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pharm > Drug Bomb - Test 3 > Flashcards

Drug Bomb - Test 3 Flashcards

1
Q

Why is a drug given Topically

A

it is too toxic to give IV

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1
Q

4 stages of a Grand Mal?

A

Aura, Tonic, Clonic, Sleep

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2
Q

Buspirone

A

anxiolytic MOA- 5HT1a agonist - partial

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2
Q

what is beta amyloid?

A

extracellular plaques

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3
Q

Sevoflurane

A

Inhalable Anesthesia Tx: anesthesia, very potent, ropic onset and recovery Benefits: low airway irritation - very commonly used

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3
Q

What drugs are given adjuvant to anesthetics?

A

benzodiazepine, barbiturates, anlagesics, scopolamine, antichhoingrgics, NMJ blocking agents

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3
Q

Trihexyphenidyl

A

Anticholinergic TX: parkinson MOA: ++GABA SE: dry up - anticholinergic

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3
Q

fentanyl

A

lipophilic opioid (TRANSDERMAL PATCH long acting ), 100xs stronger than morphine, sufentanyl is 5xs stronger than fentanyl

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3
Q

nalorphine

A

opioid

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4
Q

Chloroprocaine

A

Local Ester Anesthetic TX: epidural agent for labor (lower risk of toxcity than bupivacaine)

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4
Q

Effects of estrogen in Alzheimers disease

A

women over 75 years old that have been on estrogen replacement therapy have seen a 4X decrease in alzheimers

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5
Q

what is huntingtons protein?

A

intranuclear protein

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5
Q

butorphanol

A

opioid

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6
Q

Name this seizure: rapidly recurring seizures, need acute treatment

A

status epilepticus

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6
Q

What are EPS

A

Extrapyramidal Syndrome, sx’s include: parkinson like, akathesia (muscle restlessness), dystonia, tardive dyskinesia (irreversible movt of face and mouth, seen more in the elderly)

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6
Q

metabolism of opioids

A

through the liver, large 1st pass effect, heroin and codein are metabolized to morphine

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6
Q

dextromethorphan

A

COUGH SUPRRESSANT (as well as codeine)

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7
Q

Inclusions that we see in parkinsons and ALS?

A

lewy bodies

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7
Q

what is the date rape drug

A

flunitrazepam, a benzodiazepine

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8
Q

Caffeine

A

Methylxanthine TX: apnea of prematurity, resotre alertness MOA: –CNS Suppression via A1 antagonism

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8
Q

Theophylline

A

Methylxanthine TX: COPD, Asthma MOA: –CNS Suppression via A1 antagonism

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9
Q

barbiturate are long acting except for

A

thiopental

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11
Q

Venlafaxine

A

SNRI MOA: – SERT and NET TX severe depression

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11
Q

Carbidopa

A

–Dopa decarboxylase in the periphery = ++Ldopa to cross BBB

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12
Q

What are the 4 main anxiolytic/hypnotic drugs

A

Benzodiazepine, Barbituates, Melatonin agonists, 5HT agonists

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12
Q

what are the main uses of sedative hypnotics

A

TX of anxiety, insomnia, balanced anesthesia, epilepsy, withdrawal, muscle relaxation

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13
Q

haloperidol

A

typical antipsychotic, most potent

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13
Q

MOA of huntingtons dis

A

loss of dopaminergic neurons in the basal ganglia

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13
Q

effects of DA and Ach on GABA?

A

DA cause – GABA,, Ach ++GABA

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14
Q

How does disulfiram work?

A

–ALDH (aldehyde dehydrogenase) and causes an unpleasant reaction to alcohol ingestion

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15
Q

levorphanol

A

opioid

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16
Q

Ethanol

A

Alcohol CNS Depressant MOA: has a linear slope of action (more likely to cause death)

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17
Q

Name for this seizure: no losss of consciusness, minimal spread, localized?

