pharm 1 liners- CNS Flashcards
(162 cards)
1
Q
Ganglion blockers used in research; high affinity for neuronal nicotinic receptors
A
hexamethonium, trimethaphan
2
Q
Two direct-acting cholinomimetics that increase aqueous outflow through ciliary muscle contraction and opening of trabecular meshwork
A
pilocarpine, carbachol
3
Q
Two indirect-acting cholinomimetics that increase aqueous outflow through ciliary muscle contraction and opening of trabecular meshwork
A
physostigmine, echothiophate
4
Q
Nonselective alpha agonist that decreases aqueous production
A
epinephrine
5
Q
Selective alpha 2 agonist that decreases aqueous production
A
brimonidine
6
Q
Three beta blockers that decrease aqueous production
A
timolol (nonselective), betaxolol 9selective), carteolol (nonselective)
7
Q
Carbonic anhydrase inhibitor used to decrease aqueous humor production
A
acetazolamide
8
Q
Prostaglandin E2 alpha analog used to increase aqueous humor outflow
A
latanoprost
9
Q
Common side effect of sedative hypnotics
A
CNS depression
10
Q
Mechanism of action of benzodiazepines
A
Increase frequency of GABA-mediated chloride ion channel (GABAA) opening
11
Q
Main route of metabolism for benzodiazepines
A
hepatic
12
Q
Useful side effect of benzodiazepines in patients undergoing stressful procedures or surgery
A
anterograde amnesia
13
Q
Three benzodiazepines that are metabolized only by Phase II conjugation and therefore is useful in elderly patients
A
Lorazepam, oxazepam, and temazepam
14
Q
Two benzodiazepines that have active metabolites with long half-lives
A
diazepam, chlordiazepoxide
15
Q
Clinical uses of benzodiazepines (5)
A
Anxiety, insomnia, alcohol detoxification, status epilepticus, spasticity
16
Q
Reason why benzodiazepines are safer than barbiturates
A
Benzodiazepines do not directly activate GABAA
17
Q
Mechanism of action of barbiturates
A
Increase duration of GABAA chloride channel opening
18
Q
Most serious side effects of barbiturates (2)
A
Respiratory and cardiovascular depression
19
Q
Barbiturates may precipitate this hematologic condition
A
porphyria
20
Q
Barbiturates decrease the effectiveness of many other drugs via this pharmacokinetic property
A
induce CYP450
21
Q
Effect of benzodiazepines and barbiturates on sleep architecture
A
suppress REM
22
Q
Three nonbenzodiazepine hypnotics that lack suppressive effect on REM and are preferred over benzodiazepines for the treatment of insomnia
A
Zolpidem, zaleplon, eszopiclone
23
Q
Mechanism of action of zolpidem
A
Activates BZ1 subtype of GABAA receptor
24
Q
Drug of choice for treatment of acute status epilepticus
A
benzodiazepine
25
Drug of choice for partial seizures
carbamazepine
26
Antiepileptic drug used as first line for trigeminal neuralgia
carbamazepine
27
Antiepileptic drug that can induce CYP450, is teratogenic, and can cause diplopia, ataxia, and blood dyscrasias; follows first order kinetics of elimination
crbamazepine
28
Drugs of choice for generalized tonic-clonic seizures
Carbamazepine, phenytoin, valproic acid
29
Mechanism of action of Phenytoin, Carbamazepine, Lamotrigine
blocks sodium channels
30
Antiepileptic agent that exhibits zero-order kinetics, causes fetal hydantoin syndrome, and induces CYP450
phenytoin
31
Side effects of phenytoin (4)
Gingival hyperplasia, nystagmus, diplopia and ataxia
32
Anticonvulsant used for absence seizures; also used to treat: bipolar disorder, myoclonic siezures and as migraine prophylaxis
valproic acid
33
Antiepileptic drug that can cause fatal hepatotoxicity and neural tube defects
valproic acid
34
Drug of choice for absence seizures
ethosuximide
35
Mechanism of action of Ethosuximide
Blocks T-type calcium channels
36
Antiepileptic drugs that may also be used for bipolar disorder (3)
Valproic acid, carbamazepine, lamotrigine
37
Antiepileptic drug used also for pain of neuropathic origin
gabapentin
38
Serious side effect of lamotrigine that makes it require slow titration
stevens-johnson syndrome
39
Mechanism of action of opioids on analgesia
activate mu receptors
40
Side effects of these drugs include nausea and vomiting, euphoria, dependence, tolerance, sedation, respiratory depression, constipation
opioids
41
Tolerance to all effects of opioid agonists can develop except (2)
miosis, constipation
42
Strong opioid agonists (4)
Morphine, methadone, meperidine, and fentanyl
43
Opioids used in anesthesia (2)
Morphine and fentanyl
44
Opioid that can be given PO, IV, IM, and intrathecal to relieve anxiety associated with pulmonary edema
