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Pharmacology Drug Chart > CNS Drugs > Flashcards

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

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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

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3
Q

List the class and mechanism of Pergolide (Permax)

A

Class: Ergot derivative;
Mechanism: —

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4
Q

List the class and mechanism of Bromocriptine (Parlodel)

A

Class: Ergot derivative;
Mechanism: D2 agonist, D1 antagonist

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5
Q

List the class and mechanism of Pramipexole (Mirapex)

A

Class: Non-ergot DA receptor agonist;
Mechanism: D2 agonist

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6
Q

List the class and mechanism of Ropinorole (Requip)

A

Class: Non-ergot DA receptor agonist;
Mechanism: D2 agonist

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7
Q

List the class and mechanism of Rotigotine (Neupro)

A

Class: Non-ergot DA receptor agonist;
Mechanism: D2 agonist

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8
Q

List the class and mechanism of Apomorphine (Apokyn)

A

Class: Non-ergot DA receptor agonist;
Mechanism: D2 agonist

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9
Q

List the class and mechanism of Entacapone (Comtan)

A

Class: COMT inhibitor;
Mechanism: Prevents breakdown of DA, prolongs half-life of levodopa

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10
Q

List the class and mechanism of Tolcapone (Tasmar)

A

Class: COMT inhibitor;
Mechanism: Prevents breakdown of DA, prolongs half-life of levodopa

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11
Q

List the class and mechanism of Selegiline (Eldepryl)

A

Class: MAO-B inhibitor;
Mechanism: Prevents breakdown of DA

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12
Q

List the class and mechanism of Rasagiline (Azilect)

A

Class: ;
Mechanism:

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13
Q

List the class and mechanism of Benztropine (Cogentin)

A

Class: Anticholinergics;
Mechanism: —

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14
Q

List the class and mechanism of Biperiden (Akineton)

A

Class: Anticholinergics;
Mechanism: —

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15
Q

List the class and mechanism of Trihexyphenidyl (Artane)

A

Class: Anticholinergics;
Mechanism: —

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16
Q

List the class and mechanism of Procyclidine (Kemadrin)

A

Class: Anticholinergics;
Mechanism: —

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17
Q

List the class and mechanism of Ethopropazine (Parsidol)

A

Class: Anticholinergics;
Mechanism: —

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18
Q

List the class and mechanism of Amantadine (Symmetrel)

A

Class: Influenza A anti-viral;
Mechanism: Dopaminergic, anticholinergic, anti-NMDA

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19
Q

List the class and mechanism of Deep brain stimulation

A

Class: Surgery;
Mechanism: Hits subthalamic nucleus

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20
Q

List the class and mechanism of Tetrabenazine (Xenazine)

A

Class: —;
Mechanism: Dopamine depletion, VMAT2 inhibitor

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21
Q

List the class and mechanism of Dantrolene (Dantrium)

A

Class: —;
Mechanism: Muscle relaxant

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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

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23
Q

List the class and mechanism of Baclofen (Lioresal)

A

Class: ;
Mechanism: GABA-B agonist

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24
Q

List the class and mechanism of Tizanidine (Zanaflex)

A

Class: ;
Mechanism: α2 agonist

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25
Q

List the class and mechanism of Chlorpromazine (Thorazine)

A

Class: First Generation Antipsychotic;
Mechanism: Catalepsy (trance, muscle rigidity, lack of voluntary movement)

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26
Q

List the class and mechanism of Haloperidol (Haldol)

A

Class: First Generation Antipsychotic;
Mechanism: Catalepsy (trance, muscle rigidity, lack of voluntary movement)

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27
Q

List the class and mechanism of Fluphenazine (Prolixin)

A

Class: First Generation Antipsychotic;
Mechanism: Catalepsy (trance, muscle rigidity, lack of voluntary movement)

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28
Q

List the class and mechanism of Perphenazine (Trilafon)

A

Class: First Generation Antipsychotic;
Mechanism: Catalepsy (trance, muscle rigidity, lack of voluntary movement)

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29
Q

List the class and mechanism of Loxapine (Loxitane)

A

Class: First Generation Antipsychotic;
Mechanism: Catalepsy (trance, muscle rigidity, lack of voluntary movement)

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30
Q

List the class and mechanism of Trifluoperazine (Stelazine)

A

Class: First Generation Antipsychotic;
Mechanism: Catalepsy (trance, muscle rigidity, lack of voluntary movement)

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31
Q

List the class and mechanism of Thioridazine (Mellaril)

A

Class: First Generation Antipsychotic;
Mechanism: Catalepsy (trance, muscle rigidity, lack of voluntary movement)

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32
Q

List the class and mechanism of Thiothixene (Navane)

A

Class: First Generation Antipsychotic;
Mechanism: Catalepsy (trance, muscle rigidity, lack of voluntary movement)

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33
Q

List the class and mechanism of Clozapine (Clozaril)

A

Class: Second Gen Antipsychotic (tricyclic);
Mechanism: D2 receptor antagonist, 5HT2 receptor antagonist

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34
Q

List the class and mechanism of Olanzapine (Zyprexa)

A

Class: Second Gen Antipsychotic (tricyclic);
Mechanism: D2 receptor antagonist, 5HT2 receptor antagonist

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35
Q

List the class and mechanism of Quetiapine (Seroquel)

A

Class: Second Gen Antipsychotic (tricyclic);
Mechanism: D2 receptor antagonist, 5HT2 receptor antagonist

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36
Q

List the class and mechanism of Risperidone (Risperdal)

A

Class: Second Gen Antipsychotic (non-tricyclic);
Mechanism: D2 receptor antagonist, 5HT2 receptor antagonist

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37
Q

List the class and mechanism of Paliperidone (Invega)

A

Class: Second Gen Antipsychotic (non-tricyclic);
Mechanism: D2 receptor antagonist, 5HT2 receptor antagonist

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38
Q

List the class and mechanism of Ziprazidone (Geodon)

A

Class: Second Gen Antipsychotic (non-tricyclic);
Mechanism: D2 receptor antagonist, 5HT2 receptor antagonist

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39
Q

List the class and mechanism of Aripiprazole (Abilify)

A

Class: Second Gen Antipsychotic (non-tricyclic);
Mechanism: Partial D2 and D3 receptor agonist, partial 5HT1a agonist, 5HT2a antagonist

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40
Q

List the class and mechanism of Asenapine

A

Class: Atypical Antipsychotic;
Mechanism: complicated, but involves D2 antagonism and 5HT partial agonism

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41
Q

List the class and mechanism of Lurazidone

A

Class: Atypical Antipsychotic;
Mechanism: complicated, but involves D2 antagonism and 5HT partial agonism

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42
Q

List the class and mechanism of Iloperidone

A

Class: Atypical Antipsychotic;
Mechanism: complicated, but involves D2 antagonism and 5HT partial agonism

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43
Q

List the class and mechanism of Tranylcypromine (Parnate)

A

Class: MAOI;
Mechanism: Irreversibly inhibit both MAO-A and MAO-B

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44
Q

List the class and mechanism of Phenelzine (Nardil)

A

Class: MAOI;
Mechanism: Irreversibly inhibit both MAO-A and MAO-B

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45
Q

List the class and mechanism of Desipramine (Norpramin)

A

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

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46
Q

List the class and mechanism of Imipramine (Tofranil)

A

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

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47
Q

List the class and mechanism of Amitriptyline (Elavil)

A

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

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48
Q

List the class and mechanism of Nortriptyline (Pamelor)

A

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

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49
Q

List the class and mechanism of Fluoxetine (Prozac)

A

Class: SSRI;
Mechanism: Inhibit reuptake of 5-HT (and NE to lesser extent)

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50
Q

List the class and mechanism of Paroxetine (Paxil)

A

Class: SSRI;
Mechanism: Inhibit reuptake of 5-HT (and NE to lesser extent)

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51
Q

List the class and mechanism of Sertraline (Zoloft)

A

Class: SSRI;
Mechanism: Inhibit reuptake of 5-HT (and NE to lesser extent)

