CNS Drugs Flashcards
1
Q
List the class and mechanism of Levodopa (L-DOPA) (Dopar)
A
Class: Dopamine precursor;
Mechanism: Oral, absorbed in small bowel, rapidly converted to DA by peripheral AAD
2
Q
List the class and mechanism of Carbidopa (Lodosyn)
A
Class: AAD (aromatic amino acid decarboxylase) inhibitor;
Mechanism: Inhibits peripheral conversion of L-DOPA to dopamine; does not cross BBB
3
Q
List the class and mechanism of Pergolide (Permax)
A
Class: Ergot derivative;
Mechanism: —
4
Q
List the class and mechanism of Bromocriptine (Parlodel)
A
Class: Ergot derivative;
Mechanism: D2 agonist, D1 antagonist
5
Q
List the class and mechanism of Pramipexole (Mirapex)
A
Class: Non-ergot DA receptor agonist;
Mechanism: D2 agonist
6
Q
List the class and mechanism of Ropinorole (Requip)
A
Class: Non-ergot DA receptor agonist;
Mechanism: D2 agonist
7
Q
List the class and mechanism of Rotigotine (Neupro)
A
Class: Non-ergot DA receptor agonist;
Mechanism: D2 agonist
8
Q
List the class and mechanism of Apomorphine (Apokyn)
A
Class: Non-ergot DA receptor agonist;
Mechanism: D2 agonist
9
Q
List the class and mechanism of Entacapone (Comtan)
A
Class: COMT inhibitor;
Mechanism: Prevents breakdown of DA, prolongs half-life of levodopa
10
Q
List the class and mechanism of Tolcapone (Tasmar)
A
Class: COMT inhibitor;
Mechanism: Prevents breakdown of DA, prolongs half-life of levodopa
11
Q
List the class and mechanism of Selegiline (Eldepryl)
A
Class: MAO-B inhibitor;
Mechanism: Prevents breakdown of DA
12
Q
List the class and mechanism of Rasagiline (Azilect)
A
Class: ;
Mechanism:
13
Q
List the class and mechanism of Benztropine (Cogentin)
A
Class: Anticholinergics;
Mechanism: —
14
Q
List the class and mechanism of Biperiden (Akineton)
A
Class: Anticholinergics;
Mechanism: —
15
Q
List the class and mechanism of Trihexyphenidyl (Artane)
A
Class: Anticholinergics;
Mechanism: —
16
Q
List the class and mechanism of Procyclidine (Kemadrin)
A
Class: Anticholinergics;
Mechanism: —
17
Q
List the class and mechanism of Ethopropazine (Parsidol)
A
Class: Anticholinergics;
Mechanism: —
18
Q
List the class and mechanism of Amantadine (Symmetrel)
A
Class: Influenza A anti-viral;
Mechanism: Dopaminergic, anticholinergic, anti-NMDA
19
Q
List the class and mechanism of Deep brain stimulation
A
Class: Surgery;
Mechanism: Hits subthalamic nucleus
20
Q
List the class and mechanism of Tetrabenazine (Xenazine)
A
Class: —;
Mechanism: Dopamine depletion, VMAT2 inhibitor
21
Q
List the class and mechanism of Dantrolene (Dantrium)
A
Class: —;
Mechanism: Muscle relaxant
22
Q
List the class and mechanism of Riluzole (Rilutek)
A
Class: ;
Mechanism: Kaninate and NDMA (Glu receptors) antagonist; may inhibit Na channels and GPCRs
23
Q
List the class and mechanism of Baclofen (Lioresal)
A
Class: ;
Mechanism: GABA-B agonist
24
Q
List the class and mechanism of Tizanidine (Zanaflex)
A
Class: ;
Mechanism: α2 agonist
25
List the class and mechanism of Chlorpromazine (Thorazine)
Class: First Generation Antipsychotic;
Mechanism: Catalepsy (trance, muscle rigidity, lack of voluntary movement)
26
List the class and mechanism of Haloperidol (Haldol)
Class: First Generation Antipsychotic;
Mechanism: Catalepsy (trance, muscle rigidity, lack of voluntary movement)
27
List the class and mechanism of Fluphenazine (Prolixin)
Class: First Generation Antipsychotic;
Mechanism: Catalepsy (trance, muscle rigidity, lack of voluntary movement)
28
List the class and mechanism of Perphenazine (Trilafon)
Class: First Generation Antipsychotic;
Mechanism: Catalepsy (trance, muscle rigidity, lack of voluntary movement)
29
List the class and mechanism of Loxapine (Loxitane)
Class: First Generation Antipsychotic;
Mechanism: Catalepsy (trance, muscle rigidity, lack of voluntary movement)
30
List the class and mechanism of Trifluoperazine (Stelazine)
Class: First Generation Antipsychotic;
Mechanism: Catalepsy (trance, muscle rigidity, lack of voluntary movement)
31
List the class and mechanism of Thioridazine (Mellaril)
Class: First Generation Antipsychotic;
Mechanism: Catalepsy (trance, muscle rigidity, lack of voluntary movement)
32
List the class and mechanism of Thiothixene (Navane)
Class: First Generation Antipsychotic;
Mechanism: Catalepsy (trance, muscle rigidity, lack of voluntary movement)
33
List the class and mechanism of Clozapine (Clozaril)
Class: Second Gen Antipsychotic (tricyclic);
Mechanism: D2 receptor antagonist, 5HT2 receptor antagonist
34
List the class and mechanism of Olanzapine (Zyprexa)
Class: Second Gen Antipsychotic (tricyclic);
Mechanism: D2 receptor antagonist, 5HT2 receptor antagonist
35
List the class and mechanism of Quetiapine (Seroquel)
Class: Second Gen Antipsychotic (tricyclic);
Mechanism: D2 receptor antagonist, 5HT2 receptor antagonist
36
List the class and mechanism of Risperidone (Risperdal)
Class: Second Gen Antipsychotic (non-tricyclic);
Mechanism: D2 receptor antagonist, 5HT2 receptor antagonist
37
List the class and mechanism of Paliperidone (Invega)
Class: Second Gen Antipsychotic (non-tricyclic);
Mechanism: D2 receptor antagonist, 5HT2 receptor antagonist
38
List the class and mechanism of Ziprazidone (Geodon)
Class: Second Gen Antipsychotic (non-tricyclic);
Mechanism: D2 receptor antagonist, 5HT2 receptor antagonist
39
List the class and mechanism of Aripiprazole (Abilify)
Class: Second Gen Antipsychotic (non-tricyclic);
Mechanism: Partial D2 and D3 receptor agonist, partial 5HT1a agonist, 5HT2a antagonist
40
List the class and mechanism of Asenapine
Class: Atypical Antipsychotic;
Mechanism: complicated, but involves D2 antagonism and 5HT partial agonism
41
List the class and mechanism of Lurazidone
Class: Atypical Antipsychotic;
Mechanism: complicated, but involves D2 antagonism and 5HT partial agonism
42
List the class and mechanism of Iloperidone
Class: Atypical Antipsychotic;
Mechanism: complicated, but involves D2 antagonism and 5HT partial agonism
43
List the class and mechanism of Tranylcypromine (Parnate)
Class: MAOI;
Mechanism: Irreversibly inhibit both MAO-A and MAO-B
44
List the class and mechanism of Phenelzine (Nardil)
Class: MAOI;
Mechanism: Irreversibly inhibit both MAO-A and MAO-B
45
List the class and mechanism of Desipramine (Norpramin)
Class: Tricyclic;
Mechanism: Block reuptake of NE or 5-HT at varying potencies and selectivity; also variably block muscarinic, a-adrenergic, dopamine, and histamine receptors
46
List the class and mechanism of Imipramine (Tofranil)
Class: Tricyclic;
Mechanism: Block reuptake of NE or 5-HT at varying potencies and selectivity; also variably block muscarinic, a-adrenergic, dopamine, and histamine receptors
47
List the class and mechanism of Amitriptyline (Elavil)
Class: Tricyclic;
Mechanism: Block reuptake of NE or 5-HT at varying potencies and selectivity; also variably block muscarinic, a-adrenergic, dopamine, and histamine receptors
48
List the class and mechanism of Nortriptyline (Pamelor)
Class: Tricyclic;
Mechanism: Block reuptake of NE or 5-HT at varying potencies and selectivity; also variably block muscarinic, a-adrenergic, dopamine, and histamine receptors
49
List the class and mechanism of Fluoxetine (Prozac)
Class: SSRI;
Mechanism: Inhibit reuptake of 5-HT (and NE to lesser extent)
50
List the class and mechanism of Paroxetine (Paxil)
Class: SSRI;
Mechanism: Inhibit reuptake of 5-HT (and NE to lesser extent)
51
List the class and mechanism of Sertraline (Zoloft)
Class: SSRI;
Mechanism: Inhibit reuptake of 5-HT (and NE to lesser extent)
52
List the class and mechanism of Escitalopram (Lexapro)
Class: SSRI;
Mechanism: Inhibit reuptake of 5-HT (and NE to lesser extent)
53
List the class and mechanism of Citalopram (Celexa)
Class: SSRI;
Mechanism: Inhibit reuptake of 5-HT (and NE to lesser extent)
54
List the class and mechanism of Duloxetine (Cymbalta)
Class: SNRI;
Mechanism: Inhibits reuptake of 5-HT and NE
55
List the class and mechanism of Venlafaxine (Effexor)
Class: SNRI;
Mechanism: Inhibits reuptake of 5-HT and NE
56
List the class and mechanism of Bupropion (Wellbutrin)
Class: Atypical;
Mechanism: Blocks DA and NE reuptake
57
List the class and mechanism of Mirtazapine (Remeron)
Class: Atypical;
Mechanism: 5HT2a antagonists; also inhibit 5HT reuptake
58
List the class and mechanism of Lithium
Class: ---;
Mechanism: Unknown; lithium depletes secondary messengers IP3 and DAG, important in a-adrenergic and muscarinic-cholinergic transmission
59
List the class and mechanism of alcohol / ethanol
Class: ;
Mechanism: GABA-A agonist; binds to α subunit
60
List the class and mechanism of methyl alochol