morphine
45
Opioid available trans-dermally
fentanyl
46
Opioid with antimuscarinic activity
meperidine
47
Long-acting opioids used in the management of withdrawal states (2)
methadone, buprenorphine
48
Opioid that can cause hyperpyrexic coma with MAOI and serotonin syndrome with SSRI
meperidine
49
Moderate opioid agonists (3)
codeine, hydrocodone, oxycodone
50
Partial opioid agonist that has a long duration of action and is resistant to naloxone reversal
buprenorphine
51
Opioid antagonist that is given IV
naloxone
52
Opioid antagonist that is given orally
naltrexone
53
Opioids indicated for use as antitussive (2)
Dextromethorphan, Codeine
54
Opioids indicated for use as antidiarrheal (2)
Diphenoxylate, Loperamide
55
Directly proportional to the potency of inhalation anesthetics
lipid solubility
56
Inversely proportional to the potency of inhalation anesthetics
Minimal alveolar concentration (MAC)
57
Inversely proportional to the rate of induction and recovery of inhalation anesthetics
Blood:gas partition coefficient
58
Mechanism of action of inhalation anesthetics
Potentiation of GABA at GABAA receptors; also reduce Na and Ca influx
59
Currently the only non-halogenated inhalation anesthetic
Nitrous oxide
60
Inhalation anesthetic with the most analgesic activity
nitrous oxide
61
Inhalation anesthetic with the least respiratory and cardiovascular depression and therefore is used frequently as a component of balanced anesthesia
nitrous oxide
62
Inhalation anesthetic that can cause fatal hepatotoxicity and cardiac arrhythmia and is no longer used in the US
halothane
63
Inhalation anesthetic that is withdrawn from the market due to fatal nephrotoxicity
Methoxyflurane
64
Inhalation anesthetic that at high concentrations can produce CNS excitation, leading to seizures
enflurane
65
Rare, but fatal side effect associated with combination of halogenated inhalation anesthetic and depolarizing neuromuscular blocker
malignant hyperthermia
66
Close to ideal inhalation anesthetic that exhibits rapid and smooth induction and recovery, with little organ system toxicity
sevoflurane
67
Barbiturate used for the induction of anesthesia
thiopental
68
A short-acting benzodiazepine commonly used adjunctively with inhalation anesthetics and opioid analgesics for a balanced anesthesia
midazolam
69
Opioid safe for use of analgesia and anesthesia during cardiac surgery
fentanyl
70
Produces both rapid anesthesia and recovery, has antiemetic activity, but may cause marked hypotension
propofol
71
Produces dissociative anesthesia but has significant analgesic activity
ketamine
72
Mechanism of action of ketamine
block NMDA receptor
73
Side effects of dissociative anesthetic, ketamine (4)
Cardiovascular stimulation, increased cerebral blood flow, vivid dreams, hallucinations
74
Neuroleptanesthesia can be produced by a combination of these two agents
Fentanyl and droperidol
75
Mechanism of action of local anesthetics
Block voltage-gated sodium channels
76
This condition(environment) may necessitate larger doses of local anesthetics because the drugs become ionized and cannot penetrate the neuronal membranes
low pH
77
Almost all local anesthetics have this property and sometimes require the administration of vasoconstrictors to prolong activity
vasodilation
78
The only local anesthetic with vasoconstrictive property, but due to abuse potential, only occasionally used for nasal surgery
cocaine
79
This type of local anesthetic is more likely to cause hypersensitivity reactions
Ester-type (local anesthetic with one "I" in name)
80
Local anesthetic most widely used for obstetric anesthesia but causes the most cardiac depression
Bupivacaine
81
Side effect of most local anesthetics
CNS excitation
82
Common side effect of antipsychotics, MPTP (contaminant in illicit meperidine analog), and cholinergic excess
drug-induced parkinsonism
83
Precursor of dopamine that can cross the blood-brain-barrier and used to alleviate motor dysfunction in Parkinson's disease
levodopa (L-dopa)
84
Inhibits peripheral DOPA decarboxylase, reduces peripheral side effects of dopamine precursor and enhances its delivery to the brain
carbidopa
85
Two fluctuations in clinical response associated with long-term use of dopamine precursor
"Wearing off" and "on-off-phenomenon"
86
Inhibits monoamine oxidase type B (MAO-B), used as monotherapy for early or mild Parkinson's disease or adjunct to improve motor function in patients with fluctuations in clinical response