A

simple partial seizure

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18
Q

Lamotrigine

A

TX: all seizures SE: Stevens Johnson syndrom MOA: –Na, and Ca2+ channels

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18
Q

orlistat

A

–GI fat absorption

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19
Q

Amphetamine salts (Adderall)

A

Tx: ADAD, narcolepsy Amphetamine Schedule 2 controlled substance

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20
Q

Most common forms of ADHD

A

Combined>Predominantly inattentive>predominantly hyperactivity

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20
Q

clonidine

A

alpha 2 agonists TX: ADHD

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22
Q

Mirtazapine

A

MOA++5HT and NE, while –presynaptic alpha2 receptors TX: antidepressant SE: antiemetic (–5HT), sedation and weight gain (–H1)

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22
Q

What are false beliefs?

A

delusions

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23
Q

Midazolam

A

Benzodiazepine for Adjuvant to Anesthesia Tx: sedation, amnesia, anxiolytic, sedation for painful procedures, high risk pt’s

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24
Q

What drug treats spasticity?

A

Baclophen (++GABAb agonist)

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25
Q

Morphine, Codeine, Heroin, Oxycodone

A

Opioids RR addiction 4 Highly euphoric

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26
Q

what treats tonic clonic seizures?

A

carbamazepine, phenytoin, valproic Acid

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27
Q

name this seizure: tonic spasms, convulsion, LOC

A

Tonic-Clonic or grand mal

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28
Q

Sedatives or Hypnotics cause calming effects mainly?

A

sedative anxionlytics. Hypnotics cause sleep.

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28
Q

Cardinal Sx of parkinsons?

A

Bradykinesia, muscular rigidity, resting tremor, postural instability

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29
Q

loperamide

A

opioid, antidiarrheal

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30
Q

MOA for alzheimers tx?

A

increase Ach, –AchE, –ButyrylchE (converts Ach to choline and acetate)

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30
Q

what does opium mean?

A

coming from poppy seeds - morphine and codeine

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30
Q

Analeptic that is an analgesic

A

caffeine (excedrine)

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31
Q

excitalopram

A

SSRI

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31
Q

ascending pain pathway

A

opioid receptors on presynaptic nerve causes – in excitability. Post synaptically, opening of K+ channels

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32
Q

Thioridazine

A

typical antipsychotic, middle potent

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33
Q

Lithium

A

TX: manic depression - maintanence (bipolar) MOA: unsure but it is mood stabilizing SE: Tremor, hypothyroidism, Nephrogenic DI, skin reactions CI: Thiazides (NCCI) and Loop diuretics (NKCCI)

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33
Q

what three areas of the brain are affected in ADHD

A

dorsolateral prefrontal cortex, dorsal anterior cingulate cortex and the caudate/putamen

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34
Q

What are the three MOA for anticonvulsants?

A

–Na+ and Ca2+ voltage gated ion channels, ++GABA or it’s effects

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36
Q

what treats before and after medical procedures?

A

midazolam, diazepam, lorazepam

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36
Q

Alchohol abuse

A

sedative, hypnotic, RR adiction is 3 mild euphoria, reducing inhibitions completely absorbed in the stomach fetal alcohol concentration is the same as the mothers metabolized by ADH in the liver (some in lungs and kidney) follows 0 order kinetics (enzyme limited - only 1 cup per hour) MOA: ++GABA at GABAa receptors, –NMDA (NMDA is used in learning, cognition, etc) Low doses: slurred speech, ataxia High dose: amnesia, blackouts, respiratory distress CONTRAINDICATED:BARBITURATES, BENZODIAZEPINES, MARIJUANA, COCAINE (LIVER MAKES COCAETHYLENE) SE: wernicke korsakoff syndrome (–Vit B1 thiamin) wet brain; Fetal alcohol syndrome (up to 50%, mental retardation, hyperactivity, antisocial behavior); alcoholic fatty liver syndrome = cirrhosis = liver failure

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37
Q

Duloxetine

A

SNRI MOA: – SERT and NET TX: Chronic pain (better than TCA’s)

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38
Q

what barbiturate causes a medically induced coma?

A

pentobarbital

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38
Q

Name this seizure: sudden onset, abrupt cessation, brief LOC

A

Absence seizure, or petit mal

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38
Q

what is an opiate (meaning)?

