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Flashcards in Neuro drugs Deck (60):
1

pentazocine uses

analgesia for moderate to severe pain

2

pentazocine AE's

Can cause opioid withdrawal symptoms if patient is also taking full opioid antagonist (competition for opioid receptors)

3

butorphanol mechanism

K-agonist + mu- partial agonist

4

butorphanol uses and caveat

1) severe pain (eg, migraine, labor).
2) less respiratory depression than full opioid agonists.

5

butorphanol AE's

1) withdrawal
2) overdose not easily reversed with naloxone

6

tramadol MOA

1) weak opioid agonist
2) inhibits 5-HT and NE reuptake.

7

tramadol use

chronic pain

8

tramadol AE's

1) decreases seizure threshold
2) serotonin syndrome

9

ethosuximide AE's

Fatigue
Gi distress
Headache
Itching
stevens-johnson syndrome

10

receptor targeted by benzos

GABA *A (*increase)

11

other use for benzos?

eclampsia seizures

12

phenobarbital receptor

GABA *A (increase)

13

1st line treatment for seizures in neonates?

phenobarbital

14

other drug like phenytoin?

fosphenytoin

15

teratogenic syndrome caused by phenytoin...

fetal hydantoin syndrome

16

phenytoin AE's

1) nystagmus
2) diplopia
3) ataxia
4) sedation
5) peripheral neuropathy
6) hirsutism
7) SJS
8) gingival hyperplasia
9) DRESS syndrome
10) osteopenia
11) SLE-like syndrome
12) megaloblastic anemia

17

DRESS syndrome

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

18

osteopenia

Condition in which bone mineral density is lower than normal. Precursor to osteoporosis.

19

Carbamazepine AE's

1) diplopia
2) ataxia
3) agranulocytosis + aplastic anemia
4) liver toxicity
5) teratogenic
6) SIADH
7) SJS

20

valproic acid mechanism

1) increased Na channel inactivation
2) *increased GABA concentration by inhibiting GABA transaminase

21

valproic acid AE's

1) GI distress
2) hepatotoxicity
3) pancreatitis
4) NTDs
5) tremor
6) weight gain

22

vigabatrin mechanism

Increases GABA by irreversibly inhibiting GABA transaminase

23

Gabapentin MOA

GABA analog that primarily inhibits high-voltage-activated Ca2+ channels.

24

Gabapentin AE's

sedation + ataxia

25

other uses for gabapentin?

peripheral neuropathy

26

treatment for postherpetic neuralgia?

Gabapentin

27

topiramate MOA

1) blocks sodium channels
2) increases GABA action

28

topiramate AE's

1) sedation
2) mental dulling
3) kidney stones
4) weight loss

29

levetiracetam MOA

unknown; may modulate GABA and glutamate release

30

tiagabine MOA

Increases GABA by inhibiting reuptake.

31

First line for simple partial seizures?

carbamazepine

32

First line for simple complex seizures?

carbamazepine

33

First line for tonic-clonic seizures

Phenytoin
OR
Valproic acid

34

first line for acute status epileptics?

benzos

35

first line for status epilepticus prophylaxis?

phenytoin/fosphenytoin

36

Drugs used only for partial seizures?

vigabatrin
gabapentin
tiagabine

37

other barbiturate?

secobarbital

38

barbiturates target..

GABA*A

39

When are barbiturates contraindicated?

porphyria

40

barbiturates uses

1) sedative for anxiety
2) seizures
3) insomnia
4) thiopental used for induction of anesthesia

41

barbiturate overdose treatment?

supportive (assist respiration + maintain BP)

42

barbiturates AE's

1) respiratory/CV/CNS depression
2) dependence

43

What is the GABA A receptor?

Ligand-gated Cl- channel

44

General pharmacokinetic rule about Benzos...

Most have long half-lives and active metabolites except (ATOM --> alprazolam, triazolam, oxazepam, midazolam, which are all short acting)

45

Problem with short acting benzos?

Higher addictive potential

46

benzos to use for status epilepticus

lorazepam
*diazepam

47

other use for benzos

hypnotic for insomnia

48

Risk of flumazenil?

Can precipitate seizures by causing acute benzo withdrawal.

49

nonbenzo hypnotics...

zolpidem
zaleplon
esZopiclone

50

nonbenzo hypnotics MOA

act via BZ1 subtype of GABA receptor

51

nonbenzo hypnotics antagonist

flumazenil

52

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.

53

nonbenzo hypnotics

1) ataxia
2) headaches
3) confusion

54

nonbenzo hypnotics pharmacologic caveat

Short duration because of rapid metabolism by liver enzymes

55

What determines recovery time?

Decreased solubility = more rapid recovery time

56

What determines potency?

solubility in lipids. INCREASED solubility = higher potency (can cross BBB better)

57

potency for anesthetics described by..

1/MAC

58

What is MAC?

minimal alveolar concentration required to prevent 50% of subjects from moving in response to noxious stimuli

59

Nitrous oxide pharmacokinetics

Decreased blood and lipid solubility. Thus has a fast induction and low potency.

60

Halothane pharmacokinetics

High lipid and blood solubility and thus high potency and slow induction.