Neuro drugs Flashcards
(101 cards)
1
Q
Brimonidine?
A
Alpha 2 agonist– used for glaucoma– dec AH synthesis
2
Q
This drug should not be used in closed angle glaucoma?
A
Epinephrine –dec AH synthesis
3
Q
Beta blockers used for glaucoma?
A
Timolol, betaxolol, carteolol– dec AH synthesis
4
Q
Diuretic used to treat glaucoma?
A
Acetazolamide– dec AH synthesis
5
Q
MOA of cholinomimetics for glaucoma?
A
increase outflow of aqueous humor via contraction of ciliary muscle
6
Q
Cholinomimetic used in emergencies to treat glaucoma?
A
Pilocarpine– opens canal of schlemm
7
Q
Direct cholinomimetics used for glaucoma?
A
Pilocarpine and carbachol
8
Q
Indirect cholinomimetics used for glaucoma?
A
physostigmine and echothiophate
9
Q
Prostaglandin used for glaucoma?
A
Latanoprost– inc outflow of aqueous humor– darkens color of iris
10
Q
Glaucoma drug that darkens the iris (browning)
A
Latanoprost– prostaglandin drug for glaucoma– first line therapy
11
Q
Meperidine?
A
opioid
12
Q
diphenoxylate
A
opioid– used for diarrhea
13
Q
fentanyl
A
opioid
14
Q
MOA of opioids?
A
Open K channels, close Ca channels–>dec synaptic transmission…. inhibit release of ACh, NE, seretonin, glutamate, substance P
15
Q
Opioid toxicity treated with?
A
Naloxone or naltrexone
16
Q
Partial mu opioid agonist and kappa opioid full agonist?
A
Butorphanol– used for severe pain (migraines, labor)–OVERDOSE NOT EASILY REVERSED WITH NALOXONE
17
Q
Opioid used for severe pain that has less respiratory depression effects thatn other opioids?
A
Butorphanol
18
Q
Weak opioid agonist that also inhibits seretonin and NE reuptake?
A
Tramadol– used for chronic pain–DECREASES SEIZURE THRESHOLD
19
Q
Opioid agonist which DEC seizure threshold?
A
Tramadol
20
Q
Used for trigeminal neuralgia?
A
Carbamazepine
21
Q
1st line for status epilepticus?
A
Benzos and Phenytoin
22
Q
Seizure drug used for postherpetic neuralgia, bipolar do, peripheral neuropathy?
A
Gabapentin (for your PENis)
23
Q
1st line seizure medication in children?
A
Pehnobarbital
24
Q
Ethosuximide? MOA?
A
Blocks thalamic Ca cahnnels– used for absence seizures
25
Epileptic that causes sedation tolerance and dependance?
Benzos, phenobarbital
26
Epileptic that causes stevens johnson?
Benzos and Carbamazepine, Lamotrigine
27
Epileptic that causes agranulocytosis, aplastic anemia?
Carbamazepine-- also SIADH, Stevens johnson
28
Epileptic that causes hives?
Ethosuximide (EFGH, Fatigue, GI, Headache)
29
Epileptic that causes nystagmus, diplopia, ataxia,?
PHENYTOIN
30
Epileptic that causes gingival hyperplasia and hirsutism?
Phenytoin (Penny causes Gingy)
31
Epileptic that causes megaloblastic anemia?
Phenytoin-- also causes osteopenia
32
Epileptic that can cause fatal hepatoxicity and neural tube defects?
Valproic acid (If Val Kilmer was a FAT Alcoholic with NO HAIR, you wouldn't want to get PREGNANT with his baby)--
33
Epileptic that causes SLE like syndrome?
Phenytoin
34
Epileptics that cause ataxia?
Gabapentin and Phenytoin
35
Epileptic that causes kidney stones and weight loss?
Topiramate-- also causes mental dulling
36
MOA of phenytoin?
Blockade of Na channels; inhibits glutamate realease from presynaptic neurons
37
Epileptic that is also a class 1B antiarrhythmic?
Phenytoin
38
MOA of barbiturates?
Increase DURATION of Cl- opening leading to decreased neuronal firing-- contraindicated in porphyrias
39
Contraindicated in porphyria?
Barbidurates
40
List the benzos?
anything that ends in "azepam" or "olam" and chlordiazepoxide
41
MOA of benzos?
Increase frequency of Cl- channel opening, decreases REM sleep
Have active metabolites
42
Used in alcohol withdrawal?
Benzos
43
Treat overdose of Benzos with?
Flumazenil
44
Nonbenzo hypnotics?
Zolpidem (ambien); zaleplon, eszopiclone
45
Zolpidem? MOA?
Ambien-- act via BZ1 subtype of GABA receptor
46
1st line epileptics for partial seizures?
Carbamazepine
47
Used for seizures of ecclampsia?
Benzoes (1st line is MgSO4)
48
May be used for induction of anesthesia?
Barbiturates (thiopental)
49
anesthetics with dec solubility in blood
have rapid induction and recovery times
50
Drugs with increased solubiility in lipids?
Have increased potency
51
How is high potency measured in anesthetics?
1/MAC (minimal alveolar concentration in which 50% of population is anesthetized)
52
N2O as an anesthetic?
low blood solubility and therefore fast induction time and low potency
53
Halothane as an anesthetic?
high lipid solubility and therefore high potency and low induction
54
Inhaled anesthetics?
