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Central Nervous System Flashcards

1
Q

[Sedative Hypnotics]

acute anxiety attacks, anesthesia induction, preoperative sedation, decrease REM sleep

A

midazolam

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2
Q 
[Sedative Hypnotics]
seizure disorders (status epilepticus), alcohol withdrawal, tranquilizer
A

diazepam

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3
Q

[Sedative Hypnotics]

date-rape drug

A

flunitrazepam

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4
Q

[Sedative Hypnotics]

antidote to benzodiazepine overdose

A

flumazenil

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5
Q

[Sedative Hypnotics]

anesthesia induction, lethal injection, truth serum

A

thiopental

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6
Q

[Sedative Hypnotics]
seizure disorders in children
SE: precipitates porphyria, potent inducer of CYP450

A

phenobarbital

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7
Q

GABA receptor effects
FREnzodiazepines: FREquency
BarbiDURATes: DURATion

A

GABA receptor effects
FREnzodiazepines: FREquency
BarbiDURATes: DURATion

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8
Q

[preferred benzodiazepine]

anticonvulsant maintenance

A

clonazepam

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9
Q

[preferred benzodiazepine]

status epilepticus

A

lorazepam, diazepam

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10
Q

[preferred benzodiazepine]

skeletal muscle relaxation (eg, cerebral palsy)

A

diazepam

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11
Q

[preferred benzodiazepine]

panic disorders, phobias

A

alprazolam, clonazepam

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12
Q

[preferred benzodiazepine]

insomnia

A

estazolam, flurazepam, triazolam

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13
Q

[preferred benzodiazepine]

anesthesia induction

A

midazolam, diazepam

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14
Q

[preferred benzodiazepine]

bipolar disorder

A

clonazepam

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15
Q

[preferred benzodiazepine]

alcohol withdrawal

A

chlordiazepoxide, diazepam

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16
Q

what abnormal sleep pattern results from the use of benzodiazepines?

A

decreased REM sleep

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17
Q

which benzodiazepine has the longest half-life?

A

Chlordiazepoxide

half life: 36-200 hours

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18
Q

which drugs are considered date-rape drugs?

A

“AFG”
Alcohol (most common)
Flunitrazepam (rohypnol)
Gamma-hydroxybutyrate

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19
Q

shortest acting

A

Thiopental

“TAYOpental= TAYO agad”

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20
Q

what is the most catastrophic symptom of sedative-hypnotic withdrawal?

A

rebound suicide

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21
Q

mnemonic:
“zzzzzzzzzzzz (sleep)”
zolpidem, zaleplon = zleep disorders

A

mnemonic:
“zzzzzzzzzzzz (sleep)”
zolpidem, zaleplon = zleep disorders

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22
Q

mnemonic:
“Busiperone for Busy people”
(always anxious)
BuSPirone like your BenzodiaSePine

A

mnemonic:
“Busiperone for Busy people”
(always anxious)
BuSPirone like your BenzodiaSePine

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23
Q 
SEDATIVE-HYPONOTIC POISONING
"Hot Hot Hot DeCisioN!"
Hypothermia
Hypotension
Hypoactive BS
Disinhibition
Coma
Nystagmus
A 
SEDATIVE-HYPONOTIC POISONING
"Hot Hot Hot DeCisioN!"
Hypothermia
Hypotension
Hypoactive BS
Disinhibition
Coma
Nystagmus
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24
Q

[alcohols]
most frequently abused drug,
Wernicke-Korsakoff syndrome in overdose,
Delirium tremens in withdrawal

A

ethanol

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25
Q

[alcohols]

prevention of Wernicke-Korsakoff syndrome

A

thiamine

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26
Q

[alcohols]

treatment of alcohol withdrawal

A

diazepam

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27
Q

[alcohols]
wood alcohol
SE: visual dysfunction due to formaldehyde accumulation

A

methanol

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28
Q

[alcohols]
antifreeze
SE: nephrotoxicity due to oxalic acid accumulation

A

ethylene glycol

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29
Q

[alcohols]

alcohol dehydrogenase inhibitor

A

fomepizole

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30
Q

[alcohols]

aldehyde dehydrogenase inhibitor

A

disulfiram

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31
Q 
DISULFIRAM
"Clara took the Pre-Medical Test in the PM"
Chlorpropamide
cefoPerazone
cefoMandole
cefoTetan
cefoProcarbazine
cefoMetronidazole
A 
DISULFIRAM
"Clara took the Pre-Medical Test in the PM"
Chlorpropamide
cefoPerazone
cefoMandole
cefoTetan
cefoProcarbazine
cefoMetronidazole
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32
Q 
[antiseizure drugs]
status epilepticus,
potent CYP450 inducer,
antiarrhythmic class 1b
SE: gingival hyperplasia, hirsutism, fetal hydantoin syndrome (long upper lip, thin vermillion border)
A

phenytoin

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33
Q

[antiseizure drugs]
potent CYP450 inducer,
DOC for partial seizures and trigeminal neuralgia
SE: blood dyscrasias

