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neurology Flashcards

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0
Q

brimonidine

A

alpha2-agonists: decrease aqueous humor synthesis
TOX: blurry vision, ocular hyperemia
foreign body sensation, ocular allergic reaction, ocular pruritus

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1
Q

epinephrine

A

glaucoma drug,
alpha-agonist: decrease aqueous humor synthesis via vasoconstriction
mydriasis, do not use in closed-angle glaucoma

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2
Q

Timolol

A

beta-blockers
decrease humor synthesis
no pupillary or vision changes
topical treatment of chronic open-angle glaucoma

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3
Q

betaxolol

A

beta-blockers
decrease humor synthesis
no pupillary or vision changes

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4
Q

carteolol

A

beta-blockers
decrease humor synthesis
no pupillary or vision changes

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5
Q

nadolol

A

beta-blockers
decrease humor synthesis
no pupillary or vision changes
topical treatment of chronic open-angle glaucoma

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6
Q

acetazolamide

A

decrease aqueous humor synthesis via inhibition of carbonic anhydrase
no pupillary or vision changes
*TOX: acidosis, hypo K, NH3 toxocity

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7
Q

pilocarpine

A

Direct cholinominetics
increase out flow of aqueous humor via contraction of ciliary muscle and opening of trabecular meshwork,use pilocarpine in emergencies- very effective at opening meshwork into canal of schlemm
TOX: miosis and cyclospasm (contraction of ciliary muscle)
*diagnosis for CF

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8
Q

carbachol

A

Direct cholinominetics
increase out flow of aqueous humor via contraction of ciliary muscle and opening of trabecular meshwork
TOX: miosis and cyclospasm (contraction of ciliary muscle)

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9
Q

physostigmine

A

indirect cholinomimetics
increase out flow of aqueous humor via contraction of ciliary muscle and opening of trabecular meshwork
TOX: miosis and cyclospasm (contraction of ciliary muscle)

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10
Q

echothiophate

A

indirect cholinominetics
increase out flow of aqueous humor via contraction of ciliary muscle and opening of trabecular meshwork
TOX: miosis and cyclospasm (contraction of ciliary muscle)

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11
Q

latanoprost

A

PGF 2alpha
increase outflow of aqueous humor
darkens color of iris (browning)

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12
Q

morphine

A

act as agonist at “mu” opioid receptors- open K close Na–>decrease synaptic transmission
inhibit release of ACh, NE, 5-HT, glutamate, substance P
Use: Pain, acute pulmonary adema
TOX: addiction, resp depression, constipation, miosis(pinpoint pupil), Tolerance not happen to miosis and constipation. treat with naloxone and naltrexone

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13
Q

fentanyl

A

act as agonist at “mu” opioid receptors- open K close Na–>decrease synaptic transmission
inhibit release of ACh, NE, 5-HT, glutamate, substance P
Use: Pain, acute pulmonary adema
TOX: addiction, resp depression, constipation, miosis(pinpoint pupil), Tolerance not happen to miosis and constipation. treat with naloxone and naltrexone

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14
Q

codeine

A

act as agonist at “mu” opioid receptors- open K close Na–>decrease synaptic transmission
inhibit release of ACh, NE, 5-HT, glutamate, substance P
Use: Pain, acute pulmonary adema
TOX: addiction, resp depression, constipation, miosis(pinpoint pupil), Tolerance not happen to miosis and constipation. treat with naloxone and naltrexone

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15
Q

heroin

A

act as agonist at “mu” opioid receptors- open K close Na–>decrease synaptic transmission
inhibit release of ACh, NE, 5-HT, glutamate, substance P
TOX: addiction(clonidine, methadone, buprenorphine), resp depression, constipation, miosis(pinpoint pupil), Tolerance not happen to miosis and constipation. treat with naloxone and naltrexone

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16
Q

methadone

A

act as agonist at “mu” opioid receptors- open K close Na–>decrease synaptic transmission
inhibit release of ACh, NE, 5-HT, glutamate, substance P
Use: maintenance program for addicts(more addictive)
TOX: addiction, resp depression, constipation, miosis(pinpoint pupil), Tolerance not happen to miosis and constipation. treat with naloxone and naltrexone

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17
Q

meperidine

A

act as agonist at “mu” opioid receptors- open K close Na–>decrease synaptic transmission
inhibit release of ACh, NE, 5-HT, glutamate, substance P
Use: Pain, acute pulmonary adema
TOX: addiction, resp depression, constipation, miosis(pinpoint pupil), Tolerance not happen to miosis and constipation. treat with naloxone and naltrexone

