CNS Flashcards
Drugs c/ i in myotonic seizures
Phenytoin and carbamazepine
Minimum duration of theory of seizures
2 years
, min Duration of therapy of seizure is 2 years except in
JME(MS) and stroke induced seizure. - lifelong therapy
Valproate blocks which enzyme?
Histone deacetylase
Lennox gastaut syndrome
Valproate [ mixed seizure syndrome]
Dravet syndrome
Valproate
Rapid cyclers (bipolar disorder)
Valproate
Rheumatic chorea
Valproate
Most teratogenic drug in CNS
Valproate
S/e valproate
Alopecia, liver toxicity, hyperammoremia, pancreatitis, obesity, rash, tremor, teratogenic
Purple glove syndrome is seen with
Phenytoin
Signs of acute toxicity of antiepileptics / requirement for dose adjustment
Diplopia, ataxia, nystagmus
Anemia in phenytoin & cause?
Megaloblastic, folic acid def.
Side effects of phenytoin
Hydantoin - mnemonic
Hyperplasia of sums, hirsutism, hyperglycemic, lymphadenopathy, diplopia, ataxia, nystagmus, hypocalcemia, teratogenic, osteomalacia, induce VIT k metabolism , neutropenia
Basic diff between carbamazepine & newer congeners of it?
↓ hypersensitivity,↑ hyponatremia
Aplastic anemia is caused by
Carbamazepine
Agranulaytosis is s/e of which anti epileptic
Carbamazepine
Lamotrigine does not have action on
GABA
Valproate has no action on which neurotransmitter
Glutamate receptors
Mechanism of action of topiramate
Na+ blocker
K+ opener
CA #
# glutamate receptor
Antiepileptic of choice in prophylaxis of migraine
Topiramate
Atypical uses of topiramate
Bipolar disorder, migraine, prophylaxis alcohol dependence, Obesity
BZD antagonist
Flumazenil
GABA antagonist
Bicuculine
Name Z compounds
Zolpidem
Zopiclone
Eszopiclone
Zaleplon
Safest class of BZD in elderly
Class 3
Drugs in Class 1 BZD
Diazepam
Clorazepate
Chlordiepoxide
Quazepam
Flurazepam
Class 2 BZD
Triazolam
Midazolam
Class 3 BZD
Lorazepam
Temazepam
Oxazepam
Estazolam
BZD causing nightmares
Flurazepam
BZD used in muscle relaxation
Diazepam
Benzodiazepine preferred in alcohol dependence
Chlordiazepoxide
Benzodiazepine preferred in alcohol dependence with seizures
Diazepam
Benzodiazepine of abuse
Flunitrazepam
Date rape drug
Flunitrazepam
Tasteless, benzodiazepine
Flunitrazepam
Anterograde amnesia is caused by which class of drugs
Benzodiazepines
Which track class has both GABA mimetic and facilitator effect
Barbiturate
Reason for ultra short acting barbiturates
High lipid solubility causing redistribution
Acute intermittent porphyria is a side-effect of which class of sedatives
Barbiturate
Drug used in treatment of paradoxical seizures
Chloral hydrate
Prodrug of meprobamate
Carisprodol
Dysphoria is Seen due to which opioid receptor
Kappa
Name endogenous opioids, and which receptor they are most potent on
Enkephalin delta
Endorphin meu
Dynorphin kappa
How many times is fentanyl more potent than morphine?
100
Most potent opioid
Sufentanil
Opioid with maximum plasma protein binding
Sufentanil
Shortest and fastest acting opioid
Remifentanil
Remifentanil is metabolised by
Plasmaesterase
Which drug inhibits reuptake of 5HT or norepinephrine?
Tramadol/ Tapentadol
Which opioid should not be used in Mi
Pentazocine
What is the difference between pentazocine and buprenorphine?
Pentazocine is partial agonist at mu receptor and full agonist at Kappa
Buprenorphine is partial agonist at mu and antagonist at kappa
Which drug is partial agonist at mu receptor?
Buprenorphine
Withdrawal symptoms of opioid addiction
WITHDRAWAL (replace W with M)
mydriasis, increase yawning, hyperthermia, hyperventilation, diarrhoea, Rhinorrhea, anxiety, myalgia lacrimation
Drugs used to decrease withdrawal symptoms in opioid addiction
Methadone Buprenorphine
Drug used to prevent relapse in opioid addiction
Naltrexone
Which drugs decrease suicidal tendencies?
Lithium
Clozapine
ECT also
Drugs in ADHD
Atomoxetine, Viloxazine
Selective norepinephrine reuptake inhibitors
Resistant OCD is treated by
Clomipramine
Drug used in nocturnal enuresis
Imipramine
SNRI with withdrawal symptoms
Venlafaxine
SSRI with no withdrawal symptoms
Fluoxetine
Due to longest acting
Most common delayed side effect of SSRI
Erectile dysfunction
Most common side effect of SSRI
Nausea and vomitting
NASSA drugs block which receptors?
Noradrenergic specific serotonergic antidepressant drugs) block 5HT2 and alpha2 receptors
Anti epileptic used in fibromyalgia
Pregabalin
Opioid available as intranasal formulation
Butorphanol
Name mixed antagonists of opioid receptors
Pentazocine
Butorphanol
Buprenorphine
Nalbuphine
Nalorphine
Most toxic antipsychotic
Clozapine
Atypical antipsychotic causing agranulocytosis
Clozapine
Most effective antipsychotic
Clozapine
Antipsychotic causing cataract
Quetiapine
Minimum D2 block antipsychotic
Clozapine
Maximum D2 block antipsychotic
Risperidone/ Iloperidone
QT prolongation max and min by which antipsychotics
Max - Ziprasidone
Min - Sertindole
Antipsychotic which is partial agonist at D2 and 5HT1A Receptors?
Aripiprazole and Bexpiprazole
D2 receptor agonism causes effect on which hormone?
Prolactin - hypoprolactinemia
Only antipsychotic with no action on D2
Pimavanserin
Weight neutral antipsychotics
Aripiprazole Cariprazine Ziprasidone
Most common eps
Akathisia
Earliest EPS
Acute dystonia
Most late EPS
Tardive dyskinesia
Cause of Tardive dyskinesia
Up regulation of D2 receptors
Most lethal EPS
NMS - neuroleptic malignant syndrome
Class of drug which increases bioavailability of levodopa
COMT inhibitors
Which vitamin is contraindicated with administration of levodopa
B6
Drug available as transcranial patch
Rotigotine