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Flashcards in Neuro Pharm High Yield Deck (90):
1

How does epinephrine treat glaucoma?

decrease aqueous humor production

2

How does bromocriptine treat glaucoma?

decrease aqueous humor production

3

How do timolol, betaxolol and carteolol treat glaucoma?

decrease aqueous humor production

4

How does acetazolamide treat glaucoma?

decrease aqueous humor production via inhibition of carbonic anhydrase

5

What are the direct cholinomimetics used for glaucoma?

Pilocarpine

Carbachol

6

What is the mechanism of pilocarpine and carbachol?

increase outflow of aqueous humor (constrict ciliary muscle and open trabecular meshworl)

7

What are the indirect cholinomimetics used for glaucoma?

Physostigmine

Echothiopate

8

What is the mechanism of physostigmine and echothiopate for glaucoma treatment?

increase outflow of aqueous humor (constrict ciliary muscle and open trabecular meshworl)

9

How does latanprost treat glaucoma?

increase outflow of aqueous humor

10

Which opiod is used for diarrhea?

Lopiramide or diphenoxylate

11

Which receptors do opioids agonize? What does their action lead to?

mu receptors

open K+ channels, close Ca2+ channels--> decrease synaptic transmission

12

Which opioid is used as a cough suppressant?

dextromethorphan

13

Which opioids are used in heroine addicts as maintenance drugs?

Methadone

Buprenorphine + nalaxone

14

What are the major AEs of opiods?

Respiratory depression

Constipation (no tolerance)

Miosis (no tolerance)

CNS depression

15

Which drug is a kappa opioid receptor agonist and a mu opioid receptor partial agonist?

Butorphanol

16

What are the benefits of butorphanol?

produces analgeia without as much respiratory depression

17

What drug is a weak opiod agonist but also inhibits 5-HT and NE reuptake?

Tramadol

18

What is the 1st line treatment for absence seizures?

Ethosuximide

19

What is the mechanism of ethosuximide?

blocks thalamic T type Ca2+ channels

20

What are the AE of ethosuximide?

FGHIJ

Fatigue
GI distress
Headache
Itching
Stevens Johnson

21

What is the DOC for acute status epilepticus?

Benzos! (dazepam and lorazepam)

22

What s the mechanism of Benzos?

Increase GABA a action

23

What are the 3 first line treatments for Tonic clonic treatments?

Phenytoin
Carbamazepine
Valproic Acid

24

What is the 1st line choice for status epilepticus prophylaxis?

Phenytoin

25

What is the mechanism of phenytoin?

Increase Na channel inactivation

26

Which antiepileptic is eliminated via zero order kinetics?

Phenytoin

27

What are the AEs of phenytoin?

gingival hyperplasia, hirsutim, SLE like syndrome

INDUCTION of P450

Stevens Johnson syndrome

28

What is the 1st line treatment for simple AND complex partial seizures?

Carbamazepine

29

What is the mechanism of carbamazepine?

increase Na channel inactivatoin

30

What is the AE of carbemazepine?

agranulocytosis, liver tox

INDUCTION of P450

SIADH

Steven Johnson syndrome

31

What is the mechanism of valproic acid?

Increase Na channel inactivation

increased GABA concentratoin by inhibiting GABA transaminase

32

What are the AE of valproic acid?

Hepatotox, tremor, NO USE IN PREGNANCY

33

What is gabapentin used for?

Partial seizures

34

What is the mechanism of gabapentin?

inhibits volt gated Ca channels, designed as GABA analog

35

What is used for post hepatic neuralgia pain?

gabapentin

36

What is used for post hepatic neuralgia pain?

gabapentin

37

What is phenobarbital used for?

Patial and tonic clonic seizures

38

Mechanism of phenobarbitol

Increase GABA a action

39

What are the AEs of phenobarbitol?

INDUCTION of P450, sedation, tolerance

40

What is the DOC for seizures in neonates?

phenobarbitol

41

Which antiepileptic can cause kidney stones?

Topiramate

42

What is lamotrigine used for?

All except status epilepticus

43

What is the mechanism of lamotrigine?

Blocks volt gated Na channels

44

Which antiepiletic drugs can cause steven johnson reaction?

Ethosuximide

Phenytoin

Carbamazepine

Lamotrigine

45

Which drug increases the duration of Cl- channel opening?

Barbiturates

46

Who are barbs contraindicated in?

people with porphyria

47

How do barbiturates interact with P450?

INDUCES

48

Which drug fascilitates GABA a action by increaing frequncy of Cl- channel opening?

