Neuro Meds and treatments

Question 1

Drug of choice for absence seizures

Answer 1

ethosuximide

Question 2

First-line treatment for eclampsia

Answer 2

Magnesium sulfate

Question 3

Anti-seizure drugs that blocks sodium channels

Answer 3

Phenytoin
Carbamazepine
Lamotrigene
Topiramate
Valproic acid

Decreased action potential in neurons

Question 4

Anti-seizure drugs that increase GABA activity

Answer 4

Gabapentin
Phenobarbital
Valproic acid
Benzodiazepines
Tigabine
Vigabatrin
Levetiracetam

Decrease excitability of neurons

Question 5

Anti-seizure drugs that block T type calcium channels

Answer 5

Gabapentin
ethosuximide
Phenytoin (at very high dose)

Decreased action potentials in neurons

Question 6

Drug of choice for generalized seizures according to SANAD trial

Answer 6

valproic acid

Question 7

Drug of choice for partial seizures according to SANAD trial

Answer 7

lamotrigene

Question 8

Side effects of phenytoin

Answer 8

"Phenytoin Has Given MDs Frustration"
Peripheral neuropathy
Hirsutism
Gingival hyperplasia
Megaloblastic anemia due to decreased folate absorption
Drug-induced lupus
Steven Johnson syndrome
Fetal hydantoin syndrome (cleft lip/pallet, congenital heart disease, intellectual disabilities with developmental delay)

Question 9

Antiepileptics that are teratogens

Answer 9

Phenytoin
carbamazepine
valproic acid - spina bifida, ppx 4 mg folate daily

Question 10

Drugs that cause Steven Johnson syndrome

Answer 10

Seizure drugs: ethosuximide, lamotrigine, carbamazepine, phenytoin, phenobarbital

Antibiotics: sulfonamides, penicillins

Allopurinol

Question 11

Drug known to cause a agranulocytosis

Answer 11

carbamazapine
clozapine
colchicine
PTU and methimazole

Question 12

Hepatotoxic antiepileptic drugs

Answer 12

valproic acid

carbamazepine

Question 13

Drugs that induce CYP450

Answer 13

“Coronas, Guinness, and PBRS induce CHRONIC ALCOHOLISM”

carbamazepine
griseofulvin
phenytoin
barbiturates
rifampin
St. john wort
chronic alcoholism

Question 14

Main medication in managing parkinsonian symptoms

Answer 14

Levodopa/ carbidopa

Question 15

MAO-B inhibitor used in early Parkinson disease, neuroprotective effects

Answer 15

Selegiline

more dopamine longer

Question 16

COMT inhibitors

Answer 16

potentiate levodopa in parkinson dz

entacapone
tolcapone

Question 17

2nd line dopamine agonists in Parkinson disease

Answer 17

Bromocriptin - ergot compound

non-ergot D3 stimulators:
pramipexole
ropinirole
rotigotine (transdermal)

Apomorphine (subQ) - rescue therapy for sudden akinetic episodes

Question 18

Anticholinergics used in Parkinson disease

Answer 18

for tremor

trihexyphenidyl
Benztropine

Question 19

Drug use in short-term monotherapy in mild Parkinson disease

Answer 19

Amantadine - increase dopamine release

Question 20

Cholinesterase inhibitors used in Alzheimer’s disease

Answer 20

Donepezil
Galantamine
Rivastigmine

Question 21

NMDA receptor blocker used in Alzheimer’s disease

Answer 21

Memantine

Question 22

Initial empiric therapy in ER for patient with loss of consciousness

Answer 22

Thiamine first
Glucose - presumed hypoglycemia
Naloxone - presumed overdose

Question 23

Antihistamines used as sleep aid

Answer 23

Diphenhydramine

Associated with poor sleep quality, next day fatigue

Question 24

Trazodone for sleep aid

Answer 24

Antidepressant, anticholinergic/antihistamine effects

Next a fatigue

Question 25

TCAs used for sleep aid

Answer 25

amitriptyline doxepin Antidepressant, anticholinergic Side effects - avoid in elderly (confusion)

Question 26

Benzodiazepines used as sleep aids

Answer 26

triazolam temazepam lorazepam clonazepam Bind to GABA receptors, addictive, increase N2, decrease N3 and REM

Question 27

Nonbenzodiazepines used as sleep aids

Answer 27

Zolpidem - longest acting Zaleplon - shortest acting Eszopiclone Act at the specific GABA type A receptor, rebound insomnia when discontinued, sleepwalking

Question 28

Orexin receptor antagonist used as a sleep aid

Answer 28

Suvorexant Orexin A and B are hypothalamic neuropeptides that promote wakefulness - blocking promotes sleepiness

Question 29

Ramelteon for sleep aid

Answer 29

Agonist at melatonin receptor - non-habit forming

Question 30

Drugs used in restless legs syndrome

Answer 30

Dopamine agonists: pramipexole, ropinirole gabapentin Pregabalin severe: levodopa/carbidopa

Question 31

Topical acetazolamide- open angle glaucoma

Answer 31

reduce aqueous humor production

Question 32

Prostaglandins - open angle glaucoma

Answer 32

latanoprost - increased outflow aqueous humor

Question 33

B-blockers - open angle glaucoma

Answer 33

timolol - inhibit aqueous humor production

Question 34

alpha 2 - adrenergic agonist -open angle glaucoma

Answer 34

apraclonidine, brinomidine - reduce aqueous humor production and increase outflow

Question 35

Cholinergic agonists - open angle glaucoma

Answer 35

pilocarpine - cause miosis and open trabecular meshwork -> increased outflow of aqueous humor