Neuro Pharm from FA Flashcards Preview

‚Ėļ Med Misc 03 > Neuro Pharm from FA > Flashcards

Flashcards in Neuro Pharm from FA Deck (88):
1

where are the M receptors on the eye? what is their function?

pupillary sphincter (M3)  - causes miosis

ciliary muscles (M3)  - accomodation

A image thumb
2

where are the a1 receptors on the eye? what is their function?

pupillary dilator (a1) 

causes mydriasis

A image thumb
3

where are the ß receptors on the eye? what is their function?

ciliary epithelium 

produces aqueous humor

A image thumb
4

Glaucoma Drugs: overall mechanism?

Decr IOP via decr amount of aqueous humor. (inhibit synthesis/secretion, or increase drainage)

5

Epinephrine.

Class? Mech? SE?

Class: Glaucoma drug, a1, ß1, ß2 agonist

Mech: decr aqueous humor synthesis via vasoconstriction via a1 receptors

SE: Mydriasis (pupil dilation); do not use in closed-angle glaucoma

6

Brimonidine

Class? Mech? SE?

Class: Glaucoma drug, Alpha-2 agonist

Mech: decr aqueous humor synthesis

SEs: Blurry vision, ocular hyperemia, foreign body sensation, ocular allergic reactions, ocular pruritis

7

Timolol, Betaxolol, Carteolol

Class? Mech? SE?

Class: Glaucoma drugs, beta-blockers

Mech: decr aqueous humor synthesis

SE: None given

8

Acetazolamide

Class? Mech? SE?

Class: Glaucoma drug, diuretic

Mech: decr aqueous humor synthesis via inhibition of carbonic anhydrase.

SE: None given

9

Pilocarpine, Carbachol

Class? Mech? SE?

Class: Glaucoma drugs, Direct cholinomimetics

Mech: incr outflow of aq humor via contraction of ciliary muscle and opening of trabecular meshwork

SE: Miosis and cyclospasm (contracton of ciliary muscle)

Note: use pilocarpine in emergencies - very effective at opening meshwork into canal of Schlemm

10

Physostigimine, Echothiophate

Class? Mech? SE?

Class: Glaucoma drugs, Indirect Cholinomimetic

Mech: incr outflow of aq humor via contraction of ciliary muscle and opening of trabecular meshwork

SE: Miosis and cyclospasm (contracton of ciliary muscle)

11

Latanoprost (PGF-2alpha)

Class? Mech? SE?

Class: Glaucoma drug, Prostaglandin

Mech: increased outflow of aqueous humor

SE: darkens color of iris (browning), and lengthens eyelashes (this was actually on the boards!!)

12

Big picture for glaucoma:

which drugs decr IOP by decreasing synthesis of aqueous humor? (6)

Alpha-agonists: Epinephrine, Brimonidine

Beta-blockers: Timolol, Betaxolol, Cartelol

Diuretics: Acetazolamide

13

Big picture for glaucoma:

which drugs decr IOP by increasing drainage/outflow of aqueous humor? (5)

Cholinomimetics: Pilocarpine, Carbachol, Physostigmine, Echothiophate

Prostaglandin: Latanoprost

14

List the opioid analgesics? (8)

Generally, clinical uses?

Morphine

Fentanyl

Codeine

Loperamide

Methadone

Meperidine

Dextromethorphan

Diphenoxylate

Clinical use of this class (every drug not used for every item): Pain control, cough suppression, diarrhea, acute pulm edema, maintenance programs for heroin addicts

15

Morphine

Class? Mech? Use? Toxicity?

Class: Opioid receptor agonist (mu receptor = morphine, delta = enkephalin, kappa = dynorphin). Modulates synaptic transmission -- opens K channels, closes Ca2+ channels -> decr synaptic transmission via hyperpolarization. Inhibits release of ACh, Norepi, 5-HT, glutamate, Substance P

Clinical use: Pain, Acute pulm edema

Tox: Addiction, resp depression, constipation, miosis, addictive CNS depression with other drugs. Tolerance does not develop to miosis and constipation. Tox treated with naloxone or naltrexone (opioid receptor antagonists)

16

Fentanyl

Class? Mech? Use? Tox?

