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Pharmacology 1 Brandon's additional Cards > Neuro 3 > Flashcards

Neuro 3 Flashcards

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1
Q

how long can anxiety and sleep disturbances persist after alcohol withdrawl?

A

can persist for several months

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2
Q

how long at risk of seizures and hallucinations after stopping alcohol?

A

1-5 days

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3
Q

When do DTs start?

A

48-72hrs after stopping alochol

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4
Q

Goals of drug therapy in alcohol withrawal?

A

prevent seizures, delirium, & arrhythmias

correct electrolyte balances K Mg PO4 (as fast as kidneys allow)

substitute long acting sedative-hypnotic for alcohol and then taper the dose

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5
Q

What are the preferred benzos for alcohol withdrawal?

A

Chlordiazepoxide (Librium)
Diazepam (Valium)

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6
Q

What are shorting acting benzos you can use for alcohol withdrawl and why are they used?

A

Ativan (Lorazepam)
Oxezapam (Serax)

would use in presence of compromised liver function to avoid active metabolites of benzos

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7
Q

mech of action of alcohol?

A

enhance GABAa actions (some GABAa antagonists can attenuate alcohols effects here)

block glutamate on NMDA receptors

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8
Q

which mech of action of alcohol explains blackouts?

A

blocking glutamate on NMDA receptors

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9
Q

What is Wernicke-Korsakoff syndrome?

A

paralysis of external eye muscles, ataxia, confusion, that can progress to coma and death.

caused by thamine defeciency

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10
Q

effect of acute alcohol consumption in cold enviorments?

A

market vasodilation

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11
Q

another name for carbmazepine?

A

monohydroxy derivative (MDH)

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12
Q

3 mech of action of anti seizure drugs?

A
  1. Enhance inhibitory tranmission (GABAergic)
  2. Reduce excitatory (glutamergic)
  3. modify ion conductance
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13
Q

Two types of seziures?

A

focal onset (partial) and Generalized

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14
Q

how are focal onset (partial) seizures treated?

A

all types are treated with the same drugs

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15
Q

how are generalize seizures treated?

A

drugs are specific to seizure subtype

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16
Q

Are anti seizure drugs highly protein bound?

A

yes, except for 3

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17
Q

what 3 antiseizure drugs are not highly protein bound?

A

Tiny Pink Vagin

Tiagabine
Phenytoin
Valproic Acid

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18
Q

Anti seizure pharmaco kinetics

A

single drug therapy preferred
low therapeutic index
^ risk of congenital malformations if used in pregancy
can taper if no seizures for 3-4 years
avoid abrupt withdrawl
well absorbed, 80-100% reach circulation
medium to long acting

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19
Q

How many types of anti sezure drugs?

A

5 classes and 3 drugs

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20
Q

what are the 5 drug classes of anti seizure meds?

Study These Flashcards
A

Barbiturats
Hydantoins
Oxazolidinedions
Succinimides
Aceylureas

21
Q

what are the 3 antiseizure drugs?

Study These Flashcards
A

carbmazepine
valproic acid
Benzos

22
Q

What kind of seizures does phenytoin / dilantin treat?

Study These Flashcards
A

partial and generalized tonic-clonic seizure

23
Q

Phenytoin Mech of action?

Study These Flashcards
A

alter Na K and Ca conductance
decrease glutamate and increase GABA

24
Q

Phenytoin main mech of action?

Study These Flashcards
A

alter Na channel to inhibit rapidly repetitive APs

25
Can phenytoin cause paradoxical excitation in some cerebral neurons?
yes
26
how is phenytoin eliminated via first or zero order kinetics?
first order kinetics
27
When does phenytoin cause toxicity?
after liver hits max capactity
28
S/S of phenytoin toxicity?
diplopia ataxia nystagmus gingivial hyperplasia hirsutism sedation (only at high levels)
29
what two S/S of phenytoin toxicty require dose adjustments?
diplopia and ataxia
30
Effects of long term phenytoin use?
coarsening facial features mild peripheral neuropathy osteomalacia Vit D deficiency low folate megablastic anemia ( ^ RBCs)
31
How to typical antipsychotics work?
D2 antagonists
32
do typical antipsychotics treat + or - symptoms?
+
33
Which kind of antipsychotics increase risk of EPS?
typical antipsychotics
34
What are the two types of typical antipsychotics?
Phenotiazines Chlorpromazine (prototype for typical antipsychotics) butyrophenone derivatives Haloperidol (Haldol)
35
Who soon will you have relapse of schizophrenia if you stop taking antipsychotic meds?
Within 6 months except for clozapine, will have rapid and severe relapse after DC
36
What conditions are antipsychotics used for?
schizoprenia, bipolar, depression, organic psychosis senile psychosis drug induce psychosis
37
Explain how antipsychotic drugs have longer clincal actions than their half life?
because of prolonged occupancy of D2 receptors
38
Toxicity of anipsychotics
severe sedation anticholinergic (greater in typical) tardive dyskinesia hyperlactinemia (from blocking dopamine) hypotension (alpha blockade)
39
mech of action of atypical antipsychotics?
mild D2 antagonists
40
do atypical antipsychotics have EPS?
no
41
Clozapine mech of action?
weak D2 antagonist inverse at 5HT2A receptor (this blocks excitatory release of glutamate) some alpha, muscarinic, and H1 blockade
42
What is clozapine used to treat?
+ and - symptoms of schizophrenia agitation in Alzheimer's and Parkinson's
43
what is the most common form of psychosis?
scizophrenia
44
is psychosis present at all times in all patients with scizophrenia?
no
45
what receptor mediates + symptoms of schizophrenia?
D2
46
what receptor mediates - symptoms of schizophrenia?
5HT, especially 5HT2A
47
how many schizophrenic patients are typically drug resistant?
20-25% but this can also just be from non compliance
48
genetic aspect of scizophrenia to know?
high inheritability but no single gene is involved

Pharmacology 1 Brandon's additional Cards (7 decks)

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