Flashcards in Neuro drugs Deck (101):
Alpha 2 agonist-- used for glaucoma-- dec AH synthesis
This drug should not be used in closed angle glaucoma?
Epinephrine --dec AH synthesis
Beta blockers used for glaucoma?
Timolol, betaxolol, carteolol-- dec AH synthesis
Diuretic used to treat glaucoma?
Acetazolamide-- dec AH synthesis
MOA of cholinomimetics for glaucoma?
increase outflow of aqueous humor via contraction of ciliary muscle
Cholinomimetic used in emergencies to treat glaucoma?
Pilocarpine-- opens canal of schlemm
Direct cholinomimetics used for glaucoma?
Pilocarpine and carbachol
Indirect cholinomimetics used for glaucoma?
physostigmine and echothiophate
Prostaglandin used for glaucoma?
Latanoprost-- inc outflow of aqueous humor-- darkens color of iris
Glaucoma drug that darkens the iris (browning)
Latanoprost-- prostaglandin drug for glaucoma-- first line therapy
opioid-- used for diarrhea
MOA of opioids?
Open K channels, close Ca channels-->dec synaptic transmission.... inhibit release of ACh, NE, seretonin, glutamate, substance P
Opioid toxicity treated with?
Naloxone or naltrexone
Partial mu opioid agonist and kappa opioid full agonist?
Butorphanol-- used for severe pain (migraines, labor)--OVERDOSE NOT EASILY REVERSED WITH NALOXONE
Opioid used for severe pain that has less respiratory depression effects thatn other opioids?
Weak opioid agonist that also inhibits seretonin and NE reuptake?
Tramadol-- used for chronic pain--DECREASES SEIZURE THRESHOLD
Opioid agonist which DEC seizure threshold?
Used for trigeminal neuralgia?
1st line for status epilepticus?
Benzos and Phenytoin
Seizure drug used for postherpetic neuralgia, bipolar do, peripheral neuropathy?
Gabapentin (for your PENis)
1st line seizure medication in children?
Blocks thalamic Ca cahnnels-- used for absence seizures
Epileptic that causes sedation tolerance and dependance?
Epileptic that causes stevens johnson?
Benzos and Carbamazepine, Lamotrigine
Epileptic that causes agranulocytosis, aplastic anemia?
Carbamazepine-- also SIADH, Stevens johnson
Epileptic that causes hives?
Ethosuximide (EFGH, Fatigue, GI, Headache)
Epileptic that causes nystagmus, diplopia, ataxia,?
Epileptic that causes gingival hyperplasia and hirsutism?
Phenytoin (Penny causes Gingy)
Epileptic that causes megaloblastic anemia?
Phenytoin-- also causes osteopenia
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)--
Epileptic that causes SLE like syndrome?
Epileptics that cause ataxia?
Gabapentin and Phenytoin
Epileptic that causes kidney stones and weight loss?
Topiramate-- also causes mental dulling
MOA of phenytoin?
Blockade of Na channels; inhibits glutamate realease from presynaptic neurons
Epileptic that is also a class 1B antiarrhythmic?
MOA of barbiturates?
Increase DURATION of Cl- opening leading to decreased neuronal firing-- contraindicated in porphyrias
Contraindicated in porphyria?
List the benzos?
anything that ends in "azepam" or "olam" and chlordiazepoxide
MOA of benzos?
Increase frequency of Cl- channel opening, decreases REM sleep
Have active metabolites
Used in alcohol withdrawal?
Treat overdose of Benzos with?
Zolpidem (ambien); zaleplon, eszopiclone
Ambien-- act via BZ1 subtype of GABA receptor
1st line epileptics for partial seizures?
Used for seizures of ecclampsia?
Benzoes (1st line is MgSO4)
May be used for induction of anesthesia?
anesthetics with dec solubility in blood
have rapid induction and recovery times
Drugs with increased solubiility in lipids?
Have increased potency
How is high potency measured in anesthetics?
