Behavioral, Anesthetic, MS, Headache, CNS, Pain pharm - Unit 3 Flashcards
1
Q
Which DA pathway controls movement (mesolimbic/ mesocortical/ nigrostantial/ tuboinfundibular)
A
nigrastriatal
2
Q
Which DA pathway controls reward and perception (mesolimbic/ mesocortical/ nigrostantial/ tuboinfundibular)
A
mesolimbic
3
Q
which DA pathway controls executive function (mesolimbic/ mesocortical/ nigrostantial/ tuboinfundibular)
A
mesocortical
4
Q
which DA pathway controls pituitary prolactin function (mesolimbic/ mesocortical/ nigrostantial/ tuboinfundibular)
A
tuboinfundibular
5
Q
hyperfunction of this DA pathway causes addiction + hallucination (mesolimbic/ mesocortical/ nigrostantial/ tuboinfundibular)
A
mesolimbic
6
Q
hypofuction of this DA pathway causes dyskinesia as in parkinsons (mesolimbic/ mesocortical/ nigrostantial/ tuboinfundibular)
A
nigrostriatal
7
Q
hypofunction of this DA pathway causes innatention as in ADD (mesolimbic/ mesocortical/ nigrostantial/ tuboinfundibular)
A
mesocortical
8
Q
hypofunction of this DA pathway causes amotivation, apathy (mesolimbic/ mesocortical/ nigrostantial/ tuboinfundibular)
A
mesolimbic
9
Q
treating schizophrenia with a DA agonist can cause lactation via this pathway (mesolimbic/ mesocortical/ nigrostantial/ tuboinfundibular)
A
tuboinfundibular
10
Q
What enzyme breaks down dopamine, norepinephrine and epinephrine in the brain?
A
COMT: catechol-O-methyl transferase
11
Q
Used to treat parkinsons is the precursor to dopamine (levodopa/ carbidopa/ bupropoin)
A
levodopa
12
Q
used to prevent peripheral dopamine activity, lowers fatigue, dizziness and nausea (levodopa/ carbidopa/ bupropoin)
A
carbidopa
13
Q
A NEDA reuptake inhibitor, NDRI antidepressant (levodopa/ carbidopa/ bupropoin)
A
bupropion
14
Q
What are the 3 stimulant true amphetamines that can block DAT and even drive it backwards:
A
- dextroamphetamine 2. lisdexamfetamine 3. mixed amphetamine salts
15
Q
what are the two mild stimulants that increase histamine, used for narcolepsy, apnea and shift-work, not ADHD
A
- Modafinil 2. Armodafinil
16
Q
MAOi A and B-inhibitor for parkinsons OR depression (rasagiline/ selegiline/ isocarboxazid/ phenezine/ tranycypromine)
A
selegiline
17
Q
MAOi B-inhibitor for parkinsons (rasagiline/ selegiline/ isocarboxazid/ phenezine/ tranycypromine)
A
rasagiline, selegiline does B and A at high doses
18
Q
MAOi a-inhibitor for depression (rasagiline/ selegiline/ isocarboxazid/ phenezine/ tranycypromine)
A
selegiline, isocarboxazid, phenezine, tranycypromine
19
Q
If someone is on an MAOi they can have low BP or elevated BP due to increased NE, especially if they eat food with _________
A
tyramine
20
Q
What are the two COMTi drugs?
A
- Entacapone 2. Tolcapone
21
Q
which COMTi can cause liver failure? (Entacapone/ Tolcapone)
A
Tolcapone
22
Q
which COMTi can cause nausea and fatigue? (Entacapone/ Tolcapone)
A
Entacapone
23
Q
What are the 4 D2 receptor agonists for parkinson’s and restless leg syndrome?