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52
Q

List the class and mechanism of Escitalopram (Lexapro)

A

Class: SSRI;
Mechanism: Inhibit reuptake of 5-HT (and NE to lesser extent)

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53
Q

List the class and mechanism of Citalopram (Celexa)

A

Class: SSRI;
Mechanism: Inhibit reuptake of 5-HT (and NE to lesser extent)

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54
Q

List the class and mechanism of Duloxetine (Cymbalta)

A

Class: SNRI;
Mechanism: Inhibits reuptake of 5-HT and NE

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55
Q

List the class and mechanism of Venlafaxine (Effexor)

A

Class: SNRI;
Mechanism: Inhibits reuptake of 5-HT and NE

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56
Q

List the class and mechanism of Bupropion (Wellbutrin)

A

Class: Atypical;
Mechanism: Blocks DA and NE reuptake

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57
Q

List the class and mechanism of Mirtazapine (Remeron)

A

Class: Atypical;
Mechanism: 5HT2a antagonists; also inhibit 5HT reuptake

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58
Q

List the class and mechanism of Lithium

A

Class: —;
Mechanism: Unknown; lithium depletes secondary messengers IP3 and DAG, important in a-adrenergic and muscarinic-cholinergic transmission

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59
Q

List the class and mechanism of alcohol / ethanol

A

Class: ;
Mechanism: GABA-A agonist; binds to α subunit

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60
Q

List the class and mechanism of methyl alochol

A

Class: poison;
Mechanism: metabolized to formaldehyde and formic acid

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61
Q

List the class and mechanism of ethylene glycol

A

Class: poison;
Mechanism: metabolized to oxalic acid

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62
Q

List the class and mechanism of isopropyl alcohol

A

Class: poison;
Mechanism:

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63
Q

List the class and mechanism of barbiturates

A

Class: ;
Mechanism: GABA-A agonist

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64
Q

List the class and mechanism of benzos

A

Class: ;
Mechanism: GABA-A agonist

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65
Q

List the class and mechanism of Flunitrazepam

A

Class: benzodiazepine;
Mechanism: GABA-A agonist

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66
Q

List the class and mechanism of anesthetics

A

Class: ;
Mechanism:

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67
Q

List the class and mechanism of inhalants

A

Class: ;
Mechanism: GABA-A agonist

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68
Q

List the class and mechanism of Aliphatic nitrites

A

Class: inhalant;
Mechanism:

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69
Q

List the class and mechanism of Disulfiram (Antabuse)

A

Class: ;
Mechanism: Inhibits aldehyde dehydrogenase, causing acetaldehyde accumulation

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70
Q

List the class and mechanism of Fomepizole (Antizol)

A

Class: —;
Mechanism: Blocks alcohol dehydrogenase

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71
Q

List the class and mechanism of N-acetylcysteine (Mucomyst)

A

Class: Antioxidant;
Mechanism: Supplies sulfhydryl groups to glutathione; improves microcirculation, provides anti-inflammatory effect

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72
Q

List the class and mechanism of Cocaine

A

Class: CNS stimulant;
Mechanism: Blocks reuptake of dopamine, norepinephrine, and serotonin

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73
Q

List the class and mechanism of Amphetamines (Benzadrine)

A

Class: ;
Mechanism: Indirect sympathomimetic (release biologic amines from nerve terminals in periphery and in CNS); dopamine most important

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74
Q

List the class and mechanism of Methyxanthines

A

Class: ;
Mechanism: Antagonist at adenosine “purinergic” receptors

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75
Q

List the class and mechanism of Theophylline

A

Class: methyxanthine;
Mechanism: Antagonist at adenosine “purinergic” receptors

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76
Q

List the class and mechanism of Nicotine

A

Class: ;
Mechanism: activates nAChRs on VTA dopamine neurons leading to increased DA release in nucleus accumbens and prefrontal cortex

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77
Q

List the class and mechanism of Heroin

A

Class: opioid;
Mechanism: Mu-opioid receptor agonist

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78
Q

List the class and mechanism of Nalmefene (Revex)

A

Class: Opiod antagonist;
Mechanism: —

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79
Q

List the class and mechanism of LSD

A

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

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80
Q

List the class and mechanism of Mescaline

A

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

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81
Q

List the class and mechanism of Psilocybin

A

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

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82
Q

List the class and mechanism of MPTP

A

Class: poison, fentanyl derivative;
Mechanism: destroys substantia nigra –> Parkinson’s

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83
Q

List the class and mechanism of Marijuana (THC)

A

Class: Schedule I hallucinogen; Cannabinoid;
Mechanism: Hits cannabinoid receptors (CB1, CB2: G-protein coupled receptors)

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84
Q

List the class and mechanism of Anandamide

A

Class: Endogenous cannabinoid;
Mechanism: Hits cannabinoid receptors (CB1, CB2: G-protein coupled receptors)

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85
Q

List the class and mechanism of Dronabinol (Marinol)

A

Class: Schedule III drug; Synthetic THC;
Mechanism: Hits cannabinoid receptors (CB1, CB2: G-protein coupled receptors)

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86
Q

List the class and mechanism of Nabilone (Cesamet)

A

Class: Schedule II drug; Synthetic THC;
Mechanism: Hits cannabinoid receptors (CB1, CB2: G-protein coupled receptors)

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87
Q

List the class and mechanism of Phencyclidine (PCP)

A

Class: Dissociative anesthetic;
Mechanism: Antagonist of ion channel associated with NDMA receptor; agonist at mu opioid receptors

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88
Q

List the class and mechanism of MDMA (Ecstasy)

A

Class: Amphetamine derivative;
Mechanism:

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89
Q

List the class and mechanism of Bath salts

A

Class: Amphetamine / cathinone analog;
Mechanism:

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90
Q

List the class and mechanism of Morphine

A

Class: Opioid;
Mechanism: Mu-opioid receptor agonist

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91
Q

List the class and mechanism of Codeine

A

Class: Opioid;
Mechanism: Mu-opioid receptor agonist (low receptor affinity); demethylated to form morphine (10% of oral ingestion, via CYP2D6)

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92
Q

List the class and mechanism of Tramadol (Ultram)

A

Class: Opioid;
Mechanism: Mu opioid receptor agonist (weak); some NE/5HT uptake inhibition (leading to analgesia); synthetic codeine analog

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93
Q

List the class and mechanism of Fentanyl (Duragesic)

A

Class: Opioid;
Mechanism: Mu-opioid receptor agonist (strong); highly lipid-soluble

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94
Q

List the class and mechanism of Methadone (Methadose)

A

Class: Opioid;
Mechanism: Mu-opioid receptor agonist

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95
Q

List the class and mechanism of Oxycodone

A

Class: Opioid;
Mechanism: Mu-opioid receptor agonist

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96
Q

List the class and mechanism of Meperidine (Demerol)

A

Class: Opioid;
Mechanism: Mu-opioid receptor agonist

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97
Q

List the class and mechanism of Propoxyphene (Darvon)

A

Class: Opioid;
Mechanism: Mu-opioid receptor agonist (weak)

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98
Q

List the class and mechanism of Loperamide (Imodium)

A

Class: Opioid;
Mechanism: Slows peristalsis via opioid receptors in intestine, and possibly decreased GI secretion

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99
Q

List the class and mechanism of Diphenoxylate (Lomotil)

A

Class: Opioid;
Mechanism: Slows peristalsis via opioid receptors in intestine, and possibly decreased GI secretion

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100
Q

List the class and mechanism of Naloxone (Narcan)

A

Class: Opioid antagonist;
Mechanism: Competitive mu-, delta-, and kappa-opioid receptor antagonist

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101
Q

List the class and mechanism of Naltrexone (Revia)

A

Class: Opioid antagonist;
Mechanism: Mu-opioid receptor antagonist

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102
Q

List the class and mechanism of Diazepam (Valium)

A

Class: Benzodiazepine;
Mechanism: GABA-A agonist; binds between a1 and y2 subunits to open Cl- channel and hyperpolarize the cell

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103
Q

List the class and mechanism of Chlordiazepoxide (Librium)