1/MAC (minimal alveolar concentration in which 50% of population is anesthetized)
N2O as an anesthetic?
low blood solubility and therefore fast induction time and low potency
Halothane as an anesthetic?
high lipid solubility and therefore high potency and low induction
Halothane and "flurane"s and Nitrous oxide
Anesthetics that increase cerebral blood flow and cause myocardial depression?
Inhaled anesthetics (ahlothane and fluranes)
Can cause malignant hyperthermia?
May lead to severe hepatotoxicity (anesthetic)?
Anesthetic that can lead to nephrotoicity?
Barbiturtes and anesthesia?
IV anesthetics-- thiopenal is used for induction-- has high potency and high lipid solubility
Effects of this anesthetic are terminated by rapid redistribution into tissue? such as skeletal msucle and fat?
Thiopental-- also decreases cerebral flow
Most common drug used for endoscopy?
MOA of ketamine?
Blocks NMDA receptor-- cardiovascular stimulant and increases cerebral blood flow
Used for short procedures and rapid anesthesia induction?
Local anesthetic esters?
Esters= procaine, cocaine, tetracaine
Amides= LIdocaIne, mepIvicaIne, bupIvicaIne, amides have 2 i's
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
What are local anesthetics given with?
vasoconstrictors-- dec bleeding, inc anesthesia by dec systemic concentration
Order of pain loss in locals?
Pain, temp, touch pressure (PTTP)
Order of nerve block in locals?
Local anesthetic with severe cardiotoxicity?
SE of cocaine?
Strong ACh receptor agonist; produces sustained depolarizations and prevents muscle contraction--NOT DEGRADED BY ACETYLCHOLINESTERASE
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
Complications of depolarizing agents?
Hypercalcemia, hyperkalemia, malignant hyperthermia
Nondepolarizing neuromuscular agents?
tubocurarine, atracurium, mivacurium, pancuronium, ....
competitive ACh antagonists
Reversal of blockade for tubocurarine and atracurium?
neostigmine, edrophonium, and other cholinesterase inhibitors
Prevents release of Ca2+ from the sarcoplasmic reticulum of skeletal muscle
Patient receives inhalation anesthetics (or succinylcholine) and his fever spikes up to 41degrees-- what's the antidote?
Dantrolene-- also used in neuroleptic malignant syndrome
Loss of dopaminergic and excess cholinergic activity
Dopamine agonists? ergot? nonergot?
Nonergots preferred= pramipexole, ropinirole
Increases dopamine release and side effect is ataxia?
Amantidine--- also used against flu and rubella
Converted to dopamine in CNS
Prevent dopamine breakdown?
Selegiline (MAO b inhibitor); Entacapone, tolcapone (comt inhibitors)
Curb excess cholinergic activity?
Benztropine (antimuscarininc; improves tremor and rigidity but has little effect on bradykinesia_
Improves tremor and rigidity in parkinsons but has little effect on bradykinesia
Peripheral decarboxylase inhibitor-- limits peripheral side effects of Ldopa
Toxicity of Ldopa/carbidopa?
Arrhythmias from increased peripheral formation of catecholamines-- akinesia between doses
MOA of Selegiline?
selectively inhibits MAO B, which preferentially metabolizes dopamine over NE and 5HT-- may enhance adverse effects of L-dopa
Alzheimer drug-- NMDA receptor antagonist-- helps prevent excitotoxicity (mediated by Ca)
Memantine side effects?
Dizziness, confusion HALLUCINATION
Alzheimer drug-- acetylcholinesterase inhibitor
Donepezil; galantamine; rivastigmine
Drugs for huntingtons?
Tetrabenazine and reserpine inhibit VMAT
Haloperidol is a dopamine antagonist
Tetrabenazine and reserpine?
Inhibit VMAT--limit dopamine vesicle packaging and release-- huntingtons
5Ht agonist-- inhibits trigeminal nerve activation; USED IN MIGRAINE AND CLUSTER HEADACHES-- SUMO WRESTLER TRIPS AND FALLS ON YOUR HEAD
Sumatriptan is contraindicated in?
coronary vasospasm-- may cause mild tingling
Valproic acid-- suppressed GABA and NMDA
Valproate and Ethosuximide