A
- Bromocriptine 2. Pramipexole 3. Ropinerole 4. Apomorphine
24
Q
A D3 agonist that is for Schizophrenia but also for depression is (Aripiprazole/ Amantadine)
A
Aripiprazole
25
Used to treat parkinson's and Influenza (Aripiprazole/ Amantadine)
Amantadine
26
Which DA synapse depleting drug is used for hypertension (reserpine/ tetrabenazine)
reserpine
27
Which DA synapse depleting drug is used for Huntington's chorea (reserpine/ tetrabenazine)
tetrabenazine
28
schizophrenia w/ (+) symptoms, treat w/ D2 blocker, blocking the (mesolimbic/ mesocortical/ nigrostantial/ tuboinfundibular) pathway leads to extrapyramidal symptoms =EPS
nigrostantial
29
What are the 3 high potency first gen antipsychotics, FGA
1. haloperidol 2. fluphenazine 3. thiothixine
30
What are the 2 low potency first gen antipsychotics, FGA
1. chloropromazine 2. thioridazine
31
this drug is used for refractory schizophrenia, antagonizes D2 and 5HT2a, requires WBC monitoring, it is ________
clozapine
32
In the parasympathetics of the eye, muscarinic receptors are blocked by (atropine/ d-tubocurarine)
atropine
33
In the parasympathetics of the eye, nicotinic receptors are blocked by (atropine/ d-tubocurarine)
d-tubocurarine
34
Name 4 muscarinic agonists that cause pupillary constriction, increase aqueous outflow
1. Acetylcholine 2. Carbachol 3. Methacholine 4. Pilocarpine
35
1. Acetylcholine 2. Carbachol 3. Methacholine 4. Pilocarpine cause pupillary (dilation/ constriction)
constriction, muscarinic agonists, parasympathetic
36
Name 5 muscarinic antagonists that cause pupillary dilation and paralysis of the ciliary body, cycloplegia
1. Atropine, longest lasting 2. Scopolamine 3. Homatropine 4. Cyclopentolate 5. Tropicamide, shortest lasting
37
1. Atropine 2. Scopolamine 3. Homatropine 4. Cyclopentolate 5. Tropicamide cause pupillary (dilation/ constriction)
dilation
38
(parasymp/ symp) stimulation will suppress aqueous humor production(parasymp/ symp) stimulation will increase aqueous outflow
symps suppress productionparasymps -> contract ciliary -> spread trabecular mesh -> increase outflow
39
Parasympathetic stimulation causes (contraction/ relaxation) of the ciliary muscles
contract ciliary -> spread trabecular mesh -> increase aqueous outflow
40
Horner's syndrome, ptosis, myosis, anhydrosis, is a lesion in (symps/ parasymps)
sympathetics
41
Parasympathetic disfunction leading to large pupil, but no loss of occular movements (Adie's/ aneurysm compressing ciliary gang)
Adie's, just some lesion of ciliary gang
42
Parasympathetic disfunction leading to large pupil, with some loss of occular movements (Adie's/ aneurysm compressing ciliary gang)
aneurysm compressing ciliary gang
43
Tension headaches are usually (unilateral/ bilateral) while migraines are usually (unilateral/ bilateral)
tension: bilateral; migraine: unilateral
44
Which are more aggravated by physical activity (tension/ migraine) headaches
migraine tension headaches don't prohibit activity
45
Which is more common in women? (migraine/ tension/ cluster) headache
migraine and tension
46
Which is more common in men? (migraine/ tension/ cluster) headache
cluster
47
which is associated with smoking and lionine facies? (migraine/ tension/ cluster) headache
cluster
48
Which is best treated with O2 therapy? (migraine/ tension/ cluster) headache
cluster
49
which is the most common type of headache? (migraine/ tension/ cluster) headache
tension, episodic
50
focal neurological symptoms that precede a headache is called _______
Aura
51
which type of headache may be preceded by aura? (migraine/ tension/ cluster) headache