Class: poison;
Mechanism: metabolized to formaldehyde and formic acid
61
List the class and mechanism of ethylene glycol
Class: poison;
Mechanism: metabolized to oxalic acid
62
List the class and mechanism of isopropyl alcohol
Class: poison;
Mechanism:
63
List the class and mechanism of barbiturates
Class: ;
Mechanism: GABA-A agonist
64
List the class and mechanism of benzos
Class: ;
Mechanism: GABA-A agonist
65
List the class and mechanism of Flunitrazepam
Class: benzodiazepine;
Mechanism: GABA-A agonist
66
List the class and mechanism of anesthetics
Class: ;
Mechanism:
67
List the class and mechanism of inhalants
Class: ;
Mechanism: GABA-A agonist
68
List the class and mechanism of Aliphatic nitrites
Class: inhalant;
Mechanism:
69
List the class and mechanism of Disulfiram (Antabuse)
Class: ;
Mechanism: Inhibits aldehyde dehydrogenase, causing acetaldehyde accumulation
70
List the class and mechanism of Fomepizole (Antizol)
Class: ---;
Mechanism: Blocks alcohol dehydrogenase
71
List the class and mechanism of N-acetylcysteine (Mucomyst)
Class: Antioxidant;
Mechanism: Supplies sulfhydryl groups to glutathione; improves microcirculation, provides anti-inflammatory effect
72
List the class and mechanism of Cocaine
Class: CNS stimulant;
Mechanism: Blocks reuptake of dopamine, norepinephrine, and serotonin
73
List the class and mechanism of Amphetamines (Benzadrine)
Class: ;
Mechanism: Indirect sympathomimetic (release biologic amines from nerve terminals in periphery and in CNS); dopamine most important
74
List the class and mechanism of Methyxanthines
Class: ;
Mechanism: Antagonist at adenosine "purinergic" receptors
75
List the class and mechanism of Theophylline
Class: methyxanthine;
Mechanism: Antagonist at adenosine "purinergic" receptors
76
List the class and mechanism of Nicotine
Class: ;
Mechanism: activates nAChRs on VTA dopamine neurons leading to increased DA release in nucleus accumbens and prefrontal cortex
77
List the class and mechanism of Heroin
Class: opioid;
Mechanism: Mu-opioid receptor agonist
78
List the class and mechanism of Nalmefene (Revex)
Class: Opiod antagonist;
Mechanism: ---
79
List the class and mechanism of LSD
Class: Schedule I Hallucinogen, indole alkyl amine;
Mechanism: Agonist at 5HT2A receptors on Raphe cell body --> inhibition of Raphe Nuclei firing --> increased sensory input; partial dopamine agonist
80
List the class and mechanism of Mescaline
Class: Schedule I Hallucinogen, phenyethylamine ;
Mechanism: Agonist at 5HT2A receptors on Raphe cell body --> inhibition of Raphe Nuclei firing --> increased sensory input; partial dopamine agonist
81
List the class and mechanism of Psilocybin
Class: Schedule I Hallucinogen, indole alkyl amine;
Mechanism: Agonist at 5HT2A receptors on Raphe cell body --> inhibition of Raphe Nuclei firing --> increased sensory input; partial dopamine agonist
82
List the class and mechanism of MPTP
Class: poison, fentanyl derivative;
Mechanism: destroys substantia nigra --> Parkinson's
83
List the class and mechanism of Marijuana (THC)
Class: Schedule I hallucinogen; Cannabinoid;
Mechanism: Hits cannabinoid receptors (CB1, CB2: G-protein coupled receptors)
84
List the class and mechanism of Anandamide
Class: Endogenous cannabinoid;
Mechanism: Hits cannabinoid receptors (CB1, CB2: G-protein coupled receptors)
85
List the class and mechanism of Dronabinol (Marinol)
Class: Schedule III drug; Synthetic THC;
Mechanism: Hits cannabinoid receptors (CB1, CB2: G-protein coupled receptors)
86
List the class and mechanism of Nabilone (Cesamet)
Class: Schedule II drug; Synthetic THC;
Mechanism: Hits cannabinoid receptors (CB1, CB2: G-protein coupled receptors)
87
List the class and mechanism of Phencyclidine (PCP)
Class: Dissociative anesthetic;
Mechanism: Antagonist of ion channel associated with NDMA receptor; agonist at mu opioid receptors
88
List the class and mechanism of MDMA (Ecstasy)
Class: Amphetamine derivative;
Mechanism:
89
List the class and mechanism of Bath salts
Class: Amphetamine / cathinone analog;
Mechanism:
90
List the class and mechanism of Morphine
Class: Opioid;
Mechanism: Mu-opioid receptor agonist
91
List the class and mechanism of Codeine
Class: Opioid;
Mechanism: Mu-opioid receptor agonist (low receptor affinity); demethylated to form morphine (10% of oral ingestion, via CYP2D6)
92
List the class and mechanism of Tramadol (Ultram)
Class: Opioid;
Mechanism: Mu opioid receptor agonist (weak); some NE/5HT uptake inhibition (leading to analgesia); synthetic codeine analog
93
List the class and mechanism of Fentanyl (Duragesic)
Class: Opioid;
Mechanism: Mu-opioid receptor agonist (strong); highly lipid-soluble
94
List the class and mechanism of Methadone (Methadose)
Class: Opioid;
Mechanism: Mu-opioid receptor agonist
95
List the class and mechanism of Oxycodone
Class: Opioid;
Mechanism: Mu-opioid receptor agonist
96
List the class and mechanism of Meperidine (Demerol)
Class: Opioid;
Mechanism: Mu-opioid receptor agonist
97
List the class and mechanism of Propoxyphene (Darvon)
Class: Opioid;
Mechanism: Mu-opioid receptor agonist (weak)
98
List the class and mechanism of Loperamide (Imodium)
Class: Opioid;
Mechanism: Slows peristalsis via opioid receptors in intestine, and possibly decreased GI secretion
99
List the class and mechanism of Diphenoxylate (Lomotil)
Class: Opioid;
Mechanism: Slows peristalsis via opioid receptors in intestine, and possibly decreased GI secretion
100
List the class and mechanism of Naloxone (Narcan)
Class: Opioid antagonist;
Mechanism: Competitive mu-, delta-, and kappa-opioid receptor antagonist
101
List the class and mechanism of Naltrexone (Revia)
Class: Opioid antagonist;
Mechanism: Mu-opioid receptor antagonist
102
List the class and mechanism of Diazepam (Valium)
Class: Benzodiazepine;
Mechanism: GABA-A agonist; binds between a1 and y2 subunits to open Cl- channel and hyperpolarize the cell
103
List the class and mechanism of Chlordiazepoxide (Librium)
Class: Benzodiazepine;
Mechanism: GABA-A agonist; binds between a1 and y2 subunits to open Cl- channel and hyperpolarize the cell
104
List the class and mechanism of Lorazepam (Ativan)
Class: Benzodiazepine;
Mechanism: GABA-A agonist; binds between a1 and y2 subunits to open Cl- channel and hyperpolarize the cell
105
List the class and mechanism of Flurazepam (Dalmane)
Class: Benzodiazepine;
Mechanism: GABA-A agonist; binds between a1 and y2 subunits to open Cl- channel and hyperpolarize the cell
106
List the class and mechanism of Alprazolam (Xanax)
Class: Benzodiazepine;
Mechanism: GABA-A agonist; binds between a1 and y2 subunits to open Cl- channel and hyperpolarize the cell
107
List the class and mechanism of Triazolam (Halcion)
Class: Benzodiazepine;
Mechanism: GABA-A agonist; binds between a1 and y2 subunits to open Cl- channel and hyperpolarize the cell
108
List the class and mechanism of Midazolam (Versed)
Class: Benzodiazepine;
Mechanism: GABA-A agonist; binds between a1 and y2 subunits to open Cl- channel and hyperpolarize the cell
109
List the class and mechanism of Clonazepam
Class: Benzodiazepine;
Mechanism: GABA-A agonist; binds between a1 and y2 subunits to open Cl- channel and hyperpolarize the cell
110
List the class and mechanism of Zolpidem (Ambien)
Class: Non-benzodiazepine receptor agonist;
Mechanism: BDZ-1 selective agonist
111
List the class and mechanism of Flumazenil (Romazicon)
Class: Benzodiazepine antagonist;
Mechanism: Competitive non-selective antagonist
112
List the class and mechanism of Thiopental (Pentothal)
Class: Barbiturate;
Mechanism: GABA-A agonist; binds a or b subunit; highly lipid soluble, fast-on, fast-off
113
List the class and mechanism of Phenobarbitol
Class: Barbiturate;
Mechanism: GABA-A agonist (binds a or b subunit)
114
List the class and mechanism of Buspirone (Buspar)
Class: Non-benzo anxiolytic;
Mechanism: Partial agonist at 5HT1A (not GABA-A)
115
List the class and mechanism of Propanolol
Class: β-blocker;
Mechanism: β-adrenergic receptor antagonist
116
List the class and mechanism of Nitrous Oxide
Class: ---;
Mechanism: NMDA receptor antagonist
117
List the class and mechanism of Isoflurane (Forane)
Class: Volatile anesthetic;
Mechanism: Most potent
118
List the class and mechanism of Desflurane (Suprane)
Class: Volatile anesthetic;
Mechanism: Least soluble, least potent (allows for rapid emergence from anesthesia)
119
List the class and mechanism of Sevoflurane (Ultane)
Class: Volatile anesthetic;
Mechanism: Less soluble, less potent (but not irritating)
120
List the class and mechanism of Methohexital (Brevital)
Class: Barbiturates;