A

extracted from poppy seeds

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39
Q

Mu2

A

receptor for opioids - brainstem and spinal cord

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40
Q

Valproic acid, carbamazepine

A

TX: MDD acute sx’s of mania

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41
Q

adding a benzodiazepine with what drugs could cause additive CNS depression

A

ethanol, opioids, anticonvulsants, phenothizine, antihistamine, TCA’s

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42
Q

Amphetamines (meth, dexamphetamine, methylphenidate, cocaine, modafinil)

A

Sympathomimetic Amides Metabolized by liver, avoid MAOI and SSRI Duration of action is usually short MOA: ++ synaptic monoamines by –DAT; –VMAT = more DA to be released from presynaptic neuron

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43
Q

paroxetine

A

SSRI Short half life - see SE with sudden discontinuation

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44
Q

Whats is used more, atypical or typical antiphsychotic agents?

A

atypical are used more

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44
Q

Amantadine

A

Antiviral TX: parkinsons MOA: increase DA release, only works for 12 motnhs

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46
Q

intermediate druation benzodiazepines

A

Lorazepam

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47
Q

what treats narcolepsy

A

modafinil

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48
Q

Valproic acid

A

MOA: –T type Ca2+ channels, – GABA transaminase Tx: petit mal (absence seizure) SE: hepatotoxic syndrome, teratogenic

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49
Q

Fluoxetine

A

SSRI Longest half life of the SSRI, –P450

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49
Q

what is cross tolerance

A

seen in opioid tolerance, tolerance to one drug is tolerance to many others

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50
Q

What drug treats spasms

A

Diazepam (by ++GABA)

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51
Q

Phenytoin, Fospenytoin

A

Class: cyclic ureides Dose dependent (zero order kinetics)- low dose = linear, high dose = non linear MOA: –Na channels (keeping in inactive state), – release of Glutamate, ++GABA TX: – Seizure propagation - Grand Mal, partial seizures, status epilepticus SE: nystagmus, ataxia, gingival hypertrophy, Fetal hydantoin syndrome (teratogenic) Fosphenytoin (more soluble, better for IV) ASA increase free phenytoin (causes protein dissociation)

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52
Q

surgical tx for parkinsons

A

Fetal DA grafts, deep brain stimulation, thalamtomy (–tremors)

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53
Q

tx seizures

A

diazepam, lorazepam, clonazepam, chlorazepate

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54
Q

L-Dopa

A

most common drug for Parkinsons, L-dopa can cross the BBB SE: dyskenesias - use with a drug holiday (helps –on-off phenomenon by stopping medication for a short time), GI, Cardio prx.

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54
Q

tramadol

A

TX: pain, opioid

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55
Q

propranolol (beta Blockers)

A

TX: sympomatic relief of anxiety (tremors, sweat)

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56
Q

Benzocaine

A

Local Ester anesthetic TX: topical only (great lipid solubility) SE: may induce methemoglobin

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57
Q

what is also affected in parkisnons beside motor?

A

cognition via the hippocampus and cerebral cortex

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58
Q

risperidone

A

atypical antipsychotic

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59
Q

Flumazenil

A

used as an antidote to benzodiazepine and newer hypnotics

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59
Q

What are two neurolytics

A

Ethyl alcohol and Phenol

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59
Q

Tiagabine

A

TX: anticonvulsant MOA –GABA reptake

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60
Q

quetiapine

A

atypical antipsychotic

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61
Q

Name this seizure: starts local but spreads to a generalized seizure

A

partial becoming generalized

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62
Q

Pramipexole

A

DA receptor agonist TX: Parkinson

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62
Q

naloxone

A

TX OPIOID OVERDOSE IMMEDIATELY

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63
Q

Modafinil

A

NOT FOR USE IN CHILDREN TX: ADHD

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64
Q

what treats myoclonic Seizures?

A

clonazepam, valproate

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64
Q

What is the worst drug interaction with opioid?

A

MAOI!!! causes htn, mostly with meperidine

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65
Q

meperidine

A

active metaboilte, opioid

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66
Q

MOA of schizophrenia

A

excessive mesolimbic/mescortical Dopamine

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66
Q

descending pain pathway

A

opioids block the inhibitory GABA neurons = –of nociceptive processin

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67
Q

Rivastigmine

A

Tx: alzheimers MOA: –AchE and BchE CAN HAVE TRANSDERMAL Patch

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69
Q

tx for panic attacks

A

alprazolam

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70
Q

do opioids experience sensitization?

A

yes

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71
Q

can antidepressants be used in tx of ADHD?