migraine with auravs. migraine without aura
52
migraine med: side effects include nausea, so may be administered IV (Triptans/ ergotamines + DHE)
ergotamines + DHE
53
migraine med: selective 5HT 1B+D agonist (Triptans/ ergotamines + DHE)
triptans
54
migraine med: Work well only if administered early (Triptans/ ergotamines + DHE)
triptans
55
migraine med: side effect of chest pain (Triptans/ ergotamines + DHE)
Triptans and ergotamine + DHE
56
this headache has a clockwork daily and annual rhythm (migraine/ tension/ cluster) headache
cluster
57
which is an MAOi for depression?(tranylcypromine/ imipramine/ amitripyline/lithium/ fluoxetine/ citalopram/ bupropion/ duloxetine/ mirtazapine/ venlafaxine/ phenelzine)
tranylcypromine, phenelzine
58
which is used for bi-polar disorder? (tranylcypromine/ imipramine/ amitripyline/lithium/ fluoxetine/ citalopram/ bupropion/ duloxetine/ mirtazapine/ venlafaxine/ phenelzine)
lithium salts
59
find the SSRIs(tranylcypromine/ imipramine/ amitripyline/lithium/ fluoxetine/ citalopram/ bupropion/ duloxetine/ mirtazapine/ venlafaxine/ phenelzine)
fluxenetine, citalopram
60
which are serotinin-norepi reuptake inhibitors, SNRI? (tranylcypromine/ imipramine/ amitripyline/lithium/ fluoxetine/ citalopram/ bupropion/ duloxetine/ mirtazapine/ venlafaxine/ phenelzine)
duloxetine, venlafaxine
61
Which are the "atypicals" that inhibit 5-HT uptake? (tranylcypromine/ imipramine/ amitripyline/lithium/ fluoxetine/ citalopram/ bupropion/ duloxetine/ mirtazapine/ venlafaxine/ phenelzine)
mirtazapine, bupropion
62
Oxidizes more NE, 5-HT and tyramine (MAOa/ MAOb)
MAOa
63
If you want to prevent parkinson's, inhibit more (MAOa/ MAOb)
MAOb, oxidized DA and phenyethamine
64
Ketamine is a ______ receptor antagonist
NMDA-glutamate
65
Bupropion has most of it's effectivity on (NE/ DA/ 5-HT)
DA
66
glutamate NMDA receptor blocker (Felbamate/ Topiramte)
Felbamate
67
glutamate AMPA and Kainate receptor blocker (Felbamate/ Topiramte)
topiramate
68
Which is the "gold standard" for maintenance of general anesthesia? (Isoflurane/ Desflurane/ Sevoflurane)
Isoflurane
69
Which is the agent of choice for a mask induction b/c it is least smelly? (Isoflurane/ Desflurane/ Sevoflurane)
Sevoflurane sweet-smelling
70
Which requires a gas blender due to it's low B.P.? (Isoflurane/ Desflurane/ Sevoflurane)
Desflurane
71
Which can be nephrotoxic when combined with CO2? (Isoflurane/ Desflurane/ Sevoflurane)
Sevoflurane
72
Which anesthetic has the unique property of being anti-emetic at low concentrations (Sevoflurane/ methohexital/ Propofol/ Etomidate/ Ketamine)
Propofol
73
Which anesthetic is a GABAa receptor agonist? (Sevoflurane/ Methohexital/ Propofol/ Etomidate/ Ketamine/ Dexmedetomide)
Methohexital, Propofol and Etomidate
74
Which anesthetic causes "dissociative anesthesia"? (Sevoflurane/ Methohexital/ Propofol/ Etomidate/ Ketamine/ Dexmedetomide)
Ketamine
75
Which anesthetic stimulates the sympathetic nervous system? (Sevoflurane/ Methohexital/ Propofol/ Etomidate/ Ketamine/ Dexmedetomide)
Ketamine
76
Which binds ‘±2a and ‘±2b receptors in the locus ceruleus and brain stem to produce sedation?(Sevoflurane/ Methohexital/ Propofol/ Etomidate/ Ketamine/ Dexmedetomide)
Dexmedetomide
77
What is the only depolarizing neuromuscular blocker we use? (Rocuronium/ Pancuronium/ Vecuronium/ Succinylcholine)
Succinylcholine
78
Which Amino Steroid NMB has the side effect of increased heart rate, should be avoided in renal insufficiency (Rocuronium/ Pancuronium/ Vecuronium)
Pancuronium
79
What drug can be used to immediately reverse the effects of Rocuronium?