Class: Opioid receptor agonist (mu receptor = morphine,¬†‚Äčdelta = enkephalin, kappa = dynorphin). Modulates synaptic transmission -- opens K channels, closes Ca2+ channels -> decr synaptic transmission via¬†hyperpolarization. Inhibits release of ACh, Norepi, 5-HT, glutamate, Substance P

Clinical use: Pain, Acute pulm edema

Tox: Addiction, resp depression, constipation, miosis, addictive CNS depression with other drugs. Tolerance does not develop to miosis and constipation. Tox treated with naloxone or naltrexone (opioid receptor antagonists)

17

Codeine

Class? Mech? Use? Tox?

Class: Opioid receptor agonist (mu receptor = morphine,¬†‚Äčdelta = enkephalin, kappa = dynorphin). Modulates synaptic transmission -- opens K channels, closes Ca2+ channels -> decr synaptic transmission via¬†hyperpolarization. Inhibits release of ACh, Norepi, 5-HT, glutamate, Substance P

Clinical use: Pain, Acute pulm edema

Tox: Addiction, resp depression, constipation, miosis, addictive CNS depression with other drugs. Tolerance does not develop to miosis and constipation. Tox treated with naloxone or naltrexone (opioid receptor antagonists)

18

Loperamide

Class? Mech? Use? Tox?

Class: Opioid receptor agonist (mu receptor = morphine,¬†‚Äčdelta = enkephalin, kappa = dynorphin). Modulates synaptic transmission -- opens K channels, closes Ca2+ channels -> decr synaptic transmission via¬†hyperpolarization. Inhibits release of ACh, Norepi, 5-HT, glutamate, Substance P

Clinical use: Pain, Acute pulm edema, Diarrhea

Tox: Addiction, resp depression, constipation, miosis, addictive CNS depression with other drugs. Tolerance does not develop to miosis and constipation. Tox treated with naloxone or naltrexone (opioid receptor antagonists)

19

Methadone

Class? Mech? Use? Tox?

Class: Opioid receptor agonist (mu receptor = morphine,¬†‚Äčdelta = enkephalin, kappa = dynorphin). Modulates synaptic transmission -- opens K channels, closes Ca2+ channels -> decr synaptic transmission via¬†hyperpolarization. Inhibits release of ACh, Norepi, 5-HT, glutamate, Substance P

Clinical use: Pain, Acute pulm edema, Maintenance programs for heroin addicts

Tox: Addiction, resp depression, constipation, miosis, addictive CNS depression with other drugs. Tolerance does not develop to miosis and constipation. Tox treated with naloxone or naltrexone (opioid receptor antagonists)

20

Meperidine

Class? Mech? Use? Tox?

Class: Opioid receptor agonist (mu receptor = morphine,¬†‚Äčdelta = enkephalin, kappa = dynorphin). Modulates synaptic transmission -- opens K channels, closes Ca2+ channels -> decr synaptic transmission via¬†hyperpolarization. Inhibits release of ACh, Norepi, 5-HT, glutamate, Substance P

Clinical use: Pain, Acute pulm edema

Tox: Addiction, resp depression, constipation, miosis, addictive CNS depression with other drugs. Tolerance does not develop to miosis and constipation. Tox treated with naloxone or naltrexone (opioid receptor antagonists)

21

Dextromethorphan

Class? Mech? Use? Tox?

Class: Opioid receptor agonist (mu receptor = morphine,¬†‚Äčdelta = enkephalin, kappa = dynorphin). Modulates synaptic transmission -- opens K channels, closes Ca2+ channels -> decr synaptic transmission via¬†hyperpolarization. Inhibits release of ACh, Norepi, 5-HT, glutamate, Substance P

Clinical use: Pain, Acute pulm edema, Cough suppression

Tox: Addiction, resp depression, constipation, miosis, addictive CNS depression with other drugs. Tolerance does not develop to miosis and constipation. Tox treated with naloxone or naltrexone (opioid receptor antagonists)

22

Diphenoxylate

Class? Mech? Use? Tox?

Class: Opioid receptor agonist (mu receptor = morphine,¬†‚Äčdelta = enkephalin, kappa = dynorphin). Modulates synaptic transmission -- opens K channels, closes Ca2+ channels -> decr synaptic transmission via¬†hyperpolarization. Inhibits release of ACh, Norepi, 5-HT, glutamate, Substance P

Clinical use: Pain, Acute pulm edema, Diarrhea

Tox: Addiction, resp depression, constipation, miosis, addictive CNS depression with other drugs. Tolerance does not develop to miosis and constipation. Tox treated with naloxone or naltrexone (opioid receptor antagonists)

23

Butorphanol

Class? Mech? Use? Tox?

