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Neuro final > Lichtblau drugs > Flashcards

Lichtblau drugs Flashcards

1
Q

Mechanism of cocaine

A

Block reuptake of norepeinephrine and dopamine

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2
Q

Bad things about cocaine

A
  • Cardiac arrhythmia
  • Cerebral/coronary blood clot
  • Bad fetal brain development

PSYCHOLOGICAL WITHDRAWAL

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3
Q

MDMA - what’s it derived from?

A

amphetamines

MORE LIPOPHILIC

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4
Q

What’s MOA of MDMA?

A

Stimulate release AND block reuptake of epinephrine, norepinephrine, dopamine, 5HT

CNS STIMULANT!

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5
Q

Why do psychiatrists want to prescribe MDMA to patients with PTSD?

A

It’s an empathogen

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6
Q

What’s bad about MDMA?

A

BAD TEMPERATURE REGULATION! (you can’t control this because you have too much 5HT)

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7
Q

What’s a damn bath salt?

A

Synthetic compound that’s like amphetamine - cocaine substitute

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8
Q

MOA of bath salts

A

Block reuptake of NE/DA

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9
Q

What are some bad things about bath salts?

A
  • You can’t make them illegal because they’ll just slightly change the compound
  • Chest pain, increased BP, agitations, HALLUCINATIONS
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10
Q

What are 2 xanthines?

A

Theophylline
Caffeine

THEOPHYLLINE IS MORE POTENT

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11
Q

What’s the MOA of xanthines?

A

UNKNOWN

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12
Q

What are good things about xanthines?

A

Remember they’re caffeine/theophylline

  • Cortex stimulation –> clear thought/action
  • Smooth muscle relaxant (migraine treatment)
  • Increase skeletal muscle output (carpenters)
  • Medullary stimulation (increase respirations)
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13
Q

Bad effects/withdrawal from xanthines

A
  • Cardiac arrhythmias
  • Poop

Physical withdrawal!!!

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14
Q

Armodafinil/Modafinil - is there a difference?

A

They’re enantiomers

Armodafinil MIGHT be more active

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15
Q

MOA of armodafinil/modafinil

A
  • Increase release/block reuptake - DOPAMINE
  • Increase release (hypothalamus) - NOREPINEPHRINE
  • Increase release (amygdala/frontal) - 5HT

More wakefulness promoting compared to CNS stimulant

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16
Q

What is armodafinil/modafinil used for?

A
  • Narcolepsy
  • Shift work/sleep disorder
  • Adult ADHD
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17
Q

Bad things of armodafinil/modafinil

A

Headache
Insomnia
Decrease appetite
SKIN RASH IN KIDS SO DONT GIVE TO KIDS

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18
Q

What are some amphetamines that we need to know?

A

Dexedrine and Adderall

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19
Q

MOA of dexedrine/adderall

A
  • DOPAMINE - enhance release and block reuptake

- NE - enhance release

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20
Q

Good things of amphetamines

A
  • Decrease fatigue
  • Increase initiative
  • Slow tolerance
21
Q

Bad things of amphetamines

A

Dexedrine and Adderall

Bad - headache, arrhythmia

22
Q

What happens to drug addicts with amphetamines?

A

Reverse tolerance! - They become really sensitive to a new drug though they have tolerance to their drug of choice

23
Q

What am I going to do for an amphetamine overdose? (2 things)

A
  1. Haloperidol (D2 receptor antagonist) - Inhibit sympathetic response I think
  2. Acidify patient’s urine - the drug will be more likely to be excreted instead of reabsorbed in the kidney if the urine is acidic
24
Q

What is Methylphenidate?

A

Ritalin and Concerta

25
Q

What’s the MOA of Methylphenidate (Ritalin)?

A

Enhance DOPAMINE release and inhibit reuptake

26
Q

So…. Compare methylphenidate to amphetamines

A

BOTH - enhance DA release and block reuptake

Amphetamine - enhance NE release

27
Q

OKAY… All of these ADHD drugs are stimulants. If you want to make someone LESS HYPERACTIVE wouldn’t you want to stop stimulants?