Sugammadex
80
A drug that induces sleep is called a _______
hypnotic
81
A drug that is calming is a ________
sedative
82
GABA activation of a GABAa receptor opens ___ ion channels
chloride ion
83
When chloride ions enter the neuron, the inhibit signal transduction by (hyperpolarizing/ hypopolarizing) the cell
hyperpolarizing
84
diazepam causes more (sedation/ hypnosis)
sedation
85
The pharma generic name for valium is _______
diazepam
86
These have a 'ceiling effect' and do not produce resp. depression, coma and death (benzos/ barbiturates)
benzos
87
Can cause full CNS depression and death (benzos/ barbiturates)
barbiturates
88
The pharm generic name for Ambien, the BDZ1 psuedo benzo sleep agent is ______
Zolpidem
89
The pharm generic name for Xanax, the antixiolytic is _______
Alprazolam
90
To reverse an overdose of a benzo use ________
flumazenil
91
What are 7 antixiolytics or 'benzos'
1. midazolam 2. trizolam 3. alprazolam 4. lorazepam 5. chlordiazepoxide 6. diazepam 7. fluruzepam
92
Barbiturate used as an anticonvulsant, esp in children (thiopental/ phenobarbital/ midazolam)
phenobarbital
93
Barbiturate used as a short acting anesthetic (thiopental/ phenobarbital/ midazolam)
thiopental
94
Benzo used as a short acting anesthetic (thiopental/ phenobarbital/ midazolam)
midozolam
95
Pt has sudden onset of depression, treat with a SSRI, but in the 6 weeks waiting for the kick in use ______
benzos, alprazolam or lorazepam
96
benzos that are anti anxiety (alprazolam/ lorazepam/ triazolam/ zolpidem/ diazepam)
alprazolam + lorazepam
97
benzos that induce sleep (alprazolam/ lorazepam/ triazolam/ zolpidem/ diazepam)
triazolam + zolpidemzolpidem is a BDZ1
98
benzos that are anti-convulsant (alprazolam/ lorazepam/ triazolam/ zolpidem/ diazepam)
lorazepam + diazepam
99
benzos that are muscle relaxant (alprazolam/ lorazepam/ triazolam/ zolpidem/ diazepam)
diazepam
100
An antixiolytic without sedation, No GABAa interaction; may be partial agonist at 5HT1A is ________
Buspirone
101
Most CNS depressants work at the ______ receptor
GABAa
102
Most alcohol from beverages is absorbed in the (mouth/ stomach/ small intestines)
small intestines
103
local anesthetics are most active at the (resting/ active/ inactive) channel
active
104
for local anesthetics, the greater the lipid solubility, the (greater/ lesser) the potency
greater
105
Local anesthetics with a ester linkage are metabolized by (carboxylesterases and CYP-450's/ pseudocholinesterases)
pseudocholinesterases
106
hypofunction of this DA pathway causes hyperprolactinemia (mesolimbic/ mesocortical/ nigrostantial/ tuboinfundibular)
tuboinfundibular
107
hyperfunction of this DA pathway causes hypervigalence and insomnia (mesolimbic/ mesocortical/ nigrostantial/ tuboinfundibular)
mesocortical
108
hyperfunction of this DA pathway causes dyskinetic movements (mesolimbic/ mesocortical/ nigrostantial/ tuboinfundibular)
nigrostriatal
109
The generic drug name for novocaine is _______
procaine
110
local anesthetics work by blocking nerve cell _______
depolarization
111
A more lipid soluble anesthetic will have (higher/ lower) potency
higher
112
At what site do local anesthetics work to prevent nerve signal transduction?
Na+ channels
113
What are the two major chemical classes of local anesthetics?
1. Ester anesthetics 2. Amide anesthetics
114
Which is rapidly metabolized to water soluble products (Ester anesthetics/ Amide anesthetics)
Ester anesthetics
115
Which requires hepatic carboxyl esterases and CYP450 enzymes to be metabolized? (Ester anesthetics/ Amide anesthetics)
Amide anesthetics
116
Which form of the local anesthetic is the active form? (neutral/ ionic)
ionic
117
Which form of the local anesthetic can cross the cell membrane? (neutral/ ionic)
neutral
118
what is the HendersonäóñHasselbalch eq?
pH = pKa + log (A-/HA)
119
Duration of action of an anesthetic depends on (pKa/ lipid solubility/ protein binding)
protein binding
120
Speed of onset of an anesthetic depends on (pKa/ lipid solubility/ protein binding)
pKa and lipid solubility
121
which get blocked sooner (myelinated/ un-myelinated) nerves
myelinated
122
Which conduct the fastest? slowest? (Aα/ Aβ/ Aδ/ C)
in that order -> fastest, Aα, Aβ, Aδ, C, slowest
123
Which transmit pain? Temperature? (Aα/ Aβ/ Aδ/ C)
C: capsasin, painAδ: temperature
124
Which are non-myelinated? (Aα/ Aβ/ Aδ/ C)
C is un-myelinated; Aα, Aβ, Aδ are myelinated
125
Which amide anesthetic has the highest cardiac toxicity? (lidocaine/ mepivacaine/ bupivacaine/ ropivacaine)
Bupivacaine
126
Which is least potent and has the largest therapeutic index? (lidocaine/ mepivacaine/ bupivacaine/ ropivacaine)
Ropivacaine
127
Which has more allergic reaction? (Ester anesthetics/ Amide anesthetics)
Ester anesthetics
128
What are the three families of endogenous opioids?
1. enkephalins2. endorphines3. dynorphins
129
What are the four major opioid receptor types?