Selegiline
87
Inhibits of catechol-O-methyltransferase (COMT), used as adjunct to improve motor function in Parkinson's patients with fluctuations in clinical response
Entacapone, tolcapone
88
Ergot type 2 dopamine receptor (D2) agonist, used as adjunct to improve motor function in Parkinson's patients with fluctuations in clinical response
bromocriptine
89
Non ergot type 2 dopamine receptors (D2) agonist, used for Parkinson's and restless legs syndrome
Pramipexole and ropinirole
90
An antiviral that enhances dopamine release from nigrostriatal neurons
amantadine
91
A centrally-acting anticholinergics useful for tremor and rigidity but have little effect on bradykinesia in patients with Parkinson's
benztropine
92
Drug of choice indicated for familial or essential tremors
propranolol
93
Two drugs that inhibit vesicle monoamine transporter used for Huntington's
tetrabenazine, resrpine
94
An antipsychotic with dopamine receptor antagonist activity used for Huntington's
haloperidol
95
Three centrally-acting cholinesterase inhibitors used for Alzheimer's
Donepezil, rivastigmine, galantamine
96
Noncompetitive antagonist of NMDA receptors used for Alzheimer's
memantine
97
Three main classes of CNS depressant drugs of abuse
alcohol, opioid, barbituates/benzodiazepine
98
Agent that is metabolized by alcohol dehydrogenase or microsomal ethanol-oxidizing system (MEOS) to acetaldehyde; displays zero-order kinetics of elimination
ethanol
99
Enzyme that is induced through chronic exposure to alcohol, may contribute to tolerance
microsomal ethanol oxidizing system (MEOS)
100
Complications of the gastrointestinal system associated with chronic alcohol use
Mallory-Weiss syndrome, hepatitis, cirrhosis, pancreatitis
101
Neurological abnormality caused by chronic alcohol use and thiamine deficiency
Wernicke-Korsakoff syndrome
102
The most common neurologic abnormality in chronic alcoholics
Neurologic deficits (Peripheral neuropathy)
103
Life-threatening alcohol withdrawal syndrome that peaks at 5 days after the last drink
delirium tremens
104
Inhibits aldehyde dehydrogenase and used as deterrent for alcohol use
disulfiram
105
Opioid receptor antagonist used to prevent alcohol abuse
naltrexone
106
Competes for alcohol dehydrogenase and is used in methanol or ethylene glycol poisoning
Fomepizole, ethanol
107
Most commonly abused opioids
Heroin, morphine, oxycodone
108
Respiratory and CNS depression, pinpoint pupils, seizures, and needle track marks are symptoms of this intoxication
opioid
109
Opioid receptor antagonist that is used to treat opioid intoxication, may cause more rapid and intense symptoms of withdrawal
naloxone
110
Opioids used for long-term maintenance from opioid withdrawal
methadone, buprenorphine
111
Most widely abused sedative hypnotics
short-acting barbiturates (pentobarbital)
112
Two date rape drugs that work through enhancement of GABA receptors in the brain
Flunitrazepam, GHB (γ-hydroxybutyrate)
113
Benzodiazepine antagonist used to treat benzodiazepine intoxication
flumazenil
114
Four major CNS stimulant drugs of abuse
Caffeine, nicotine, cocaine, amphetamines
115
Treatments available for nicotine addiction
Patch, gum, lozenge, bupropion, varenicline
116
CNS stimulant that acts by inhibiting reuptake of neurotransmitters; may cause pupil dilation, alter tactile sensation, irregular breathing, and cardiac toxicity
cocaine
117
Amphetamine derivatives commonly abused
Methamphetamine (crystal meth), MDMA (methylenedioxymeth-amphetamine, or ecstasy)
118
Drug of abuse that was developed as a dissociative anesthetic; intoxication leads to both horizontal and vertical nystagmus, analgesia, psychosis, delirium, and seizures
PCP (phencyclidine, or angel dust)
119
Synthetic ergot derivative that can produce perceptual hallucinations and used as an illicit drug; may cause paranoia
LSD (lysergic acid diethylamide)
120
Active ingredient is tetrahydrocannabinol (THC); side effects include impairment of judgment, altered sense of time, increased appetite, and hallucinations
marijuana
121
Use of all antipsychotic medication in this group of patients is associated with increased risk of deaths
Elderly with dementia-related psychosis
122
Antipsychotics that repress primarily the positive symptoms of schizophrenia
typical antipsychotics
123
Primary mechanism of action of typical antipsychotics
inhibits D2 receptors