A

yes

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72
Q

what are lewy bodies?

A

intracellular alpha synuclein

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73
Q

Gabapentin, Pregabalin

A

GABA analog - but –presynaptic Ca2+ channels TX: grand mal (tonic clonic), partial seizures, Neuropathic pain

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74
Q

Codeine

A

Metabolized to morpine in the liver

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75
Q

SE of anticonvulsants:

A

Sedation, Diplopia, nystagmus, ataxia, GI upset, withdrawal, –oral contraceptive effectiveness, teratogenic (except phenobarbital)

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76
Q

SE of Stimulants

A

Euphoria, dysphoria, insomnia, irriability, tremor, loss of appetite, Cardio risks (MI and Stroke), Addiction, No long term affect on growth

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77
Q

benzodiazepine that treats bipolarism

A

clonazepam, lorazepam

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78
Q

what causes most of the SE of the antipsychotics?

A

the Dopamine antagonists

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79
Q

what drug interaction is bad with antiAlzheimers?

A

TCA, AVOID THEM, orthostatic hypotension

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81
Q

Alprazolam, Clorazepate, Diazepam, Lorazepam, Oxazepam

A

Anxiolytic, benzodiazepine, anxiolytic TX: anxiolytic, sedative, hypnotic

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82
Q

atomexetine

A

NE reuptake inhibitor TX: ADHD no abuse potential

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83
Q

what are the three pathologies of Alzheimers Disease

A

Brain atrophy, amyloid plaques, tau protein (neurofibrillary tangles)

84
Q

Selegiline

A

MAOI Class, MAO B (just Dopamine) at lower dose, MAO A and B with higher dose Irreversible Low Dose TX: parkisons disease Higher dose TX: antidepressant via a patch (transdermal)

85
Q

Diazepam, Lorazepam

A

Benzodiazepine TX: initial tx for Status epilepticus MOA: ++GABAa response Lorazepam>diazepam SE: sedative, tolerance

85
Q

aripiprazole

A

atypical antipsychotic

86
Q

what atypical agent is has most EPS?

A

risperidone

87
Q

Desflurane

A

Inhalable Halogenated Tx: anesthesia, very rapid onset and recovery, good minute to minute SE: more irritable to Respiratory system

88
Q

Cause of ADHD

A

DA deficit

91
Q

What treats Partial Seizures

A

Carbamazepine, Phenytoin, Valproic Acid

92
Q

In what disease do we see and ++ in alzheimers disease

A

Trisomy 21

93
Q

heroin

A

no medical use

94
Q

what cell do we see an accumulation of near the plaques in alzheimers?

A

microglial - cns macrophages

95
Q

pharmacokinetic tolerance

A

increased drug metabolism

97
Q

Cocaine

A

Local Ester anesthetic TX: ENT procedures SE: abuse, CNS excitation, HTN

98
Q

Imipramine

A

TCA Class, Anticholinergic. TX: enuresis MOA: –5HT and NE reuptake

98
Q

MOA of benzodiazepine

A

potentiate effects of GABA –> ++frequency of Cl- channel opening –> cause hyperpolarization –> inhibition

99
Q

What is the VTA?

A

part of the mesolimbic/mesocortical area, effects behavior and psychosis, is the Ventral Tegmental Area, projects to the nucleus accumbens (DA1 receptors)

100
Q

hydrocodone

A

opioid, used in combo with acetaminophen, nsaids, etc.

101
Q

oxymorphone

A

opioid

102
Q

What two general anesthetics are pungent?

A

enflurane and isoflurane

103
Q

what antipsychotics especially cause weight gain?

A

clozapine and olanzapine

105
Q

Topiramate

A

Tx: anticonvulsant, anorexia

105
Q

sx’s of Alzheimers

A

Loss of short term memory, aphasia (difficulty with words), apraxia (–motor use), agnosia(–recognition of objects), disorientation

107
Q

negative signs of schizophrenia

A

no emotions, no socialness, no attentiveness

107
Q

another name for emotional dependance

A

addiction

108
Q

what treats agitation

A

lorazepam and diazepam

109
Q

Narcotic meaning?