Class: Opioid agonist

Mech: Mu-opioid receptor partial agonist and kappa opioid receptor agonist. Causes analgesia

Use: Severe pain (labor, migraine). Causes less resp depression than full opioid agonists

Tox: If pt is also taking full opioid agonist, can cause opioid withdrawal symptoms (due to competition for opioid receptors). Overdose not easily reversed with naloxone

24

Tramadol

Class? Mech? Use? Tox?

Class: Opioid agonist (weak)

Mech: Very weak opioid agonist. Also inhibits serotonin and norepi reuptake - works on multiple neurotransmitters ("tram it all" in with tramadol)

Use: Chronic pain

Tox: similar to opioids. Decreases seizure threshold. Serotonin syndrome.

25

Epilepsy: First line drug for Simple Partial seizure?

Carbamazepine

26

Epilepsy: First line drug for Complex Partial seizure?

Carbamazepine

27

Epilepsy: First line drugs for Generalized Tonic-Clonic seizure? (3)

Phenytoin, Carbamazepine, Valproic acid

28

Epilepsy: First line drug for Absence seizure?

Ethosuximide

(Sucks to have Silent Seizures)

29

Epilepsy: First line drug for Status Epilepticus (Acute)?

Benzodiazepines (diazepam, lorazepam)

30

Epilepsy: First line drug for prophylaxis of Status Epilepticus?

Phenytoin

31

Ethosuximide

Use? Mech? SEs? Notes?

Use: Absence seizures

Mech: blocks thalamic T type Ca2+ channels

SEs: fatigue, GI, urticaria, Steven-Johnson synd.

EFGHIJ: Ethosuximide causes Fatigue, GI distress, Headache, Itching, and Stevens-Johnson synd.

Notes: Sucks to have silent seizures

32

Benzodiadepines (diazepam, lorazepam)

Use? Mech? SEs? Notes?

Use: first line for acute status epilepticus

Mech: increases GABA-a action

SEs: sedation, tolerance, dependence, resp depression

Notes: also for eclampsia seizures (first line is MgSO4)

33

Phenytoin

Use? Mech? SEs? Notes?

Use: simple, complex, tonic-clonic (first line), prophy for status epilepticus

Mech: increases Na channel inactivation; zero-order kinetics

Ses: nystagmus, doplopia, ataxia, sedation, gingical hyperplasia, hirsutism, peripheral neuropathy, megaloblastic anemia, tertatogenesis (fetal hydantoin syndrome), SLE like synd, induction of cytochrome P-450, Stevens-Johnson synd, osteopenia

Notes: fosphenytoin for parenteral use

34

Carbamazepine

Use? Mech? SEs? Notes?

Use: Simple, Complex, Tonic-Clonic seizures (first line for each)

Mech: incr Na channel inactivation

SEs: diplopia, ataxia, blood dyscrasias (agranulocytosis, aplastic anemia), liver toxicity, teratogenesis, induction of cytochrome P-450, SIADH, Steven-Johnson synd. 

Notes: first line for trigeminal neuralgia

35

Valproic acid

Use? Mech? SEs? Notes?

Use: tonic clonic seizures (first line), simple, complex, absence seizures

Mech: incr Na channel inactivation, Incr GABA concentration by inhibiting GABA transaminase

SEs: GI distress, rare but fatal hepatotixicity (measure LFTs), neural tube defects -> spina bifida, tremor, weight gain, contraindicated in preg.

Notes: also used for myoclonic seizures, bipolar d/o

36

Gabapentin

Use? Mech? SEs? Notes?

Use: simple, complex, tonic-clonic seizures

Mech: Inhibits high-voltage-activated Ca channels. Designed as GABA analog

SEs: sedation, ataxia

Notes: also used for peripheral neuropathy, postherpetic neuralgia, migraine prophy, bipolar d/o

37

Phenobarbital

Use? Mech? SEs? Notes?

Use: simple, complex, tonic-clonic seizures

Mech: incr GABAa action

SEs: sedation, tolerance, dependence, induction of cytochrome P-450, cardioresp depression

Note: first line in neonates

38

Topiramate

Use? Mech? SEs? Notes?

Use: simple, complex, tonic-clonic seizures

Mech: Blocks Na channels, incr GABA action

SEs: sedation, mental dulling, kidney stones, weight loss

Note: also used in migraine prevention

39

Lamotrigine

Use? Mech? SEs?

Use: simple, complex, tonic-clonic, absence seizures

Mech: Blocks voltage-gated Na channels

SE: Stevens-Johnson synd. (must be titrated slowly)

 

40

Levetiracetam

Use? Mech? SEs?

