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Flashcards in Neuro drugs Deck (101):
1

Brimonidine?

Alpha 2 agonist-- used for glaucoma-- dec AH synthesis

2

This drug should not be used in closed angle glaucoma?

Epinephrine --dec AH synthesis

3

Beta blockers used for glaucoma?

Timolol, betaxolol, carteolol-- dec AH synthesis

4

Diuretic used to treat glaucoma?

Acetazolamide-- dec AH synthesis

5

MOA of cholinomimetics for glaucoma?

increase outflow of aqueous humor via contraction of ciliary muscle

6

Cholinomimetic used in emergencies to treat glaucoma?

Pilocarpine-- opens canal of schlemm

7

Direct cholinomimetics used for glaucoma?

Pilocarpine and carbachol

8

Indirect cholinomimetics used for glaucoma?

physostigmine and echothiophate

9

Prostaglandin used for glaucoma?

Latanoprost-- inc outflow of aqueous humor-- darkens color of iris

10

Glaucoma drug that darkens the iris (browning)

Latanoprost-- prostaglandin drug for glaucoma-- first line therapy

11

Meperidine?

opioid

12

diphenoxylate

opioid-- used for diarrhea

13

fentanyl

opioid

14

MOA of opioids?

Open K channels, close Ca channels-->dec synaptic transmission.... inhibit release of ACh, NE, seretonin, glutamate, substance P

15

Opioid toxicity treated with?

Naloxone or naltrexone

16

Partial mu opioid agonist and kappa opioid full agonist?

Butorphanol-- used for severe pain (migraines, labor)--OVERDOSE NOT EASILY REVERSED WITH NALOXONE

17

Opioid used for severe pain that has less respiratory depression effects thatn other opioids?

Butorphanol

18

Weak opioid agonist that also inhibits seretonin and NE reuptake?

Tramadol-- used for chronic pain--DECREASES SEIZURE THRESHOLD

19

Opioid agonist which DEC seizure threshold?

Tramadol

20

Used for trigeminal neuralgia?

Carbamazepine

21

1st line for status epilepticus?

Benzos and Phenytoin

22

Seizure drug used for postherpetic neuralgia, bipolar do, peripheral neuropathy?

Gabapentin (for your PENis)

23

1st line seizure medication in children?

Pehnobarbital

24

Ethosuximide? MOA?

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