Halothane and "flurane"s and Nitrous oxide
55
Anesthetics that increase cerebral blood flow and cause myocardial depression?
Inhaled anesthetics (ahlothane and fluranes)
56
Can cause malignant hyperthermia?
Inhaled anesthetics
57
May lead to severe hepatotoxicity (anesthetic)?
Halothane
58
Anesthetic that can lead to nephrotoicity?
Methoxyflurane
59
Barbiturtes and anesthesia?
IV anesthetics-- thiopenal is used for induction-- has high potency and high lipid solubility
60
Effects of this anesthetic are terminated by rapid redistribution into tissue? such as skeletal msucle and fat?
Thiopental-- also decreases cerebral flow
61
Most common drug used for endoscopy?
Midazolam
62
MOA of ketamine?
Blocks NMDA receptor-- cardiovascular stimulant and increases cerebral blood flow
63
Used for short procedures and rapid anesthesia induction?
Propofol
64
Local anesthetic esters?
| Amides?
```
Esters= procaine, cocaine, tetracaine
Amides= LIdocaIne, mepIvicaIne, bupIvicaIne, amides have 2 i's
```
65
MOA of local anesthetics?
Block Na channels on inner portion of channel; preferentially bind activated Na channels. Tertiary amines penetrate membrane in uncharged form and then bind to ion channels as charged form
66
What are local anesthetics given with?
vasoconstrictors-- dec bleeding, inc anesthesia by dec systemic concentration
67
Order of pain loss in locals?
Pain, temp, touch pressure (PTTP)
68
Order of nerve block in locals?
small>large fibers
| Myelinated>unmyelinated
69
Local anesthetic with severe cardiotoxicity?
bupivacaine
70
SE of cocaine?
Arrhythmias
71
Succinylcholine?
Strong ACh receptor agonist; produces sustained depolarizations and prevents muscle contraction--NOT DEGRADED BY ACETYLCHOLINESTERASE
72
Reversal of blockade in depolarizing agents?
Phase 1= prolonged depolarization-- no antidote-- block potentiated by cholinesterase inhibitors
Phase 2= Repolarized but blocked; ACh receptors are available but sensitized-- antidote consists of cholinesterase inhibitor (neostigmine)
Complications of depolarizing agents-- hypercalcemia hyperkalemia, and malignant hyperthermia
73
Complications of depolarizing agents?
Hypercalcemia, hyperkalemia, malignant hyperthermia
74
Nondepolarizing neuromuscular agents?
tubocurarine, atracurium, mivacurium, pancuronium, ....
competitive ACh antagonists
75
Reversal of blockade for tubocurarine and atracurium?
neostigmine, edrophonium, and other cholinesterase inhibitors
76
Prevents release of Ca2+ from the sarcoplasmic reticulum of skeletal muscle
dantrolene
77
Patient receives inhalation anesthetics (or succinylcholine) and his fever spikes up to 41degrees-- what's the antidote?
Dantrolene-- also used in neuroleptic malignant syndrome
78
Parkinsons?
Loss of dopaminergic and excess cholinergic activity
79
Dopamine agonists? ergot? nonergot?
Nonergots preferred= pramipexole, ropinirole
| Ergot= bromocriptine
80
Increases dopamine release and side effect is ataxia?
Amantidine--- also used against flu and rubella
81
Ldopa/carbidopa?
Converted to dopamine in CNS
82
Prevent dopamine breakdown?
Selegiline (MAO b inhibitor); Entacapone, tolcapone (comt inhibitors)
83
Curb excess cholinergic activity?
Benztropine (antimuscarininc; improves tremor and rigidity but has little effect on bradykinesia_
84
Improves tremor and rigidity in parkinsons but has little effect on bradykinesia
Benztropine
85
Carbidopa?
Peripheral decarboxylase inhibitor-- limits peripheral side effects of Ldopa
86
Toxicity of Ldopa/carbidopa?
Arrhythmias from increased peripheral formation of catecholamines-- akinesia between doses
87
MOA of Selegiline?
selectively inhibits MAO B, which preferentially metabolizes dopamine over NE and 5HT-- may enhance adverse effects of L-dopa
88
Memantine MOA?
Alzheimer drug-- NMDA receptor antagonist-- helps prevent excitotoxicity (mediated by Ca)
89
Memantine side effects?
Dizziness, confusion HALLUCINATION
90
Donepezil?
Alzheimer drug-- acetylcholinesterase inhibitor
91
Galantamine?
Acetylcholinesterase inhibitors
92
Rivastigmine?
Acetylcholinesterase inhibitors
93
Acetylcholinesterase inhibitors?
Donepezil; galantamine; rivastigmine
94
Drugs for huntingtons?
Tetrabenazine and reserpine inhibit VMAT
| Haloperidol is a dopamine antagonist
95
Tetrabenazine and reserpine?
Inhibit VMAT--limit dopamine vesicle packaging and release-- huntingtons
96
SumatriptanMOA? uses?
5Ht agonist-- inhibits trigeminal nerve activation; USED IN MIGRAINE AND CLUSTER HEADACHES-- SUMO WRESTLER TRIPS AND FALLS ON YOUR HEAD
97
Sumatriptan is contraindicated in?
coronary vasospasm-- may cause mild tingling
98
Partial seizures?
Carbamezapin
99
Myoclonic seizures?
Valproic acid-- suppressed GABA and NMDA
100
Absence seizures?
Valproate and Ethosuximide
101
Antiseizure that causes siadh?
Carbamezapine