1. MOR, mu opioid receptor 2. DOR, delta 3. KOR, kappa 4. NOR, N/OFQ opioid receptor
130
Agonists of opioid receptors inhibit release of _______
substance P
131
most opioid analgesics work on the (MOR/ DOR/ KOR/ NOR) opioid receptor
Mu, MOR
132
Opioids cause (mydriasis/ miosis)
miosis, mimics parasympathetics
133
Opioids cause (urination/ urinary retention)
urinary retention
134
Opioids cause (vasoconstriction/ vasodilation)
vasodilation
135
most opioids are excreted by conjugation with ________
glucuronide
136
10% of inactive codeine is converted to active morphine by CYP___
2D6
137
Can be prescribed as a transdermal patch, strong opioid (Morphine/ Codeine/ Tramadol/ Fentanyl/ Methadone/ Oxycodone)
Fentanyl
138
Extended duration opioid, 90% bound to plasma protiens and accumulates in tissues (Morphine/ Codeine/ Tramadol/ Fentanyl/ Methadone/ Oxycodone)
Methadone
139
Great oral analgesic, commonly abused (Morphine/ Codeine/ Tramadol/ Fentanyl/ Methadone/ Oxycodone)
Oxycodone
140
What are the two opioid antagonists
1. Naloxone 2. Naltrexone
141
Used to treat alcoholism (Naloxone/ Naltrexone)
Naltrexone
142
Opioids are great for breakthrough pain since they only take ___ minutes to work
10-15 minutes, IV admin
143
Oral doses of opioids are typically 2-3x (higher/lower) than parentaral doses
2-3x higher, first pass effect with oral
144
When switching from one opioid to another, doses are usually (increased/ decreased) by 50%
decreased, assume the patient has tolerance to the old opioid
145
opioid (lower/raise) seizure threshold
lowers, makes them more common
146
Part of this drug's pain relief comes from preventing 5HT and NE re-uptake (Morphine/ Codeine/ Tramadol/ Fentanyl/ Methadone/ Oxycodone)
Tramadol
147
Best for chronic pain in heroin users (Morphine/ Codeine/ Tramadol/ Fentanyl/ Methadone/ Oxycodone)
methadone
148
Percocet is acetaminophen plus ______ (Morphine/ Codeine/ Tramadol/ Fentanyl/ Methadone/ Oxycodone)
oxycodone
149
To treat diarhhea, use imodium, _______ or lomotin, _______
Imodium is Loperamide; Lomotin is Diphenoxylate
150
In the case of opioid overdose, treat with (Morphine/ Codeine/ Methadone/ Oxycodone/Naloxone/ Naltrexone)
Naloxone, opioid antagonist
151
Which opioids cause urticaria by directly causeing mast cell degranulation (Morphine/ Codeine/ Methadone/ hydromorphone/ Oxycodone/Naloxone/ Naltrexone)
morphine and hydromorphone
152
whenever you prescribe an opioid for long term pain mnagement, you should also prescribe a ________
laxative
153
MS occurs more frequently (near/ away from) the equator
more frequent distant from the equator
154
The most commomly used drugs for MS are ________
corticosteriods
155
_______ is treatment for for MS and other autoimmune DZ, removes the circulating antibodies that are thought to be active in these diseases.
