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Pharma > CNS > Flashcards

CNS Flashcards

1
Q

Treatment for rheumatic chorea
Mild
Severe
Refractory

A

-Calm environment
-Valproate, haloperidol carbamazepine
-Steroids

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2
Q

Dose of epinephrine for anaphylaxis

A

1:1000 , 0.5ml IM

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3
Q

Side effects of levo dopa due to action on D1

A

Hypotension

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4
Q

Side effects of levo dopa due to action on D2

A

Nausea , vomiting

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5
Q

Side effects of levo dopa due to action on limbic system

A

Psychosis
DOC- pimavanserin

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6
Q

Side effects of levo dopa due to action on striatum

A

Dyskinesia
Doc- amantidine, levetiracetam

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7
Q

Contraindications of levodopa

A

Psychosis
Closed angle glaucoma

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8
Q

Opiod used in non secretory diarrhoea like IBS by reducing motility

A

Loperamide(do not cross BBB)
Diphenoxylate and difenoxin(can cross bbb so combined with atropine to prevent abuse)

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9
Q

Contraindications of morphine

A

Head trauma
Bronchial asthma

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10
Q

Activationof codeine is by

A

CYP2D6 (10%)

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11
Q

DOC for postop or post anaesthesia chills/chills due to monoclonal antibodies/amphotericin B

A

Pethidine

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12
Q

Normeperidine (derivative of pethidine) is neurotoxic and can cause ___

A

Seizures

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13
Q

Normeperidine is MAO inhibitor amd causes risk of

A

Serotonin syndrome

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14
Q

DOC for opoid dependence

A

Methadone/buprenorphine
During tapering if symptoms of withdrawal occur, give beta blockers or clonidine

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15
Q

QT prolongation is caused due to which opoid drug

A

Methadone

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16
Q

Drugs contraindicated with MAO inhibitor

A

Tramadol
Pethidine

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17
Q

Pentazocine is partial agonist at MU receptor and full agonist at kappa. Contraindicated in

A

Myocardial infarction

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18
Q

Buprenorphine is C/I in labor pain because

A

Naloxone cannit reverse neonatal depression caused by it

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19
Q

Tolerance develops to all effects of opoid except

A

Miosis
Constipation
Convulsions

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20
Q

Prevent relapse of opioid dependence

A

Naltrexone

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21
Q

Most teratogenic anti epileptic

A

Valproate
Neural tube defects

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22
Q

Doc for liver toxicity due to valproate

A

Carnitine

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23
Q

Side effects of phenytoin

A

Hyperplasia of gums
Hirsutism
Hyperglycemia
Lymphadenopathy
Decreased vitamind D
Diplopia ataxia nystagmus- signs of acute toxicity
Teratogenic- cleft lip palate
Induces vitamin K metabolism-2,7,9,10 factor deficiency
Megaloblastic anemia ,neutropenia (folic acid absorption is less)
Purple glove syndrome
Tissue necrosis if extravasation occurs

Precipitates with glucose so use with Normal saline

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24
Q

Valproate is enzyme _
And phenytoin is enzyme _

A

Inhibitor
Inducer

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25
Q

Side effects of carbamazepine

A

SIADH causing hyponatremia
Hypersensitivity
SJS
Aplastic anemia
Agranulocytosis

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26
Q

Doc trigeminal neuralgia

A

Carbamazepine

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27
Q

Doc for partial seizure

A

Carbamazepine

28
Q

Lamotrigine bolus dose can cause

A

SJS

29
Q

Side effect of topiramate in the eye

A

Secondary angle closure glaucoma (due to choroidal edema pushes lens forward)

30
Q

Most preferred anti epileptic for migrane prophylaxis

A

Topiramate
(Also used for obesity with phentermine)

31
Q

Lacosamida can increase _ tendency

A

Suicidal (black box warning)
Also cause PR prolonging
Used for partial seizure

32
Q

Tiagabine MOA and use

A

Increase GABA at synapse
Resistant partial seizure

33
Q

Vigabatrin inhibits

A

GABA transaminase
Can cause irreversible visual fieled defect

34
Q

Treatment of infantile spasm

A

Vigabatrin (tuberous sclerosis +)
Acth/ steroids(no tuberous sclerosis)

35
Q

Pregabalin and gabapentin MOA

A

Inhibit a subunit of presynaptic calcium channels to inhibit glutamate release

36
Q

SV2 A inhibitor

A

Levetiracetam
Also N type calcium channel blocker
Saftest anti epileptic in pregnancy