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18
Q

dextromethorphan

A

act as agonist at “mu” opioid receptors- open K close Na–>decrease synaptic transmission
inhibit release of ACh, NE, 5-HT, glutamate, substance P
Use: cough suppression
TOX: addiction, resp depression, constipation, miosis(pinpoint pupil), Tolerance not happen to miosis and constipation. treat with naloxone and naltrexone

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19
Q

diphenoxylate

A

act as agonist at “mu” opioid receptors- open K close Na–>decrease synaptic transmission
inhibit release of ACh, NE, 5-HT, glutamate, substance P
Use: DIARRHEA
TOX: addiction, resp depression, constipation, miosis(pinpoint pupil), Tolerance not happen to miosis and constipation. treat with naloxone and naltrexone

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20
Q

loperamide

A

act as agonist at “mu” opioid receptors- open K close Na–>decrease synaptic transmission
inhibit release of ACh, NE, 5-HT, glutamate, substance P
Use: DIARHEA
TOX: addiction, resp depression, constipation, miosis(pinpoint pupil), Tolerance not happen to miosis and constipation. treat with naloxone and naltrexone

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21
Q

DELTA OPIOID

A

enkepholins

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22
Q

kappa opioid

A

dynorphin

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23
Q

tolerance mechanism?

A

normal: Gi–>cAMP decrease
tolenrace: increase cAMP through other pathway, need more to decrease cAMP.
withdraw, NE decrease, receptor increase, if with draw then NE increase, 作用于增多的receptor，作用放大。