Mechanism: GABA-A receptor binding; produce hypnosis and sedation, but are anti-analgesics
121
List the class and mechanism of Propofol (Diprivan)
Class: Alkylphenol (a fatty acid);
Mechanism: GABA-A receptor agonist, antagonist of NMDA-glutamate receptor; some a2 receptor activity; rapid onset and offset
122
List the class and mechanism of Etomidate (Amidate)
Class: Carboxylated imidazole;
Mechanism: GABA-A receptor agonist (only D-isomer)
123
List the class and mechanism of Ketamine (Ketalar)
Class: Phencyclidine;
Mechanism: NMDA receptor antagonist, kappa opiate agonist; leads to dose-dependent unconsciousness, amnesia, analgesia
124
List the class and mechanism of Dexmedetomidine (Precedex)
Class: a2 adrenergic agonist;
Mechanism: Binds a2a and a2b in locus coeruleus and spinal cord (produces sedation, sympatholysis, and analgesia)
125
List the class and mechanism of Succinylcholine (Anectine)
Class: Depolarizing NMB;
Mechanism: Divalent ACh molecule; attaches to all ACh receptors, overstimulating them (first seen as disorganized muscular contractions (fasiculations), then paralysis)
126
List the class and mechanism of Pancuronium (Pavulon)
Class: Amino steroid non-depolarizing NMB;
Mechanism: Competitive blockade of ACh (no depolarization); vagolytic
127
List the class and mechanism of Vecuronium (Norcuron)
Class: Amino steroid non-depolarizing NMB;
Mechanism: Competitive blockade of ACh (no depolarization)
128
List the class and mechanism of Rocuronium (Zemuron)
Class: Amino steroid non-depolarizing NMB;
Mechanism: Competitive blockade of ACh (no depolarization)
129
List the class and mechanism of Atracurium (Tracrium)
Class: Isoquinoline non-depolarizing NMB;
Mechanism: Competitive blockade of ACh (no depolarization)
130
List the class and mechanism of Cis-atracurium (Nimbex)
Class: Isoquinoline non-depolarizing NMB;
Mechanism: Competitive blockade of ACh (no depolarization)
131
List the class and mechanism of Sugammadex (Bridion)
Class: Selective relaxant binding agent;
Mechanism: Complexes with rocuronium, rendering it inactive; no effect on AChesterase
132
List the class and mechanism of Edrophonium (Enlon)
Class: AChE-I;
Mechanism: ---
133
List the class and mechanism of Neostigmine (Prostigmin)
Class: AChE-I;
Mechanism: ---
134
List the class and mechanism of Pyridostigmine (Mestinon)
Class: AChE-I;
Mechanism: ---
135
List the class and mechanism of Glycopyrrolate (Robinul)
Class: Anti-muscarinic;
Mechanism: ---
136
List the class and mechanism of Ester anesthetic
Class: Ester;
Mechanism: Nonionized form crosses axonal membrane; ionized form (active form) blocks intracellular portion of inactive (refractory) voltage-gated sodium channel
137
List the class and mechanism of Amide anesthetic
Class: Amide;
Mechanism: Nonionized form crosses axonal membrane; ionized form (active form) blocks intracellular portion of inactive (refractory) voltage-gated sodium channel
138
List the class and mechanism of Avonex
Class: IFNβ-1a;
Mechanism: Many, potentially: inhibit T-cell activation, shift from Th1 to Th2, inhibit lymphocyte movement into CNS, anti-proliferative effect, apoptosis of T-cells, anti-viral, IFN-g antagonism
139
List the class and mechanism of Rebif
Class: IFNβ-1a;
Mechanism: Many, potentially: inhibit T-cell activation, shift from Th1 to Th2, inhibit lymphocyte movement into CNS, anti-proliferative effect, apoptosis of T-cells, anti-viral, IFN-g antagonism
140
List the class and mechanism of Betaseron / Betaferon
Class: IFNβ-1b;
Mechanism: Many, potentially: inhibit T-cell activation, shift from Th1 to Th2, inhibit lymphocyte movement into CNS, anti-proliferative effect, apoptosis of T-cells, anti-viral, IFN-g antagonism
141
List the class and mechanism of Extavia
Class: IFNβ-1b;
Mechanism: Many, potentially: inhibit T-cell activation, shift from Th1 to Th2, inhibit lymphocyte movement into CNS, anti-proliferative effect, apoptosis of T-cells, anti-viral, IFN-g antagonism
142
List the class and mechanism of Glatiramer acetate (Copaxone)
Class: Myelin basic protein analog;
Mechanism: Mixture of 4 AAs in myelin basic protein; causes T-cell apoptosis (looks like MBP), induces anti-inflammatory Th2 cells (cytokine shift from Th1), induces Treg with induction of anergy
143
List the class and mechanism of Natalizumab (Tysabri)
Class: Monoclonal antibody;
Mechanism: Binds VLA4 (integrin subunit), inhibiting leukocyte migration across BBB
144
List the class and mechanism of Fingolimod (Gilenya)
Class: Sphingosine-1-phosphate analog;
Mechanism: Prodrug; sequesters circulating lymphocytes in secondary lymphoid organs via induction of intracellular internalization of receptors on lymphocytes (no effect on lymphocyte induction, proliferation, or memory function)
145
List the class and mechanism of Teriflunomide (Aubagio)
Class: Immunosuppressants;
Mechanism: Selective dihydro-orotate dehydrogenase (DHODH) inhibitor: blocks de novo pyramidine synthesis which reduces T- and B-cell proliferation and function; preserves replication and function of cells living on salvage pathway (e.g., hematopoietic cells, memory cells)
146
List the class and mechanism of Dimethyl fumarate / BG12 (Tecfidera)
Class: ---;
Mechanism: Enhances Nrf2 pathway; some Th1 -> Th2 shift
147
List the class and mechanism of Mitoxantrone (Novantrone)
Class: Anthracenedione;
Mechanism: Broad immune suppression and modulation of B cells, T cells and macrophages
148
List the class and mechanism of Azathioprine (Imuran)
Class: Immunosuppressants;
Mechanism: Immunosuppressive
149
List the class and mechanism of Methotrexate (Trexall)
Class: Immunosuppressants;
Mechanism: Immunosuppressive
150
List the class and mechanism of Cyclophosphamide (Cytoxan)
Class: Immunosuppressants;
Mechanism: Immunosuppressive
151
List the class and mechanism of Mycophenolate mofetil (CellCept)
Class: Immunosuppressants;
Mechanism: Immunosuppressive
152
List the class and mechanism of Methylprednisolone (MTP)
Class: Corticosteroid (immunosuppressant);
Mechanism: Unclear mechanism (suppress both B and T cells, may reduce cytokine release)
153
List the class and mechanism of Plasmapharesis
Class: ---;
Mechanism: Unclear mechanism
154
List the class and mechanism of Phenytoin (Dilantin)
Class: Voltage-gated Na channel stabilizer;
Mechanism: Stabilize inactive conformation of Na channel
155
List the class and mechanism of Carbamazepine (Tegretol)
Class: Voltage-gated Na channel stabilizer;
Mechanism: Stabilize inactive conformation of Na channel
156
List the class and mechanism of Oxcarbazepine (Trileptal)
Class: Voltage-gated Na channel stabilizer;
Mechanism: Stabilize inactive conformation of Na channel (metabolite of carbamazepine)
157
List the class and mechanism of Lamotrigine (Lamictal)
Class: Voltage-gated Na channel stabilizer;
Mechanism: Stabilize inactive conformation of Na channel
158
List the class and mechanism of Valproate (Depakote)
Class: --;
Mechanism: Unknown; likely affects Na-gated channels and GABA system
159
List the class and mechanism of Benzodiazapines
Class: GABAergic anti-epileptic;
Mechanism: GABA-A agonist
160
List the class and mechanism of Barbiturates (Phenobarbital)
Class: GABAergic anti-epileptic;
Mechanism: GABA-A agonist
161
List the class and mechanism of Vigabatrin (Sabril)
Class: GABAergic anti-epileptic;
Mechanism: GABA transaminase binder (slows down intracellular breakdown of GABA)
162
List the class and mechanism of Tigabine (Gabitril)
Class: GABAergic anti-epileptic;
Mechanism: GABA reuptake inhibitor
163
List the class and mechanism of Gabapentin (Neurontin)
Class: GABA analog;
Mechanism: Block presynaptic influx of Ca
164
List the class and mechanism of Pregabalin (Lyrica)
Class: GABA analog;
Mechanism: Block presynaptic influx of Ca
165
List the class and mechanism of Topiramate (Topamax)
Class: Glutamate Receptor Blockers;
Mechanism: Partial AMPA, Kainate Ca receptor blocker; secondary effect at voltage-gated Na channel, GABA system
166
List the class and mechanism of Felbamate (Felbatol)
Class: Glutamate Receptor Blockers;
Mechanism: NMDA receptor blocker; secondary effect at voltage-gated Na and Ca channels, GABA system
167
List the class and mechanism of Levetiracetam (Keppra)
Class: Synaptic vesicle binder;
Mechanism: Binds synaptic vesicle protein 2, leading to less NT release
168
List the class and mechanism of Ethosuximide (Zarontin)
Class: Voltage-gated Ca channel blocker;
Mechanism: Blocks T-type Ca-channels in thalamo-cortical circuits
169
List the class and mechanism of Analgesics
Class: ---;
Mechanism: Inhibition of COX (COX2 may be preferential)