A

Class: Benzodiazepine;
Mechanism: GABA-A agonist; binds between a1 and y2 subunits to open Cl- channel and hyperpolarize the cell

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104
Q

List the class and mechanism of Lorazepam (Ativan)

A

Class: Benzodiazepine;
Mechanism: GABA-A agonist; binds between a1 and y2 subunits to open Cl- channel and hyperpolarize the cell

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105
Q

List the class and mechanism of Flurazepam (Dalmane)

A

Class: Benzodiazepine;
Mechanism: GABA-A agonist; binds between a1 and y2 subunits to open Cl- channel and hyperpolarize the cell

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106
Q

List the class and mechanism of Alprazolam (Xanax)

A

Class: Benzodiazepine;
Mechanism: GABA-A agonist; binds between a1 and y2 subunits to open Cl- channel and hyperpolarize the cell

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107
Q

List the class and mechanism of Triazolam (Halcion)

A

Class: Benzodiazepine;
Mechanism: GABA-A agonist; binds between a1 and y2 subunits to open Cl- channel and hyperpolarize the cell

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108
Q

List the class and mechanism of Midazolam (Versed)

A

Class: Benzodiazepine;
Mechanism: GABA-A agonist; binds between a1 and y2 subunits to open Cl- channel and hyperpolarize the cell

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109
Q

List the class and mechanism of Clonazepam

A

Class: Benzodiazepine;
Mechanism: GABA-A agonist; binds between a1 and y2 subunits to open Cl- channel and hyperpolarize the cell

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110
Q

List the class and mechanism of Zolpidem (Ambien)

A

Class: Non-benzodiazepine receptor agonist;
Mechanism: BDZ-1 selective agonist

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111
Q

List the class and mechanism of Flumazenil (Romazicon)

A

Class: Benzodiazepine antagonist;
Mechanism: Competitive non-selective antagonist

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112
Q

List the class and mechanism of Thiopental (Pentothal)

A

Class: Barbiturate;
Mechanism: GABA-A agonist; binds a or b subunit; highly lipid soluble, fast-on, fast-off

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113
Q

List the class and mechanism of Phenobarbitol

A

Class: Barbiturate;
Mechanism: GABA-A agonist (binds a or b subunit)

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114
Q

List the class and mechanism of Buspirone (Buspar)

A

Class: Non-benzo anxiolytic;
Mechanism: Partial agonist at 5HT1A (not GABA-A)

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115
Q

List the class and mechanism of Propanolol

A

Class: β-blocker;
Mechanism: β-adrenergic receptor antagonist

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116
Q

List the class and mechanism of Nitrous Oxide

A

Class: —;
Mechanism: NMDA receptor antagonist

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117
Q

List the class and mechanism of Isoflurane (Forane)

A

Class: Volatile anesthetic;
Mechanism: Most potent

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118
Q

List the class and mechanism of Desflurane (Suprane)

A

Class: Volatile anesthetic;
Mechanism: Least soluble, least potent (allows for rapid emergence from anesthesia)

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119
Q

List the class and mechanism of Sevoflurane (Ultane)

A

Class: Volatile anesthetic;
Mechanism: Less soluble, less potent (but not irritating)

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120
Q

List the class and mechanism of Methohexital (Brevital)

A

Class: Barbiturates;
Mechanism: GABA-A receptor binding; produce hypnosis and sedation, but are anti-analgesics

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121
Q

List the class and mechanism of Propofol (Diprivan)

A

Class: Alkylphenol (a fatty acid);
Mechanism: GABA-A receptor agonist, antagonist of NMDA-glutamate receptor; some a2 receptor activity; rapid onset and offset

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122
Q

List the class and mechanism of Etomidate (Amidate)

A

Class: Carboxylated imidazole;
Mechanism: GABA-A receptor agonist (only D-isomer)

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123
Q

List the class and mechanism of Ketamine (Ketalar)

A

Class: Phencyclidine;
Mechanism: NMDA receptor antagonist, kappa opiate agonist; leads to dose-dependent unconsciousness, amnesia, analgesia

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124
Q

List the class and mechanism of Dexmedetomidine (Precedex)

A

Class: a2 adrenergic agonist;
Mechanism: Binds a2a and a2b in locus coeruleus and spinal cord (produces sedation, sympatholysis, and analgesia)

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125
Q

List the class and mechanism of Succinylcholine (Anectine)

A

Class: Depolarizing NMB;
Mechanism: Divalent ACh molecule; attaches to all ACh receptors, overstimulating them (first seen as disorganized muscular contractions (fasiculations), then paralysis)

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126
Q

List the class and mechanism of Pancuronium (Pavulon)

A

Class: Amino steroid non-depolarizing NMB;
Mechanism: Competitive blockade of ACh (no depolarization); vagolytic

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127
Q

List the class and mechanism of Vecuronium (Norcuron)

A

Class: Amino steroid non-depolarizing NMB;
Mechanism: Competitive blockade of ACh (no depolarization)

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128
Q

List the class and mechanism of Rocuronium (Zemuron)

A

Class: Amino steroid non-depolarizing NMB;
Mechanism: Competitive blockade of ACh (no depolarization)

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129
Q

List the class and mechanism of Atracurium (Tracrium)

A

Class: Isoquinoline non-depolarizing NMB;
Mechanism: Competitive blockade of ACh (no depolarization)

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130
Q

List the class and mechanism of Cis-atracurium (Nimbex)

A

Class: Isoquinoline non-depolarizing NMB;
Mechanism: Competitive blockade of ACh (no depolarization)

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131
Q

List the class and mechanism of Sugammadex (Bridion)

A

Class: Selective relaxant binding agent;
Mechanism: Complexes with rocuronium, rendering it inactive; no effect on AChesterase

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132
Q

List the class and mechanism of Edrophonium (Enlon)

A

Class: AChE-I;
Mechanism: —

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133
Q

List the class and mechanism of Neostigmine (Prostigmin)

A

Class: AChE-I;
Mechanism: —

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134
Q

List the class and mechanism of Pyridostigmine (Mestinon)

A

Class: AChE-I;
Mechanism: —

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135
Q

List the class and mechanism of Glycopyrrolate (Robinul)

A

Class: Anti-muscarinic;
Mechanism: —

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136
Q

List the class and mechanism of Ester anesthetic

A

Class: Ester;
Mechanism: Nonionized form crosses axonal membrane; ionized form (active form) blocks intracellular portion of inactive (refractory) voltage-gated sodium channel

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137
Q

List the class and mechanism of Amide anesthetic

A

Class: Amide;
Mechanism: Nonionized form crosses axonal membrane; ionized form (active form) blocks intracellular portion of inactive (refractory) voltage-gated sodium channel

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138
Q

List the class and mechanism of Avonex

A

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

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139
Q

List the class and mechanism of Rebif

A

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

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140
Q

List the class and mechanism of Betaseron / Betaferon

A

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

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141
Q

List the class and mechanism of Extavia

A

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

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142
Q

List the class and mechanism of Glatiramer acetate (Copaxone)

A

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

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143
Q

List the class and mechanism of Natalizumab (Tysabri)

A

Class: Monoclonal antibody;
Mechanism: Binds VLA4 (integrin subunit), inhibiting leukocyte migration across BBB

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144
Q

List the class and mechanism of Fingolimod (Gilenya)

A

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)

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145
Q

List the class and mechanism of Teriflunomide (Aubagio)

A

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)

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146
Q

List the class and mechanism of Dimethyl fumarate / BG12 (Tecfidera)

A

Class: —;
Mechanism: Enhances Nrf2 pathway; some Th1 -> Th2 shift

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147
Q

List the class and mechanism of Mitoxantrone (Novantrone)

A

Class: Anthracenedione;
Mechanism: Broad immune suppression and modulation of B cells, T cells and macrophages

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148
Q

List the class and mechanism of Azathioprine (Imuran)

A

Class: Immunosuppressants;
Mechanism: Immunosuppressive

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149
Q

List the class and mechanism of Methotrexate (Trexall)

