AntiEpileptics, Lipids, Tb drugs Flashcards

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1
Q

Antipsychotics

A

Both work similiarly, you pick drug based on SEs; long half lives; concerned with tardive dyskinesias as SEs—irreversible and immediate stoppage required. Toxicity—parkinsonian effects, SNS effects from muscarinic blockade; also an Alpha adrenergic blockade=postural hypotension and failure to ejaculate, cardiac=prolonged QT Typical (first generation)–D2 antagonists: most have “-zine” cuz the make you zzzzzz -SEs: Extrapyramidal neuro effects (neuroleptic drugs–tranquilizers, bradykinesia, mild rigidity, tremor, akathisia–subjective restlessness) -Also increased release of prolactin–>lacrimation; Dystonias caused by typcals can be relieved via diphenhydramine (benadril) or benzotropine -NB: Haloperidol (haldol), chlorpromazine (thorazine), thioridazine (mellarlil) Atypical (2nd generation): 5-Ht2 antagonists > D2 antagonists; most have “-pine” -SEs: less extrapyramidal symtoms. Do have hypotension, seizures, weight gain, increased risk of type II db, ad hyperlipidemia -NB: Clozapine (clozaril), risperidone (risperdal), paliperidone (invega), olanzapine (zyprexa), quetiapine (seroquel) short half life , ziprasidone short half life, aripiprazole (abilify) Neuroleptic Malignant syndrome: Bromocriptine (ergot DA agonist) and stop antipyshcotic

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2
Q

Chlorpromazine

A

Typical Antipsychotics–D2 Antagonist; originally called neuroleptic drugs=tranquilizers SEs-Extrapyramidal effects: bradykinesia, mild rigidity, tremor, subjective restlessness (akathisia), reduced initiative and interest, emotional manifestations.

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3
Q

Thioridazine

A

Typical Antipsychotics–D2 Antagonist; Also has mACh activity which might explain less extrapyramidal effects. Orthostatic hypotension and urinary retention originally called neuroleptic drugs=tranquilizers SEs-Extrapyramidal effects: bradykinesia, mild rigidity, tremor, subjective restlessness (akathisia), reduced initiative and interest, emotional manifestations.

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4
Q

Haloperidol

A

Typical Antipsychotics–D2 Antagonist; Increased risk for extrapyramidal effect originally called neuroleptic drugs=tranquilizers SEs-Extrapyramidal effects: bradykinesia, mild rigidity, tremor, subjective restlessness (akathisia), reduced initiative and interest, emotional manifestations.

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5
Q

Clozapine (as opposed with Clonidine)

A

Clozaril; Reduced risk of extrapyrmaidal effects, saved for tx resistant psychosis, works well but risk of agranulocytosis (monitor blood counts) Atypical Antipsychotic–5-ht2 antagonists and D2r antagonist SEs-Seizures, hypotension, weight gain, increased risk for type II db, and hyperlipidemia (clonidine: central alpha 2 agonist which decreases SNS tone in HTN)

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6
Q

Clozapine (as opposed with Clonidine)

A

Clozaril; Reduced risk of extrapyrmaidal effects, saved for tx resistant psychosis, works well but risk of agranulocytosis (monitor blood counts) Atypical Antipsychotic–5-ht2 antagonists and D2r antagonist (WORKS ON D4 agonists as welL) SEs-Seizures, hypotension, weight gain, increased risk for type II db, and hyperlipidemia (clonidine: central alpha 2 agonist which decreases SNS tone in HTN)

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7
Q

Paliperidone

A

Atypical Antipsychotic–5-ht2 antagonists and D2r antagonist SEs-Seizures, hypotension, weight gain, increased risk for type II db, and hyperlipidemia

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8
Q

Olanzapine

A

Atypical Antipsychotic–5-ht2 antagonists and D2r antagonist SEs-Seizures, hypotension, weight gain, increased risk for type II db, and hyperlipidemia

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9
Q

Quetiapine

A

Atypical Antipsychotic–5-ht2 antagonists and D2r antagonist SEs-Seizures, hypotension, weight gain, increased risk for type II db, and hyperlipidemia

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10
Q

Ziprasidone

A

Atypical Antipsychotic–5-ht2 antagonists and D2r antagonist SEs-Seizures, hypotension, weight gain, increased risk for type II db, and hyperlipidemia

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11
Q

Aripiprazole

A

Abilify Atypical Antipsychotic–5-ht2 antagonists and D2r antagonist SEs-Seizures, hypotension, weight gain, increased risk for type II db, and hyperlipidemia

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12
Q

Datrolene

A

Antidote for malignant hyperthermia. Inhibits release from sarcoplasmic reticulum

