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Pharm > CNS + Psych > Flashcards

CNS + Psych Flashcards

1
Q

Opioid OD reversal

A

Methadone

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2
Q

Mood stabilizers

A

Lithium (m+d)
- hypothyroidism + ebstein

Valproate (m>d)
- hepatotoxic + NTDs

Lamotrigine d
- rash + SJS

Carbamazepine m
- aplastic anemia + SIADH + NTDs

Mania Sx
Depressive Sx

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3
Q

NE + DA reuptake inhin

A

Bupropion

Antidepressants

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4
Q

Tx for trigeminal neuralgia

A

Carbamazepine

Also, bipolar + seizures

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5
Q

Antidepressant which no sexual dys(f) or weight gain

A

Bupropion

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6
Q

SE bupropion

A

Seizures

Inc risk in pre-existing seizure disorder or eating / electrolyte disorders

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7
Q

SNRI w inc BP SE

A

Venlafaxine

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8
Q

SJS SE seen w?

A

Lamotrigine

Anticonvulsant + Bipolar Tx

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9
Q

Which drugs are +ve allosteric modulators of GABA A receptors?

A

BDZ

  • inc FREQUENCY of Cl- ch opening IN PRESENCE OF GABA
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10
Q

Alcohol withdrawal Tx

A
  1. BDZ
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11
Q

Anti seizure drugs

A
  1. Block Na ch : Phenytoin (recurrence). Carbamazepine.
  2. Block Na ch + Inc GABA levels : VALPROIC acid, Topiramate
  3. Inc GABA action : BDZ (initial Tx). Phenobarbital.
  4. Modulates GABA + glutamate release : Levetiracetam
  5. Blocks Ca ch, thalamus : Ethosuximide (T), Gabapentin
  6. Irrev GABA transaminase inhib : Vigabatrin (Tx-resistant epilepsy), Valproic acid
  7. GABA reuptake inhib :
    Tiagabine
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12
Q

Li tox manifested by which other drugs?

A
  1. Thiazides
  2. Diuretics
  3. NSAIDs
  4. ACE inhib
  5. Dec glomerular filtration (vol depletion, CHF, cirrhosis)

Tx: Hydration. Hemodialysis.

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13
Q

Which opioid can ppt opioid-withdrawal Sx?

A

Buprenorphine (partial ag acts as antag in presence of full ag)

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14
Q

Opioid long term SE?

A

Central sensitization: inc pain sensitivity

  1. Receptor down regulation
  2. Unreg of NMDA receptors

» tolerance + opioid-induced hyperalgesia

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15
Q

Opioid intox

RF:

CF:

Tx:

A

RF: Subs abuse. Post-op. Hepatic/ renal insuff.

CF: somnolence. AMS. dec RR, dec HR, dec bowel sounds. Resp acidosis. Hypothermia. MIOSIS.

Tx: Naloxone (t1/2=<1hr : repeat dosing)

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16
Q

Rapid recovery from Propofol d/t?

A

Redistribution from organs w high blood from (brain, heart, kidney, liver) to organs w low blood flow (bone, adipose, CT)

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17
Q

Prolonged paralysis after Succinylcholine d/t ?

A

Pseudocholinesterase def

Succinylcholine rapidly hydrolyzed by plasma pseudocholinesterase : only 10% reached NMJ
Def : large amt reached NMJ » inc paralysis

🌟 polymorphism in BCHE gene

18
Q

NET blockers

A
  1. Cocaine
  2. SSRIs, SNRIs
  3. TCA
19
Q

What inhibits DA to NE conversion?

A

Reserpine

20
Q

Lithium tox

A

» LiTHIUM «

  1. Low Thyroid
  2. Heart - ebstein anomaly
  3. diabetes Insipidus
  4. Unwanted Movements - tremors (#MC)
21
Q

Synth of NTs - DA, NE etc

A

Tyrosine - L dopa - Dopamine - NE - Epi - Melanin

22
Q

Theophylline tox + Tx

A

~ caffeine : mild cortical arousal + insomnia
-N/V/D, abd pain, cardiac arrhythmia, SEIZURES

Tx:
activated charcoal.
Beta blockers (arrhythmia)
BDZ + phenobarbital (seizures)

23
Q

blood-gas partition coefficient

A

Low B-G partition coefficient = low solubility : meaning more free to produce effect in blood : quickly saturated : inc partial pressure :: rapid onset of action
Eg. N2O

High B-G partition coefficient = high solubility, less free in blood to produce an effect : partial pressure rises slowly :: slow onset of action
Eg. Halothane

24
Q

How is potency of inhaled anesthetics measured?

A

MAC : Min alveolar conc

  • conc of anesthetic in alveoli that renders 50% pts unresponsive to painful stimuli (ED50)

❗️Potency inv proportional to MAC ❗️

25
Q

What is added to local lidocaine?

A
  1. Lidocaine + Epi : vasoconstriction
    - dec local bleeding
    - prolonged duration of action of lidocaine since more remains at site of injection
    - dec systemic absorption: dec SE
  2. Lidocaine + Na bicarbonate:
    - dec pH : inc potency : dec pain at injection site
26
Q

NTs of pain in PNS

A

Glutamate + Subs P

27
Q

Tx of GAD in pts w Hx of OD

A

Buspirone (NOT BDZ) + SSRI

28
Q

2nd gen antipsychotics MOA

A
  1. D2 receptor antag PLUS
  2. 5HT2A receptor antag

1st gen - only D2 r antag

29
Q

Tx of FGA SE

A

Acute dystonia rxn

  1. Diphenhydramine Or Benztropine + switching to SGAs
30
Q

SNRI SE HTN seen w?

A

Venlaxafine

31
Q

Full opioid Ag used for Tx of opioid use disorder?

A

Methadone
- withdrawal + maintenance

SE:

  • resp depression + QT prolongation
  • dependence
32
Q

Partial opioid Ag used for Tx of opioid use disorder?

A

Buprenorphine

Used alone or w Naloxone, opioid antagonist

33
Q

Tx DI acute dystonia

A

Diphenhydramine

Benztropine

34
Q

Tx cluster headaches

A

Sumatriptan
100% O2
Prophylaxis: Verapamil

35
Q

Tx Migraines

A

NSAIDs
Triptans
Dihydroergotamine

Prophylaxis: b-blockers, valproate. Botulinum. Anti-CGRP MAB.

36
Q

Tx tension headache

A

NSAIDs

Acetaminophen

37
Q

Tx trigeminal neuralgia

A

Carbamazepine

38
Q

Tx essential tremors

A 
Propranolol 
Primidone (barbiturate)
39
Q

Tx restless leg syndrome

A

DA Ag:

Pramipexole, Ropinirole

40
Q

Na ch inactivating Antiepileptics

A
  1. Valproate
  2. Topiramate
  3. Lamotrigine
  4. Levitiracetam

— seize the land —

Pharm (11 decks)

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