37
Q

Treatment alzheimer disease

A

Reversible cholinesterase inhibitors
Donepezil
Galantamine
Transdermal rivastigmine
NMDA antagonist- memantine

38
Q

Disease modifying agent in alzhemiers

A

Aducanumab
Monoclonal IgG1 abtibody
Reduces amyloid plaques in brain

39
Q

Doc for acute mania

A

Atypical antipsychotics
Combined with BZD
Alternatives- valproate , carbamazepine
DOC for prophylaxis of mania and treatment of bipolar disorder is Lithium

40
Q

Lithium MOA

A

Inhibits Gq receptor and inositol moniphosphate to decrease BNDF
Also inhibit GSK3 to increase beta catenin pathway to increase BNDF
Hence mood stabilizer

41
Q

Side effects of lithium

A

Fine tremors
Hypercalcemia
Acne
Obesity
Ebstein anomaly in fetus, floppy infant(hypotonia)
Worsen psoriasis

42
Q

Toxicity of lithium

A

Nausea vomit
Profuse diarrhea
Ataxia
Dysarthria
Coarse tremors
Arrhythmia

43
Q

Drugs that inhibit serotonin reuptake

A

Ssri
Snri
TCA

44
Q

TCA has action on multiple receptors like

A

H1
M
5HT
ALFA1

45
Q

Selective norepinephrine reuptake inhibitors

A

Atomoxetine, viloxazine
Used in ADHD, not used in depression

46
Q

Typical antidepressants

A

MOA Inhibitors
TCA
SSRI
SNRI take 2 weeks to act
Increase serotonin and NE

47
Q

Cheese reaction is seen with

A

MAO inhibitors
When taken with cheese block tyramine metabolism, increase NE, causing HTN crisis
DOC phentolamine iv

48
Q

MOA inhibitors can cause _ when consumed with other durgs like

A

Serotonin syndrome
Ssri, snri, tca, opioids

49
Q

Drugs for treatment of serotonin syndrome

A

Cyproheptadine or chlorpromazine

50
Q

Most lethal TCA on overdosing

A

Desipramine
Use- cocaine dependence

51
Q

TCA for nocturnal enuresis

A

Imipramine

52
Q

Amoxapine, D2 blocker used in

A

Psychotic depression
Similar drug is loxapine

53
Q

DOC For TCA toxicity

A

Sodium bicarbonate
Cause of death is arrhythmia is tca toxicity due to sodium channel blockade
High risk for suicidal death

54
Q

Venlafaxine, duolexetine, milnacipran are

A

SNRIs
Venlafaxine is shortest acting

55
Q

Duloxetine js used for

A

PMS, fibromyalgia, neuropathic pain, stress incontinence
Milnacipran also used in fibromyalgia

56
Q

SSRI are DOC for

A

Depression
PMS
Neurosis- OCD, phobia, GAD, anorexia, bulemia

57
Q

Longest acting SSRI

A

Fluoxetine
Once a week formulation, no withdrawal symptoms

58
Q

Depression along with insomnia give

A

Paroxetine as it causes sedation
Side effect- erectile dysfunction ,Teratogenic
Shortest acting SSRI

59
Q

Vilazodone is SSRI plus

A

5HT1a agonist
Used in resistant depression

60
Q

Side effects of SSRI SNRI

A

Nausea vomiting
Loose stools
Erectile dysfunction, anorgasmia, delayed ejaculation
Anxiety(transiet for 2 to 6 weeks), vibd dreams
akathasia
Increase risk of bleeding

61
Q

Trazodone acts as _ and used for_

A

5HT2 blocker
Depression and erectile dysfunction
Side effects- PRIAPISM, sedation

62
Q

Mirtazapine and mianserin are together called as

A

NASSA noradrenergic specific serotonergic antidepressant drugs)
5HT3 block- antiemetic
Alfa 2 and 5HT2 block- antidepressant
H1 block- sedation
Hence used in depression with insomnia
Mirtazapine can cause agramulocytosis

63
Q

Bupropion increases _ and _

A

NE and dopamine
Used in ADHD, obesity(decreases appetite)
Depression
SMOKING DEPENDENCE
peripheral neuropathy
Side effects- anxiety++

64
Q

DOC for restless leg syndrome

A

Gabapentin

65
Q

DOC for drug induced parkinsonism

A

Benzhexol aka trihexiphenydil

66
Q

Ambenonium is used in

A

Myasthenia gravis(anti cholinestrase)

Pharma (6 decks)

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