170
List the class and mechanism of Barbiturates
Class: Anxiolytic;
Mechanism: ---
171
List the class and mechanism of Lidocaine
Class: Anesthetic;
Mechanism: Blocks Na channel depolarization
172
List the class and mechanism of Ergotamines
Class: Ergot;
Mechanism: α adrenergic antagonist and 5HT agonist in trigeminovascular pathway, some vasoconstriction
173
List the class and mechanism of DHE / dihydroergotamines (Migranal)
Class: Ergot;
Mechanism: α adrenergic antagonist and 5HT agonist in trigeminovascular pathway, some vasoconstriction
174
List the class and mechanism of Triptans, esp. Sumatriptan (Imitrex)
Class: Triptan;
Mechanism: Selective 5HT1b-d agonists: penetration of CNS, vasoconstriction of extracerebral intracranial vessels, inhibition of trigeminovascular system
175
List the class and mechanism of Onabotulinum toxin (Botox)
Class: ---;
Mechanism: Unknown (possibly decreased afferent stimulation of trigeminovascular system, or downregulation of sensory and parasympathetic receptors)
176
List the class and mechanism of TCA
Class: Antidepressant;
Mechanism: ---
177
List the class and mechanism of SSRIs
Class: Antidepressant;
Mechanism: ---
178
List the class and mechanism of Beta-blockers
Class: Anti-HTN;
Mechanism: ---
179
List the class and mechanism of Calcium Channel Blockers
Class: Anti-HTN;
Mechanism: ---
180
List the class and mechanism of Topiramate
Class: Antiepileptic;
Mechanism: Partial AMPA, Kainate Ca receptor blocker; secondary effect at voltage-gated Na channel, GABA system
181
List the class and mechanism of Valproate
Class: Antiepileptic;
Mechanism: Unknown; likely affects Na-gated channels and GABA system
182
List the class and mechanism of Gabapentin
Class: Antiepileptic ;
Mechanism: GABA analog, block presynaptic influx of Ca
183
List the class and mechanism of Tizanidine (Zanaflex)
Class: Muscle Relaxant;
Mechanism: α2-adrenergic auto receptor agonist
184
List the class and mechanism of Lithium
Class: ---;
Mechanism: Unknown; lithium depletes secondary messengers IP3 and DAG, important in a-adrenergic and muscarinic-cholinergic transmission
185
List the class and mechanism of Donepezil (Aricept)
Class: AChE inhibitor;
Mechanism: Inhibits AChE
186
List the class and mechanism of Galantamine (Razadyne)
Class: AChE inhibitor;
Mechanism: Inhibits AChE and modulates nACh receptors to increase Ach in the brain
187
List the class and mechanism of Rivastigmine (Exelon)
Class: AChE inhibitor;
Mechanism: Inhibits AChE and BuChE
188
List the class and mechanism of Tacrine (Cognex)
Class: AChE inhibitor;
Mechanism: Inhibits AChE and BuChE
189
List the class and mechanism of Memantine (Namenda)
Class: ---;
Mechanism: Antagonist of NMDA receptor
190
What is the theraputic use or uses of Levodopa (L-DOPA) (Dopar), and what are its miscellanous quirks?
Given with carbidopa, first-line treatment for Parkinson's unless patient is young (want to delay as long as possible);
Misc: Relatively short half-life (3 hours), MAO-A inhibitors are contraindicated, "wearing off" effect after 2-5 years
191
What is the theraputic use or uses of Carbidopa (Lodosyn), and what are its miscellanous quirks?
Given with levodopa, first line treatment for Parkinson's unless patient is young;
Misc: MAO-A inhibitors are contraindicated, "wearing off" effect after 2-5 years
192
What is the theraputic use or uses of Pergolide (Permax), and what are its miscellanous quirks?
No longer used for Parkinson's;
| Misc:
193
What is the theraputic use or uses of Bromocriptine (Parlodel), and what are its miscellanous quirks?
Parkinson's; NMS; hyperprolactinemia;
| Misc: Must be titrated slowly due to hypotension
194
What is the theraputic use or uses of Pramipexole (Mirapex), and what are its miscellanous quirks?
Parkinson's (less effective than bromocriptine at controlling motor symptoms), restless legs syndrome;
Misc: Can be titrated more quickly than bromocriptine
195
What is the theraputic use or uses of Ropinorole (Requip), and what are its miscellanous quirks?
Parkinson's (less effective than bromocriptine at controlling motor symptoms), restless legs syndrome;
Misc: Can be titrated more quickly than bromocriptine
196
What is the theraputic use or uses of Rotigotine (Neupro), and what are its miscellanous quirks?
Parkinson's (less effective than bromocriptine at controlling motor symptoms), restless legs syndrome;
Misc: Transdermal patch, not available in U.S. (recalled in 2008, reformulated in 2012)
197
What is the theraputic use or uses of Apomorphine (Apokyn), and what are its miscellanous quirks?
Rescue therapy for 'off' periods (immobility);
| Misc: Injectable only; 5HT antagonists contraindicated
198
What is the theraputic use or uses of Entacapone (Comtan), and what are its miscellanous quirks?
Adjunct to levodopa/carbidopa, reduce 'off' time and motor fluctuations;
Misc: Short-acting (2 hours), use with levodopa/carbidopa, primarily works peripherally
199
What is the theraputic use or uses of Tolcapone (Tasmar), and what are its miscellanous quirks?
Adjunct to levodopa/carbidopa, reduce 'off' time and motor fluctuations;
Misc: Short-acting (2 hours), use with levodopa/carbidopa if entacapone fails, primarily works peripherally
200
What is the theraputic use or uses of Selegiline (Eldepryl), and what are its miscellanous quirks?
Mild early Parkinson's (monotherapy); may delay onset of levodopa therapy; antidote to environmental toxins;
Misc: Contraindications: decongestants, dextromethorphan, St. John's wort, analgesics, methadone, tramadol, propoxyphene; caution with SSRIs, MAO-A inhibitors
201
What is the theraputic use or uses of Rasagiline (Azilect), and what are its miscellanous quirks?
Mild early Parkinson's (monotherapy); may delay onset of levodopa therapy; adjunct with levodopa / reduce 'off' time;
Misc: Contraindications: decongestants, dextromethorphan, St. John's wort, analgesics, methadone, tramadol, propoxyphene; caution with SSRIs, MAO-A inhibitors
202
What is the theraputic use or uses of Benztropine (Cogentin), and what are its miscellanous quirks?
Tremor and drooling in Parkinson's, and really only used if drooling is a major problem (otherwise, very bad mental symptoms);
Misc: Contraindicated in patients with dementia; abrupt discontinuation exacerbates symptoms
203
What is the theraputic use or uses of Biperiden (Akineton), and what are its miscellanous quirks?
Tremor and drooling in Parkinson's, and really only used if drooling is a major problem (otherwise, very bad mental symptoms);
Misc: Contraindicated in patients with dementia; abrupt discontinuation exacerbates symptoms
204
What is the theraputic use or uses of Trihexyphenidyl (Artane), and what are its miscellanous quirks?
Tremor and drooling in Parkinson's, and really only used if drooling is a major problem (otherwise, very bad mental symptoms);
Misc: Contraindicated in patients with dementia; abrupt discontinuation exacerbates symptoms
205
What is the theraputic use or uses of Procyclidine (Kemadrin), and what are its miscellanous quirks?
Tremor and drooling in Parkinson's, and really only used if drooling is a major problem (otherwise, very bad mental symptoms);
Misc: Contraindicated in patients with dementia; abrupt discontinuation exacerbates symptoms
206
What is the theraputic use or uses of Ethopropazine (Parsidol), and what are its miscellanous quirks?
Tremor and drooling in Parkinson's, and really only used if drooling is a major problem (otherwise, very bad mental symptoms);
Misc: Contraindicated in patients with dementia; abrupt discontinuation exacerbates symptoms
207
What is the theraputic use or uses of Amantadine (Symmetrel), and what are its miscellanous quirks?
Reduce diskinesias for: mild early Parkinson's (2nd-line monotherapy), adjunct to levodopa/carbidopa, Huntington's chorea;
Misc: Excreted unchanged in urine (renal dysfunction requires lower dose); contraindicated in patients with dementia (anticholinergic effects)
208
What is the theraputic use or uses of Deep brain stimulation, and what are its miscellanous quirks?
Dyskinesias refractory to other medications; reduces 'off' time, may reduce levodopa dosage; anxiety disorders like OCD;
Misc: Patients must still be sensitive to levodopa/carbidopa for this to be effective
209
What is the theraputic use or uses of Tetrabenazine (Xenazine), and what are its miscellanous quirks?
Movement disorders in Huntingtons, tardive dyskinesia from typical antipsychotics;
Misc: ---
210
What is the theraputic use or uses of Dantrolene (Dantrium), and what are its miscellanous quirks?
