decrease glutamate and therefore decrease spread of seizure

Question 18

Seizure med, used for absence seizures, MoA on T-type Ca channels

Answer 18

Ethosuximide “Sux to have silent seizures”

Question 19

What is the mnemonic for Ethosuximide side effects and what are they?

Answer 19

EFGHIJ: Ethosuximide causes Fatigue, GI distress, Headache, Itching, stevens-Johnson syndrome

Question 20

Seizure med, used for tonic clonic, partial, and status epilepticus seizures, increase Na channel inactivation, need to monitor liver

Answer 20

Phenytoin

Question 21

What are the more well known side effects of phenytoin?

Answer 21

Enlarged gums, hirsuitism, p450, nystagmus, yellow skin, teratogen, interferes with B12 metabolism, osteomalacia, neuropathy, Stevens-Johnson syndrome

Question 22

Seizure med, increase Na channel inactivation, 1st line for trigeminal neuralgia, used for tonic clonic and partial seizures

Answer 22

Carbamazepine

Question 23

What are the side effects of Carbamezepine?

Answer 23

SIADH (hyponatremia), SJS, diplopia, ataxia, liver toxicity, teratogen

Question 24

Seizure med: increase Na channel inactivation, inc. GABA, 1st line in tonic clonic seizure, can be used to treat all seizures

Answer 24

Valproic acid

Question 25

What are the side effects of Valproic acid?

Answer 25

Hepatotoxicity (inhibits hepatic enzymes, regular LFTs needed), termor, weight gain, teratogen

Question 26

Seizure med: blocks voltage gated Na channels, may be used for all types of seizures

Answer 26

Lamotrigine

Question 27

What are the side effects of Lamotrigine?

Answer 27

SJS

Question 28

Anti-psychotic drug: typical, blocks D2 receptors to ameliorate POSITIVE symptoms. May cause tardive dyskinesia, hyperprolactinemia (and orthostatic HTN, weight gain, anticholinergic effects)

Answer 28

Haloperidol, chloropromazine

Question 29

Anti-psychotic drug: atypical, blocks D2, S4 and 5HT receptors for POS and NEG symptoms. May cause hyperprolactin at high dose

Answer 29

Olanzapine

Question 30

Anti-psychotic: atypical, blocks D4 more than D2, inverse agonist of 5HT, best for relieving symptoms. May cause agranulocytosis (need WBC weekly).

Answer 30

Clozapine (must watch CLOZapine CLOZely!)

Question 31

Anti-psychotic: atypical, blocks D2 and 5HT receptors for POS and NEG symptoms, may cause hyperprolactinemia

Answer 31

Risperidone

Question 32

Anti-psychotic: atypical, block 5HT more than D2, and also H1 for POS and NEG symptoms. May cause Prolactin side effects.

Answer 32

Quetipine, ziprasidone

Question 33

Anti-psychotic: atypical, partial D2 agonist and 5HT

Answer 33

Aripiprazole

Question 34

Mnemonic for Atypical antipsychotics:

Answer 34

It's ATYPICAL for OLd CLOSets to QUIETly RISPER from A to Z. | ATYPICAL antipsychotics include: OLanzapine, CLOZapine, QUETIapine, RISPERidone, Aripiprazole, Ziprasidone

Question 35

Sedative med, facilitates GABA(A) action by increasing duration of Cl- channel opening thus dec. neuronal firing, used for anxiety, seizures, insomnia, induction of anesthesia. Side effects include respiratory and CNS depression, drug interactions with cytochrome P450

Answer 35

Barbiturates: Phenobarbital, pentobarbital, thiopental, secobarbital

Question 36

Sedative med, facilitates GABA(A) action by increasing frequency of Cl- channel opening, dec. REM sleep, used for anxiety, spasticity, status epilepticus, detox, night terrors, sleep walking, general anesthetic, and as a hypnotic. Side effects include dependence, additive CNS depression effects with alcohol but otherwise low risk of respiratory and CNS depression.

Answer 36

Benzodiazepines: Diazepam (Valium), Lorazepam (Ativan), Triazolam, Temazepam, Oxazepam, Midazolam, Chlorodiazepoxide, Alprozolam (Xanax)

Question 37

What is used to treat Benzodiazepine overdose?

Answer 37

Flumazenil (competitive antagonist at GABA benzodiazepine receptor).

Question 38

Clinical use of Alprazolam (Xanax)

Answer 38

A benzodiazepine used for anxiety

Question 39

Use of clonazepam (Klonopin)

Answer 39

A benzodiazepine used for SEIZURES, mania, movement disorders

Question 40

Use of diazepam (Valium)

Answer 40

A benzodiazepine used for anxiety, STATUS EPILEPTICUS, muscle relaxation, preanesthetic medication

Question 41

Use of lorazepam (Ativan)

Answer 41

A benzodiazepine used for anxiety, STATUS EPILEPTICUS, preanesthetic medication

Question 42

Centrally acting spasmolytic drug, used for spasticity and MSK problems. Adverse effects include sedation and respiratory depression in ALS.

Answer 42

Benzodiazepines: Diazepam and Clonazepam

Question 43

Centrally acting spasmolytic drug, GABA(B) receptor agonists that reduces trasmitter release by increasing K+ permeability and inhibiting Ca 2+ influx into nerve terminals. Adverse effects include: drowsiness, inc risk seizures, CNS depression

Answer 43

baclofen (Lioresal)

Question 44

Centrally acting spasmolytic drug, central alpha-2 recepotr agonist, increases pre and postsynaptic inhibition of motor neurons. Adverse effects include drowsiness, hypotension, dry mouth, weakness

Answer 44

tizanidine (Zanaflex)

Question 45

Direct acting spasmolytic, decreases Ca2+ release from sarcoplasmic reticulum thereby inhibiting excitation-contraction coupling. Adverse effects include: general muscle weakness, sedation, rare but serious hepatotoxicity. Also used for malignant hyperthermia

Answer 45

dantrolene (Dantrium)