Neurology Pharmacology Flashcards
(19 cards)
flumazenil
Benzodiazepine receptor antagonist to reverse benzo overdose.
phenytoin
Blocks voltage gated sodium channels to inhibit spread of seizure activity.
ADRs: blood dyscrasias, gingival hyperplasia, hepatotoxicity, hypersensitivity, CNS changes
Do not use with absence seizures
carbamazepine (Tegretol)
Blocks voltage gated sodium channels to inhibit spread of seizure activity. Also pain relief.
ADRs: bone marrow depression, hepatotoxicity, hypersensitivity (esp in Asians), hyponatremia, GI upset
valproate (Depakote)
Antiseizure.
Inhibits enzymes that catabolize GABA or block GABA reuptake and inhibit voltage gated sodium channels.
First-line for partial and generalized seizures.
ADRs: irritating to throat and mouth, hepatotoxicity, GI upset, pancreatitis, polycystic ovarian syndrome, birth defects, alopecia
topiramate (Topamax)
Antiseizure.
Enhances GABA, blocks voltage gated sodium channels, weakly inhibits carbonic anhydrase.
Used to treat seizures and for migraine prophylaxis.
ADRs: bad taste, metabolic acidosis, impaired cognition, depression, epistaxis.
lamotrigine (Lamictal)
Antiseizure. MOA unknown. Very common first-line therapy. ADRs: hypersensitivity, DIC and multi-organ failure, aseptic meningitis. Do not give with valproate.
gabapentin (Neurotonin)
Antiseizure.
MOA unknown, structurally related to GABA.
Widely used for neuropathic pain, also can be used for treatment of seizures.
ADRs: well-tolerated, CNS depression
phenobarbital/primidone
Antiseizure.
Agonist of GABA receptors.
Not a drug of choice for any seizure disorder.
ethosuximide
Antiseizure.
Modifies calcium channel function in thalamic neurons.
Drug of choice for absence seizures.
ADRs: blood dyscrasias
benzotropine (Cogentin)
Antiparkinsons.
Selective M1 muscaranic ACh receptor antagonist.
Minimizes resting tremor.
Used as mono therapy in patients under 70.
ADRs: memory impairment, confusion, hallucinations, constipation, orthostasis
amantadine
Antiparkinsons and antiviral.
MOA unknown.
Minimizes rigidity and akinesia.
ADRs: taper recommended, CNS changes, livedo reticularis (skin discoloration)
selegiline, rasagiline
MAO-B inhibitors. Antiparkinsons. Neuroprotective.
Prevent free radical formation from oxidative metabolism of dopamine.
Enhances effects of levodopa.
ADRs: blurred vision, N+V, HTN, arrhythmias
pramipexole, ropinirole
Dopamine agonists. Antiparkinsons.
First-line for most young patients.
More selective than levodopa.
ADRs: orthostatic hypotension, N+V, peripheral edema, Dopamine Agonist Withdrawal Syndrome (severe leg restlessness)
levodopa-carbidopa (L-Dopa)
Antiparkinsons.
Levodopa is immediate precursor to dopamine.
Carbidopa blocks peripheral conversion of levodopa.
Drug of choice for Parkinson’s, first-line for patients over 65 with cognitive impairment.
Effects tend to decline after 3-4 years, tx is delayed as long as possible.
ADRs: N+V, orthostatic hypotension, arrhythmias, dyskinesias, behavioral effects
tolcapone, entacapone
Catechol-O-methyltransferase inhibitors (COMT). Antiparkinsons.
Block peripheral metabolism of levodopa.
ADRs: liver failure (tolcapone), nausea, orthostatic hypotension, hallucinations
sumatriptan, rizatriptan
Triptans.
Migraine rescue medications.
Vasoconstrict blood vessels involved in pain production and inhibit activity of trigeminal nerve.
First-line for acute migraine.
dihydroergotamine
Ergot alkaloid.
Migraine rescue medication.
Causes prolonged vasoconstriction.
Second-line for acute migraine.
donepezil (Aricept)
Acetylcholinesterase inhibitor.
Alzheimer’s dementia treatment.
ADRs: GI effects, syncopal episodes, bradycardia
memantine
NMDA receptor blocker.
Alzheimer’s dementia treatment.
NMDA is responsible for controlling synaptic plasticity and memory function.
