CNS IV Flashcards
cyclobenzaprine
mm relaxer
TCA like effects because increases 5HT and NE and closes pain gait
Midrin
mm relaxer, has acetaminophen
antihistamine and babiturate like effects
Fiorinal
mm relaxer, has aspirin and caffeine
barbiturate like effects
Ergotamine
ergot, direct vasoconstrictor and 5HT agonist
- explains Vascular hypothesis of Wolff
- side effects: ergotism (nausea, gangrene)
sumatriptan
calcium gene related peptide reducer because activate 5HT1D and 5HT1B
- explains sterile inflammation hypothesis of migraine
- can cause coronary vasospasm and chest tightness, arrythmias, swollen neck, pain at the injection site and nausea/vomiting
propranolol
beta blocker, migraine prophylactic, reduces spreading depression because blocks NE
Amitriptyline
TCA, migraine prophylactic,
prevents excitation in locus cereleus that releases NE that blocks spreading depression
verapamil
Ca channel antagonist
-cluster headache
metoclopramide
DA and 5HT anatagonist
prevents nausea and promoted peristalsis
-widely used, cleaner drug
ondansetron
5Ht antagonist in the CTZ
facilitates peristalsis and reduces nausea
very expensive
prochlorperazine
reduces nausea and vomiting
broader spectrum of action and more SE
halothane
ptototypical abasthetic
not used much due to toxicity
halothane hep (because most metabolized
catecholamine sensitazation and arrhythmias
isoflurane
gas anasthetic
sevoflurane
gas anasthetic
most commonly used
nitrious oxide
gas anasthetic
MAC not achieved at normal barometri pressure
good analgesic
airway irritant
etomidate
iv anasthetic, barb
great inducing agent with few CV effects, used often with people with CV problems
propofol
iv anasthetic, barb, most widely used with short recovery period
CV and respiratory depresant
antiemetic
ketamine
iv anasthetic
indirect glu antagonist, dissociative anesthesia
psychotomimemtic effects, icreases SANS and great for hypovolemia
potent analgesic
fentanyl
iv opioid
potent analgesic
esters
local anasthetic
converted to PABA-hypersensitivity can occur
short acting because metabolised by non-specific esterases locally
procaine
local anasthetic
tetracaine
local anasthetic
amides
local anasthetic
longer acting. metabolized in liver comp to ester
lidocaine
local anasthetic
bupivacaine
local anasthetic
phenytoin/fosphenynytoin
prototypical anti- epileptic
Na+ channel inhibitor
many side effects- fetal hydantoin syndrome
therapeutic dosage close to zero-order and is highly bound
fosphenynytoin-used to chase status epilepticus
phenobarbital
primary AED
barbiturate with global inhibition, significant sedation and CYP induction
-morbilliform rash
Carbamazepine
primary AED
Na+ channel inhibitor with numerous side effects due to P450 induction
divalproex(valproate)
primary AED
- increases GABA and decreases Glu
- broad spectrum agent that also blocks T Ca channels
- high molecular burden associated with hep
- very teratogenic
ethosuximide
primary AED
T-type Ca channel inhibitor (that spread current through thalamus)
-abscence seizures
lamotrigine
primary AED
Na and Ca channel inhibitor
broad spectrum
topiramate
primary AED
many MOA (phenytoin, barbiturate like etc)
SE: reduces contraception effectiveness, hyperthermia, glaucoma
levitiracetam
adjuvant AED
few side effects and few drug interactions
lorazepam
status epilepticus
Alteplase
tPA, trombolytic
activates plasminogen in clots - forms plasmin-breaks bonds between fibrin molecules
SE: bleeding and breaking clots in other locations
warfarin
anticoag
reduces regeniration of Vit K and synthesis of factors II, VII, IX and X in liver
-highly protein bounds, high food and drug interaction
SE: bleeding
requires INR monitoring
dabigatran
anticoag
thrombin inhibitor
heparin
anticoag
mostly inpatient
clopidogrel
platelet inhibitor, prevents platelet aggregation
aspirin
platelet inhibitor
inhibit COX and thromboxane necessary for platelet activation
SE: gastric bleeding and gastritis
mannitol
oasmotic diaretic used to reduce post-stroke edema
disulfiram
- anti alcoholism
- causes dysphoria when alcohol is consumed because increases aldehydes by inhibiting aldehyde dehydrogenaze enzyme(nausea, vomiting, anxiety)
- orthostasis
naltrexone
- anti alcoholism
- OPIATE ANTAGONIST, decreases overall pleasure
acamprosate
- anti alcoholism,
- Glu antagonist and GABA agonist
- attacks insentive salience
methadone
against opioid addiction
buprenophrine
against opioid addiction
-partial opiod agonist/antagonist: in naive users analgesic/ in chronic precipitates withdrowal and provides opioid activity to ease withdrawal symtoms
varenicline
smoking sessation
partial agonist/antagonist at nicotinic receptors athat responsible for increasing DA in NA
bupropion
for general drug dependence
DA agonist, antidepressant
stimulates NA and increases reward activity when combined with counseling
not very effective
chloral Hydrate
CNS depressant,
with EtOH -Mickey Finn: its active metabolite trichloroethanol is potent sedative hypnotic
methanol
CNS depressant
formaldehyde toxicity
treated with ethanol
fomepizole
DIRECT ALCOHOL DEHYDROGENAZE INHIBITOR
TX OF METHANOL AND ANTI-FRIZZ TOX
cannabidiol
mariuanna compound
reduces seizures in children in Dravet’s syndrome
marinol
synthetic THC
interferon beta
MS 1st line
slow progression of the disease
Se: flue like symptoms, elevated liver enzymes
Glatiramer
MS 1st line
reduces frequency of relapses but not progression
mixture of 4 amino acids, serves as a decoy for immune system not to attack mylien
Terflunomide
MS 1st line
reduces cell production (e.g activated T-cells) that modulate immune response
SE: hair loss. diarrhea, nausea
Natalizymab
MS escalation therapy
antibody, reduces migration of lymphocytes into CNS
SE: rare PROGRESSIVE MULTIFOCA: LEUCOENCEPALOPATHY
Fingolimod
MS escalation
prevents lymphocytes regress from lymph nodes
high risk of infections anf liver enzyme elevation