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13
Q

NO

A

Inhaled Anesthetic Used as adjunct for amnesia and has analgesic actions

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14
Q

Isoflurane, Sevoflurane, Desflurane

A

Volatile Inhaled Anesthetics Sevoflurane is the most pleasant to inhale and used for induction of kids Iso>Sevo>Des (least soluable thus better (Lower) MAC=minimum alveolar concnetration)

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15
Q

Propofol

A

IV anesthetic “MJ Juice, Milk of amnesia” Used as induction agent Vasodilatory and negative inotropy, decreases tidal volume, RR and minute volume, decrease in upper airway reflexes antiemtic

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16
Q

Etomidate

A

IV Anesthetic Use with Cardiovascualry comprimised patient (no hemodynamic effects: HR, BP, inotropy) Non-analgesic, Respiratory depressant, associated with PONV (post op nausea and vomitting)

17
Q

Ketamine

A

IV Anesthetic Airway reflexes are preserved in most situations, secretions/lacrimations are increase, hallucinations and upleasant emergence might occur (suggested benzo co-administration) sub-analgesic doses might help in limiting or reversing opioid tolerance (effectively lowering the therapuetic doses necessary for opioids)

18
Q

Dexmedetomidine

A

IV Anesthetic Used for sedation or adjunct to general anesthetic, and analgesic Significant deceases in BP/HR (to the point you need to give atropine sometimes) Mechanism of action: Alpha 2 agonist in LC and SC Good cuz preserve respiratory drive, context sensitive half life significantly increases after 8 hours of infusion

19
Q

Antiepileptics

A

3 Mechanisms of action: 1) Decrease Glutamate 2) Increase GABA 3) Modify Na/Ca Conductances Partial Seizures: Phenytoin, Carbamazepine, Valproate Generalized Tonic-Clonic (grand mal): Phenytoin, Carbamazepine, Valproate Absent (petit mal Seizures): Ethosuximide, Valproate (clonazepam) Myoclonic Seizures: Phenobarbital, Valproate (Clonazepam) Status Epilepticus: Phenobarbital, Diazepam (REALLY YOU WANT THEM UNDER GENERAL ANESTHESIA)

20
Q

Phenytoin

Used for? Mechanism? SEs?

A

Tonic-Clonic, simple, partial. ** First line for prophylaxis of Status epilepticus.**

Increases Na channel inactivation (ZERO ORDER KINETICS: “PEAs”: Phenytoin, Ethanol, Aspirin)

“Phenytion makes you look funny”

SEs: GINGIVAL HYPERPLASIA, course facial features, lymphadenopathy, Megaloblastic anemia (inhibits folate), Drug Induced SLE, SJS

21
Q

Ethosuximide

Used for? Mechanism? SEs?

A

Absence seizures: “Kids Stare into the Ethos”

slows T-ca2+ channels in thalmus (make sense since you are losing input)

EFGHI: Ethos causes Fatigue, GI, H/A, Itching, stevens Johnson syndrome

22
Q

Valproate

Used for? Mechanism? SEs?

A

Myoclonic/atonic, Gen Tonic-clonic. Can be used for 2nd line for absence. Also used as Mood stabilizer.

Increases Na channel inactivation and Increases GABA.

HEPATOTOXIC, Teratogenic (NT tube defects) Weight gain

23
Q

Carbamazepine

Used for? Mechanism? SEs?

A

Simplex/Complex and Tonic Clonic Seizures. Also first line for **Trigeminal neuralgia **

Also Mood stabilizer (BP) and antipsychotic agent for schizo.

Increases Na Channel Inactivation

SEs: AGRANULOCYTOSIS AND APLASTIC CRISIS; Diplopia, Ataxia, Teratogenesis, Inducer of Cyp450s, SIADH, Steven Johnson Syndrome

24
Q

Lamotrigene

Used for? Mechanism? SEs?

A

Antiepileptic

Increases inactivation of Na channels

Toxic-epidermal necrosis (Stevens-Johnson syndrome)

25
Q

Dementia Txs

A

AChEI’s and NMDA’s Receptor Antagonists

26
Q

Donepazil, Rivastigmine, Galantamine

A

Dementia Txs: AChEI’s

27
Q

Mementine

A

Dementia Tx: NMDA receptor antagonists (protects against glutamate excitotoxicity)

28
Q

Drug used to prevent cerebral vasospasm following stroke?

A

Nimodipine (Calcium channel blocker)

29
Q

Most common cause of bacterial meningitis in adults?

A

Lancet Gram positive Cocci in pairs (strep pneumonia)

30
Q

Tramidol?

A

“Tram it all” works on multiple NTs.

Very weak opioid agonists (inhibits 5ht and NE too)