Use: Simple, Complex, Tonic-clonic seizures

Mech: unknown (may modulate GABA and glutamate release)

SEs: none

41

Tiagabine

Use? Mech? SEs? Notes?

Use: Simple, Complex seizures

Mech: Incr GABA by inhibiting uptake

SEs: none

42

Vigabatrin

Use? Mech? SEs? Notes?

Use: Simple, Complex seizures

Mech: Incr GABA by irreversibly inhibiting GABA transaminase

SEs: none

43

what is Stevens-Johnson syndrome?

Which epilepsy meds cause it? (4)

Prodrome of malaise and fever, followed by rapid onset of erythematous/purpuric macules (oral, ocular, genital). Skin lesions progress to epidermal necrosis and sloughing.

Caused by:

Carbamazepine

Ethosuximide

Lamotrigine

Phenytoin

44

Barbituates (Phenobarbital, pentobarbital, thiopental, secobarbital): Mechanism?

Facalitate GABA-A action by increasing duration of Cl channel opening, thus decreasing neuron firing. (BarbiDURAtes increase DURAtion)

Contraindicated in porphyria.

45

Barbituates (Phenobarbital, pentobarbital, thiopental, secobarbital): Clinical Use? Toxicity?

Use: Sedative for anxiety, seizures, insomnia, induction of anesthesia (Thiopental)

Tox: Resp and CV depression can be fatal. CNS depression (can be exacerbated by EtOH use). Dependence. Drug interactions: induces cytochrome p-450.

Overdose treatment is supportive (assist resp, maintain BP)

46

Benzodiazepines (Diazepam, lorazepam, triazolam, temazepam, temazepam, oxazepam, midalozam, chlordiazepoxide, alprazolam): Mech?

Facilitate GABA-A action by increasing frequency of Cl- channel opening. Decr REM sleep. Most have long half-lives and active metabolites.

(Exception: Triazolam, oxazepam, midazolam are short acting --> higher addictive potential. But short-acting best for minimizing side effects)

"FREnzodiazepines increase FREquency"

47

Benzodiazepines (Diazepam, lorazepam, triazolam, temazepam, temazepam, oxazepam, midalozam, chlordiazepoxide, alprazolam): 

Clinical Use? Tox?

Use: Anxiety, spasticity, status epilepticus (lorazepam, diazepam), detox (esp alcohol withdrawal w/ DTs), night terrors, sleepwalking, general anesthetic (amnesia, muscle relaxation), hypnotic (insomnia)

Tox: Dependence, addictive CNS depression effects with alcohol. Less risk of resp depression and coma than with barbituates.

Treat OD with Flumazenil (competitive antagonist at GABA benzodiazepine receptor)

48

Nonbenzodiazepine hypnotics (Zoplidem, Zaleplon, esZopicline": Mech? How to reverse?

(All ZZZZs put you to sleep)

Mech: Act via the BZ1 subtype of the GABA receptor. 

Reverse with flumazenil.

49

Nonbenzodiazepine hypnotics (Zoplidem, Zaleplon, esZopicline": Use? Tox?

Use: Insomnia

Tox: Ataxia, headaches, confusion. Short duration because of rapid metabolism by liver enzymes. Unlike older sedative-hypnotics, cause only modest day-after psychomotor depression and few amnestic effects. 

Lower risk of dependence than Benzodiapezines.

50

What is a requirement for anesthetic drugs? 

If drug has low solubility in blood, how does that affect its function?

If drug has high solubility in lipids, how does that affect its function?

-Must be lipid soluble in order to cross the blood-brain barrier, or actively transported

-Low solubility in blood --> rapid induction and recovery times

-High solubility in lipids --> high potency (1/MAC)

51

MAC: what is this and how does it relate to anesthetics?

MAC = Mean Alveolar Concentration (of inhaled anesthetic) that is required to prevent 50% of patients from moving in response to noxious stimulus (ie skin incision)

52

N2O has low solubility in blood and lipid --> what is its speed of induction and potency?

Halothane has high solubility in blood and lipid --> what is its speed of induction and potency? 

N2O: fast induction, low potency

Halothane: slow induction, high potency

53

Inhaled anesthetics (halothane, enflurane, isoflurane, sevoflurane, methoxyflurane, nitrous oxide): Mech? Effects?

Mech is unknown (that is unsettling!)