124
Common endocrine side effects of all typical antipsychotic drugs
Hyperprolactinemia, galactorrhea
125
Two low potency, typical antipsychotic drugs
Chlorpromazine, thioridazine
126
Typical antipsychotic associated with retinopathy and cardiac toxicity
thioridazone
127
Common side effects of low potency typical antipsychotic drugs
Dry mouth (anticholinergic), sedation (antihistamine), hypotension (α1 block)
128
Three high potency, typical antipsychotic drugs
Haloperidol, fluphenazine, trifluoperazine
129
Typical antipsychotic that can also be used for Tourette syndrome
haloperidol
130
Side effects more commonly associated with high potency typical antipsychotic drugs
Dystonia, akathisia, bradykinesia, tardive dyskinesia (extrapyramidal symptoms)
131
Treatment for drug-induced acute extrapyramidal symptoms
Benztropine, diphenhydramine
132
Life-threatening side effect associated with typical antipsychotic drugs
Neuroleptic malignant syndrome
133
Treatment for drug-induced neuroleptic malignant syndrome
dantrolene
134
Advantage of atypical over typical antipsychotics
Less extrapyramidal symptoms, more effect against negative symptoms of schizophrenia
135
Primary mechanism of action of atypical antipsychotics
Inhibit 5-HT2 receptors
136
Atypical antipsychotic that can produce potentially fatal agranulocytosis and increase incidence of seizures
clozapine
137
Two atypical antipsychotics that can cause weight gain
Clozapine, olanzapine
138
Two atypical antipsychotics that can prolong the QT interval
Risperidone, ziprasidone
139
Atypical antipsychotic that can increase prolactin levels and cause gynecomastia and irregular menstruation in men and women, respectively
risperidone
140
Atypical antipsychotic that can also be used to treat irritability in autistic children
Aripiprazole
141
Tricyclic antidepressants
-iptyline, -ipramine, doxepin, amoxapine
142
Mechanism of action of tricyclic antidepressants
Block serotonin and norepinephrine reuptake
143
Common side effects of tricyclic antidepressants
Autonomic (block muscarinic and α1), sedation
144
Tricyclic secondary amines that produce less sedation and autonomic side effects (compared with tricyclic tertiary amines)
Nortriptyline, desipramine
145
Three life-threatening side effects associated with tricyclic antidepressants
convulsion, cardiotoxicity, coma (3 C's)
146
Tricyclic antidepressant used for enuresis
imipramine
147
Tricyclic antidepressant used in obsessive compulsive disorder
clomipramine
148
Tricyclic antidepressant with antihistamine effect and is indicated for insomnia
doxepin
149
Class of antidepressants that has fewer sedative and autonomic side effects than tricyclic antidepressants and indicated for panic disorder, generalized anxiety disorder, social phobias, bulimia, obsessive compulsive behavior, and post-traumatic stress disorder
SSRI
150
Four selective serotonin reuptake inhibitors
Fluoxetine, paroxetine, sertraline, citalopram
151
Serious side effect of selective serotonin reuptake inhibitors when used with other drugs such as monoamine oxidase inhibitors, serotonin-norepinephrine reuptake inhibitors, or tricyclic antidepressants
serotonin syndrome
152
Two selective serotonin-norepinephrine reuptake inhibitors
Duloxetine, venlafaxine
153
Class of drugs that is most useful in patients with anxiety, hypochondriasis, and depression that is refractory to other antidepressants
monoamine oxidase inhibitors
154
Mechanism of action of isocarboxazid, phenelzine, and tranylcypromine
Irreversible inhibition of monoamine oxidase A and B
155
Mechanism of action of selegiline
Selectively inhibits monoamine oxidase B
156
A fatal condition that results from combination of monoamine oxidase inhibitors with tyramine-containing foods
Hypertensive crisis
157
Antidepressant that non-selectively inhibits neuronal reuptake; less likely to cause sedation, autonomic, cardiovascular, or sexual dysfunction; also used for smoking cessation
Bupropion
158
Antidepressant that inhibits serotonin reuptake but also antagonizes 5HT-2 receptors; causes priapism
trazodone
159
Antidepressant that inhibits alpha 2, 5HT-2, and 5HT-3 receptors to increase release of norepinephrine and serotonin
mirtazapine
160
First line drug for classic bipolar disorder with euphoric mania
lithium
161
Major route of elimination for Lithium
kidneys
162
Side effects of lithium (4)
Tremor, hypothyroidism, nephrogenic diabetes insipidus, fetal cardiac defects