A

carbamazepines

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34
Q

[antiseizure drugs]
potent CYP450 inhibitor,
DOC for GTC and myoclonic seizures
SE: teratogen (spina bifida)

A

valproic acid

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35
Q

[antiseizure drugs]
potent CYP450 inducer,
DOC for seizures in children and pregnant women
SE: porphyria

A

phenobarbital

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36
Q

[antiseizure drugs]
DOC for absence seizures
SE: behavioral changes

A

ethosuximide (Ca channels)

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37
Q

[antiseizure drugs]
DOC for status epilepticus
SE: anterograde amnesia

A

diazepam

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38
Q

[antiseizure drugs]
treatment of neuropathic pain
SE: nystagmus, tremor

A

gabapentin

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39
Q

[antiseizure drugs]
anti-seizure for pregnant women
SE: Stevens Johnson Syndrome

A

lamotrigine

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40
Q

DOC for generalized tonic clonic seizures

A

DOC:
valproic acid
phenytoin
carbamazepine

alternative drugs:
phenobarbital
lamotrigine
topiramate

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41
Q

DOC for partial seizures

A

DOC:
carbamazepine
lamotrigine
phenytoin

alternative drugs:
felbamate
phenobarbital
topiramate
valproic acid
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42
Q

DOC for absence seizures

A

DOC:
ethosuzimide
valproic acid

alternative drugs:
lamotrigine
levetiracetam
zonisamide
clonazepam
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43
Q

DOC for myoclonic and atypical absence syndromes

A

DOC:
valproic acid

alternative drugs:
clonazepam
levetiracetam
topiramate
zonisamide
felbamate
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44
Q

DOC for status epilepticus

A

lorazepam
diazepam
phenytoin
phenobarbital

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45
Q

DOC for bipolar affective disorders

A

valproic acid (first-line for mania)
carbamazepine
lamotrigine

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46
Q

DOC for trigeminal neuralgia

A

carbamazepine (DOC)

oxcarbazepine

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47
Q

DOC for neuropathic pain (postherpetic neuralgia)

A

gabapentin

pregabalin

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48
Q

DOC for migraine

A

gabapentin
phenytoin
topiramate

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49
Q

[general anesthetics]
highest MAC (lowest potency)
SE: euphoria

A

nitrous oxide (least cardiotoxic)

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50
Q

[general anesthetics]
facilitated GABA-mediated inhibition, block NMDA and ACh-N receptor
SE: pulmonary irritant

A

desflurane

does not cause bronchodilation

51
Q

[general anesthetics]
facilitated GABA-mediated inhibition, block NMDA and ACh-N receptor
SE: postoperative hepatitis, malignant hyperthermia

A

halothane (if given with succinylcholine)

52
Q

[general anesthetics]
lowest MAC (highest potency),
slowest induction and recovery
SE: renal insufficiency

A

methoxyflurane

53
Q

[general anesthetics]
dissociative anesthesia, NMDA receptor blocker
SE: emergence delirium

54
Q

[general anesthetics]
anesthesia for patients with limited cardiopulmonary reserve
SE: adrenal suppression

55
Q

[general anesthetics]
prolonged sedation,
“milk of amnesia”
SE: hypotension

56
Q

[local anesthesia]

how will you distinguish whether local anesthetics are esters or amides?

A

ESTERS have only 1 i in their names.
tetracaine
procaine
benzocaine

AMIDES have 2 i’s in their names.
bupivacaine
ropivacaine
lidocaine

57
Q

[local anesthesia]

which local anesthetics have the shortest and longest half-lives?

A

PROCAINE = shortest half-life (1-2 mins)
A PRO finishes the race fastest.

ROPIVACAINE = longest half-life (4.2 hrs)
at the end of the long ROPe.

58
Q

[local anesthesia]

why should we not inject LIDOCAINE into abscesses?

A

*don’t inject lidocaine into abscess
*won’t work due to acidic environment
(below pKa = protonated form predominates, so it can’t penetrate tissues)

59
Q

[local anesthesia]

what is the toxic dose of lidocaine?