```
Malignant hyperthermia (associated with NMS);
Misc: ---
```
211
What is the theraputic use or uses of Riluzole (Rilutek), and what are its miscellanous quirks?
ALS (improves median survival by 60 days);
| Misc: Pertussis toxin reverses some of riluzole's clinical effects
212
What is the theraputic use or uses of Baclofen (Lioresal), and what are its miscellanous quirks?
Spasticity;
| Misc: Avoid sedative-hypnotic muscle relaxants
213
What is the theraputic use or uses of Tizanidine (Zanaflex), and what are its miscellanous quirks?
Spasticity, prevention of chronic tension-type headaches;
| Misc: ---
214
What is the theraputic use or uses of Chlorpromazine (Thorazine), and what are its miscellanous quirks?
Schizophrenia positive symptoms (delirium, paranoia, hallucinations, delusions), movement disorder in Huntingtons;
Misc: First "typical antipsychotic," little effect on negative symptoms (apathy, withdrawal, anhedonia)
215
What is the theraputic use or uses of Haloperidol (Haldol), and what are its miscellanous quirks?
Schizophrenia positive symptoms; movement disorders in Huntington's ;
Misc: Little effect on negative symptoms
216
What is the theraputic use or uses of Fluphenazine (Prolixin), and what are its miscellanous quirks?
Schizophrenia positive symptoms; movement disorders in Huntington's ;
Misc:
217
What is the theraputic use or uses of Perphenazine (Trilafon), and what are its miscellanous quirks?
Schizophrenia positive symptoms;
| Misc:
218
What is the theraputic use or uses of Loxapine (Loxitane), and what are its miscellanous quirks?
Schizophrenia positive symptoms;
| Misc: Little effect on negative symptoms, shorter half-life
219
What is the theraputic use or uses of Trifluoperazine (Stelazine), and what are its miscellanous quirks?
Schizophrenia positive symptoms;
| Misc: Little effect on negative symptoms
220
What is the theraputic use or uses of Thioridazine (Mellaril), and what are its miscellanous quirks?
Schizophrenia positive symptoms;
| Misc:
221
What is the theraputic use or uses of Thiothixene (Navane), and what are its miscellanous quirks?
Schizophrenia positive symptoms;
| Misc:
222
What is the theraputic use or uses of Clozapine (Clozaril), and what are its miscellanous quirks?
Treatment-resistant psychoses (esp. of schizophrenia); decrease risk of suicides;
Misc: No catalepsy, no EPS, no TD; can be used in pregnancy, but not first-line because of agranulocytosis
223
What is the theraputic use or uses of Olanzapine (Zyprexa), and what are its miscellanous quirks?
Schizophrenia (positive and negative symptoms); severe bipolar, PTSD;
Misc: ---
224
What is the theraputic use or uses of Quetiapine (Seroquel), and what are its miscellanous quirks?
Schizophrenia (positive and negative symptoms); severe bipolar;
Misc: shorter half-life
225
What is the theraputic use or uses of Risperidone (Risperdal), and what are its miscellanous quirks?
Schizophrenia (positive and negative symptoms); severe bipolar;
Misc:
226
What is the theraputic use or uses of Paliperidone (Invega), and what are its miscellanous quirks?
Schizophrenia (effective against positive symptoms, modest effect on negative);
Misc: Active metabolite of risperidone after P450 metabolism
227
What is the theraputic use or uses of Ziprazidone (Geodon), and what are its miscellanous quirks?
Schizophrenia (effective against positive symptoms, modest effect on negative);
Misc:
228
What is the theraputic use or uses of Aripiprazole (Abilify), and what are its miscellanous quirks?
Schizophrenia (less effective than other typical and atypicals); severe bipolar, adjunct for depression;
Misc: ---
229
What is the theraputic use or uses of Asenapine, and what are its miscellanous quirks?
Schizophrenia, bipolar type 1, stuttering;
| Misc:
230
What is the theraputic use or uses of Lurazidone, and what are its miscellanous quirks?
Schizophrenia;
| Misc: Can be used in pregnancy
231
What is the theraputic use or uses of Iloperidone, and what are its miscellanous quirks?
Schizophrenia;
| Misc:
232
What is the theraputic use or uses of Tranylcypromine (Parnate), and what are its miscellanous quirks?
Depression, anxiety, PTSD, chronic pain, enuresis (can't control bowels), bulimia, alcoholism;
Misc: ---
233
What is the theraputic use or uses of Phenelzine (Nardil), and what are its miscellanous quirks?
Depression, anxiety, PTSD, chronic pain, enuresis (can't control bowels), bulimia, alcoholism;
Misc: ---
234
What is the theraputic use or uses of Desipramine (Norpramin), and what are its miscellanous quirks?
Depression, anxiety, PTSD, chronic pain, enuresis (can't control bowels), bulimia, alcoholism;
Misc: Not very safe; rarely used anymore
235
What is the theraputic use or uses of Imipramine (Tofranil), and what are its miscellanous quirks?
Depression, anxiety, PTSD, chronic pain, enuresis (can't control bowels), bulimia, alcoholism;
Misc: Not very safe; rarely used anymore; forms active metabolite (desipramine)
236
What is the theraputic use or uses of Amitriptyline (Elavil), and what are its miscellanous quirks?
Depression, anxiety, PTSD, chronic pain, enuresis, bulimia, alcoholism, also prevention of tension headaches, migraines;
Misc: Not very safe; rarely used anymore; forms active metabolite (nortriptyline)
237
What is the theraputic use or uses of Nortriptyline (Pamelor), and what are its miscellanous quirks?
Depression, anxiety, PTSD, chronic pain, enuresis, bulimia, alcoholism;
Misc: Not very safe; rarely used anymore
238
What is the theraputic use or uses of Fluoxetine (Prozac), and what are its miscellanous quirks?
Depression, anxiety, PTSD, chronic pain, enuresis, bulimia, alcoholism; pre-menstrual dystrophic disorder;
Misc: Potent P450 inhibitor; forms active metabolite (norfluoxetine)
239
What is the theraputic use or uses of Paroxetine (Paxil), and what are its miscellanous quirks?
Depression, anxiety, PTSD, chronic pain, enuresis, bulimia, alcoholism;
Misc: Potent P450 inhibitor
240
What is the theraputic use or uses of Sertraline (Zoloft), and what are its miscellanous quirks?
Depression, anxiety, PTSD, chronic pain, enuresis, bulimia, alcoholism;
Misc: ---
241
What is the theraputic use or uses of Escitalopram (Lexapro), and what are its miscellanous quirks?
Depression, anxiety, PTSD, chronic pain, enuresis, bulimia, alcoholism;
Misc: ---
242
What is the theraputic use or uses of Citalopram (Celexa), and what are its miscellanous quirks?
Depression, anxiety, PTSD, chronic pain, enuresis, bulimia, alcoholism;
Misc: ---
243
What is the theraputic use or uses of Duloxetine (Cymbalta), and what are its miscellanous quirks?
Depression, anxiety, PTSD, chronic pain, enuresis, bulimia, alcoholism;
Misc: ---
244
What is the theraputic use or uses of Venlafaxine (Effexor), and what are its miscellanous quirks?
Depression, anxiety, PTSD, chronic pain, enuresis, bulimia, alcoholism;
Misc: ---
245
What is the theraputic use or uses of Bupropion (Wellbutrin), and what are its miscellanous quirks?
Depression, anxiety, PTSD, chronic pain, enuresis, bulimia, alcoholism; maintain nicotine abstinence in quitting smokers;
Misc: ---
246
What is the theraputic use or uses of Mirtazapine (Remeron), and what are its miscellanous quirks?
Depression, anxiety, PTSD, chronic pain, enuresis, bulimia, alcoholism;
Misc: ---
247
What is the theraputic use or uses of Lithium, and what are its miscellanous quirks?
Bipolar disorder mood stabilization; long-term cluster headache prevention;
Misc: Nausea and vomiting early sign of lithium OD; indomethacin and Na-depleting diuretics should be avoided (increase [Li])
248
What is the theraputic use or uses of alcohol / ethanol, and what are its miscellanous quirks?
;
| Misc: Metabolized by alcohol dehydrogenase and then acetaldehyde dehydrogenase
249
What is the theraputic use or uses of methyl alochol, and what are its miscellanous quirks?
;
| Misc: Treat with ethyl alcohol (vodka) and bicarb, or with fomepizole
250
What is the theraputic use or uses of ethylene glycol, and what are its miscellanous quirks?
;
| Misc: Treat with ethyl alcohol (vodka) and bicarb, or with fomepizole
251
What is the theraputic use or uses of isopropyl alcohol, and what are its miscellanous quirks?
;
| Misc: no antidote, symptomatic support
252
What is the theraputic use or uses of Flunitrazepam , and what are its miscellanous quirks?
"roofies," date rape drug;
| Misc:
253
What is the theraputic use or uses of Aliphatic nitrites, and what are its miscellanous quirks?
vasodilation for angina relief; misuse: giddiness (via cerebral ischemia) and lengthening erection (pre-Viagra);
Misc:
254
What is the theraputic use or uses of Disulfiram (Antabuse) , and what are its miscellanous quirks?
Averison therapy for ethanol;
| Misc:
255
What is the theraputic use or uses of Fomepizole (Antizol), and what are its miscellanous quirks?
Antidote for methanol & ethylene glycol poisoning;
| Misc: Very expensive
256
What is the theraputic use or uses of N-acetylcysteine (Mucomyst), and what are its miscellanous quirks?