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24
butorphanol
mu-opioid receptor partial and kappa-opioid receptor agonist; produce analgesia use in severe ain(migragrain, labor), causes less resp depression than full agonist. TOX: causes opioid withdrawal symptoms if patient is also taking full opioids agonist(competition for receptors). overdose do not reverse with naloxone
25
tramadol
weak opioid agonist, inhibits serotonin and NE reuptake (works on multiple neurotransmitters-tram it all with tramadol) use: chronic pain Tox: similar to opioids. "DECREASES SEIZURE THRESHOLD"
26
phenytoin | fosphenytoin for parenteral use
Mech: increase Na inactivation, inhibition of glutamate *partial, tonic-clonic, 1st line prophylaxis for status epilepticus *class IB antiarrhythmic TOX: nystagmus, diplopia, SLE, gingival hyperplasia, hirsutism, ataxia, sedation, megaloblastic anemia(decrease folate absorb), teratogenesis(fetal hydantoin syndrome), inducer of CYP450, lymphadenopathy, Steven-johnson, osteopenia
27
carbamazepine
1st line for partial, 1st line for tonic-clonic mech: increase Na channel inactivation 1st line for Trigeminal neuralgia TOX: diplopia, ataxia, blood dyscrasia(agranulocytosis, Aplastic anemia),liver toxicity, teratogenic, inducer of P450, SIADH, Steven Johnson
28
lamotrigine
Partial tonic-clonic Mech: Blocks voltage-gated Na channel TOX: Stevens-Johnson syndrome, hepatoxic
29
Gabapentin
Partial tonic-clonic Mech: Designed as GABA analog, but primarily inhibits high-voltage-activated Ca channel TOX: peripheral neuropathy, post-therapy neuralgia,migraine prophylaxis, bipolar disorder
30
Topiramate
Partial tonic-clonic Mech: Blocks voltage-gated Na channel, increase GABA TOX: sedation, mental dulling, kidney stones, weight loss Also used for migraine prevention
31
Phenobarbital
Partial, tonic-clonic,(1st line in children seizure) sedative for anxiety, seizure, insomia, induction of anesthesia Mech: increase GABA action by increasing duration, CI in porphyria TOX: sedation, tolerance,, dependence, induction of P450 treat with supprtive
32
Valproic acid
Partial 1st line tonic-clonic, absence generalized and General myoclonic Mech: increase voltage-gated Na channel inactivation, increase GABA concentration TOX: Gi distress, hepatotoxicity (LFT), neural tube defects(spinal bifida), tremor, weight gain. CI in pregnancy
33
Ethosuximide
1st line for absence Mech: Blocks thalamic T-type Ca channel TOX: GI distress, fatigue, headache, urticaria, Steven Johnson
34
benzodiazepine | diazepam, lorazepam
1st line for acute status epilepticus Mech: increase GABA action TOX: sedation, tolerance, dependence also used for seizure of eclampsia(1st line MgSO4)
35
tiagabine
Partial Mech: inhibits GABA reuptake TOX:
36
vigabatrin
Partial Mech: inhibits GABA reuptake TOX:
37
levetiracetam
Partial tonic-clonic Mech: modulate GABA and glutamate relase TOX:
38
pentobarbital
Partial, tonic-clonic,(1st line in children seizure) sedative for anxiety, seizure, insomia, induction of anesthesia Mech: increase GABA action by increasing duration, CI in porphyria TOX: sedation, tolerance,, dependence, induction of P450 treat with supprtive
39
thiopental
Partial, tonic-clonic,(1st line in children seizure) sedative for anxiety, seizure, insomia, *induction of anesthesia(SHORT ACTING) Mech: increase GABA action by increasing duration, CI in porphyria TOX: sedation, tolerance,, dependence, induction of P450 treat with supportive
40
secobarbital
Partial, tonic-clonic,(1st line in children seizure) sedative for anxiety, seizure, insomia, induction of anesthesia Mech: increase GABA action by increasing duration, CI in porphyria TOX: sedation, tolerance,, dependence, induction of P450 treat with supprtive
41
Primidone
primidone->phenobarbital + PEMA
42
Diazepam
benzodiazepine, increase GABA action by increase freq of Cl- decrease REM sleep long half life used in anxiety, spasticity, status epilepticus,detoxification TOX: dependence, additive with alcohol, less risk of resp depression and coma than barbiturate. Treat over dose with flumazenil
43
lorazepam
benzodiazepine, increase GABA action by increase freq of Cl- decrease REM sleep long half life used in anxiety, spasticity, status epilepticus,detoxification TOX: dependence, additive with alcohol, less risk of resp depression and coma than barbiturate. Treat over dose with flumazenil
44
triazolam
benzodiazepine, increase GABA action by increase freq of Cl- decrease REM sleep short-acting, used in insomnia, TOX: dependence, additive with alcohol, less risk of resp depression and coma than barbiturate. more addictive Treat over dose with flumazenil
45
midazolam
benzodiazepine, increase GABA action by increase freq of Cl- decrease REM sleep short-acting, used in insomnia, TOX: dependence, additive with alcohol, less risk of resp depression and coma than barbiturate. more addictive Treat over dose with flumazenil
46
oxazepam
benzodiazepine, increase GABA action by increase freq of Cl- decrease REM sleep short-acting, used in insomnia, do not meta by liver(can be used in liver defect) TOX: dependence, additive with alcohol, less risk of resp depression and coma than barbiturate. more addictive Treat over dose with flumazenil
47
temazepam
benzodiazepine, increase GABA action by increase freq of Cl- decrease REM sleep long-acting, do not meta by liver(can be used in liver defect) TOX: dependence, additive with alcohol, less risk of resp depression and coma than barbiturate. more addictive Treat over dose with flumazenil
48
chloridazepoxide
benzodiazepine, increase GABA action by increase freq of Cl- decrease REM sleep long-acting, meta by liver with 3 active metabolites, TOX: dependence, additive with alcohol, less risk of resp depression and coma than barbiturate. more addictive Treat over dose with flumazenil