A

any drug that causes sedative and stuporous effects

110
Q

Bupivacaine

A

Local Amide Anesthetic TX: epidural infusion for labor, excellent spinal anesthetic

111
Q

MOA of parkinson

A

loss of dopaminergic neurons in the basal ganglia that project into striatum

113
Q

hydromorphone

A

10xs stronger than morphine

114
Q

what receptor is more important in antipsychotics?

A

5HT>>D2, less EPS toxic than if D2>>5HT

114
Q

Benztropine

A

Anticholinergic TX: parkinson MOA: ++GABA SE: dry up - anticholinergic

116
Q

fluphenazine/prochlorperazine

A

typical antipsychotic, highly potent

116
Q

nalbuphine

A

opioid

118
Q

What is a nuerolytic’s tx?

A

to permanently decrease nerve conduction

119
Q

pentazocine

A

opioid

121
Q

eszopiclone, zolpidem

A

new hypnotics Tx: insomnia MOA: binds and activates GABAa channel ——>—–> hyperpolarization

122
Q

what happens if the SE of opioids are too severe?

A

change opioids

124
Q

Phenelzine Tranylcypromine

A

MAOI Class Irreversable and Non selective (Both MAO A and B) (NE, 5HT, Dopa, tyramine) Bad Side effects

125
Q

what are three natural opioids?

A

morphine, codeine

126
Q

THC - marijuana, dronabinol

A

RR addiction 2 MOA: disinhibition of DA neurons in VTA

128
Q

what classes of drugs have a non linear slope

A

benzodiazepines and newer hypnotics -exzopiclone and zopidem (safer- less likely to cause OD)

129
Q

tx of Parkinsons D?

A

work with DA. Increase DA, decrease degradation of DA, agonist of DA, Anticholingergic

129
Q

Apomorphine

A

DA receptor agonist TX: Parkinson

130
Q

long lasting benzodiazepien

A

Diazepam

131
Q

morphine

A

prototype Mu agonist, opioid, tx severe pain

133
Q

What sleep aid do we not see dependance?

A

ramelteon (melatonin agonist)

135
Q

Propofol

A

Milk of Amnesia, Intravenous Anesthetic Tx: most used IV anesthetic, rapid induction, rapid recovery with little hangover

136
Q

what drug is used to tx alcohol addiction?

A

Disulfiram

137
Q

Cocaine

A

Stimulant, topical anesthetic, appetite suppressant Affects reward center (VTA), ++libido and energy Schedule 2 controlled substance MOA: –DAT transporter = ++ DA in synapse RR addtiction is 5 (strongest of any drug) When mixed with alcohol = cocaethylene

138
Q

what is the grading of abused drugs

A

Schedules 1 (highly addictive, no clinical use) to 5 (high clinical use, low addiction rate)

139
Q

methadone

A

TX: OPIATE ADDICTION, long acting = less withdrawal

140
Q

effects of opioids?

A

respiration depresssion, miosis, –cough, analgesia, euphoria, sedation, Emesis, GI constipation, urinary retention, –uterus contraction, cause PANS effect on Heart, and Histamine release

141
Q

meth abuse

A

Lasts much longer than cocaine SE: sympathomimetic effects, RR addiction = 5

142
Q

what treats status epilepticus?

A

Lorazepam>Diazepam, Phenytoin/Fosphenytoin

143
Q

What general anesthetic is an irritant

A

Desflurane

144
Q

Felbamate

A

TX: anticonvulsant adjunct, aplastic anemia

145
Q

What is cardinal sign of ADHD

A

Inattention (but a total of 6 sx’s have to be present)

147
Q

Trazodone

A

5HT2 Antagonist MOA: –5HT receptor post synaptically TX: unlabeled for hypnotic, SE: Priapism (long lasting boner), Sedation (block H1)

149
Q

Desipramine

A

TCA Class MOA: –NE reptake>5HT Tx: neuropathic pain

150
Q

Nicotine Abuse

A

mesolimbic reward pathway, highly abused substance, MOA: ++Nicotinic Ach receptors in VTA Tx addiction iwth burpropion and verenicline (chantix)

151
Q

best drug to treat ADHD

A

Methylphenidate

153
Q

Amitriptyline

A

TCA Class Anticholingergic TX: sedative effects

154
Q

Do benzodiazepines experience dependence?