plasmapheresis
156
The 3 second line oral agents for MS are:
1. Fingolimod 2. Teriflunomide 3. Dimethyl fumarate
157
What are the potential actions of the INF therapies for MS
1. inhibit t-cell activation 2. cytokine shift from Th1 to Th23. inhibit lymphocte migration to CNS4. apoptosis auto-reactive T-cells 5. antiviral effect
158
MS treatment: Mixture of Amino Acids, causes T-cell apoptosis, induces anti-inflammatory cytokine shift from Th1 to Th2 (IFN/ Fingolimod/ Teriflunomide/ Dimethyl fumarate/ Glatiramer acetate/ Natalizumab)
Glatiramer acetate
159
The best MS IFN therapy is (Avonex/ Rebif/ Betaseron/ Extavia)
Rebif = IFN-beta-1a
160
For MS, binds VLA-4 on the surface of leukocytes and inhibits their migration (IFN/ Fingolimod/ Teriflunomide/ Dimethyl fumarate/ Glatiramer acetate/ Natalizumab)
Natalizumab
161
Which MS treatment carries an increased risk for infection with JC virus? (IFN/ Fingolimod/ Teriflunomide/ Dimethyl fumarate/ Glatiramer acetate/ Natalizumab)
Natalizumab
162
MS treatment, Prodrug; sequesters circulating lymphocytes in secondary lymphoid organs by inducing internalization of receptors on lymphocytes (IFN/ Fingolimod/ Teriflunomide/ Dimethyl fumarate/ Glatiramer acetate/ Natalizumab)
Fingolimod
163
MS treatment, can cause heart block, bradycardia and macular edema (IFN/ Fingolimod/ Teriflunomide/ Dimethyl fumarate/ Glatiramer acetate/ Natalizumab)
Fingolimod
164
MS treatment, selective DHODH inhibitor (IFN/ Fingolimod/ Teriflunomide/ Dimethyl fumarate/ Glatiramer acetate/ Natalizumab)
Teriflunomide
165
MS treatment, can cause liver damage and teratogenicity, avoid in young women (IFN/ Fingolimod/ Teriflunomide/ Dimethyl fumarate/ Glatiramer acetate/ Natalizumab)
Teriflunomide
166
MS treatment, induces Nrf2 pathway for antioxdant production, protects oligodendrocytes, some Th1 -> Th2 shift (IFN/ Fingolimod/ Teriflunomide/ Dimethyl fumarate/ Glatiramer acetate/ Natalizumab)
Dimethyl fumarate
167
Which AD drug is an AChE inhibitor (Tacrine/ Donepezil/ Rivastigmine/ Galantamine/ Memantine)
Tacrine, Donepezil, Rivastigmine, Galantamine
168
Which AD drug is a NDMA antagonist for severe alzheimers? (Tacrine/ Donepezil/ Rivastigmine/ Galantamine/ Memantine)
Memantine
169
Which AD drug can be given as a patch and has the least side effects? (Tacrine/ Donepezil/ Rivastigmine/ Galantamine/ Memantine)
Rivastigmine
170
which second gen antipsychotic causes aganulocytosis? (Clonzapine/ Olanzapine/ Risperidone/ Aripirazol)
Clonzapine
171
Used to treat migraine, stimulates presynaptic 5-HT1d receptors, inhibiting vasodilation and inflammation of the dura
Sumatriptan
172
Inhibits re-uptake of NE and DA, nicotinic antagonist, used for smoking cessation
Bupropion
173
An anxiolytic without sedation, 5-HT1a partial receptor agonsit, good for GAD
Buspirone
174
Which get blocked last with a local anesthetic?
First: Aδ, Aβ , Aα, C, last
175
What is the premier drug for prevention of chronic tension type headache?
Amitriptyline
176
A side effect of daily use of analgesics (like ibuprofen) is ____.
Rebound migraines
177
What is the quickest acting and most effective medication for prevention of cluster headaches?
prednisone
178
What is the FDA approved tx for prevention of migraine headaches?
propranolol (SSRIs are often used, but not FDA approved)
179
What are the premier migraine abortive drugs?
Triptans
180
Which one can be found as an injectable: ergotamine or dihydroergotamine?
dihydroergotamine (ergotamine comes inroad tablet or suppository; DHE comes in IM and IV)
181
How do vigabatrine and tiagabine work?
vig: GABA transaminase binder (slows down breakdown of GABA)tiag: GABA reuptake inhibitor
182
What drugs binds to synaptic vesicle protein 2 resulting in less neurotransmitter release and what is it used for?
levetiracetam; anti-convulsant
183
MS drugs: dacilizumab and alemtuzumab: how do they work?
dac: binds IL-2 and prevents activation of T cells (have to fail two other drugs before going on)alem: binds CD52 receptors on mature lymphocytes (can cause ITP)
184
Name 5 secondary progressive MS treatments (4 immunosupppresants, and 1 that works by broad immune suppression and modulation of B cells, t cells, and macrophages (anthracenedione))
4: CAMM: cylcophosphamide, azathioprine, methotrexate, mycophenolate mofetil1: mitoxantrone
185
How do LSD, mescaline, and psilocybin work?
They are agonists at 5HT2A receptors -- inhibition of Raphe Nuclei firing -- increased sensory input; also are partial dopamine agonists
186
What is the endogenous cannabinoid? Name two synthetic THC compounds
anandamide; dronabinol, nabilone(they all hit CB1, CB2, which are GPCR)
187
What does fomepizole and N-acetylcysteine do?
fom: blocks alcohol dehydrogenase - used for methanol and ethylene glycol poisoning (expensive)N-ac: supplies sulfhydryl groups to glutathione (antioxidant) (acetaminophen OD antidote)
188
What is nalmefene?
An opioid antagonist