Benzo

49

Of the following benzo's, which DO NOT have active metabolites and also have a shorter half life?

Diazepam
Alprazolam
triazolam
lorazepam
oxazepam
midazolam
temazepam

ATOM

Alazopram
Triazolam
Oxazepam
Midazolam

50

What is the antidote for benzos

Flumazenil

51

What is the action of zolpidem, zaleplon, eszopiclone?

specific to BZ1 subtype

52

How does potency of anesthetic and lipid solubility relate?

the more lipid soluble, to more potent and the longer the action time

53

What are the following drugs:

Halothane
Enflurane
Isoflurane
Sevoflurane
Methoxyflurane
N2O

Inhaled anesthetics

54

What is the response of cerebral blood flow to inhaled anesthetics?

Increase

55

What is a possible serve/ life threatening response to inhaled anesthetics?

Malignant hyperthermia--> fever and severe muscle contractions

56

What is the treatment for inhaled anesthetics?

Dantrolene

57

What is thiopental used for during surgery?

induction and short term surgical procedures

58

What is midazolam used for?

endoscopy

59

What is ketamine used for?

acts as dissociative anesthtics

60

What is the mechanism of ketamine?

Blocks NMDA receptor

61

What is propofol used for?

Sedation in ICU rapid anesthesia induction, short procedures

62

How can you tell an ester from an amide local anesthetic by name?

Amides have two "i's" in the name

63

How do local anesthetics work?

Block Na channels by binding to specific receptors on inner portion of channel

64

What type of Na channels do local anesthetics prefer?

Actvated Na channels

65

Which factor predominates in action of local anesthtics...size or myelination?

Size!

So small myeliated and unmyelinated will be blocked before large myelinated and unmyelinated

66

What is the order of types of fibers blocked by locals?

1- pain
2- temp
3- Touch
4- pressure

67

Which local can cuase methemoglobinemia?

Benzocaine

68

What local can cause severe cardiovascular toxicity?

Bupivacaine

69

What are the 2 phases of depolarizing NM blockers (succinylcholine)?

Phase I (prolonged depolarization

Phase II (repolarized but blocked)

70

Can succinylcholine blockage be revered?

Phase II can be revered by cholinesterase inhibitors

71

What is the action of:

tubocurarine
pancuronium
vecuronium

Nondepolarizing NM block--> competive antagonist of ACh receptor

72

What is the action of:

tubocurarine
pancuronium
vecuronium

Nondepolarizing NM block--> competive antagonist of ACh receptor

73

What is the mechanism of dantroline?

Prevents the release of Ca from teh sarcoplasmic reticulum of skeletal muscle

74

What is the mechanism of baclofen?

Inhibits GABA B receptors at spinal cord lvel

75

What is baclofen used for?

muscle spasms

76

What is the mechanism of cyclobenzaprin?

centrally acting skeletal muscle relaxant, related to TCAs

77

What are the drugs used for Parkinson's disease?

Bromocriptine
Amantadine
Levodopa
Selegiline
Antimuscarinics

78

What is the function of carbidopa in levodopa treatment?

block peripheral conversion of L-DOPA to dopamine by inhibiting DOPA decarboxyase

79

What is the function of entacapone and tolcapone in levodopa therapy?

precent peripheral L- dopa degredation by inhibiting COMT

80

What is the function of selegile?

Block central breakdown of dopamine by inhibiting MAO-B

81

Which antimuscarinic is used for treatment of parkinson disease?

Benztropine

82

Which antimuscarinic is used for treatment of parkinson disease?

Benztropine

83

Name 3dopamine agonists?

Bromocriptine
Pramipexole
Ropinirole

84

What converty L-dopa to dopamine?

Dopa decarboxylase

85

Which alzheimer drug is an NMDA receptor antagonist?

Memantine

86

What is the use and actio of the following drugs:

Donepezil
Galantamine
Rivastigmine
Tacrine

AChE inhibitor

87

What are the drugs used to treat Huntington's disease?

Tetrabenazine
Reserpine--> inhibit VMAT, limiting DA vesicle packaging and release

Haloperidol--> D2 blocker

88

What are the drugs used to treat Huntington's disease?

Tetrabenazine
Reserpine--> inhibit VMAT, limiting DA vesicle packaging and release

Haloperidol--> D2 blocker

89

What receptors do triptans act on?

5-HT 1B/1D

90

What is an AE of triptans?

Coronary vasospasm--> so contraindicated inpatients with CAD and Prinzmetal angina

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