A

Class: Immunosuppressants;
Mechanism: Immunosuppressive

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150
Q

List the class and mechanism of Cyclophosphamide (Cytoxan)

A

Class: Immunosuppressants;
Mechanism: Immunosuppressive

151
Q

List the class and mechanism of Mycophenolate mofetil (CellCept)

A

Class: Immunosuppressants;
Mechanism: Immunosuppressive

152
Q

List the class and mechanism of Methylprednisolone (MTP)

A

Class: Corticosteroid (immunosuppressant);
Mechanism: Unclear mechanism (suppress both B and T cells, may reduce cytokine release)

153
Q

List the class and mechanism of Plasmapharesis

A

Class: —;
Mechanism: Unclear mechanism

154
Q

List the class and mechanism of Phenytoin (Dilantin)

A

Class: Voltage-gated Na channel stabilizer;
Mechanism: Stabilize inactive conformation of Na channel

155
Q

List the class and mechanism of Carbamazepine (Tegretol)

A

Class: Voltage-gated Na channel stabilizer;
Mechanism: Stabilize inactive conformation of Na channel

156
Q

List the class and mechanism of Oxcarbazepine (Trileptal)

A

Class: Voltage-gated Na channel stabilizer;
Mechanism: Stabilize inactive conformation of Na channel (metabolite of carbamazepine)

157
Q

List the class and mechanism of Lamotrigine (Lamictal)

A

Class: Voltage-gated Na channel stabilizer;
Mechanism: Stabilize inactive conformation of Na channel

158
Q

List the class and mechanism of Valproate (Depakote)

A

Class: –;
Mechanism: Unknown; likely affects Na-gated channels and GABA system

159
Q

List the class and mechanism of Benzodiazapines

A

Class: GABAergic anti-epileptic;
Mechanism: GABA-A agonist

160
Q

List the class and mechanism of Barbiturates (Phenobarbital)

A

Class: GABAergic anti-epileptic;
Mechanism: GABA-A agonist

161
Q

List the class and mechanism of Vigabatrin (Sabril)

A

Class: GABAergic anti-epileptic;
Mechanism: GABA transaminase binder (slows down intracellular breakdown of GABA)

162
Q

List the class and mechanism of Tigabine (Gabitril)

A

Class: GABAergic anti-epileptic;
Mechanism: GABA reuptake inhibitor

163
Q

List the class and mechanism of Gabapentin (Neurontin)

A

Class: GABA analog;
Mechanism: Block presynaptic influx of Ca

164
Q

List the class and mechanism of Pregabalin (Lyrica)

A

Class: GABA analog;
Mechanism: Block presynaptic influx of Ca

165
Q

List the class and mechanism of Topiramate (Topamax)

A

Class: Glutamate Receptor Blockers;
Mechanism: Partial AMPA, Kainate Ca receptor blocker; secondary effect at voltage-gated Na channel, GABA system

166
Q

List the class and mechanism of Felbamate (Felbatol)

A

Class: Glutamate Receptor Blockers;
Mechanism: NMDA receptor blocker; secondary effect at voltage-gated Na and Ca channels, GABA system

167
Q

List the class and mechanism of Levetiracetam (Keppra)

A

Class: Synaptic vesicle binder;
Mechanism: Binds synaptic vesicle protein 2, leading to less NT release

168
Q

List the class and mechanism of Ethosuximide (Zarontin)

A

Class: Voltage-gated Ca channel blocker;
Mechanism: Blocks T-type Ca-channels in thalamo-cortical circuits

169
Q

List the class and mechanism of Analgesics

A

Class: —;
Mechanism: Inhibition of COX (COX2 may be preferential)

170
Q

List the class and mechanism of Barbiturates

A

Class: Anxiolytic;
Mechanism: —

171
Q

List the class and mechanism of Lidocaine

A

Class: Anesthetic;
Mechanism: Blocks Na channel depolarization

172
Q

List the class and mechanism of Ergotamines

A

Class: Ergot;
Mechanism: α adrenergic antagonist and 5HT agonist in trigeminovascular pathway, some vasoconstriction

173
Q

List the class and mechanism of DHE / dihydroergotamines (Migranal)

A

Class: Ergot;
Mechanism: α adrenergic antagonist and 5HT agonist in trigeminovascular pathway, some vasoconstriction

174
Q

List the class and mechanism of Triptans, esp. Sumatriptan (Imitrex)

A

Class: Triptan;
Mechanism: Selective 5HT1b-d agonists: penetration of CNS, vasoconstriction of extracerebral intracranial vessels, inhibition of trigeminovascular system

175
Q

List the class and mechanism of Onabotulinum toxin (Botox)

A

Class: —;
Mechanism: Unknown (possibly decreased afferent stimulation of trigeminovascular system, or downregulation of sensory and parasympathetic receptors)

176
Q

List the class and mechanism of TCA

A

Class: Antidepressant;
Mechanism: —

177
Q

List the class and mechanism of SSRIs

A

Class: Antidepressant;
Mechanism: —

178
Q

List the class and mechanism of Beta-blockers

A

Class: Anti-HTN;
Mechanism: —

179
Q

List the class and mechanism of Calcium Channel Blockers

A

Class: Anti-HTN;
Mechanism: —

180
Q

List the class and mechanism of Topiramate

A

Class: Antiepileptic;
Mechanism: Partial AMPA, Kainate Ca receptor blocker; secondary effect at voltage-gated Na channel, GABA system

181
Q

List the class and mechanism of Valproate

A

Class: Antiepileptic;
Mechanism: Unknown; likely affects Na-gated channels and GABA system

182
Q

List the class and mechanism of Gabapentin

A

Class: Antiepileptic ;
Mechanism: GABA analog, block presynaptic influx of Ca

183
Q

List the class and mechanism of Tizanidine (Zanaflex)

A

Class: Muscle Relaxant;
Mechanism: α2-adrenergic auto receptor agonist

184
Q

List the class and mechanism of Lithium

A

Class: —;
Mechanism: Unknown; lithium depletes secondary messengers IP3 and DAG, important in a-adrenergic and muscarinic-cholinergic transmission

185
Q

List the class and mechanism of Donepezil (Aricept)

A

Class: AChE inhibitor;
Mechanism: Inhibits AChE

186
Q

List the class and mechanism of Galantamine (Razadyne)

A

Class: AChE inhibitor;
Mechanism: Inhibits AChE and modulates nACh receptors to increase Ach in the brain

187
Q

List the class and mechanism of Rivastigmine (Exelon)

A

Class: AChE inhibitor;
Mechanism: Inhibits AChE and BuChE

188
Q

List the class and mechanism of Tacrine (Cognex)

A

Class: AChE inhibitor;
Mechanism: Inhibits AChE and BuChE

189
Q

List the class and mechanism of Memantine (Namenda)

A

Class: —;
Mechanism: Antagonist of NMDA receptor

190
Q

What is the theraputic use or uses of Levodopa (L-DOPA) (Dopar), and what are its miscellanous quirks?

A

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
Q

What is the theraputic use or uses of Carbidopa (Lodosyn), and what are its miscellanous quirks?

A

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
Q

What is the theraputic use or uses of Pergolide (Permax), and what are its miscellanous quirks?

A

No longer used for Parkinson’s;

Misc:

193
Q

What is the theraputic use or uses of Bromocriptine (Parlodel), and what are its miscellanous quirks?

A

Parkinson’s; NMS; hyperprolactinemia;

Misc: Must be titrated slowly due to hypotension

194
Q

What is the theraputic use or uses of Pramipexole (Mirapex), and what are its miscellanous quirks?

A

Parkinson’s (less effective than bromocriptine at controlling motor symptoms), restless legs syndrome;
Misc: Can be titrated more quickly than bromocriptine

195
Q

What is the theraputic use or uses of Ropinorole (Requip), and what are its miscellanous quirks?

A

Parkinson’s (less effective than bromocriptine at controlling motor symptoms), restless legs syndrome;
Misc: Can be titrated more quickly than bromocriptine

196
Q

What is the theraputic use or uses of Rotigotine (Neupro), and what are its miscellanous quirks?