A

yes, can be minimized via long acting (diazepam) drug, or tapering

155
Q

When do I not give benzodiazepines to?

A

pregnant women, elderly individuals (only after dose changing)

156
Q

Thiopental

A

Intravenous Anesthetic Barbiturate Tx: induction, not maintainence SE: hyperalgesic

158
Q

what is tau protein

A

intracellular neurofibrillary tangles, affects the microtubules, from hyperphosphorylated tau protein

160
Q

How are the benzodiazepines metabolized

A

metabolised via: liver, CYP3A4. Varying length of activity.

161
Q

dextroamphetamine

A

TX:ADHD

163
Q

what treats acute alcohol withdawal

A

diazepam and oxazepam

165
Q

Positive sx of Schizophrenia

A

delusions, hallucinations, agitation, paranoia, intrusion of thoughts

166
Q

Bupropion

A

MOA: –NE and Dopa reuptake TX: smoking cesation, MDD

166
Q

what classes of drugs have a linear dosing slope

A

barbiturates and ethanol (deadlier, more likely from an OD)

167
Q

loss of what neurotransmitter is correlated with progression of Alzheimers disease

A

Ach

169
Q

Entacapone

A

COMTI (catechol o methyltranserase inhibitor) Tx; parkinsons MOA: Peripheral COMT I - no CNS

170
Q

Nitrous Oxide

A

Inhalable (Laughing Gas), Systemic Anesthetic Good analgesics- rapid onset and recovery Never used by itself (Low potency)- helps the potency of others

171
Q

codeine

A

tx moderate pain, opioid, used in combo with acetaminophen (ANIT-TUSSANT, along with dextromethorphan) less addictive than morphine

172
Q

Inclusions that we see in Alzheimers?

A

beta amyloid and tau protein

173
Q

what drug causes Stevens Johnson Syndrome (Severe allergic reaction, red patchy skin)?

A

lamotrigine

175
Q

Flurazepam, Temazepam, Triazelam, Midazolam, Flunitrazepam

A

benzodiazepine, sedative/hypnotic Tx: anxiolytic and sedative, hypnotic

176
Q

Why is a drug given IV

A

it isn’t too lipophilic to cross skin

177
Q

what is an opioid (meaning)?

A

anything that binds to opioid receptors

178
Q

what is the antibenzodiazepine?

A

flumazenil –the benzodiazepine receptor

179
Q

what drugs reduce Ca2+ influx

A

valproate and ethosuximide (effective in petit mal seizures)

180
Q

what receptors are targeted with antipsychotics?

A

D2 is the most used receptor (antagonized), cna use 5HT2a as well (antagonized)

181
Q

Do benzodiazepines experience tolerance?

A

yes

183
Q

Name this seizure: starts local but spreads quickly, altered conscousness

A

complex partial seizure

184
Q

what is required for the benzodiazepines to have sedative hypnotic activity?

A

a negative on the number 7 position

185
Q

ramelteon

A

melatonin agonist, CNS Depressant Tx: insomnia MOA: MT1-sleep onset, MT2-circadian rhythm

186
Q

naltrexone

A

TX OPIOID AND ALCOHOL ADDICTION/OVERDOSE - MAINTANENCE

187
Q

LSD (lysergic acid diethylamide), psilocybin

A

Hallucinogen RR addiction =1 severly altered judgement = harm others and yourself MOA: 5HT2a (Gq) = ++Ca2+ = ++Glutamate in cortex

188
Q

buprenorphine

A

opioid

189
Q

What treats absence seizures?

A

ethosuximide, valproic acid (by reducing Ca2+ influx)

190
Q

What is EMLA and give an example

A

Eutectic Micture of Local Anesthetics Lidocaine and prilocaine

191
Q

fluvoxamine

A

SSRI

192
Q

TCA SE

A

orthostatic hypotension - hip breakers (alpha 1), weight gain (H1), anti cholinergic effects, 3 C’s = convulsions (CNS), Coma (CNS), Cardiac arrhythmias (Cardiac)

193
Q

What are the thre states of Na channel

A

Resting, open, inactive

194
Q

What are 3 underlying causes of Seizures?

