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ESUN MS2Unit3 > Kaplan > Flashcards

Kaplan Flashcards

1
Q

DA antagonist and agonist causes what in nigrostriatal pathway?

A

bradykinesia (Parkinson like)/hyperkinesia

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2
Q

Drug that increase DA in mesolimbic and mesocortical tract would?

A

Increase reinforcement/psychosis (side effect of DA drugs)

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3
Q

DA antagonist in tuberoinfundibular pathway causes?

A

gynecomastia/amenorrhea and galactorrhea

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4
Q

DA antagonist can be used for ___ during chemo and radio therapy

A

antiemetic

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5
Q

DA agonist can also causes weight gain or lost?

A

Weight lost

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6
Q

D1/D2 receptor are __ coupled receptors?

A

Gs/Gi

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7
Q

Where are D2A and D2C found in the brain?

A

nigrostriatal and mesolimbic

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8
Q

What is the reason behind cogwheel rigidity and resting tremor in Parkinson’s pts?

A

Increase ACh on muscarinic receptors

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9
Q

What is the transmitter imbalance in Parkinson’s?

A

Decrease DA and increase ACh

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10
Q

In nigrostriatal pathway, DA binds to __ receptor on the GABA neuron to inhibit GABA and start movement?

A

D2A receptor

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11
Q

In nigrostriatal pathway, ___ bind to GABA neuron to promote GABA and inhibit movement?

A

ACh binds to muscarinic receptor

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12
Q

What are the 4 ways to treat Parkinson’s at the nigrostriatal level?

A

L-DOPA (increase DA)/D2 agonist/inhibit MAO-B (selegiline)/Muscarinic blocker

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13
Q

Levodopa is converted to DA by?

A

AAAD

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14
Q

Is carbidopa a competitive or noncompetitive inhibitor of AAAD in periphery?

A

Non-competitive

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15
Q

Why do we use levodopa with other drugs?

A

Levodopa causes on and off dyskinesia—>use with other drugs to reduce the fluctuation of DA in CNS

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16
Q

Tolcapone is highly?

A

Hepatotoxic

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17
Q

COMT metabolizes DA and L-DOPA to partial agonists which ___ during ___? and why tolcapone and entacapone are used?

A

Blocks DA from binding to receptor when there are high level of DA/these drugs block COMT therefore prevent partial agonists from forming

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18
Q

Selegiline is metabolized into ___ and causes ___?

A

Amphetamine (stimulant) and causes insomnia

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19
Q

Pramipexole and ropinerole are also ___?

A

Antioxidant (key in Parkinson’s disease)

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20
Q

What drug causes livedo recticularis (lace like rash)?

A

Amantidine

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21
Q

What kind of drugs do you use to treat EPS?

A

Antimuscarinic

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22
Q

What is acute and chronic EPS?

A

acute: pesudoparkinsonism/dystonia/dyskinesia/akathisia (I like to move it move it, I like to move it move it…)
chronic: tardive dyskinesia

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23
Q

How does tardive dyskinesia happen?

A

Chronic using of D2 blocking antipsychotic drugs—->upregulation of D2 receptor—>hyperkientic (similar to Hungtinton’s)

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24
Q

DA antagonist would worsen ___ symptoms of schizo pt and also cause increase ___ that cause ___ in male and ___ in female?

A

worsen - symptoms (decrease DA)/increase prolactin/gynecomastia in male and amenorrhea and galactorrhea in female

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25
Q

Antipsychotic drugs (both 1st and 2nd gen) besides block D2, what else do they block?

A

Muscarinic and alpha

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26
Q

What cause neuroleptic malignant syndrome? and what do you give pt for that?

A

Caused by antipsychotic drugs such as haloperidol/give pt bromocriptine

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27
Q

What caused neuroleptic malignant syndrome?

A

DA antagonist of antipsychotic drugs interrupt temp control in the brain cause fever and muscle rigidity (from antimuscarinic affect)

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28
Q

Clozapine (SGA) blocks D2_ and __ that results in___?

A

D2C (in mesolimbic system)—>no tardive dyskinesia/5HT—>improve negative symptoms

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29
Q

All antipsychotic drugs causes weight __?

A

gain

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30
Q

90% of 5HT is in ___ system and block 5HT results in __?

A

digestion system/increase salivation (side effect of clozapine)

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31
Q

SGA has __ EPS symptoms only ___ gives agranulocytosis?

A

little EPS symptoms/clozapine

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32
Q

Aripiprazole is a ___ blocker but also a partial ___ agonis results in?

A

DA blocker and also a partial D2/3 agonist—>not as potent as DA blocker

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33
Q

The goal of antidepressant is to increase ___ and ___?

A

NE and 5HT

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34
Q

Antidepressant can causes high NE and 5HT which are called?

A

HTN crisis/serotonin syndrome

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35
Q

Do we still use MAOi and TCA?

A

Not really due to their side effects, mainly SSRI now

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36
Q

What else do we use amitriptyline for besides depression?

A

Neuropathic pain

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37
Q

What do we use for enuresis that also treats depression?

A

Imipramine

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38
Q

What are 2 side effect of TCA?

A

Antimuscarinic and alpha blockade

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39
Q

What to give with SSRI in the beginning to prevent anxiety and further suicide?

A

Alprazolam (a benzodiazepine)

40
Q

SSRI has the side effect of ?

A

Serotonin syndrome/bruxism and anorgasmia/weight loss

41
Q

Venlafaxine is like TCA but?

A

It does not have antimuscarinic and alpha blockade

42
Q

What is the only antidepressant that causes weight gain and often used for anorexia?