A

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
Q

What is the theraputic use or uses of Apomorphine (Apokyn), and what are its miscellanous quirks?

A

Rescue therapy for ‘off’ periods (immobility);

Misc: Injectable only; 5HT antagonists contraindicated

198
Q

What is the theraputic use or uses of Entacapone (Comtan), and what are its miscellanous quirks?

A

Adjunct to levodopa/carbidopa, reduce ‘off’ time and motor fluctuations;
Misc: Short-acting (2 hours), use with levodopa/carbidopa, primarily works peripherally

199
Q

What is the theraputic use or uses of Tolcapone (Tasmar), and what are its miscellanous quirks?

A

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
Q

What is the theraputic use or uses of Selegiline (Eldepryl), and what are its miscellanous quirks?

A

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
Q

What is the theraputic use or uses of Rasagiline (Azilect), and what are its miscellanous quirks?

A

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
Q

What is the theraputic use or uses of Benztropine (Cogentin), and what are its miscellanous quirks?

A

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
Q

What is the theraputic use or uses of Biperiden (Akineton), and what are its miscellanous quirks?

A

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
Q

What is the theraputic use or uses of Trihexyphenidyl (Artane), and what are its miscellanous quirks?

A

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
Q

What is the theraputic use or uses of Procyclidine (Kemadrin), and what are its miscellanous quirks?

A

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
Q

What is the theraputic use or uses of Ethopropazine (Parsidol), and what are its miscellanous quirks?

A

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
Q

What is the theraputic use or uses of Amantadine (Symmetrel), and what are its miscellanous quirks?

A

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
Q

What is the theraputic use or uses of Deep brain stimulation, and what are its miscellanous quirks?

A

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
Q

What is the theraputic use or uses of Tetrabenazine (Xenazine), and what are its miscellanous quirks?

A

Movement disorders in Huntingtons, tardive dyskinesia from typical antipsychotics;
Misc: —

210
Q

What is the theraputic use or uses of Dantrolene (Dantrium), and what are its miscellanous quirks?

A 
Malignant hyperthermia (associated with NMS);
Misc: ---
211
Q

What is the theraputic use or uses of Riluzole (Rilutek), and what are its miscellanous quirks?

A

ALS (improves median survival by 60 days);

Misc: Pertussis toxin reverses some of riluzole’s clinical effects

212
Q

What is the theraputic use or uses of Baclofen (Lioresal), and what are its miscellanous quirks?

A

Spasticity;

Misc: Avoid sedative-hypnotic muscle relaxants

213
Q

What is the theraputic use or uses of Tizanidine (Zanaflex), and what are its miscellanous quirks?

A

Spasticity, prevention of chronic tension-type headaches;

Misc: —

214
Q

What is the theraputic use or uses of Chlorpromazine (Thorazine), and what are its miscellanous quirks?

A

Schizophrenia positive symptoms (delirium, paranoia, hallucinations, delusions), movement disorder in Huntingtons;
Misc: First “typical antipsychotic,” little effect on negative symptoms (apathy, withdrawal, anhedonia)

215
Q

What is the theraputic use or uses of Haloperidol (Haldol), and what are its miscellanous quirks?

A

Schizophrenia positive symptoms; movement disorders in Huntington’s ;
Misc: Little effect on negative symptoms

216
Q

What is the theraputic use or uses of Fluphenazine (Prolixin), and what are its miscellanous quirks?

A

Schizophrenia positive symptoms; movement disorders in Huntington’s ;
Misc:

217
Q

What is the theraputic use or uses of Perphenazine (Trilafon), and what are its miscellanous quirks?

A

Schizophrenia positive symptoms;

Misc:

218
Q

What is the theraputic use or uses of Loxapine (Loxitane), and what are its miscellanous quirks?

A

Schizophrenia positive symptoms;

Misc: Little effect on negative symptoms, shorter half-life

219
Q

What is the theraputic use or uses of Trifluoperazine (Stelazine), and what are its miscellanous quirks?

A

Schizophrenia positive symptoms;

Misc: Little effect on negative symptoms

220
Q

What is the theraputic use or uses of Thioridazine (Mellaril), and what are its miscellanous quirks?

A

Schizophrenia positive symptoms;

Misc:

221
Q

What is the theraputic use or uses of Thiothixene (Navane), and what are its miscellanous quirks?

A

Schizophrenia positive symptoms;

Misc:

222
Q

What is the theraputic use or uses of Clozapine (Clozaril), and what are its miscellanous quirks?

A

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
Q

What is the theraputic use or uses of Olanzapine (Zyprexa), and what are its miscellanous quirks?

A

Schizophrenia (positive and negative symptoms); severe bipolar, PTSD;
Misc: —

224
Q

What is the theraputic use or uses of Quetiapine (Seroquel), and what are its miscellanous quirks?

A

Schizophrenia (positive and negative symptoms); severe bipolar;
Misc: shorter half-life

225
Q

What is the theraputic use or uses of Risperidone (Risperdal), and what are its miscellanous quirks?

A

Schizophrenia (positive and negative symptoms); severe bipolar;
Misc:

226
Q

What is the theraputic use or uses of Paliperidone (Invega), and what are its miscellanous quirks?

A

Schizophrenia (effective against positive symptoms, modest effect on negative);
Misc: Active metabolite of risperidone after P450 metabolism

227
Q

What is the theraputic use or uses of Ziprazidone (Geodon), and what are its miscellanous quirks?

A

Schizophrenia (effective against positive symptoms, modest effect on negative);
Misc:

228
Q

What is the theraputic use or uses of Aripiprazole (Abilify), and what are its miscellanous quirks?

A

Schizophrenia (less effective than other typical and atypicals); severe bipolar, adjunct for depression;
Misc: —

229
Q

What is the theraputic use or uses of Asenapine, and what are its miscellanous quirks?

A

Schizophrenia, bipolar type 1, stuttering;

Misc:

230
Q

What is the theraputic use or uses of Lurazidone, and what are its miscellanous quirks?

A

Schizophrenia;

Misc: Can be used in pregnancy

231
Q

What is the theraputic use or uses of Iloperidone, and what are its miscellanous quirks?

A

Schizophrenia;

Misc:

232
Q

What is the theraputic use or uses of Tranylcypromine (Parnate), and what are its miscellanous quirks?

A

Depression, anxiety, PTSD, chronic pain, enuresis (can’t control bowels), bulimia, alcoholism;
Misc: —

233
Q

What is the theraputic use or uses of Phenelzine (Nardil), and what are its miscellanous quirks?

A

Depression, anxiety, PTSD, chronic pain, enuresis (can’t control bowels), bulimia, alcoholism;
Misc: —

234
Q

What is the theraputic use or uses of Desipramine (Norpramin), and what are its miscellanous quirks?

A

Depression, anxiety, PTSD, chronic pain, enuresis (can’t control bowels), bulimia, alcoholism;
Misc: Not very safe; rarely used anymore

235
Q

What is the theraputic use or uses of Imipramine (Tofranil), and what are its miscellanous quirks?

A

Depression, anxiety, PTSD, chronic pain, enuresis (can’t control bowels), bulimia, alcoholism;
Misc: Not very safe; rarely used anymore; forms active metabolite (desipramine)

236
Q

What is the theraputic use or uses of Amitriptyline (Elavil), and what are its miscellanous quirks?

A

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
Q

What is the theraputic use or uses of Nortriptyline (Pamelor), and what are its miscellanous quirks?

A

Depression, anxiety, PTSD, chronic pain, enuresis, bulimia, alcoholism;
Misc: Not very safe; rarely used anymore

238
Q

What is the theraputic use or uses of Fluoxetine (Prozac), and what are its miscellanous quirks?

A

Depression, anxiety, PTSD, chronic pain, enuresis, bulimia, alcoholism; pre-menstrual dystrophic disorder;
Misc: Potent P450 inhibitor; forms active metabolite (norfluoxetine)

239
Q

What is the theraputic use or uses of Paroxetine (Paxil), and what are its miscellanous quirks?