A

CNS injury, Congenityal Prx, Genetics Prx

196
Q

MAOI Class SE

A

orthostatic hypotension, weight gain, Tyramine interaction (too ++mono amines, cheese and wine)

198
Q

SE of benzodiazepines

A

drowsiness, ataxia, respiratory depression (lethal if combo with other Depressant), date rape (anterograde amnesia - flunitrazepam)

199
Q

ziprasidone

A

atypical antipsychotic

200
Q

Fentanyl

A

100x’s more potent than morphine

201
Q

SSRI SE

A

Seratonin syndrome (if not titrated off one med before starting another SSRI= lethargy, confusion, diaphoresis, tremor)

203
Q

Carbamazepine, oxacarbazapine

A

TCA TX: grand mal, partial seizures, trigeminal neuralgia (drug of choice) MOA: –Na channels, potent inducer of P450s and it’s own metabolism SE: SIADH (sx of Inapropriate ADH secretion, Teratogenic Oxacarbaxepine has longer duration and fewer drug interactions

205
Q

Spasticity vs Spasm

A

Spasticity is CNS injury, spasm is local Muskuloskeletal injury

206
Q

What drug interacts with L-dopa, never give with it

A

Pyridoxine - Vit B6 - causes ++decarboxylation of L Dopa

207
Q

psychosis that is heritable and includes lots of delusions

A

Schizophrenia

209
Q

What two things do we need to have on hand in case of a bad reaction to a local anesthetic?

A

antihistamine and epinephrine

210
Q

Galantamine

A

similar to Donepezil

211
Q

Phenobarbital, Primidone

A

Class: cyclic ureides, barbiturate MOA: ++GABAa recptor response TX: status epilepticus Primidone is metabolized by MES (liver P450) into phenobarbital

212
Q

Ketamine and Phencyclidine (PCP, angel dust)

A

Hallucinogen dissociative anesthesia/analgesic MOA: block NMDA glutamate receptors = –CNS cortex and limbic system

213
Q

diphenoxylate

A

opioid, antidiarrheal

215
Q

what barbiturate is an anticonvulsant

A

phenobarbital

216
Q

ethosuximide

A

Class: cyclic ureides TX: petit mal (absence seizure) MOA: –T type Ca2+ channels

217
Q

What does the dorsal anterior cingulate cortex affect

A

attention

219
Q

how many patients don’t respond to antiepileptic meds?

A

20%

221
Q

inclusions that we see in huntingtons dis?

A

huntingtons protein

222
Q

What is TAC and when it is used?

A

Tetracaine, Adrenalin and Cocaine used in Pediatric Emergency Rooms

223
Q

methylphenidate (ritalin)

A

TX: ADHD

225
Q

Chlorpromazine

A

typical antipsychotic, least potent

226
Q

Fomepizole

A

TX: antifreeze ingestion via –ADH

227
Q

what is different about the MOA of cocaine and amphetemine?

A

Cocaine is blocker of DA reuptake, Amphetamines also block NET, cause ++ release of DA and NE,

229
Q

Roinirole

A

DA receptor agonist TX: Parkinson

231
Q

What drugs do you never combine

A

MAOI, TCA, SSRI

232
Q

are amphetamines appetite supressants?

A

yes

233
Q

What is the abuse pathway of benzodiazepines and barbiturates?

A

Disinhibition of the VTA = activation of the mesolimbir reward pathway

234
Q

what is an analeptic?

A

restores the CNS - stimulant

235
Q

Hydroxyzine, Diphenhydramine

A

antihistamine CNS Depressant agent (off label) = sedative action

236
Q

olanzapine

A

atypical antipsychotic

237
Q

Rasagiline/Selegiline

A

MAOI-B TX: adjunct to L Dopa in parkinsons MOA: –MAOB and ++ DA (at higher doses also –MAOA) SE: serotonins Syndrome

238
Q

clozapine

A

atypical antipsychotic

239
Q

Mu1

A

receptor for opioids - supraspinal analgesia

240
Q

what are opioid used for

A

relief of pain, moderate to severe pain

241
Q

barbiturates abuse

A

Sedative, hypnotic, RR adiction is 3

242
Q

another name for physical dependance

A

withdrawal

244
Q

pentobarbital, phenobarbital, thiopental

A

CNS depressant, barbiturate MOA: linear slope (can cause death more easily), metabolites have NO activity, acts on GABA channels and keeps them open –> hyperpolarization

