Neuro

Question 1

Name the classes of drugs and how they function to treat glaucoma

Answer 1

1. alpha agonists - dec aqueous humor synthesis
2. beta blockers - dec aqueous humor synthesis
3. acetazolamide - dec aqueous humor synthesis
4. cholinomimetics - inc outflow - contraction of ciliary muscle opening trabecular network
5. PGF2a - latonoprost - inc aq humor

Question 2

What drug do you use in emergencies for glaucoma

Answer 2

pilocarpine - direct cholinmimetic

Question 3

What are the other cholinmimetics for glaucoma

Answer 3

direct - pilocarpine, carbachol

indirect - physostigmine, echothiophate

Question 4

What are the two alpha agonist drugs for glaucoma

Answer 4

epinephrine, brimonidine

Question 5

What are the three beta blockers used for glaucoma

Answer 5

timolol
betaxolol,
carteolol

Question 6

When cant you use an alpha agonist for glaucoma

Answer 6

closed angle - causes mydriasis

Question 7

What glaucoma drug can cause iris darkening

Answer 7

latanoprost

Question 8

MOA of opioids?

Answer 8

open K+ and ca2+ channels - block synaptic transmission of ach, epi, 5HT, glutamate, substance P

Question 9

Which opioids are used for diarrhea

Answer 9

loperamide, diphenoxylate

Question 10

What is the maintenance regimen for heroin addicts

Answer 10

methadone + naloxone + buprenorphine

Question 11

MOA of butorphanol, use?

Answer 11

k agonist, partial mu agonist

used for severe pain - causes less resp depression

Question 12

s/e of butorphanol

Answer 12

can cause opioid withdrawal syndrome with other opioids - competition for receptors

Question 13

MOA and use of tramadol

Answer 13

weak opioid agonist, inhibits 5HT, NE uptake

use for chronic pain

Question 14

s/e of tramadol

Answer 14

similar to opioids also dec seizure threshold and can cause serotonin syndrome

Question 15

What is the first line treatment for absence seizures

Answer 15

ethosuximide

Question 16

what is the first line treatment acutely for status epilepticus

Answer 16

benzos - diazepam and lorazepam

Question 17

what is the first line treatment for prophylaxis of status epilepticus

Answer 17

phenytoin

Question 18

what are three first line treatments for tonic clonic seizure

Answer 18

1. phenytoin
2. carbamazepine
3. valproic acid

Question 19

what drug is the first line treatment for complex seizures

Answer 19

carbamazepine

Question 20

what drug is the first line treatment for simplex seizures

Answer 20

carbamazepine

Question 21

carbamazepine is the first line treatment for what seizures

Answer 21

simple
complex
tonic clonic

Question 22

What drug is first line in neonates

Answer 22

phenobarbital

Question 23

How would you treat eclampsia seizures

Answer 23

MgSO4 or benzos

Question 24

What would you treat trigem neuralgia with

Answer 24

carbamazepine

Question 25

Which seizure drugs can cause SJS

Answer 25

1. Ethosuximide 2. phenytoin 3. carbamazepine 4. lamotrigine

Question 26

What seizure drugs are contraindicated in pregnancy? why?

Answer 26

1. valproic acid - can cause NT defects 2. carbamazepine - teratogen 3. phenytoin - fetal hydantoin syndrome

Question 27

What is another major s/e of valproic acid - what do you need to do while taking this drug

Answer 27

rare but fatal hepatotoxicity - measure LFTs

Question 28

MOA of ethosuximide

Answer 28

blocks thalamic T ca2 channels

Question 29

MOA of benzos

Answer 29

inc GAA

Question 30

Phenytoin MOA

Answer 30

inc na channel activation

Question 31

what other drug inc Na+ activation

Answer 31

besides phenytoin - carbamazepine and valproic acid

Question 32

What seizure drug is also used for migraine prevention

Answer 32

topiramate

Question 33

What seizure drug is also used for bipolar disorder

Answer 33

valproic acid, carbamazapine

Question 34

if you dont know the MOA of the other seizure drugs what should you smartly guess

Answer 34

inc GABA

Question 35

which drugs should you not use for generalized/ myoclonic seizures

Answer 35

narrow spectrum drugs: carbamazepine, barbs, phenytoin, gabapentin

Question 36

which drugs should you not use for generalized/ myoclonic seizures

Answer 36

narrow spectrum drugs: carbamazepine, barbs, phenytoin, gabapentin

Question 37

what seizures are valproate especially good for

Answer 37

combined tonic clonic and absence | myoclonic

Question 38

s/e of phenytoin

Answer 38

- ataxia and nystagmus - gingival hyperplasia, hirsuitism - megalobalstic anemia - induces P450 - fetal hydantoin syndrome