A

Mirtazapine

43
Q

Diuretics would ___ Li clearance hence ___ Li level

A

decrease clearance and increase Li level

44
Q

What congenital defect can Li cause?

A

Ebstein’s anomaly (downward displacement of tricuspid valve)

45
Q

Stimulant drugs like methylphenidate and amphetamine for ADHD should not be stopped abruptly because?

A

It may produce severe depression—>suicide

46
Q

Cocaine block reuptake of ? and __ channel blocker as well?

A

NE/5HT/DA and Ca channel blocker (local anesthetic)

47
Q

Increase 5HT in cocaine abuser might cause?

A

Aggressiveness

48
Q

Difference between benzodiazepine and barbiturate?

A

Benzo is GABA agonist/barb prolong GABA

49
Q

benzodiazepine and barbiturate both are CNS ___?

A

depressant

50
Q

What does BZ1 and BZ2 of benzodiazepine mediate?

A

BZ1: sedation/BZ2: cognitive impairment

51
Q

Benzodiazepine toxicity can be reversed by?

A

Flumazenil

52
Q

What are the 3 opioid receptors and which one is the most potent?

A

mu/kappa/delta—>mu is the most potent one

53
Q

Which area within the limbic system that is associated with DA and addition?

A

Nucleus accumbens

54
Q

Which two drugs are life threatening if withdrawal?

A

Barbiturate and ethanol

55
Q

What is MDMA?

A

Amphetamine like/hallucinogenic/ppl died of dehydration during RAVE parties

56
Q

Only __ form of inhaled anesthetics (gas inhalation) is active and they go to ___ first rapidly and redistribute to __ that can go back to the blood and ___?

A

Free form/CNS/fat/CNS

57
Q

The more ___ the anesthetic, the ___ MAC and the greater the potency

A

Lipid soluble/lower

58
Q

MAC is lower in ___ population and with ___ kind of drug?

A

Elderly/opiate

59
Q

___ blood gas ratio drugs has fast onset and recovery

A

Lower

60
Q

What are the 2 side effects of N2O?

A

Diffusional hypoxia/spontaneous abortion

61
Q

Halothane and the newer agents (-flurane) also succinylcholine can cause

A

Malignant hyperthermia

62
Q

Sensitivity of nerve fibers to local anesthetics in descending order

A

(smaller diameter fiber response first) B and C >A delta

63
Q

What to give with local anesthetics to prevent systemic effect?

A

Alpha 1 agonist—>prolonged effects

64
Q

What does tetradotoxin TTX work on?

A

It blocks Na channel (from puffer fish)

65
Q

How many molecule of NMB is needed to block Nm?

A

Just 1

66
Q

What is the progression for NMB?

A

Face—>limbs–>respiratory muscles

67
Q

What is the angle in open and closed angle glaucoma?

A

Angle between iris and cornea

68
Q

Is open angle glaucoma chronic or acute?is it painful or painless? and what does it caused by?

A

Chronic/painless/decrease reabsorption of aqueous humor

69
Q

Where is the aqueous humor produced and drained?

A

Ciliary body (beta 1 receptor)/through the tribecular meshwork in the angle

70
Q

What does closed angle glaucoma lead to?and it is chronic or acute?

A

It leads to the obstruction of canal of Schlemm/it can be both chronic and acute

71
Q

What is use dependence of anesthetics?

A

Use-dependence relates to the fact that more drug binds to the sodium channel protein
when the fiber fires at a faster rate.

72
Q

All local anesthetics are ___ molecule

A

Amphipathic

73
Q

Gabapentin undergoes ___ clearance unlike all the other anti seizure drugs?

A

Renal

74
Q

Gabapentin can also treat ___?

A

Neuropathic pain

75
Q

Opioid causes broncho__?

A

Constriction

76
Q

Which alcohol compound form crystal?

A

Ethylene glycol

77
Q

SSRI and TCA takes how long to work?

A

8 weeks

78
Q

Benzo has a slow or fast onset?

A

Fast

79
Q

Which benzo does not have active metabolites?

A

Lorazepam

80
Q

What therapy works the fastest for antidepressant?

A

ECT

81
Q

High LI causes what dysfunction?

A

Renal

82
Q

Major side effect of SSRI?

A

Sexual dysfunction?

83
Q

Only injectable drug for migraine? IV?

A

Sumotriptan/DHE

84
Q

What is Baclofen?

A

GABAb agonist—>antispaticity

85
Q

What is the Henry’s law equation?

A

Partial pressure = concentration/solubility

86
Q

What drug do you give before giving general anesthesia?

A

Benzo

87
Q

What brain part does general anesthesia target to cause LOS?

A

Thalamus

88
Q

MAC means to prevent ___?

A

Movement—>immobility

89
Q

Which anesthesia causes dissociative anesthesia?

A

Ketamine

90
Q

What brain part does general anesthesia target to cause immobility?

A

Spinal cord

91
Q

ACh comes from what part of the brain?

A

Nucleus of maynert

92
Q

What drug to give if the Parkinson’s pt is young and has mild disease? what about mild and older pt?

A

Anticholinergic/amantidine

93
Q

What is the concern of L-dopa drug for Parkinson?

A

Delay it as long as possible, only use it for severe disease under 65

94
Q

Most important of determining the type of headache is ?

A

Time course

95
Q

Jaw pain and visual symptoms with headache indicate?

A

Temporal arteritis

96
Q

Concern regarding treating migraine?

A

Only use NSAIDs first

97
Q

What is the proprolaxysis guidline for migrain headache?

A

more than 2 headaches per month and less than 8

ESUN MS2Unit3 (11 decks)

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