Acetaminophen overdose;
| Misc: ---
257
What is the theraputic use or uses of Cocaine, and what are its miscellanous quirks?
Topical anesthetic for URT, combined vasoconstrictor and local anesthetic;
Misc: Rapidly hydrolyzed by plasma cholinesterase (AChE); cocaine+heroin="speedball"
258
What is the theraputic use or uses of Amphetamines (Benzadrine), and what are its miscellanous quirks?
Narcolepsy, ADHD;
| Misc: Others: dextroamphetamine (Dexedrine), methamphetamine (Desoxyn), methylphenidate (Ritalin)
259
What is the theraputic use or uses of Theophylline, and what are its miscellanous quirks?
Asthma (relieves bronchoconstriction and reduces inflammation);
Misc:
260
What is the theraputic use or uses of LSD, and what are its miscellanous quirks?
"model hallucinogen," mydriasis, increased HR and BP, hyperreflexia, tachypnea; perceptual distortions and disordered thoughts;
Misc: Oxidized in liver; cross tolerance with mescaline and psilocybin
261
What is the theraputic use or uses of Mescaline, and what are its miscellanous quirks?
---;
| Misc: Cross tolerance with LSD and psilocybin
262
What is the theraputic use or uses of Psilocybin, and what are its miscellanous quirks?
---;
| Misc: Cross tolerance with mescaline and LSD
263
What is the theraputic use or uses of Marijuana (THC), and what are its miscellanous quirks?
Anti-emetic, anti-nausea, and appetite stimulate for cancer chemotherapy and AIDS patients; analgesic for neuropathic pain; potentially: glaucoma, asthma, anxiolytic, migraine, and multiple sclerosis treatment;
Misc: Active ingredient is delta-9-tetrahydrocannabinol; metabolized by P450, tolerance with chronic use, highly lipid soluble
264
What is the theraputic use or uses of Anandamide, and what are its miscellanous quirks?
Regulates energy balance, lipid and glucose metabolism, food intake;
Misc: ---
265
What is the theraputic use or uses of Dronabinol (Marinol), and what are its miscellanous quirks?
Anti-emetic, anti-nausea, and appetite stimulant for cancer chemotherapy and AIDS patients;
Misc: ---
266
What is the theraputic use or uses of Nabilone (Cesamet), and what are its miscellanous quirks?
Treatment-resistant nausea and vomiting, weight loss and anorexia in AIDS patients;
Misc: Less psychoactive side effects than marijuana
267
What is the theraputic use or uses of Phencyclidine (PCP), and what are its miscellanous quirks?
;
Misc: Long half-life due to being highly lipid soluble and having active metabolites; counter with isolation and diazepam or haloperidol (can't "talk down")
268
What is the theraputic use or uses of MDMA (Ecstasy), and what are its miscellanous quirks?
acts like amphetamine + LSD + fluoxetine;
| Misc:
269
What is the theraputic use or uses of Morphine, and what are its miscellanous quirks?
Severe analgesia, mood alteration, antitussive, sedation;
| Misc: 2 major active metabolites: M6 (more potent/active), M3 (little affinity); intraspinal administration possible
270
What is the theraputic use or uses of Codeine, and what are its miscellanous quirks?
Moderate analgesia, antitussive (found in many cough medicines);
Misc: 10% of Caucasians unable to convert codeine to morphine (can still experience side effects, though)
271
What is the theraputic use or uses of Tramadol (Ultram), and what are its miscellanous quirks?
Moderate (not severe) analgesia;
| Misc: 1 metabolite: demethylated, more potent analgesic
272
What is the theraputic use or uses of Fentanyl (Duragesic), and what are its miscellanous quirks?
Severe analgesia after identification of dose level via other opiod (e.g., morphine);
Misc: IV, transdermal; do not change dose more than 1/week (long half-life); intraspinal administration possible
273
What is the theraputic use or uses of Methadone (Methadose), and what are its miscellanous quirks?
Chronic, severe pain; treatment of heroin and opiod addicts;
Misc: 90% bound to plasma protein, accumulates in tissues (thus, extended duration of action); do not change dose more than 1/week (long half-life)
274
What is the theraputic use or uses of Oxycodone, and what are its miscellanous quirks?
Moderate to severe analgesia;
| Misc: Oxycontin is extended release
275
What is the theraputic use or uses of Meperidine (Demerol), and what are its miscellanous quirks?
Don't use this;
| Misc: 1 metabolite: normeperidine
276
What is the theraputic use or uses of Propoxyphene (Darvon), and what are its miscellanous quirks?
Don't use this;
| Misc: 1 metabolite: norpropoxyphene (has long half-life)
277
What is the theraputic use or uses of Loperamide (Imodium), and what are its miscellanous quirks?
Diarrhea;
| Misc: Meperidine congener
278
What is the theraputic use or uses of Diphenoxylate (Lomotil), and what are its miscellanous quirks?
Diarrhea;
| Misc: Meperidine congener
279
What is the theraputic use or uses of Naloxone (Narcan), and what are its miscellanous quirks?
Acute opioid toxicity (depressed RR best predicts reponse);
Misc: Continuous parenteral infusion, as lasts only 15-30 minutes (oral almost completely metabolized by liver); patient has normal mental status
280
What is the theraputic use or uses of Naltrexone (Revia), and what are its miscellanous quirks?
Alcoholism;
| Misc: ---
281
What is the theraputic use or uses of Diazepam (Valium), and what are its miscellanous quirks?
Anxiety disorders / depression (ex. acute anxiety, generalized anxiety disorder, panic disorder), bipolar disorder, anticonvulsant, muscle relaxant;
Misc: "Ceiling effect" due to augmenting action of GABA, half-life of 43 hours (active metabolites up to 100 hours)
282
What is the theraputic use or uses of Chlordiazepoxide (Librium), and what are its miscellanous quirks?
Anxiety disorders / depression, bipolar disorder;
| Misc:
283
What is the theraputic use or uses of Lorazepam (Ativan), and what are its miscellanous quirks?
Anxiety disorders / depression, bipolar disorder; acute anxiety, anticonvulsant; prevent withdrawal symptoms in alcoholics;
Misc: "Ceiling effect" due to augmenting action of GABA; half-life of 14 hours, directly conjugated into inactive metabolite
284
What is the theraputic use or uses of Flurazepam (Dalmane), and what are its miscellanous quirks?
Anxiety disorders / depression, bipolar disorder;
| Misc: "Ceiling effect" due to augmenting action of GABA; half-life of 74 hours (active metabolites up to 100 hours)
285
What is the theraputic use or uses of Alprazolam (Xanax), and what are its miscellanous quirks?
Anxiety disorders / depression, acute anxiety, bipolar disorder;
Misc: "Ceiling effect" due to augmenting action of GABA; half-life of 12 hours
286
What is the theraputic use or uses of Triazolam (Halcion), and what are its miscellanous quirks?
Anxiety disorders / depression, bipolar disorder, hypnosis (sleeping pills);
Misc: "Ceiling effect" due to augmenting action of GABA; half-life of 2.9 hours
287
What is the theraputic use or uses of Midazolam (Versed), and what are its miscellanous quirks?
Anesthesia (calming effects, production of anterograde amnesia), anxiety disorders / depression, bipolar disorder;
Misc: Give i.v. or i.m.; "ceiling effect" due to augmenting action of GABA; half-life of 1.9 hours
288
What is the theraputic use or uses of Clonazepam, and what are its miscellanous quirks?
Chorea and rigidity in Huntington's;
| Misc:
289
What is the theraputic use or uses of Zolpidem (Ambien), and what are its miscellanous quirks?
Sedation and hypnosis without muscle relaxation or anticonvulsant activity, esp. hypnosis (sleeping pills);
Misc: eszopiclone (Lunesta) is similar
290
What is the theraputic use or uses of Flumazenil (Romazicon), and what are its miscellanous quirks?
Benzodiazapine overdose;
| Misc: Non uniform in reversal of respiratory depression
291
What is the theraputic use or uses of Thiopental (Pentothal), and what are its miscellanous quirks?
Induce anesthesia;
Misc: Abrupt withdrawal life-threatening; redistribute from brain to muscle and fat, metabolized by liver; dosed based on lean body mass, not available in U.S.?
292
What is the theraputic use or uses of Phenobarbitol, and what are its miscellanous quirks?
Antiepileptic, anticonvulsant;
| Misc: Abrupt withdrawal life-threatening
293
What is the theraputic use or uses of Buspirone (Buspar), and what are its miscellanous quirks?
Anxiolytic without sedation, esp. for generalized anxiety disorder;
Misc: ---
294
What is the theraputic use or uses of Propanolol, and what are its miscellanous quirks?
Anxiolytic without sedation, esp. for controlling autonomic symptoms like tachycardia;
Misc:
295
What is the theraputic use or uses of Nitrous Oxide, and what are its miscellanous quirks?
Mask induction in children;
| Misc: No muscle relaxation
296
What is the theraputic use or uses of Isoflurane (Forane), and what are its miscellanous quirks?
Gold standard for maintenance of anesthesia;
| Misc: ---
297
What is the theraputic use or uses of Desflurane (Suprane), and what are its miscellanous quirks?
---;
| Misc: ---
298
What is the theraputic use or uses of Sevoflurane (Ultane), and what are its miscellanous quirks?
Mask induction in children and adults;
| Misc: ---
299
What is the theraputic use or uses of Methohexital (Brevital), and what are its miscellanous quirks?