Effects: Myocardial depression, resp depression, nausea/vomiting, incr cerebral blood flow (decr cerebral metabolic demand)

54

Inhaled anesthetics (halothane, enflurane, isoflurane, sevoflurane, methoxyflurane, nitrous oxide): Tox?

Hepatotoxicity (halothane)

Nephrotoxiticy (methozyflurane)

Proconvulsant (enflurane)

Expension of trapped gas in a body cavity (NO).

Can cause malignant hyperthermia: rare, life threatening hereditary condition in which inhaled anesthetics (except NO) and succinylcholine induce fever and severe muscle contractions.

55

Malignant hyperthermia can be caused by what class of drugs?

Treatment?

Inhaled anesthetics

Tx = Dantrolene

56

which barbiturate is used as an IV anesthetic?

what are the qualities that allow it rapid entry to CNS? what types/duration of procedures is it used for?

What terminates its anesthetic effect?

Thiopental

High potency, high lipid solubility --> rapid entry into brain.

Used for induction of anesthesia and short surg procedures.

Effect terminated by rapid redistribution into tissue (ie skel muscle) and fat. Decreases cerebral blood flow.

57

what is the most common IV anesthetic used for endoscopy?

what class does it belong to?

what can it cause in post-op?

Tx for overdose?

Midazolam (Benzodiazepine)

Used along with gaseous anesthetics and narcotics. 

May cause severe post-op resp depression, decreased BP and anterograde amnesia.

OD treated with flumazenil.

58

Arylcyclohexylamine: what class does it belong to? aka what?

Mech?

Side effects?

IV Anesthetic. (aka Ketamine)

PCP analog, acts as dissociative anesthetic. Blocks NMDA receptors. 

CV stimulant, can cause disorientation, hallucination, bad dreams. 

Increases cerebral blood flow.

59

What are some opioids that are used as IV anesthetics? 

Used along with what other drugs?

Morphine, fentanyl

Used with other CNS depressants during general anesthesia.

60

Propofol: Use? Mech?

How does it compare to Thiopental?

IV anesthetic.

Use: sedation in ICU rapid induction of anesthesia, short procedures. 

Mech: potentiates GABA-A

Less post op nausea than Thiopental.

61

Local anesthetics that are Esters? (3)

-Procaine

-Cocaine

-Tetracaine

62

Local anesthetics that are Imides? (3)

-Ildocaine

-Mepivacaine

-Bupivacaine

(Amides have 2 I's in the name)

63

Local anesthetics (both esters and imides): Mech?

Block Na+ channels by binding to specific receptors on inner portion of channel. Preferentially bind to activated Na+ channels - therefore most effective in rapidly firing neurons.

Tertiary amine local anesthetics penetrate membrane in uncharged form, then bind ions as charged form

64

Local anesthetics (both esters and imides): Principles

-can be given with what?

-in infected/acidic tissue, what occurs?

Can be given with vasoconstrictors (usually epi) to enhance local action. decreases bleeding, increases anesthesia by decreasing systemic concentration.

-In infected/acidic tissue, alkaline anesthetics are charged and cannot penetrate membrane effectively --> need more anesthetic.

65

Local anesthetics (both esters and imides): Principles

-what is the order of nerve blockade?

-Order of nerve blockade:

small-diameter fibers > large diameter.

myelinated > unmyelinated.

Overall, size factor predominates over myelination such that small myelinated fibers > small unmyelinated fibers > large myelinated fibers > large unmyelinated fibers.

66

Local anesthetics (both esters and imides): Principles

-what is the order of sensory loss?

Order of sensory loss:

(1) pain (2) temp (3) touch (4) pressure

(pain/temp are carried by ALS/STT neurons; unmyelinated. touch/pressure carried by DC-ML neurons; myelinated)

67

Local anesthetics (both esters and imides): Clinical Use?

minor surg procedures, spinal anesthesia.

If allergic to esters, give amides

68

Local anesthetics (both esters and imides): Tox?

CNS excitation, severe CV tox (bupivacaine), HTN, hypotension, arrhythmias (cocaine)

69

Neuromuscular blocking drugs: used for what? what receptor are they selective for?

Used for muscle paralysis in surgery or mechanical ventilation.

Selective for motor (vs autonomic) nicotinic receptor

70

Depolarizing NM blocking drugs: name one. 

Mech?

How to reverse the effect?

Complications?

Succinylcholine

Mech: strong ACh receptor agonist; produces sustained depolarization and prevents muscle contraction.