A

5mg/kg for any drug or solution, 1%=10mg/mL

60
Q

[skeletal muscle relaxants]
prototype nondepolarizing neuromuscular blocker
SE: orthostatic hypotension

A

tubocurarine

61
Q

[skeletal muscle relaxants]
undergoes Hoffman elimination
SE: bronchospasm, most frequently used non-depolarizing neuromuscular blocker

A

atracurium

62
Q

[skeletal muscle relaxants]
lethal injection, strychnine poisoning
SE: hypertension

A

pancuronium

KCl, thiopental, pancuronium

63
Q

[skeletal muscle relaxants]
reversal agent for nondepolarizing neuromuscular blockade
SE: miosis, salivation, diarrhea

A

neostigmine

64
Q

[skeletal muscle relaxants]
depolarizing neuromuscular blocker
SE: malignant hyperthermia, affected by pseudocholinesterase activity

A

succinylcholine

65
Q

[anti-parkinsonism drugs]

DOC for Parkinson disease

A

levodopa + carbidopa

66
Q

[anti-parkinsonism drugs]
treatment of hyperprolactinemia
SE: erythromelalgia, pulmonary fibrosis

A

bromocriptine

67
Q

[anti-parkinsonism drugs]
adjunctive drug for wearing-off phenomena
SE: red-orange urine

A

entocarpine

68
Q

[anti-parkinsonism drugs]

cause fulminant hepatitis

A

tolcarpone

69
Q

[anti-parkinsonism drugs]
anti-parkinsonism drug with antiviral properties
SE: livedo reticularis, cerebellar ataxia

A

amantadine

70
Q

[anti-parkinsonism drugs]

improves tremor and rigidity but has no effect of bradykinesia, atropine-like side effects

A

benztropine, biperiden

71
Q

what are the primary signs of Parkinson disease?

A 
Parkinson Disease
"It's a TRAP!"
tremor
rigidity
akinesia
postural instability
72
Q

What drugs ca cause livedo reticularis?

A 
livedo reticularis
"A man reads FHM and GQ!"
amantadine
hydroxyurea
minocycline
gemcitabine
quinidine
73
Q

[anti-psychotic drugs]
prototype typical antipsychotic; may also block alpha and histamine receptor
SE: corneal/lens deposits, failure of ejaculation

A

chlorpromazine, promethazine

74
Q

[anti-psychotic drugs]
treatment of floridly psychotic patients
SE: major EPS (neuroleptic malignant syndrome)

A

haloperidol

75
Q

[anti-psychotic drugs]
DOC for suicidal and refractory schizophrenics
SE: agranulocytosis

76
Q

[anti-psychotic drugs]
2nd generation (5HT»>D2)
SE: obesity, hyperglycemia

A

Olanzapine

77
Q

[anti-psychotic drugs]
2nd generation (5HT»>D2)
SEL priapism, hypnagogic hallucinations

A

quetiapine

78
Q

[anti-psychotic drugs]
for schizophrenia in the youth and elderly
SE: marked hyperprolactinemia, insomnia, gynecomastia

A

risperidone

79
Q

[anti-psychotic drugs]
for mania and SIADH
SE: nephrogenic diabetes insipidus, teratogen (Ebstein’s anomaly)

80
Q

what are the features of neuroleptic malignant syndrome?

A 
neuroleptic malignant syndrome
"fever"
fever
encephalopathy
vitals unstable
elevated CPK
rigidity
81
Q

[anti-depressants]
tricyclic antidepressant,
treatment of eneuresis
SE: atropine-like effects, cardiotoxicity

A

imipramine

82
Q

[anti-depressants]
selective serotonin reuptake inhibitor (SSRI),
first lime drug for major depressive disorder
SE: erectile dysfunction, serotonin syndrome, CYP450 inhibitor

A

fluoxetine

83
Q

[anti-depressants]
serotonin-norepinephrine reuptake inhibitor (SNRI)
SE: hypertension, CYP450 inhibitor

A

venlafaxine

84
Q

[anti-depressants]
serotonin antagonist
SE: priapism

85
Q

[anti-depressants]
tetracyclic antidepressant, smoking cessation
SE: weight loss, priapism, seizures

86
Q

[anti-depressants]
monoamine oxidase inhibitor
SE: hypertensive crisis when taken with tyramine (cheese, wine), serotonine syndrome

A

phenelzine

87
Q

what are the features of tricyclic antidepressant overdose?

A

3Cs of TCA overdose
coma
convulsions
cardiotoxicity

88
Q

what drugs can cause erectile dysfunction?

A 
erectile dysfunction
"SOREE, Sore Penis Fucked Hard!"
SSRIs
Opiates
Risperidone
Ethanol
Estrogens
Spironolactone
Propranolol
Finasteride
Hydrochlorothiazide
89
Q

what drugs can cause priapism?

