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Neurological System > 1-Pharmacology > Flashcards

1-Pharmacology Flashcards

Migraines, Glaucoma, Opiods, Antivirals

1
Q

Why are triptans contraindicated in patients with coronary artery disease?

A

They are the first line of treatment for acute severe migraines, but they are contraindicated because their mechanism of action causes can cause vasospasms in coronary arteries.

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2
Q

Which triptan is preferred for pts with long duration migraines and why?

A

Naratriptan

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3
Q

Prophylactic treatment of migraines DOC?

A

Considerded with more than 2 attacks/month

Propanolol DOC
Possibly Amitriptyline
Possibly Verapamil
Valproic acid and Topiramate (anticonvulsants)

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4
Q

Describe two drugs given for neuropathic pain?

A

Treat trigeminal neuralgia with Carbamazepine and Oxcarbazine

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5
Q

What kind of drugs are carbamazepine and oxacarbazine? Use?

A

Na/Ca channel blockers used to treat neuropathic pain (i.e. Trigeminal Neuralgia)

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6
Q

Distinguish betweeen open and closed angle glaucoma

A

open-angle: loss of peripheral vision gradually growing to tunnel vision in old age. Caused by increased aqueous production.

Closed-angle: dialated iris blocks drainage and causes pressure build-up and damage

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7
Q

Give three symptoms of closed-angle glaucoma

A

eye pain
sudden visual disturbance
Halos around lights
Nausea and vomiting from eye pain

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8
Q

What are the 2 drugs given for closed-angle glaucoma?

A
  1. Cholinomimetics: (pilocarpine, carbachol, physostigmine)

2. Acetazolamide (carbonic anhydrase inhibitors – diuretic)

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9
Q

What kinds of drugs are given orally vs topically to glaucoma patients

A

Only the diuretics are topical!!! Carbonic anhydrase inhibitors (Dorzolamide, Brinzolamide)

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10
Q

What receptor facilitates aqueous humor secretion in the eye?

A

B1 parasympathetic

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11
Q

What receptor facilitates reduction of aqueous humor production?

A

A2

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12
Q

What receptor is responsible for ciliary muscle contraction to allow for accomodation and opening the pores of the trabecular meshwork for aqueous outflow?

A

M3 parasympathetic

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13
Q

What are the Cholinergic drugs used for glaucoma and what is their mechanism of action/use?

A

Pilocarpine, Carbachol, Physostigmine

Ciliary contraction — opens trabecular meshwork– treats open and closed

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14
Q

What are the Beta blockers used for galucoma treatment and what is their action/use?

A

Timolol (non-selective), Betaxolol(selective), carteolol, levobunolol, metipranolol

They decrease production of aqueous

Used for chronic open angle

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15
Q

What are the prostaglandin analogs? What is their action/use?

A

Latanoprost, Bitamoprost, Travoprost, Unoprostone

PGF2 alpha lowers IOP via relaxation of the ciliary muscle increasing outflow through meshwork.

Used for open angle

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16
Q

What are the Carbonic Anhydrase Inhibitors?

What is their action/use?

A

Acetazolamide, Brinzolamide, Dorzolamide (all oral)

Decrease HCO3 which decreases humor production

Used for both closed and open

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17
Q

What are the Alpha2 selective agonists?

What is their action/use?

A

Apraclonidine, brimonidine

They stimulate alpha2 receptors which decreases secretion of aqueous.

Brimonidine is given for open angle
Clonidine is given postop for pressure reduction.

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18
Q

Which alpha2 agonist is used for post op ocular hypertension?

A

Apraclonidine

19
Q

Which alpha2 agonist is used for open angle glaucoma/ocular hypertension?

A

Brimonidine

20
Q

What are the non-selective adrenergic agonists used for glaucoma treatment?

A

Dipivefrin, epinephrine

Cause vasoconstriction which decreases humor production.

Open angle

21
Q

What is a very useful opiod thatcan be widely used for the treatment of opioid abuse?

A

Methadone - less withdrawl sickness, slower tolerance changes, long lasting relief of pain

22
Q

Which strong opiate can be used to prevent miosis?

Side effect?

A

Meperidine - causes mydriasis unlike other opioids, but also causes increased HR. Look out for serotonin syndrome or OD with MAOIs

Can also cause seizures

23
Q

What is a cardiovascularly safe opioid that can be used?

A

Fentanyl - no histimine release.

high abuse potential,

24
Q

WHich opioid is widely used in anesthesia applications?

A

Fentanyl

25
Q

List the mild/moderate opioids that can be used for pain?

A

Codeine, Hydrocodone, Oxycodone

26
Q

What are the drugs used for opioid overdose?

A

Naloxone (short duration) inclinic setting

Naltrexone - orally in outpatient settings

27
Q

What drugs can be given for Neuropathic pain Post operative/

A

Dextromethorphan or ketamine

28
Q

What Are some neuropathic pain drugs that can be given

A

Amitriptyline, nortriptyline (Na channel blockers)

Duloxetine, venlafaxine (SNRI, 5HT inhibitor)

Gabapentin, pregabalin(DOC) (GABA analogs)

29
Q

What drug is recommended for the treatment of trigeminal neuralgia?

A

Carbamazepine

30
Q

Which drug is limited due to its side effect of postural hypotension?

A

Clonidine

31
Q

Why is acyclovir more selectively toxic than other antivirals

A

Initial phosphorylation by viral TKinase which is only present in viral cells

32
Q

What drug is used to treat the herpes viruses? List the viruses?

A

Acyclovir (HSV,VZV,CMV)

33
Q

List 2 indications for valacyclovir.

A

Genital herpes

Herpes zoster

34
Q

List 3 indications for famiciclovir?

A

Acute herpes zoster

Recurrent Genital herpes

35
Q

DOC for herpes encephalitis?

A

Vidarabine

36
Q

How does ganciclovir metabolized to active form inside host cells?

A

Phosphorylated by viral monophosphorylation then by the cellular kinases

37
Q

Explain cidofovir’s selective toxicity

A

cytosine analog

38
Q

List four viruses attacked by foscarnet?

What is unique about foscarnet

A

HSV, VZV, CMV, EBV, HHV-6, HBV, HIV

Does not require phosphorylation for activity

39
Q

Influenza drug for adults over 7?

A

Zanamivir

40
Q

Influenza drug for children ?

A

Oseltamivir

41
Q

Influenza A drug for adults?

A

Rimanatadine

42
Q

Influenza A drug for kids?

A

Amantadine

43
Q

Respiratory syncytial virus drug?

A

Palivizumab

Ribavirin Inhaler

Neurological System (10 decks)

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