Induce general anesthesia;
| Misc: Redistribute from brain to muscle and fat, metabolized by liver; dosed based on lean body mass
300
What is the theraputic use or uses of Propofol (Diprivan), and what are its miscellanous quirks?
Anti-emetic at low doses; induction and maintenance of general anesthesia; sedation in ICU, procedural sedation;
Misc: Administered IV in a lipid emulsion (cause of pain); be aware of allergies (egg and soy in emulsion); no malignant hyperthermia
301
What is the theraputic use or uses of Etomidate (Amidate), and what are its miscellanous quirks?
Hypnosis; no analgesic activity;
| Misc: Minimal cardiorespiratory depression (good agent in patients with minimal cardiac reserve)
302
What is the theraputic use or uses of Ketamine (Ketalar), and what are its miscellanous quirks?
Sedative/anesthetic for pediatric/developmentally delayed patients; induction in patients with reactive airway disease, hypovolemia (trauma patients), cardiac disease; with propofol for IV procedural sedation; adjuvant during and after surgery to reduce opiod use; part of multimodal pain therapy regimen; depression treatment;
Misc: Racemic mixture (S more potent); metabolized by P450 (norketamine, a third to a fifth as effective); great bronchodilator; contraindicated in CAD, patients with intracranial lesions
303
What is the theraputic use or uses of Dexmedetomidine (Precedex), and what are its miscellanous quirks?
Awake intubations, awake craniotomies; adjunct to general anesthesia in patients susceptible to narcotic-induced post-op respiratory depression; withdrawal/detoxification;
Misc: Since GABA not hit, sedation is easier to wake from and is similar to non-REM sleep; FDA approved only for ventilation of ICU patients for under 24 hours
304
What is the theraputic use or uses of Succinylcholine (Anectine), and what are its miscellanous quirks?
Skeletal muscle relaxant (intubation);
Misc: Hydrolyzed by pseudocholinesterase (in plasma); blockade cannot be reversed; only NMB with rapid onset and ultra-short duration of action
305
What is the theraputic use or uses of Pancuronium (Pavulon), and what are its miscellanous quirks?
Skeletal muscle relaxant; avoid in patients with renal insufficiency;
Misc: Only long acting non-depolarizing agent; supplied as liquid; 80% excreted unchanged in liver (low metabolism in liver); reverse with AChEI
306
What is the theraputic use or uses of Vecuronium (Norcuron), and what are its miscellanous quirks?
Skeletal muscle relaxant;
Misc: Intermediate acting; supplied as a powder (reconstitute); hepatic metabolism, hepatic and renal excretion; reverse with AChEI
307
What is the theraputic use or uses of Rocuronium (Zemuron), and what are its miscellanous quirks?
Skeletal muscle relaxant (can substitute succinylcholine in rapid sequence intubation);
Misc: Intermediate acting; supplied as a liquid; hepatic metabolism, hepatic and renal excretion; can speed onset with higher dose; reverse with AChEI
308
What is the theraputic use or uses of Atracurium (Tracrium), and what are its miscellanous quirks?
Skeletal muscle relaxant; use in patients with liver or renal dysfunction;
Misc: Undergoes spontaneous, non-enzymatic degradation (Hofman elimination); intermediate acting; reverse with AChEI
309
What is the theraputic use or uses of Cis-atracurium (Nimbex), and what are its miscellanous quirks?
Skeletal muscle relaxant; use in patients with liver or renal dysfunction;
Misc: Undergoes spontaneous, non-enzymatic degradation (Hofman elimination); intermediate acting; reverse with AChEI
310
What is the theraputic use or uses of Sugammadex (Bridion), and what are its miscellanous quirks?
Immediate reversal of rocuronium;
| Misc: Not yet FDA approved
311
What is the theraputic use or uses of Edrophonium (Enlon), and what are its miscellanous quirks?
Reversal of NMB;
| Misc: Short-acting, fast onset
312
What is the theraputic use or uses of Neostigmine (Prostigmin), and what are its miscellanous quirks?
Reversal of NMB (most commonly used);
| Misc: More complete antagonism than edrophonium
313
What is the theraputic use or uses of Pyridostigmine (Mestinon), and what are its miscellanous quirks?
Reversal of NMB;
| Misc: Longer duration of action than neostigmine, edrophonium
314
What is the theraputic use or uses of Glycopyrrolate (Robinul), and what are its miscellanous quirks?
Reversal of NMB's muscaranic effects;
| Misc: Could also use atropine
315
What is the theraputic use or uses of Ester anesthetic, and what are its miscellanous quirks?
Local anesthesia;
Misc: Cocaine, procaine, benzocaine more likely to have allergic reaction than amides due to containing PABA derivitives; used less frequently than amides; metabolized by plasma esterases
316
What is the theraputic use or uses of Amide anesthetic, and what are its miscellanous quirks?
Local anesthesia;
Misc: Lidocaine, mepivicaine, bupivicaine, etidocaine, prilocaine, ropivicaine, dibucaine (names have 2 or more "i"s; metabolized in liver, cleared by kidneys
317
What is the theraputic use or uses of Avonex, and what are its miscellanous quirks?
RRMS (low-dose): decreases relapse rate by 1/3 and reduces MRI lesions, with a trend toward decreasing disability and brain atrophy - slows disease progression;
Misc: Doesn't cross BBB
318
What is the theraputic use or uses of Rebif, and what are its miscellanous quirks?
RRMS (high-dose); first-line treatment, same effects as Avonex - slows disease progression;
Misc: Doesn't cross BBB, more efficacious than Avonex
319
What is the theraputic use or uses of Betaseron / Betaferon, and what are its miscellanous quirks?
RRMS (high-dose); same effects as Avonex except no effects on disease progression;
Misc: Doesn't cross BBB, more efficacious than Avonex
320
What is the theraputic use or uses of Extavia, and what are its miscellanous quirks?
RRMS (high-dose); same effects as Avonex except no effects on disease progression;
Misc: Doesn't cross BBB
321
What is the theraputic use or uses of Glatiramer acetate (Copaxone), and what are its miscellanous quirks?
RRMS: reduce relapse by 1/3, modest reduction in MRI lesion and reduction of atrophy, but no effect on disease progression;
Misc: Active in CNS (not peripherally); try to use early, efficiency about the same as betaseron
322
What is the theraputic use or uses of Natalizumab (Tysabri), and what are its miscellanous quirks?
RRMS (2nd or 3rd line): decrease relapse rate by 2/3, greatly reduce MRI lesions;
Misc: Antibodies to natalizumab cause it to stop working; once/month; side effects more common in patients positive for NAB
323
What is the theraputic use or uses of Fingolimod (Gilenya), and what are its miscellanous quirks?
RRMS;
| Misc: Patients must be VZV immune before prescription; oral daily
324
What is the theraputic use or uses of Teriflunomide (Aubagio), and what are its miscellanous quirks?
RRMS;
| Misc: Oral daily, probably won't use in young women due to side effects (ex. teratogenicity bad in pregnancy)
325
What is the theraputic use or uses of Dimethyl fumarate / BG12 (Tecfidera), and what are its miscellanous quirks?
Antiinflammatory, neuroprotective, decreases disease progression; fumarates also used for psoriasis;
Misc: Oral 2x/day
326
What is the theraputic use or uses of Mitoxantrone (Novantrone), and what are its miscellanous quirks?
SPMS; RRMS (2nd line): decreases frequency of clinical relapse, reduces disease progress, and reduces disability;
Misc: IV; once/3 months
327
What is the theraputic use or uses of Azathioprine (Imuran), and what are its miscellanous quirks?
SPMS (resistant, or as combination with other therapies);
| Misc: ---
328
What is the theraputic use or uses of Methotrexate (Trexall), and what are its miscellanous quirks?
SPMS (resistant, or as combination with other therapies);
| Misc: ---
329
What is the theraputic use or uses of Cyclophosphamide (Cytoxan), and what are its miscellanous quirks?
SPMS (resistant, or as combination with other therapies);
| Misc: ---
330
What is the theraputic use or uses of Mycophenolate mofetil (CellCept), and what are its miscellanous quirks?
SPMS (resistant, or as combination with other therapies);
| Misc: Oral
331
What is the theraputic use or uses of Pulse steroids, and what are its miscellanous quirks?
SPMS (resistant, or as combination with other therapies), PPMS (off label);
Misc:
332
What is the theraputic use or uses of Methylprednisolone (MTP), and what are its miscellanous quirks?
Acute MS attack, SPMS; shortens acute attack duration,speeds recovery;
Misc: Given IV with oral prednisone taper
333
What is the theraputic use or uses of ACTH, and what are its miscellanous quirks?
Acute MS attack not responsive to MTP;
| Misc: Advantage: can give at home; disadvantage: more expensive than MTP
334
What is the theraputic use or uses of Plasmapharesis, and what are its miscellanous quirks?
Acute MS attack not responsive to MTP;
| Misc: ---
335
What is the theraputic use or uses of Phenytoin (Dilantin), and what are its miscellanous quirks?
Immediate treatment for all seizures types; less effective for absence (particular pediatric), myoclonic, atonic seizures, IV for status epilepticus;
Misc: IV infusion limited by hypotension; hepatic enzyme inducer (both auto- and hetero-inducer), highly protein bound; don't want to use for more than 1-5 years
336
What is the theraputic use or uses of Carbamazepine (Tegretol), and what are its miscellanous quirks?
