Week 3 - Neuro Drugs

Question 1

addictive opioids

Answer 1

the most addictive opioids are the strongest Mu receptor agonists leading to euphoric effects

Question 2

codeine

Answer 2

opioid, moderate mu agonist, not very addictive

Question 3

pentacozine

Answer 3

opioid, mixed weak agonist / antagonist of mu receptor, kappa-sigma agonist, less addictive

Question 4

merperidine

Answer 4

opioid, full mu receptor agonist

Question 5

drugs the cause mydriasis (pupil dilation)

Answer 5

sympathomimetics and parasympathetic inhibitors

Question 6

phenylephrine

Answer 6

dilates, alpha1 adrenergic stimulant, used in eye drops to dilate eyes, 2.5-10% solution, reverses Horner’s Syndrome ptosis (drooping eyelid)

Question 7

epinephrine

Answer 7

dilates, 0.5-2% solution, Tx for glaucoma, increases aqueous humor outflow and inhibits formation, alpha1 adrenergic stimulant

Question 8

nicotine

Answer 8

dilates, activates nicotinic receptor, also activates parasympathetics producing miosis (more common)

Question 9

amphetamine

Answer 9

dilates, reverses axoplasmic pump causing NE release, response = normal postganglionic nerve

Question 10

cocaine

Answer 10

dilates, blocks axoplasmic pump increasing NE near andrenergic receptor, only works if NE being released, used to diagnose Horner’s Syndrome instead of aniscoria

Question 11

mydriatics

Answer 11

pupil dilation, muscarinic receptor antagonists

Question 12

atropine

Answer 12

pupil dilation, produces cycloplegia, bella donna alkaloid, pharacological inhibition of parasympathetic by muscarinic receptor antagonism

Question 13

Q - most likely to cause mydriasis (pupil dilation)

Answer 13

phenylephrine

Question 14

nicotine

Answer 14

activates parasympathetics, miosis (pupil constriction)

Question 15

pilocarpine

Answer 15

pupil constriction, muscarinic agonist, Tx glaucoma by increasing drainage by making more space near Schlemms canal, used to see if there is muscarinic receptor problem in eye

Question 16

acetylcholine

Answer 16

pupil constriction, muscarinic agonist

Question 17

physostigmine / ecothiophate

Answer 17

pupil constriction, inhibit AChE

Question 18

terazosin

Answer 18

pupil constriction, not for eye disease but side effect, alpha1 antagonist

Question 19

reserpine

Answer 19

pupil constriction, NE depleting, ocular side effect

Question 20

Q - most likely to produce miosis (pupil constriction)

Answer 20

pilocarpine

Question 21

Q - pt with miosis, best pharmacological Tx

Answer 21

atropine

Question 22

timolol

Answer 22

Tx glaucoma, beta receptor blocker that reduces aqueous humor formation in ciliary body

Question 23

pilocarpine

Answer 23

Tx glaucoma, muscarinic receptor agonist, enhanced aqueous humor drainage through trabecular meshwork and canal of Schlemm by constricting pupil and making more room for drainage

Question 24

physostigmine / ecothiophate

Answer 24

Tx glaucoma, anticholinesterase, enhances aqueous humor drainage through trabecular meshwork and canal of schlemm

Question 25

latanoprost

Answer 25

Tx glaucoma, increases uveo-sceral outflow of aqueous humor, prostaglandin E derivative

Question 26

acetazolamide

Answer 26

Tx glaucoma, carbonic anhydrase inhibitor, CA makes bicarbonate in non-pigemented epithelium of ciliary bodies -> moved to pigmented epithelial cell layer in exchange for Na+ and Cl- which water follows

Question 27

Q - most likely to increase aqueous humor drainage

Answer 27

pilocarpine

Question 28

Q - most likely to precipitate closed angle gluacoma

Answer 28

phenylephrine

Question 29

strabismus

Answer 29

deviation of eyes due to muscle spasms

Question 30

blepharospasm

Answer 30

spasm leading to closed eyelid

Question 31

botulinum toxin

Answer 31

Tx muscle spams around eye, inhibits ACh release by cleaving synpatic associated proteins, can relieve strabismus or blepharospasm

Question 32

ptosis (drooping eyelid)

Answer 32

sympathetic nerve disruption via superior tarsal, can also be caused by skeletal muscle dysfunction and CN III palsy

Question 33

also cause drooping eyelid (ptosis)

Answer 33

myasthenia gravis, botulinism, occulomotor palsy, muscular dystrophy

Question 34

phyenylephrine

Answer 34

pupil dilation, alpha1 agonist

Question 35

atropine

Answer 35

pupil dilation, muscarinic antagonist

Question 36

amphetamine

Answer 36

pupil dilation, causes release of NE from nerve

Question 37

cocaine

Answer 37

pupil dilation, prevents NE reuptake into nerve

Question 38

phenylephrine

Answer 38

mydriatic - dilating, alpha1 receptor agonist, can precipitate closed angle gluacoma

Question 39

atropine

Answer 39

mydriatic - dilating, muscarinic antagonist, can precipitate closed angle gluacoma

Question 40

amphetamine

Answer 40

mydriatic - dilating, causes release of norepinephrine, can precipitate closed angle gluacoma

Question 41

cocaine

Answer 41

mydriatic - dilating, prevents norepiniphrine reuptake, can precipitate closed angle gluacoma

Question 42

pilocarpine

Answer 42

miotic - constricts, muscarinic agonist

Question 43

acetylcholine

Answer 43

miotic - constricts, muscarinic agonist

Question 44

terazosin

Answer 44

miotic - constricts, alpha1 adrenergic antagonist

Question 45

physostigmine

Answer 45

miotic - constricts, anticholinesterase

Question 46

nicotine

Answer 46

miotic - constricts

Question 47

cocaine

Answer 47

tests for intact sympathetic system, pupil dilation = nerves work, lack of pupil dilation = sympathetic defect (possibly Horner's syndrome)

Question 48

amphetamine

Answer 48

tests for intact sympathetic system, pupil dilation if postganglionic nerve is intact (and contains norepinephrine)

Question 49

glaucoma Tx - enhancing aqueous humor flow

Answer 49

pilocarpine (muscarinic agonist), latanaprost (prostaglandins), epinephrine

Question 50

glaucoma Tx - suppress aqueous humor production

Answer 50

timolol (beta adrenergic antagonist), acetazolamide (carbonic anhydrase inhibitor)

Question 51

Tx muscle spasms (blephorospasm or strabismus)

Answer 51

botulinum toxin relaxes skeletal muscle by suppressing acetylcholine release

Question 52

Q - tests for sympathetic postganglionic nerve function

Answer 52

amphetamine

Question 53

Q - tests parasympathetic activity

Answer 53

atropine, pharmacological antagonist of muscarinic receptors

Question 54

Q - discriminates between CN III defect and ocular defect

Answer 54

pilocarpine - will stimulate parasympathetic part of CN III to sphincter pupillae and ciliary muscles