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Pharmacology > Neurology > Flashcards

Neurology Flashcards

1
Q

Morphine, fentanyl, codine, loperamide, methadone, meperidine, dextromethorphan, diphenoxylate (MOA)

A

Agonist at opioid receptors (mu=morphine, delta=enkephaline, kappa=dynorphin) to modulate synaptic transmission - open K channels, close Ca channels -> decreased synaptic transmission. Inhibit release of ACh, norepinephrine, 5-HT, glutamate, substance P.

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2
Q

Morphine, fentanyl, codine, loperamide, methadone, meperidine, dextromethorphan, diphenoxylate (CU)

A

Pain, cough suppression (dexatromethorphan), diarrhea (loperamide and diphenoxylate), acute pulmonary edema, maintenance programs for heroin addicts (methadone)

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3
Q

Morphine, fentanyl, codine, loperamide, methadone, meperidine, dextromethorphan, diphenoxylate (T)

A

Addiction, respiratory depression, constipation, miosis, additive CNS depression with other drugs. Tolerance does not develop to miosis and constipation. Toxicity treated with naloxone and naltrexone (opioid receptor antagonist)

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4
Q

Butorphanol (MOA)

A

Mu-opiod receptor partial agonist and kappa-opiod agonist; produces analgesia

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5
Q

Butorphanol (CU)

A

severe pain (migraine, labor). causes less respiratory depression than full opioid agonist.

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6
Q

Tramadol (MOA)

A

Very weak opioid agonist; also inhibits serotonin and norepinephrine reuptake (works on multiple neurotransmitters- “tram it all”)

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7
Q

Tramadol (CU)

A

Chronic pain

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8
Q

Tramadol (T)

A

similar to opioids. decreases seizure threshold. serotonin syndrome.

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9
Q

Ethosuximide (MOA)

A

Blocks thlamic T-type Ca channels

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10
Q

Ethosuximide (CU)

A

Generalized absence seizures

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11
Q

Ethosuximide (T)

A

EFGHIJ; Ethosuximide causes Fatigue, GI distress, HA, Itching, stevens-Johnson syndrome

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12
Q

Benzodiazepines (Diazepam, Lorazepam) (MOA)

A

increases GABA action

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13
Q

Benzodiazepines (Diazepam, Lorazepam) (CU)

A

Status epilepticus

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14
Q

Benzodiazepines (Diazepam, Lorazepam) (T)

A

Sedation, tolerance, dependence, respiratory depression

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15
Q

Phenytoin (MOA)

A

increases Na channel inactivation; 0 order kinetics

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16
Q

Phenytoin (CU)

A

Status epilepticus and tonic-clonic seizures

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17
Q

Phenytoin (T)

A

Nystagmus, diplopia, ataxia, sedation, gingival hyperplasia, hirsutism, peripheral neuropathy, megaloblastic anemia, teratogenesis (fetal hydantoin syndrome), SLE like syndrome, induction of cytochrome P-450, lymphadenopathy, Stevens-Johnson syndrome, osteopenia

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18
Q

Carbamazepine (MOA)

A

increases Na channel inactivation

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19
Q

Carbamazepine (CU)

A

Drug of choice for Complex partial seizures, also used for tonic-clonic seizures

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20
Q

Carbamazepine (T)

A

Diplopia, ataxia, blood dyscrasias (agranulocytosis, aplastic anemia), liver toxicity, teratogenesis, induction of cyp P450, SIADH, Steven-Johnson syndrome

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21
Q

Valproic acid (MOA)

A

Increases Na channel inactivation, increases GABA concentration by inhibiting GABA transaminase

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22
Q

Valproic acid (CU)

A

Drug of choice for pts with tonic-clonic and absence seizures

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23
Q

Valproic acid (T)

A

GI distress, rare but fetal hepatotoxicity (check LFTs), neural tube defects in fetus (spina bifida), tremor, weight gain, contraindicated in pregnancy

24
Q

Gabapentin (MOA)

A

Primarily inhibits high voltage activated Ca channels; designed as GABA analog

25
Q

Gabapentin (CU)

A

simple, complex, tonic-clonic seizures

26
Q

Gabapentin (T)

A

sedation, ataxia

27
Q

Phenobarbital (MOA)

A

increases GABA action

28
Q

Phenobarbital (CU)

A

Simple, complex, tonic-clonic seizures. 1st line in neonates

29
Q

Phenobarbital (T)

A

Sedation, tolerance, dependence, induction of cyt P450, cardiorespiratory depression

30
Q

Topiramate (MOA)

A

Blocks Na channels, increases GABA action

31
Q

Topiramate (CU)

A

Simple, complex, tonic-clonic seizures

32
Q

Topiramate (T)

A

Sedation, mental dulling, kidney stones, weigh loss

33
Q

Bromocriptine

A

Dopamine agonist. Used for Parkinsons

34
Q

Amantadine (MOA/CU)

A

Increases dopamine. Parkinsons. Also used as antiviral against influenza A and rubella.

35
Q

Amantadine (T)

A

ataxia

36
Q

Levdopa/carbidopa (MOA)

A

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

37
Q

Levdopa/carbidopa (CU)

A

Parkinson Ds

38
Q

Levdopa/carbidopa (T)

A

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

39
Q

Selegiline (MOA)

A

Selectively inhibits MOA-B which preferential metabolizes dopamine over norepi and 5-HT thereby increasing dopamine.

40
Q

Selegiline (CU)

A

Adjunctive therapy to L-dopa in treatment of Parkinson Ds.

41
Q

Selegiline (T)

A

May enhance adverse effects of L-dopa

42
Q

Memantine (MOA)

A

NMDA receptor antagonist; helps prevent excitotoxicity (mediated by Ca)

43
Q

Memantine (CU)

A

Alzeheimers

44
Q

Memantine (T)

A

Dizziness, confusion, hallucinations

45
Q

Donepezil (MOA)

A

AChE inhibitors

46
Q

Donapezil (CU)

A

Alzeheimers

47
Q

Galantamine (MOA)

A

AChE inhibitors

48
Q

Galantamine (CU)

A

Alzeheimers

49
Q

Rivastigmine (MOA)

A

AChE inhibitors

50
Q

Rivastigmine (CU)

A

Alzeheimers

51
Q

Tetrabenazine

A

Inhibit vesicular monoamine transporter (VMAT); limit dopamine vesicle packaging and release. Huntingtons.

52
Q

Reserpine

A

Inhibit vesicular monoamine transporter (VMAT); limit dopamine vesicle packaging and release. Huntingtons.

53
Q

Haloperidol

A

dopamine receptor antagonist. Huntingtons.

54
Q

Sumatriptan (MOA)

A

5-HT agonist. Inhibits trigeminal nerve activation; prevents vasoactive peptide release; induces vasoconstriction.

55
Q

Sumatriptan (CU)

A

Acute migraine, cluster HA attacks.

56
Q

Sumatriptan (T)

A

Coronary vasospasm (contraindicated in pots with CAD or Prinzmental angina), mild tingling.

Pharmacology (10 decks)

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