A

Depression, anxiety, PTSD, chronic pain, enuresis, bulimia, alcoholism;
Misc: Potent P450 inhibitor

240
Q

What is the theraputic use or uses of Sertraline (Zoloft), and what are its miscellanous quirks?

A

Depression, anxiety, PTSD, chronic pain, enuresis, bulimia, alcoholism;
Misc: —

241
Q

What is the theraputic use or uses of Escitalopram (Lexapro), and what are its miscellanous quirks?

A

Depression, anxiety, PTSD, chronic pain, enuresis, bulimia, alcoholism;
Misc: —

242
Q

What is the theraputic use or uses of Citalopram (Celexa), and what are its miscellanous quirks?

A

Depression, anxiety, PTSD, chronic pain, enuresis, bulimia, alcoholism;
Misc: —

243
Q

What is the theraputic use or uses of Duloxetine (Cymbalta), and what are its miscellanous quirks?

A

Depression, anxiety, PTSD, chronic pain, enuresis, bulimia, alcoholism;
Misc: —

244
Q

What is the theraputic use or uses of Venlafaxine (Effexor), and what are its miscellanous quirks?

A

Depression, anxiety, PTSD, chronic pain, enuresis, bulimia, alcoholism;
Misc: —

245
Q

What is the theraputic use or uses of Bupropion (Wellbutrin), and what are its miscellanous quirks?

A

Depression, anxiety, PTSD, chronic pain, enuresis, bulimia, alcoholism; maintain nicotine abstinence in quitting smokers;
Misc: —

246
Q

What is the theraputic use or uses of Mirtazapine (Remeron), and what are its miscellanous quirks?

A

Depression, anxiety, PTSD, chronic pain, enuresis, bulimia, alcoholism;
Misc: —

247
Q

What is the theraputic use or uses of Lithium, and what are its miscellanous quirks?

A

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
Q

What is the theraputic use or uses of alcohol / ethanol, and what are its miscellanous quirks?

A

;

Misc: Metabolized by alcohol dehydrogenase and then acetaldehyde dehydrogenase

249
Q

What is the theraputic use or uses of methyl alochol, and what are its miscellanous quirks?

A

;

Misc: Treat with ethyl alcohol (vodka) and bicarb, or with fomepizole

250
Q

What is the theraputic use or uses of ethylene glycol, and what are its miscellanous quirks?

A

;

Misc: Treat with ethyl alcohol (vodka) and bicarb, or with fomepizole

251
Q

What is the theraputic use or uses of isopropyl alcohol, and what are its miscellanous quirks?

A

;

Misc: no antidote, symptomatic support

252
Q

What is the theraputic use or uses of Flunitrazepam , and what are its miscellanous quirks?

A

“roofies,” date rape drug;

Misc:

253
Q

What is the theraputic use or uses of Aliphatic nitrites, and what are its miscellanous quirks?

A

vasodilation for angina relief; misuse: giddiness (via cerebral ischemia) and lengthening erection (pre-Viagra);
Misc:

254
Q

What is the theraputic use or uses of Disulfiram (Antabuse) , and what are its miscellanous quirks?

A

Averison therapy for ethanol;

Misc:

255
Q

What is the theraputic use or uses of Fomepizole (Antizol), and what are its miscellanous quirks?

A

Antidote for methanol & ethylene glycol poisoning;

Misc: Very expensive

256
Q

What is the theraputic use or uses of N-acetylcysteine (Mucomyst), and what are its miscellanous quirks?

A

Acetaminophen overdose;

Misc: —

257
Q

What is the theraputic use or uses of Cocaine, and what are its miscellanous quirks?

A

Topical anesthetic for URT, combined vasoconstrictor and local anesthetic;
Misc: Rapidly hydrolyzed by plasma cholinesterase (AChE); cocaine+heroin=”speedball”

258
Q

What is the theraputic use or uses of Amphetamines (Benzadrine), and what are its miscellanous quirks?

A

Narcolepsy, ADHD;

Misc: Others: dextroamphetamine (Dexedrine), methamphetamine (Desoxyn), methylphenidate (Ritalin)

259
Q

What is the theraputic use or uses of Theophylline, and what are its miscellanous quirks?

A

Asthma (relieves bronchoconstriction and reduces inflammation);
Misc:

260
Q

What is the theraputic use or uses of LSD, and what are its miscellanous quirks?

A

“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
Q

What is the theraputic use or uses of Mescaline, and what are its miscellanous quirks?

A

—;

Misc: Cross tolerance with LSD and psilocybin

262
Q

What is the theraputic use or uses of Psilocybin, and what are its miscellanous quirks?

A

—;

Misc: Cross tolerance with mescaline and LSD

263
Q

What is the theraputic use or uses of Marijuana (THC), and what are its miscellanous quirks?

A

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
Q

What is the theraputic use or uses of Anandamide, and what are its miscellanous quirks?

A

Regulates energy balance, lipid and glucose metabolism, food intake;
Misc: —

265
Q

What is the theraputic use or uses of Dronabinol (Marinol), and what are its miscellanous quirks?

A

Anti-emetic, anti-nausea, and appetite stimulant for cancer chemotherapy and AIDS patients;
Misc: —

266
Q

What is the theraputic use or uses of Nabilone (Cesamet), and what are its miscellanous quirks?

A

Treatment-resistant nausea and vomiting, weight loss and anorexia in AIDS patients;
Misc: Less psychoactive side effects than marijuana

267
Q

What is the theraputic use or uses of Phencyclidine (PCP), and what are its miscellanous quirks?

A

;
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
Q

What is the theraputic use or uses of MDMA (Ecstasy), and what are its miscellanous quirks?

A

acts like amphetamine + LSD + fluoxetine;

Misc:

269
Q

What is the theraputic use or uses of Morphine, and what are its miscellanous quirks?

A

Severe analgesia, mood alteration, antitussive, sedation;

Misc: 2 major active metabolites: M6 (more potent/active), M3 (little affinity); intraspinal administration possible

270
Q

What is the theraputic use or uses of Codeine, and what are its miscellanous quirks?

A

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
Q

What is the theraputic use or uses of Tramadol (Ultram), and what are its miscellanous quirks?

A

Moderate (not severe) analgesia;

Misc: 1 metabolite: demethylated, more potent analgesic

272
Q

What is the theraputic use or uses of Fentanyl (Duragesic), and what are its miscellanous quirks?

A

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
Q

What is the theraputic use or uses of Methadone (Methadose), and what are its miscellanous quirks?

A

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
Q

What is the theraputic use or uses of Oxycodone, and what are its miscellanous quirks?

A

Moderate to severe analgesia;

Misc: Oxycontin is extended release

275
Q

What is the theraputic use or uses of Meperidine (Demerol), and what are its miscellanous quirks?

A

Don’t use this;

Misc: 1 metabolite: normeperidine

276
Q

What is the theraputic use or uses of Propoxyphene (Darvon), and what are its miscellanous quirks?

A

Don’t use this;

Misc: 1 metabolite: norpropoxyphene (has long half-life)

277
Q

What is the theraputic use or uses of Loperamide (Imodium), and what are its miscellanous quirks?

A

Diarrhea;

Misc: Meperidine congener

278
Q

What is the theraputic use or uses of Diphenoxylate (Lomotil), and what are its miscellanous quirks?

A

Diarrhea;

Misc: Meperidine congener

279
Q

What is the theraputic use or uses of Naloxone (Narcan), and what are its miscellanous quirks?

A

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
Q

What is the theraputic use or uses of Naltrexone (Revia), and what are its miscellanous quirks?

A

Alcoholism;

Misc: —

281
Q

What is the theraputic use or uses of Diazepam (Valium), and what are its miscellanous quirks?

A

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
Q

What is the theraputic use or uses of Chlordiazepoxide (Librium), and what are its miscellanous quirks?

A

Anxiety disorders / depression, bipolar disorder;

Misc:

283
Q

What is the theraputic use or uses of Lorazepam (Ativan), and what are its miscellanous quirks?