Reversal of Phase I (prolonged depolarization): no antidote. Block potentiated by cholinesterase inhibitors

Reversal of Phase II (repolarized but blocked, ACh receptors are available but desensitized): antidote = cholinesterase inhibitors

Complications: hypercalcemia, hyperkalemia, malignant hyperthermia

71

Nondepolarizing NM blocking drugs: name 6

Mech?

How to reverse the blockade?

Tubocurarine, atracurium, mivacurium, pancuronium, vecuronium, rocuronium

Competitive antagonists, compete with ACh for receptors

Reversal of blockade: neostigmine (must be given with atropine to prevent muscarinic effects like bradycardia), edrophonium, other cholinesterase inhibitors

72

Dantrolene

Mech? Use?

Mech: prevents the release of Ca2+ from the SR of skeletal muscle

Use: treatment of malignant hyperthermia and neuroleptic malignant syndrome (a toxicity of antipsychotic drugs)

73

Parkinsonism: due to loss of what neurons? increase of what activity?

What is an acronym for the Parkinson disease drugs?

Loss of dopaminergic neurons and excess cholinergic activity

BALSA: Bromocriptine, Amantidine, Levodopa/carbidopa, Selegiline, Antimuscarinics)

+ Benztropine

74

What Parkinson disease drugs are dopamine agonists? (3)

Bromocriptine (ergot), pramipexole, ropinirole (non-ergot)

Non-ergots are preferred.

75

What Parkinson disease drugs increase dopamine? (2)

-Amantadine (may increase dopamine release). also used as an antiviral against Inf A and rubella. Toxicity = ataxia

-L-dopa/carbidopa (converted to dopamine in CNS)

76

What Parkinson disease drugs prevent dopamine breakdown? (3)

-Selegiline (selective MAO type B inhibitor)

-Entacapone & Tolcapone (COMT inhibitors - prevent L-dopa degradation, increases dopamine availability)

77

What Parkinson disease drugs curb excess cholinergic activity? (1)

Benztropine (antimuscarinic; improves tremor and rigidity, but has little effect on bradykinesia)

"Park(insons) your Benz"

78

use what drug for essential tremor or familial tremor?

Beta-blocker (ie propranolol)

79

L-dopa/carbidopa: Mech?

Use?

Tox?

Mech: incr level of dopamine in brain. Unlike dopamine, L-dopa can cross the BBB and is converted by dopa decarboxylase in the CNS to dopamine. Carbidopa, a peripheral decarboxylase inhibitor, is given with L-dopa to increase the bioavailability of L-dopa in the brain and to limit peripheral side effects

Use: Parkinson's

Tox: Arrythmias from increased peripheral formation of catecholamines. Long term use can lead to dyskinesia following administration (on-off phenomenon), akinesia between doses.

80

Selegiline

Mech? Use? Tox?

Mech: selectively inhibits MAO-B, which preferentially metabolizes dopamine over norepi and 5-HT, thereby increasing the availability of dopamine.

Use: Adjunctive agent to L-dopa for treating Parkinson's

Tox: May enhance adverse effects of L-dopa

81

Name 4 drugs for Alzheimers?

-Memantine

-Donepezil

-Galantamine

-Rivastigmine

82

Memantine

Use? Mech? Tox?

Use: Alz

Mech: NMDA receptor antagonist; helps prevent excitotoxicity (mediated by Ca2+)

Tox: dizziness, confusion, hallucinations

83

Donepezil, Galantamine, Rivastigmine

Use? Mech? Tox?

Use: Alz

Mech: AChE inhibitors

Tox: nausea, dizziness, insomnia

84

Huntington's: 3 drugs?

-Tetrabenazine

-Reserpine

-Haloperidol

85

What are the nT changes that occur with Huntingtons?

decreased GABA

decreased ACh

increased dopamine

86

Tetrabenazine and Reserpine

Use? Mech?

Huntington's

Mech: inhibit vesicular monoamine transporter (VMAT); limit dopamine vesicle packaging and release

87

Haloperidol

Use? Mech?

Huntingtons

Mech: dopamine receptor antagonist

88

Sumatriptan

Mech? Use? Tox?

Half-life?

Use: Acute migraine, cluster headaches

Mech: 5-HT (1B/1D) agonist. Inhibits trigeminal nerve activation. Prevents vasoactive peptide release; induces vasoconstriction.

Halflife

Tox: Coronary vasospasm (contraindicated in pts with CAD or Prinzmetal angina); mild tingling

"SUMO wrestler TRIPs ANd falls on your HEAD" (seriously?)