More effective for complex partial seizure than primary generalized; bipolar disorder; neuropathic pain; TCA-like antidepressant actions;
Misc: Hepatic enzyme inducer (both auto- and hetero-inducer); highly protein bound; must increase dose in 1-2 wks due to autoinduction; side effects likely due to epoxide metabolite
337
What is the theraputic use or uses of Oxcarbazepine (Trileptal), and what are its miscellanous quirks?
More effective for complex partial seizure than primary generalized; bipolar disorder; neuropathic pain;
Misc: Designed to bypass carbamazepine epoxide; less protein-bound, less autoinduction, fewer interactions, less toxic, longer half-life than carbamazepine
338
What is the theraputic use or uses of Lamotrigine (Lamictal), and what are its miscellanous quirks?
Primary generalized epilepsies, complex partial seizures, absence seizures; indicated in children; bipolar disorder; neuropathic pain;
Misc: May exacerbate myoclonic seizures; competes with valproic acid for excretion (potential synergy); hepatic enzyme inducer; not very protein bound
339
What is the theraputic use or uses of Valproate (Depakote), and what are its miscellanous quirks?
Broad spectrum seizures: absence, myoclonic, tonic-clonic, primary generalized, partial onset, and secondary generalized seizures (but not absence seizures); IV for status epilepticus; bipolar treatment, migraine and long-term cluster headache prophylaxis;
Misc: ---
340
What is the theraputic use or uses of Benzodiazapines, and what are its miscellanous quirks?
```
Status epilepticus (refractory); anesthesia;
Misc: Long-term usefulness limited by tolerance
```
341
What is the theraputic use or uses of Barbiturates (Phenobarbital), and what are its miscellanous quirks?
Anti-epileptic;
| Misc:
342
What is the theraputic use or uses of Vigabatrin (Sabril), and what are its miscellanous quirks?
Anti-epileptic;
| Misc: Works on GABA-A
343
What is the theraputic use or uses of Tigabine (Gabitril), and what are its miscellanous quirks?
Anti-epileptic;
| Misc: Works on GABA-A
344
What is the theraputic use or uses of Gabapentin (Neurontin), and what are its miscellanous quirks?
Adjunct for partial complex epilepsy; more commonly used for neuropathic pain;
Misc: Absorption limited by intestinal AA transporter (there is a Tm); limited protein binding; no metabolism or drug interaction in humans (so few side effects)
345
What is the theraputic use or uses of Pregabalin (Lyrica), and what are its miscellanous quirks?
Adjunct for partial complex epilepsy; more commonly used for neuropathic pain;
Misc: ---
346
What is the theraputic use or uses of Topiramate (Topamax), and what are its miscellanous quirks?
Partial onset seizures, secondary generalized seizures, primary generalized epilepsy; migraine prevention, long-term prevention of cluster headaches;
Misc: Carbonic anhydrase activity leads to mild metabolic acidosis, which leads to respiratory compensation, which leads to mild alkalosis, which leads to calcium ionization, which leads to tingling; treat with vitamin C (acidify urine)
347
What is the theraputic use or uses of Felbamate (Felbatol), and what are its miscellanous quirks?
Partial onset seizures with or without secondary generalization; medically refractory epilepsy;
Misc: ---
348
What is the theraputic use or uses of Levetiracetam (Keppra), and what are its miscellanous quirks?
Partial onset seizures, secondary generalized seizures; maybe primary generalized epilepsy;
Misc: ---
349
What is the theraputic use or uses of Ethosuximide (Zarontin), and what are its miscellanous quirks?
Absence seizures only (and neuropathic pain);
| Misc: Readily absorbed, minimal first pass metabolism; not protein bound
350
What is the theraputic use or uses of Analgesics, and what are its miscellanous quirks?
Acute treatment of moderate migraine (combination of acetaminophen, aspirin, and caffeine); acute treatment of tension headaches;
Misc: ---
351
What is the theraputic use or uses of Barbiturates, and what are its miscellanous quirks?
Acute treatment of migraines; use when more traditional therapies unavailable or contraindicated;
Misc: Use limited to 2-3 times per week
352
What is the theraputic use or uses of Opioids, and what are its miscellanous quirks?
Acute treatment of migraines; patients with infrequent headaches; generally, for patients who wake up with a headache;
Misc: Use less than 2 days per week; pregnant women may use codeine or meperidine with caution
353
What is the theraputic use or uses of Corticosteroids, and what are its miscellanous quirks?
Acute treatment of migraines; migraine, prolonged headache syndromes (e.g., chronic daily headache); rescue treatment of cluster headache;
Misc: Chronic medicaton/overuse most common cause of chronic daily headaches
354
What is the theraputic use or uses of Lidocaine, and what are its miscellanous quirks?
Acute treatment of cluster headache;
| Misc:
355
What is the theraputic use or uses of Oxygen, and what are its miscellanous quirks?
Acute treatment of cluster headaches;
| Misc: Rebound can occur when oxygen stopped
356
What is the theraputic use or uses of Marijuana, and what are its miscellanous quirks?
;
| Misc:
357
What is the theraputic use or uses of Ergotamines, and what are its miscellanous quirks?
Acute treatment of migraines, short-term prevention of cluster headaches (along with corticosteroids);
Misc:
358
What is the theraputic use or uses of DHE / dihydroergotamines (Migranal), and what are its miscellanous quirks?
Acute treatment of migraines; acute treatment & short-term prevention of cluster headaches (along with corticosteroids);
Misc: Less likely to cause nausea and rebound headache than ergotamines
359
What is the theraputic use or uses of Triptans, esp. Sumatriptan (Imitrex), and what are its miscellanous quirks?
Acute treatment of migraines (premier option); also photo/phonophobia, nausea and vomiting; acute treatment of cluster headaches;
Misc: Sumatriptan comes as nasal spray and is injectable; zolmitriptan is also a nasal spray
360
What is the theraputic use or uses of Onabotulinum toxin (Botox), and what are its miscellanous quirks?
Prevention of chronic migraine headaches (occuring 15+ days/mo);
Misc: ---
361
What is the theraputic use or uses of TCA, and what are its miscellanous quirks?
Migraine prevention, tension headache prevention;
| Misc: Amitriptyline, protriptyline, nortriptyline
362
What is the theraputic use or uses of SSRIs, and what are its miscellanous quirks?
Migraine prevention, tension headache prevention;
| Misc: Fluoxetine, paroxetine, sertraline
363
What is the theraputic use or uses of Beta-blockers, and what are its miscellanous quirks?
```
Migraine prevention (only propranolol and timolol FDA approved);
Misc: Propranolol, timolol, nadolol, atenolol; contraindicated in asthma, diabetes, CHF, or Raynaud's
```
364
What is the theraputic use or uses of Calcium Channel Blockers, and what are its miscellanous quirks?
Migraine prevention; particularly useful in prolonged or disabling aura, or complicated migraine syndromes (e.g., hemiplegic migarine); long-term prevention of cluster headaches;
Misc: Verapamil most commonly used
365
What is the theraputic use or uses of Topiramate, and what are its miscellanous quirks?
Seizures, epilepsy; migraine prevention, long-term prevention of cluster headaches;
Misc: Most commonly used anti-epileptic for migraine prevention
366
What is the theraputic use or uses of Valproate, and what are its miscellanous quirks?
Seizures; IV for status epilepticus; bipolar treatment, migraine and long-term cluster headache prevention;
Misc: Most common formulation is divalproex sodium
367
What is the theraputic use or uses of Gabapentin, and what are its miscellanous quirks?
Migraine prevention; adjunct for partial complex epilepsy; more commonly used for neuropathic pain;
Misc: Absorption limited by intestinal AA transporter (there is a Tm); limited protein binding; no metabolism or drug interaction in humans (so few side effects)
368
What is the theraputic use or uses of Tizanidine (Zanaflex), and what are its miscellanous quirks?
Chronic tension type headache prevention, spasticity in ALS;
| Misc: ---
369
What is the theraputic use or uses of Lithium, and what are its miscellanous quirks?
Bipolar disorder mood stabilization; long-term cluster headache prevention;
Misc: Nausea and vomiting early sign of lithium OD; indomethacin and Na-depleting diuretics should be avoided (increase [Li])
370
What is the theraputic use or uses of Donepezil (Aricept), and what are its miscellanous quirks?
Mild to moderate Alzheimers; severe Alzheimers (maybe also Parkinson's, dementia with Lewy bodies, vascular dementia);
Misc: Metabolized by P450; dosed 1/day (long half life 70h), rapidly absorbed
371
What is the theraputic use or uses of Galantamine (Razadyne), and what are its miscellanous quirks?
Mild to moderate Alzheimers (also vascular dementia);
| Misc: Metabolized by P450; dosed 2/day (1/day for ER strength)
372
What is the theraputic use or uses of Rivastigmine (Exelon), and what are its miscellanous quirks?
Mild to moderate Alzheimers (maybe also Parkinson's, dementia with Lewy bodies, vascular dementia);
Misc: Hydrolyzed by cholinesterases, excreted in urine - short half life in plasma, long in CNS (10h); dosed 2/day; transdermal patch available
373
What is the theraputic use or uses of Tacrine (Cognex), and what are its miscellanous quirks?
Mild to moderate Alzheimers;
| Misc: Metabolized by P450; dosed 4/day; now obsolete
374
What is the theraputic use or uses of Memantine (Namenda), and what are its miscellanous quirks?
Severe Alzheimers, combine with donepezil (also vascular dementia);
Misc: Excreted unchanged in urine; dosed 2/day - long half life 60-80h