A

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
Q

What is the theraputic use or uses of Flurazepam (Dalmane), and what are its miscellanous quirks?

A

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
Q

What is the theraputic use or uses of Alprazolam (Xanax), and what are its miscellanous quirks?

A

Anxiety disorders / depression, acute anxiety, bipolar disorder;
Misc: “Ceiling effect” due to augmenting action of GABA; half-life of 12 hours

286
Q

What is the theraputic use or uses of Triazolam (Halcion), and what are its miscellanous quirks?

A

Anxiety disorders / depression, bipolar disorder, hypnosis (sleeping pills);
Misc: “Ceiling effect” due to augmenting action of GABA; half-life of 2.9 hours

287
Q

What is the theraputic use or uses of Midazolam (Versed), and what are its miscellanous quirks?

A

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
Q

What is the theraputic use or uses of Clonazepam, and what are its miscellanous quirks?

A

Chorea and rigidity in Huntington’s;

Misc:

289
Q

What is the theraputic use or uses of Zolpidem (Ambien), and what are its miscellanous quirks?

A

Sedation and hypnosis without muscle relaxation or anticonvulsant activity, esp. hypnosis (sleeping pills);
Misc: eszopiclone (Lunesta) is similar

290
Q

What is the theraputic use or uses of Flumazenil (Romazicon), and what are its miscellanous quirks?

A

Benzodiazapine overdose;

Misc: Non uniform in reversal of respiratory depression

291
Q

What is the theraputic use or uses of Thiopental (Pentothal), and what are its miscellanous quirks?

A

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
Q

What is the theraputic use or uses of Phenobarbitol, and what are its miscellanous quirks?

A

Antiepileptic, anticonvulsant;

Misc: Abrupt withdrawal life-threatening

293
Q

What is the theraputic use or uses of Buspirone (Buspar), and what are its miscellanous quirks?

A

Anxiolytic without sedation, esp. for generalized anxiety disorder;
Misc: —

294
Q

What is the theraputic use or uses of Propanolol, and what are its miscellanous quirks?

A

Anxiolytic without sedation, esp. for controlling autonomic symptoms like tachycardia;
Misc:

295
Q

What is the theraputic use or uses of Nitrous Oxide, and what are its miscellanous quirks?

A

Mask induction in children;

Misc: No muscle relaxation

296
Q

What is the theraputic use or uses of Isoflurane (Forane), and what are its miscellanous quirks?

A

Gold standard for maintenance of anesthesia;

Misc: —

297
Q

What is the theraputic use or uses of Desflurane (Suprane), and what are its miscellanous quirks?

A

—;

Misc: —

298
Q

What is the theraputic use or uses of Sevoflurane (Ultane), and what are its miscellanous quirks?

A

Mask induction in children and adults;

Misc: —

299
Q

What is the theraputic use or uses of Methohexital (Brevital), and what are its miscellanous quirks?

A

Induce general anesthesia;

Misc: Redistribute from brain to muscle and fat, metabolized by liver; dosed based on lean body mass

300
Q

What is the theraputic use or uses of Propofol (Diprivan), and what are its miscellanous quirks?

A

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
Q

What is the theraputic use or uses of Etomidate (Amidate), and what are its miscellanous quirks?

A

Hypnosis; no analgesic activity;

Misc: Minimal cardiorespiratory depression (good agent in patients with minimal cardiac reserve)

302
Q

What is the theraputic use or uses of Ketamine (Ketalar), and what are its miscellanous quirks?

A

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
Q

What is the theraputic use or uses of Dexmedetomidine (Precedex), and what are its miscellanous quirks?

A

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
Q

What is the theraputic use or uses of Succinylcholine (Anectine), and what are its miscellanous quirks?

A

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
Q

What is the theraputic use or uses of Pancuronium (Pavulon), and what are its miscellanous quirks?

A

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
Q

What is the theraputic use or uses of Vecuronium (Norcuron), and what are its miscellanous quirks?

A

Skeletal muscle relaxant;
Misc: Intermediate acting; supplied as a powder (reconstitute); hepatic metabolism, hepatic and renal excretion; reverse with AChEI

307
Q

What is the theraputic use or uses of Rocuronium (Zemuron), and what are its miscellanous quirks?

A

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
Q

What is the theraputic use or uses of Atracurium (Tracrium), and what are its miscellanous quirks?

A

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
Q

What is the theraputic use or uses of Cis-atracurium (Nimbex), and what are its miscellanous quirks?

A

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
Q

What is the theraputic use or uses of Sugammadex (Bridion), and what are its miscellanous quirks?

A

Immediate reversal of rocuronium;

Misc: Not yet FDA approved

311
Q

What is the theraputic use or uses of Edrophonium (Enlon), and what are its miscellanous quirks?

A

Reversal of NMB;

Misc: Short-acting, fast onset

312
Q

What is the theraputic use or uses of Neostigmine (Prostigmin), and what are its miscellanous quirks?

A

Reversal of NMB (most commonly used);

Misc: More complete antagonism than edrophonium

313
Q

What is the theraputic use or uses of Pyridostigmine (Mestinon), and what are its miscellanous quirks?

A

Reversal of NMB;

Misc: Longer duration of action than neostigmine, edrophonium

314
Q

What is the theraputic use or uses of Glycopyrrolate (Robinul), and what are its miscellanous quirks?

A

Reversal of NMB’s muscaranic effects;

Misc: Could also use atropine

315
Q

What is the theraputic use or uses of Ester anesthetic, and what are its miscellanous quirks?

A

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
Q

What is the theraputic use or uses of Amide anesthetic, and what are its miscellanous quirks?

A

Local anesthesia;
Misc: Lidocaine, mepivicaine, bupivicaine, etidocaine, prilocaine, ropivicaine, dibucaine (names have 2 or more “i”s; metabolized in liver, cleared by kidneys

317
Q

What is the theraputic use or uses of Avonex, and what are its miscellanous quirks?

A

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
Q

What is the theraputic use or uses of Rebif, and what are its miscellanous quirks?

A

RRMS (high-dose); first-line treatment, same effects as Avonex - slows disease progression;
Misc: Doesn’t cross BBB, more efficacious than Avonex

319
Q

What is the theraputic use or uses of Betaseron / Betaferon, and what are its miscellanous quirks?

A

RRMS (high-dose); same effects as Avonex except no effects on disease progression;
Misc: Doesn’t cross BBB, more efficacious than Avonex

320
Q

What is the theraputic use or uses of Extavia, and what are its miscellanous quirks?

A

RRMS (high-dose); same effects as Avonex except no effects on disease progression;
Misc: Doesn’t cross BBB

321
Q

What is the theraputic use or uses of Glatiramer acetate (Copaxone), and what are its miscellanous quirks?

A

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
Q

What is the theraputic use or uses of Natalizumab (Tysabri), and what are its miscellanous quirks?

A

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
Q

What is the theraputic use or uses of Fingolimod (Gilenya), and what are its miscellanous quirks?

A

RRMS;

Misc: Patients must be VZV immune before prescription; oral daily

324
Q

What is the theraputic use or uses of Teriflunomide (Aubagio), and what are its miscellanous quirks?

A

RRMS;

Misc: Oral daily, probably won’t use in young women due to side effects (ex. teratogenicity bad in pregnancy)

325
Q

What is the theraputic use or uses of Dimethyl fumarate / BG12 (Tecfidera), and what are its miscellanous quirks?

A

Antiinflammatory, neuroprotective, decreases disease progression; fumarates also used for psoriasis;
Misc: Oral 2x/day

326
Q

What is the theraputic use or uses of Mitoxantrone (Novantrone), and what are its miscellanous quirks?

A

SPMS; RRMS (2nd line): decreases frequency of clinical relapse, reduces disease progress, and reduces disability;
Misc: IV; once/3 months

327
Q

What is the theraputic use or uses of Azathioprine (Imuran), and what are its miscellanous quirks?

A

SPMS (resistant, or as combination with other therapies);

Misc: —

328
Q

What is the theraputic use or uses of Methotrexate (Trexall), and what are its miscellanous quirks?

