Flashcards in Neuro drugs Deck (60):
analgesia for moderate to severe pain
Can cause opioid withdrawal symptoms if patient is also taking full opioid antagonist (competition for opioid receptors)
K-agonist + mu- partial agonist
butorphanol uses and caveat
1) severe pain (eg, migraine, labor).
2) less respiratory depression than full opioid agonists.
2) overdose not easily reversed with naloxone
1) weak opioid agonist
2) inhibits 5-HT and NE reuptake.
1) decreases seizure threshold
2) serotonin syndrome
receptor targeted by benzos
GABA *A (*increase)
other use for benzos?
GABA *A (increase)
1st line treatment for seizures in neonates?
other drug like phenytoin?
teratogenic syndrome caused by phenytoin...
fetal hydantoin syndrome
5) peripheral neuropathy
8) gingival hyperplasia
9) DRESS syndrome
11) SLE-like syndrome
12) megaloblastic anemia
o Code: Anna by the counter: /Drug Reaction with Eosinophilia and Systemic Symptoms. She’s sweating profusely + face is edematous + she’s topless with a morbilloform rash + has an edematous face/presentation = fever + generalized lymphadenopathy + facial edema + diffuse morbilliform skin rash. Bennett behind the counter + ryan O’connell + big aloe plant in the middle of the store + Ivan + bathtub of minos + geyser going off by entrance/associated with anticonvulsants (phenytoin + carbamazepine) + allopurinol + sulfonamides (sulfasalazine) + minocycline + vancomycin. Giant Andrew black standing in corner/MOA = thought to be drug-induced herpesvirus reactivation followed by clonal expansion of T cells that cross-react with the drug. /typically occurs 2-8 weeks after exposure to high-risk drugs.
o Location: Urban Outfitters in Portland, walls lined with dresses
Condition in which bone mineral density is lower than normal. Precursor to osteoporosis.
3) agranulocytosis + aplastic anemia
4) liver toxicity
valproic acid mechanism
1) increased Na channel inactivation
2) *increased GABA concentration by inhibiting GABA transaminase
valproic acid AE's
1) GI distress
6) weight gain
Increases GABA by irreversibly inhibiting GABA transaminase
GABA analog that primarily inhibits high-voltage-activated Ca2+ channels.
sedation + ataxia
other uses for gabapentin?
treatment for postherpetic neuralgia?
1) blocks sodium channels
2) increases GABA action
2) mental dulling
3) kidney stones
4) weight loss
unknown; may modulate GABA and glutamate release
Increases GABA by inhibiting reuptake.
First line for simple partial seizures?
First line for simple complex seizures?
First line for tonic-clonic seizures
first line for acute status epileptics?
first line for status epilepticus prophylaxis?
Drugs used only for partial seizures?
When are barbiturates contraindicated?
1) sedative for anxiety
4) thiopental used for induction of anesthesia
barbiturate overdose treatment?
supportive (assist respiration + maintain BP)
1) respiratory/CV/CNS depression
What is the GABA A receptor?
Ligand-gated Cl- channel
General pharmacokinetic rule about Benzos...
Most have long half-lives and active metabolites except (ATOM --> alprazolam, triazolam, oxazepam, midazolam, which are all short acting)
Problem with short acting benzos?
Higher addictive potential
benzos to use for status epilepticus
other use for benzos
hypnotic for insomnia
Risk of flumazenil?
Can precipitate seizures by causing acute benzo withdrawal.
nonbenzo hypnotics MOA
act via BZ1 subtype of GABA receptor
nonbenzo hypnotics antagonist
Nice thing about nobenzo hypnotics...
Don't affect sleep cycle as much and unlike older sedative-hypnotics, cause only modest day-after psychomotor depression and a few amnestic effects. Also less risk of dependence.
nonbenzo hypnotics pharmacologic caveat
Short duration because of rapid metabolism by liver enzymes
What determines recovery time?
Decreased solubility = more rapid recovery time
What determines potency?
solubility in lipids. INCREASED solubility = higher potency (can cross BBB better)
potency for anesthetics described by..
What is MAC?
minimal alveolar concentration required to prevent 50% of subjects from moving in response to noxious stimuli
Nitrous oxide pharmacokinetics
Decreased blood and lipid solubility. Thus has a fast induction and low potency.