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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
Side effects of carbamazepine
SIADH causing hyponatremia Hypersensitivity SJS Aplastic anemia Agranulocytosis
26
Doc trigeminal neuralgia
Carbamazepine
27
Doc for partial seizure
Carbamazepine
28
Lamotrigine bolus dose can cause
SJS
29
Side effect of topiramate in the eye
Secondary angle closure glaucoma (due to choroidal edema pushes lens forward)
30
Most preferred anti epileptic for migrane prophylaxis
Topiramate (Also used for obesity with phentermine)
31
Lacosamida can increase _ tendency
Suicidal (black box warning) Also cause PR prolonging Used for partial seizure
32
Tiagabine MOA and use
Increase GABA at synapse Resistant partial seizure
33
Vigabatrin inhibits
GABA transaminase Can cause irreversible visual fieled defect
34
Treatment of infantile spasm
Vigabatrin (tuberous sclerosis +) Acth/ steroids(no tuberous sclerosis)
35
Pregabalin and gabapentin MOA
Inhibit a subunit of presynaptic calcium channels to inhibit glutamate release
36
SV2 A inhibitor
Levetiracetam Also N type calcium channel blocker Saftest anti epileptic in pregnancy
37
Treatment alzheimer disease
Reversible cholinesterase inhibitors Donepezil Galantamine Transdermal rivastigmine NMDA antagonist- memantine
38
Disease modifying agent in alzhemiers
Aducanumab Monoclonal IgG1 abtibody Reduces amyloid plaques in brain
39
Doc for acute mania
Atypical antipsychotics Combined with BZD Alternatives- valproate , carbamazepine DOC for **prophylaxis** of mania and treatment of bipolar disorder is Lithium
40
Lithium MOA
Inhibits Gq receptor and inositol moniphosphate to decrease BNDF Also inhibit GSK3 to increase beta catenin pathway to increase BNDF Hence mood stabilizer
41
Side effects of lithium
Fine tremors Hypercalcemia Acne Obesity Ebstein anomaly in fetus, floppy infant(hypotonia) Worsen psoriasis
42
Toxicity of lithium
Nausea vomit Profuse diarrhea Ataxia Dysarthria Coarse tremors Arrhythmia
43
Drugs that inhibit serotonin reuptake
Ssri Snri TCA
44
TCA has action on multiple receptors like
H1 M 5HT ALFA1
45
Selective norepinephrine reuptake inhibitors
Atomoxetine, viloxazine Used in ADHD, not used in depression
46
Typical antidepressants
MOA Inhibitors TCA SSRI SNRI take 2 weeks to act Increase serotonin and NE
47
Cheese reaction is seen with
MAO inhibitors When taken with cheese block tyramine metabolism, increase NE, causing HTN crisis DOC phentolamine iv
48
MOA inhibitors can cause _ when consumed with other durgs like
Serotonin syndrome Ssri, snri, tca, opioids
49
Drugs for treatment of serotonin syndrome
Cyproheptadine or chlorpromazine
50
Most lethal TCA on overdosing
Desipramine Use- cocaine dependence
51
TCA for nocturnal enuresis
Imipramine
52
Amoxapine, D2 blocker used in
Psychotic depression Similar drug is loxapine
53
DOC For TCA toxicity
Sodium bicarbonate Cause of death is arrhythmia is tca toxicity due to sodium channel blockade High risk for suicidal death
54
Venlafaxine, duolexetine, milnacipran are
SNRIs Venlafaxine is shortest acting
55
Duloxetine js used for
PMS, fibromyalgia, neuropathic pain, stress incontinence Milnacipran also used in fibromyalgia
56
SSRI are DOC for
Depression PMS Neurosis- OCD, phobia, GAD, anorexia, bulemia
57
Longest acting SSRI
Fluoxetine Once a week formulation, no withdrawal symptoms
58
Depression along with insomnia give
Paroxetine as it causes sedation Side effect- erectile dysfunction ,Teratogenic Shortest acting SSRI
59
Vilazodone is SSRI plus
5HT1a agonist Used in resistant depression
60
Side effects of SSRI SNRI
Nausea vomiting Loose stools Erectile dysfunction, anorgasmia, delayed ejaculation Anxiety(transiet for 2 to 6 weeks), vibd dreams akathasia Increase risk of bleeding
61
Trazodone acts as _ and used for_
5HT2 blocker Depression and erectile dysfunction Side effects- PRIAPISM, sedation
62
Mirtazapine and mianserin are together called as
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
Bupropion increases _ and _
NE and dopamine Used in ADHD, obesity(decreases appetite) Depression SMOKING DEPENDENCE peripheral neuropathy Side effects- anxiety++
64
DOC for restless leg syndrome
Gabapentin
65
DOC for drug induced parkinsonism
Benzhexol aka trihexiphenydil
66
Ambenonium is used in
Myasthenia gravis(anti cholinestrase)

Pharma (6 decks)

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