A 
PRIAPISM
"Tig-a Si Pitoy Qu, BAW!"
trazodone
sildenafil
papaverine
quetiapine
bupropion
alprostadil
warfarin
90
Q

symptoms of serotonin syndrome

A 
serotonin syndrome
"FAT CHD"
fever
agitation
tremor
clonus
hyperreflexia
diaphoresis
91
Q

symptoms of malignant hyperthermia

A 
malignant hyperthermia
"FCHART"
fever
clonus
hypertension
acidosis
rhabdomyolysis
trismus
92
Q

first line treatment for malignant hyperthermia (life threatening condition characterized by massive Ca release)

A

dantrolene

93
Q

first line treatment for neuroleptic malignant syndrome

A

diphenhydramine

94
Q

first line treatment for serotonin syndrome

A

sedation, paralysis, intubation and ventilation

95
Q 
[opioids]
prototype opioid (full agonist)
SSE: miosis, respiratory depression, constipation
96
Q

[opioids]

severe pain, breakthrough cancer pain, available in lollipop form or transdermal patch

97
Q

[opioids]
opioid of choice for acute pancreatitis and biliary colic, does not cause miosis
SE: seizures
Can cause HYPERTENSIVE CRISIS when used with Tyramine

A

meperidine

98
Q

[opioids]

replacement therapy for opioid dependence

99
Q

[opioids]

cough suppression

A

dextromethorpan, codeine

100
Q

[opioids]

balanced anesthesia, frequently abused by healthcare professionals

A

nalbuphine

101
Q

[opioids]

antidote to opioid overdose

102
Q

[opioids]

treatment of opioid and alcohol dependence

A

naltrexone

103
Q

which opioids have the shortest and longest half-lives?

A 
REMIFENTANIL= shortest half-life (3-4 mins)
BUPRENORPHINE = longest half-life (4-8 hrs)
104
Q

what is the triad of opioid overdose?

A 
Opioid overdose
"PCR"
pupillary constriction
comatose state
respiratory depression
105
Q

[drugs of abuse]

euphoria, sleeplessness, self-confidence

A

amphetamine

106
Q

[drugs of abuse]

sexual enhancement, hyponatremia

A

MDMA (ecstasy)

107
Q

[drugs of abuse]

mydriasis, crack lung, teratogen (cystic cortical lesions)

108
Q

[drugs of abuse]

most dangerous hallucinogen, psychotomimetic effects, nystagmus

A

phencyclidine

109
Q 
[drugs of abuse]
psychedelic effects (out of body experience), mind raveling effects, bad trips
110
Q

[drugs of abuse]

dream-like state, red conjunctiva, tachycardia, dry mouth

111
Q

[sedative hypnotics]

Longest acting benzodiazepines (t1/2: 36-200 hrs)

A

Chlordiazepixide

112
Q

[sedative hypnotics]

Most catastrophic symptom of sedative-hypnotic withdrawal

A

Rebound suicide

113
Q

Drugs used in lethal injection

A

“PaPaTay”
Pancuronium (100mg)
Potassium Chloride (100mEq)
Thiopental (5g)

114
Q

Early sign of malignant hyperthermia

A

Trismus (contraction of jaw muscles)

115
Q

Drugs for Huntington Disease

A

Tetrabenzamine/Reserpine

116
Q

MOA: deplete amine transmitters esp Dopa from nerve endings by reversibly inhibiting VMAT2, resulting in decreased uptake of monoamines
Uses: reduces chorea severity
SE: hypotension, sedation, depression, diarrhea

A

Tetrabenzamine/Reserpine

Drugs for Huntington disease

117
Q

Drugs for Tourette Syndrome

A

Haloperidol/ Pimozide

118
Q

MOA: blocks central D2 receptor
Uses: reduces vocal and motor tic frequency and severity
SE: Parkinsonism, dyakinesia, sedation, blurred vision, dry mouth, visual disturbance, arrhythmia

A

Haloperidol/Pilozide

119
Q

Drugs that cause Livedo Reticularis

A 
“HAM GQ”
Hydroxyurea
Amantadine
Minocycline
Gemcitabine
Quinidine
120
Q

[anti-psychotics]
Only anti-paychotic with Fatal Overdose;
Has strongest autonomic effects
SE: retinal deposits

A

Thioridazine

121
Q

[anti-psychotics]
Least sedating atypical
Uses: MDD, cocaine dependence, autism, schizophrenia, BPD manic phase

A

Arpiprazole

122
Q

Morphine Side Effects

A 
Miosis
Increase ICP
Constipation
Urinary retention
Pruritus
Restlessness
Respiratory depression
Postural hypotension
Addiction liability
123
Q

Anticonvulsant that should not be given intramuscularly because of unpredictable absorption and precipitation of the drug in the muscle

124
Q

Anticonvulsant that act by inhibiting neurotransmission through NMDA receptor antagonism

Pharma Review (15 decks)

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