245
Q

what anxiolytic wont induce sleep or drowsiness

A

buspirone

246
Q

short duration benzodiazepines

A

midazolam, triazolam

247
Q

Donepezil

A

Long half life - 3days, once a day dosing, increase compliance TX: alzheimers mild, moderate and severe MOA: –AchE

248
Q

tolcapone

A

COMTI (catechol o methyltranserase inhibitor) Tx; parkinsons MOA: Central and Peripheral COMTI SE: hepatotoxic

249
Q

Articiane

A

Amide Anesthitic TX: dental procedures local anesthetic

250
Q

Doxapram

A

Analeptic Respiratory stimulant TX: post anesthesia MOA: increase tidal volume and RR via –GABAa

251
Q

Enflurane

A

Inhalable Halogenated Tx anesthesia SE: CNS stimulation (jerking, twitching) and Pungent odor

252
Q

gama hydroxy butyric acid (GHB)

A

sedative, hypnotic, RR adiction is 3 can be used as date rape drug, cause amnesia, reward pathway activation

253
Q

What are some general SE to general anesthesia?

A

low blood pressure, low cardiac output, arrhythmias

254
Q

sertraline

A

SSRI Short half life - see SE with sudden disncontinuation

255
Q

what drug is an antispasmodic

A

Diazepam

256
Q

Isoflurane

A

Inhalable Halogenated Tx: maintanence of anesthesia Low toxcitiy high pungency

257
Q

memantine

A

TX: moderate to severe Alzheimers Disease MOA: –NMDA receptor (glutamate receptor), = –Ca2+ influx = –glutamate toxicity

258
Q

MDMA (ecstasy)

A

designer drug MOA: Causes ++release of 5HT via SERT SE: 5HT depletion following the next 24 hours, acutely: hyperthermia and dehydration

259
Q

SE of DA receptor agonist?

A

GI N/V/C

260
Q

how much of poputlation does alzheimers affect?

A

10% over 65, 50% over 85

261
Q

metabolism of antipsychotics

A

metabolized by liver, cyp450, metabolized into active metabolites

262
Q

Antipsychotics can treat what dieseases?

A

schizophrenia, psychotic behavior, mania, emesis, coughing

263
Q

3 MOA for analgesics

A

1) inhibition of adenylyl cyclase (–cAMP) 2) –Ca2+ influx = – release of Neurotransmitter 3) opening post synaptic K+ channels = loss of intracellular K+ = hyperpolarization

265
Q

Acetazolamide

A

TX: anticonvulsant MOA: – Carbonic Anhydrase

266
Q

what are the effects of Dopaminergic antagonists?

A

cognitive fxn, EPS, antiemetic, ++prolactin, weight gain

267
Q

What seizure is often found in children?

A

Atonic - wear helmet

268
Q

Halothane

A

Halogenated Inhalables tx: maintancence of anethesia prototype drug for this class

269
Q

tx for depression (that is a benzodiazapine)

A

alprazolam

271
Q

signs and sx’s of ADHD

A

Inattention, impulsivity, hyperactivity, aggression

273
Q

if pts with alzheimers are treated and see psychotic sx’s, what next?

A

give an atypical antipsychotic, SSRI if we see depression (sertraline and citalopram)

274
Q

oxycodone

A

opioid, used for postsurgical pain

275
Q

what atypical agent has least EPS?

A

clozapine and quetiapine

276
Q

Benzodiazepines abuse

A

Sedative, hypnotic, RR adiction is 3 diazepam and alprazolam are the most abused

277
Q

pharmacodynamic tolerance

A

receptor downregulation, desensitization

278
Q

Lidocaine

A

Local Amide Anesthetic Reference Standard TX: pain MOA: topically or injection (not too toxic and still lipophilic) SE: Transient neurologic symptoms with high dose

279
Q

Name for recurring seizures?

A

epilepsy

280
Q

Ketamine

A

IV anesthetic MOA: non competitiveglutamate NMDA receptor antagonist Tx: analgesia and amnesia SE: emergence phenomenon - zombie stuff

281
Q

citalopram

A

SSRI Safest for adeverse interactions

282
Q

Most common seizures?

A

Complex Partial>tonic clonic> the rest

pharm (11 decks)

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