A

Well… good logic but you’re wrong

Low therapeutic doses of these ADHD drugs will cause an increase in focus/attention/etc…

28
Q

WHAT ARE THE ADULT ADHD DRUGS

A

Modinafil/Armodinafil

Atomoxetine

29
Q

Tell me MOA of Atomoxetine

A

NE reuptake inhibitor
Increase DOPAMINE in PREFRONTAL CORTEX! (you aren’t increasing dopamine in striatum/nucleus accumbens - no euphoria associated)

Can have some working memory issues….

30
Q

Okay…. Alzheimer. Tell me what we are going to inhibit

A

Breakdown of acetylcholine… SO MOST DRUGS WILL BE ANTI-ACETYLCHOLINESTERASES

31
Q

What are some broad bad effects of anticholinesterases?

A

Nausea, anorexia, vomiting, diarrhea

BE CAREFUL EVEN WITH NSAID DRUGS!

32
Q

Rivastigmine - what’s it do? What’s not so good?

A

Anticholinesterase
Good compliance
More GI issues than normal

33
Q

Tacrine - tell me about it

A

Anticholinesterase
Poor compliance

DRUG DRUG INTERACTIONS/LIVER ACTIONS

34
Q

Galantamine - go

A

Anticholinesterase AND stimulates stored acetylcholine release by acting on nicotinic neurons

DRUG DRUG INTERACTIONS

35
Q

When am I going to give Memantine?

A

Severe Alzheimer…

JOB: GLUTAMATE NMDA RECEPTOR ANTAGONIST

36
Q

What is one thing that all inhalation anesthetics have in common

A

All cause physical ∆ in cell membrane fluidity

37
Q

Can you use nitrous oscine alone for anesthesia?

A

NO! It’s an analgesic
Low blood solubility (high induction time)
No muscle relaxation

So…. you should give it before another anesthetic to decrease the MAC of stronger anesthetics

38
Q

What’s a bad effect of nitrous oxide?

A

DIFFUSION HYPOXIA

39
Q

Halothane advantages

A

Inhaled with fast induction
Fast recovery
No airway irritation!

40
Q

Halothane disadvantages

A
  • Bad at analgesia and muscle relaxation
  • CATECHOLAMINE SENSITIZATION - induce arrhythmia if you try to give epinephrine to raise blood pressure
  • Id want to raise BP because I’d have less cardiac output because my baroreceptors wouldn’t be working as great
  • HEPATOTOXICITY
  • MALIGNANT HYPERTHERMIA (remember this is a crazy Ca++ release in the sarcoplasmic reticulum) - treat with dantrolene
41
Q

Isoflurane advantages and disadvantages

A

Advantages - potent (high fat solubility) and fast induction time (low blood solubility)
- Doesn’t sensitize to catecholamines

Disadvantages - malignant hyperthermia

42
Q

Sevoflurane

A

PERFECT DRUG!

High potency and low blood solubility (so rapid onset and fast recovery)

43
Q

Why wouldn’t I use desflurane?

A

Need special equipment to use because it has a low boiling point

44
Q

What’s the MOA of barbiturates again? (ANESTHESIA)

What’s bad about barbs?

A

THIOPENTAL AND METHOHEXITAL USED IN ANESTHESIA

GABA induced Cl- (DURATION) entry into neurons –> CNS depression

LOW THERAPEUTIC INDEX! - CV/respiratory depression (remember linear graph thing)

45
Q

MOA of benzodiazepines again? (ANESTHESIA)

What will the patient always be?

A

MIDAZOLAM AND DIAZEPAM USED IN ANESTHESIA

GABA induced Cl- entry into neurons (FREQUENCY)

PATIENT WILL ALWAYS BE CONSCIOUS! Remember… nonlinear graph so you’re never gonna get to CNS depression

46
Q

What shouldn’t you do if you give a patient propofol?

A

leave them alone you idiot 1 in 3 of your patients will die if you do

47
Q

MOA of Ketamine?

A

NMDA glutamate receptor antagonists

Dissociative anesthestic –> hallucinations and nightmares

Airway can be maintained normally and you might stimulate your CV instead of depress it

48
Q

MOA of opioids?

A

FENTANYL, SUFENTANYL, ALFENTANIL

Hemodynamic stability

Artificial respirations required

You’ll lose your memory!

Neuro final (6 decks)

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