49
alprazolam
benzodiazepine, increase GABA action by increase freq of Cl- decrease REM sleep long-acting, panic and phobic TOX: dependence, additive with alcohol, less risk of resp depression and coma than barbiturate. more addictive Treat over dose with flumazenil
50
Flurazepam
benzodiazepine, increase GABA action by increase freq of Cl- decrease REM sleep long-acting TOX: dependence, additive with alcohol, less risk of resp depression and coma than barbiturate. more addictive Treat over dose with flumazenil
51
Zolpidem | ambien
act via BZ1 subtype of GABA receptor effects reversed by flumazenil use in insomnia tox: ataxia, hadache, confusion, short duration meta by liver, mild psychmotor depression lower depandence risk than benzodiazepine
52
zaleplone
act via BZ1 subtype of GABA receptor effects reversed by flumazenil use in insomnia tox: ataxia, hadache, confusion, short duration meta by liver, mild psychmotor depression lower depandence risk than benzodiazepine
53
eszopiclone
act via BZ1 subtype of GABA receptor effects reversed by flumazenil use in insomnia tox: ataxia, hadache, confusion, short duration meta by liver, mild psychmotor depression lower depandence risk than benzodiazepine
54
Halothane
inhaled anethetics low MAC, high potency effects: myocardial, resp depression, N/V, increase cerebral blood flow TOX: hepatotoxicity, malignant hyperthermia
55
enflurance
inhaled anethetics effects: myocardial, resp depression, N/V, increase cerebral blood flow TOX: proconvulsant, malignant hyperthermia
56
isoflurane
inhaled anethetics effects: myocardial, resp depression, N/V, increase cerebral blood flow TOX: malignant hyperthermia
57
sevoflurance
inhaled anethetics effects: myocardial, resp depression, N/V, increase cerebral blood flow TOX: malignant hyperthermia
58
methoxyflurane
inhaled anethetics effects: myocardial, resp depression, N/V, increase cerebral blood flow TOX: nephrotoxicity, malignant hyperthermia
59
nitrous oxide
inhaled anethetics high MAC, low potency->good induce, no metabolism, rapid effect,minimal cardioeffect effects: myocardial, resp depression, N/V, increase cerebral blood flow TOX: expansion of trapped gas in a body cavity diffusional hypoxia
60
thiopental in iv anesthetics
high potency, high lipid solubility, rapid entry to brain used for induction of anesthesia and short procedures effects terminated by rapid redistribution into tissue and fat decrease cerebral blood flow
61
Midazolam in iv anesthetics
most commonly used for endoscopy, used with gaseous anesthetics and narcotics cause severe postoperative respiratory depression decrease BP with overodse, treat flumazenil
62
arylcyclohexylamines | ketamine
``` PCP analogs, dissociative anesthetics block NMDA receptors cardiovascular stimulants TOX: cause disorientation, hallucination and bad dream increase cerebral blood flow ```
63
opioids in iv anesthetics
morphine fentanyl used with other CNS depressants during general anesthesia
64
propofol
used for sedation in ICU rapid anesthesia induction and short procedures loss post-op nausea than thiopental, potentiates GABA
65
procaine
local anesthetics- esters Block Na channel by binding receptor on inner portion of channel bind to active Na, most effective in firing neurons. 3'amine penetrate membrane in uncharged form and bind in charged form(more needed in acidic wound) used in minor surgical procedure, if allergic give amides TOX: CNS excitation, hypo/hyperTN,
66
cocaine
local anesthetics- esters Block Na channel by binding receptor on inner portion of channel bind to active Na, most effective in firing neurons. 3'amine penetrate membrane in uncharged form and bind in charged form(more needed in acidic wound) used in minor surgical procedure, if allergic give amides TOX: CNS excitation, hypo/hyperTN, "arrhythmia"
67
tetracaine
local anesthetics- esters Block Na channel by binding receptor on inner portion of channel bind to active Na, most effective in firing neurons. 3'amine penetrate membrane in uncharged form and bind in charged form(more needed in acidic wound) used in minor surgical procedure, if allergic give amides TOX: CNS excitation, hypo/hyperTN,
68
Ildocaine
local anesthetics- amides Block Na channel by binding receptor on inner portion of channel bind to active Na, most effective in firing neurons. 3'amine penetrate membrane in uncharged form and bind in charged form(more needed in acidic wound) used in minor surgical procedure TOX: CNS excitation, hypo/hyperTN,
69
mepivacaine
local anesthetics- amides Block Na channel by binding receptor on inner portion of channel bind to active Na, most effective in firing neurons. 3'amine penetrate membrane in uncharged form and bind in charged form(more needed in acidic wound) used in minor surgical procedure TOX: CNS excitation, hypo/hyperTN,
70
bupivacaine
local anesthetics- amides Block Na channel by binding receptor on inner portion of channel bind to active Na, most effective in firing neurons. 3'amine penetrate membrane in uncharged form and bind in charged form(more needed in acidic wound) used in minor surgical procedure TOX: CNS excitation, hypo/hyperTN," CV toxicity"
71
Local anesthesia points | can be given with?
vasoconstrictor-alpha1-epi: enhance local action, decrease bleeding and increase anesthesia by decrease systemic concentration
72
Local anesthesia points | order of blockage
small-diameter fibers>large diameter myelinated>demye small mye>small unmye>large mye>large unmye order:pain>temp>touch>pressure

Pharm (13 decks)

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