A

SPMS (resistant, or as combination with other therapies);

Misc: —

329
Q

What is the theraputic use or uses of Cyclophosphamide (Cytoxan), and what are its miscellanous quirks?

A

SPMS (resistant, or as combination with other therapies);

Misc: —

330
Q

What is the theraputic use or uses of Mycophenolate mofetil (CellCept), and what are its miscellanous quirks?

A

SPMS (resistant, or as combination with other therapies);

Misc: Oral

331
Q

What is the theraputic use or uses of Pulse steroids, and what are its miscellanous quirks?

A

SPMS (resistant, or as combination with other therapies), PPMS (off label);
Misc:

332
Q

What is the theraputic use or uses of Methylprednisolone (MTP), and what are its miscellanous quirks?

A

Acute MS attack, SPMS; shortens acute attack duration,speeds recovery;
Misc: Given IV with oral prednisone taper

333
Q

What is the theraputic use or uses of ACTH, and what are its miscellanous quirks?

A

Acute MS attack not responsive to MTP;

Misc: Advantage: can give at home; disadvantage: more expensive than MTP

334
Q

What is the theraputic use or uses of Plasmapharesis, and what are its miscellanous quirks?

A

Acute MS attack not responsive to MTP;

Misc: —

335
Q

What is the theraputic use or uses of Phenytoin (Dilantin), and what are its miscellanous quirks?

A

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
Q

What is the theraputic use or uses of Carbamazepine (Tegretol), and what are its miscellanous quirks?

A

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
Q

What is the theraputic use or uses of Oxcarbazepine (Trileptal), and what are its miscellanous quirks?

A

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
Q

What is the theraputic use or uses of Lamotrigine (Lamictal), and what are its miscellanous quirks?

A

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
Q

What is the theraputic use or uses of Valproate (Depakote), and what are its miscellanous quirks?

A

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
Q

What is the theraputic use or uses of Benzodiazapines, and what are its miscellanous quirks?

A 
Status epilepticus (refractory); anesthesia;
Misc: Long-term usefulness limited by tolerance
341
Q

What is the theraputic use or uses of Barbiturates (Phenobarbital), and what are its miscellanous quirks?

A

Anti-epileptic;

Misc:

342
Q

What is the theraputic use or uses of Vigabatrin (Sabril), and what are its miscellanous quirks?

A

Anti-epileptic;

Misc: Works on GABA-A

343
Q

What is the theraputic use or uses of Tigabine (Gabitril), and what are its miscellanous quirks?

A

Anti-epileptic;

Misc: Works on GABA-A

344
Q

What is the theraputic use or uses of Gabapentin (Neurontin), and what are its miscellanous quirks?

A

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
Q

What is the theraputic use or uses of Pregabalin (Lyrica), and what are its miscellanous quirks?

A

Adjunct for partial complex epilepsy; more commonly used for neuropathic pain;
Misc: —

346
Q

What is the theraputic use or uses of Topiramate (Topamax), and what are its miscellanous quirks?

A

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
Q

What is the theraputic use or uses of Felbamate (Felbatol), and what are its miscellanous quirks?

A

Partial onset seizures with or without secondary generalization; medically refractory epilepsy;
Misc: —

348
Q

What is the theraputic use or uses of Levetiracetam (Keppra), and what are its miscellanous quirks?

A

Partial onset seizures, secondary generalized seizures; maybe primary generalized epilepsy;
Misc: —

349
Q

What is the theraputic use or uses of Ethosuximide (Zarontin), and what are its miscellanous quirks?

A

Absence seizures only (and neuropathic pain);

Misc: Readily absorbed, minimal first pass metabolism; not protein bound

350
Q

What is the theraputic use or uses of Analgesics, and what are its miscellanous quirks?

A

Acute treatment of moderate migraine (combination of acetaminophen, aspirin, and caffeine); acute treatment of tension headaches;
Misc: —

351
Q

What is the theraputic use or uses of Barbiturates, and what are its miscellanous quirks?

A

Acute treatment of migraines; use when more traditional therapies unavailable or contraindicated;
Misc: Use limited to 2-3 times per week

352
Q

What is the theraputic use or uses of Opioids, and what are its miscellanous quirks?

A

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
Q

What is the theraputic use or uses of Corticosteroids, and what are its miscellanous quirks?

A

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
Q

What is the theraputic use or uses of Lidocaine, and what are its miscellanous quirks?

A

Acute treatment of cluster headache;

Misc:

355
Q

What is the theraputic use or uses of Oxygen, and what are its miscellanous quirks?

A

Acute treatment of cluster headaches;

Misc: Rebound can occur when oxygen stopped

356
Q

What is the theraputic use or uses of Marijuana, and what are its miscellanous quirks?

A

;

Misc:

357
Q

What is the theraputic use or uses of Ergotamines, and what are its miscellanous quirks?

A

Acute treatment of migraines, short-term prevention of cluster headaches (along with corticosteroids);
Misc:

358
Q

What is the theraputic use or uses of DHE / dihydroergotamines (Migranal), and what are its miscellanous quirks?

A

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
Q

What is the theraputic use or uses of Triptans, esp. Sumatriptan (Imitrex), and what are its miscellanous quirks?

A

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
Q

What is the theraputic use or uses of Onabotulinum toxin (Botox), and what are its miscellanous quirks?

A

Prevention of chronic migraine headaches (occuring 15+ days/mo);
Misc: —

361
Q

What is the theraputic use or uses of TCA, and what are its miscellanous quirks?

A

Migraine prevention, tension headache prevention;

Misc: Amitriptyline, protriptyline, nortriptyline

362
Q

What is the theraputic use or uses of SSRIs, and what are its miscellanous quirks?

A

Migraine prevention, tension headache prevention;

Misc: Fluoxetine, paroxetine, sertraline

363
Q

What is the theraputic use or uses of Beta-blockers, and what are its miscellanous quirks?

A 
Migraine prevention (only propranolol and timolol FDA approved);
Misc: Propranolol, timolol, nadolol, atenolol; contraindicated in asthma, diabetes, CHF, or Raynaud's
364
Q

What is the theraputic use or uses of Calcium Channel Blockers, and what are its miscellanous quirks?

A

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
Q

What is the theraputic use or uses of Topiramate, and what are its miscellanous quirks?

A

Seizures, epilepsy; migraine prevention, long-term prevention of cluster headaches;
Misc: Most commonly used anti-epileptic for migraine prevention

366
Q

What is the theraputic use or uses of Valproate, and what are its miscellanous quirks?

A

Seizures; IV for status epilepticus; bipolar treatment, migraine and long-term cluster headache prevention;
Misc: Most common formulation is divalproex sodium

367
Q

What is the theraputic use or uses of Gabapentin, and what are its miscellanous quirks?

A

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
Q

What is the theraputic use or uses of Tizanidine (Zanaflex), and what are its miscellanous quirks?

A

Chronic tension type headache prevention, spasticity in ALS;

Misc: —

369
Q

What is the theraputic use or uses of Lithium, and what are its miscellanous quirks?

A

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
Q

What is the theraputic use or uses of Donepezil (Aricept), and what are its miscellanous quirks?

A

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
Q

What is the theraputic use or uses of Galantamine (Razadyne), and what are its miscellanous quirks?

A

Mild to moderate Alzheimers (also vascular dementia);

Misc: Metabolized by P450; dosed 2/day (1/day for ER strength)

372
Q

What is the theraputic use or uses of Rivastigmine (Exelon), and what are its miscellanous quirks?

A

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
Q

What is the theraputic use or uses of Tacrine (Cognex), and what are its miscellanous quirks?

A

Mild to moderate Alzheimers;

Misc: Metabolized by P450; dosed 4/day; now obsolete

374
Q

What is the theraputic use or uses of Memantine (Namenda), and what are its miscellanous quirks?

A

Severe Alzheimers, combine with donepezil (also vascular dementia);
Misc: Excreted unchanged in urine; dosed 2/day - long half life 60-80h

Pharmacology Drug Chart (2 decks)

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