Drugs Flashcards
Phenytoin
Simple, complex; 1st Line for tonic-clonic 1st line prophylaxis for Status ^ Na+ channel inactivation -SE: nystagmus, diplopia, ataxia, sedation, gingival hyperplasia , hirsuitism, megaloblastic anemia, teratogen (fetal hydantoin), SLE-like syndrome, P-450 induction
Carbamazepine
-1st line for simple/complex/tonic clonic -^ Na+ channel inactivation -1st line for Trigeminal neuralgia -Diplopia, ataxia, blood dyscrasias, liver tox, teratogen, cytochrome P-450 induction, SIADH, Steven-Johnson syndrome
Lamotrigine
-Simple, complex, TC -Blocks voltage gated Na+ channels -SE: Steven-Johnson syndrome
Gabapentin
-Simple, complex, TC -Designed as GABA analog, but primarily inhibits HVA Ca2+ channels - Also peripheral neuropathy, BPD
Topiramate
-Simple, complex, TC -Blocks Na+ channels, ^ GABA action -SE: sedation, mental dulling, kidney stones, weight loss
Phenobarbital
-Simple, complex, TC -^ GABAa action -1st line in pregnant women, children -SE: Sedation, tolerance, dependence, induction of P-450
Valproic Acid
-Simple, complex, Absence; -1st line TC -^ Na+ channel inactivation, ^ GABA concentration -Myoclonic seizures -SE: Gi distress, rare but fatal hepatotoxicity, (measure LFTs), neural tube defects, tremor, weight gain. CI in pregnancy
Ethosuximide
-1st line absence -Blocks thalamic T-type Ca2+ channels -SE: GI distres, fatigue, HA, urticaria, Steven Johnson Syndrome EFGH: Ethosuximide, Fatigue, GI, Head
Benzodiazapines (diazepam/lorazepam)
-1st line for acute Status E - ^ GABA action -Also used for eclamptic seizures but first line if MgSO4 -SE: Sedation, tolerance, dependence
Tiagabine
-Simple, complex - Inhibit GABA re-uptake
Vigabatrin
-Simple, complex -Irreversibly inhibits GABA transaminase-> ^ GABA
Levetiracetam (keppra)
-Simple, complex, TC - Unknown; may modulate GABA and glutamate release
Barbiturates (phenobarbital, pentobarbital, thiopental, secobarbital)
-Facilitate GABAa action by duration of Cl-channel opening thus decreasing neuron firing. -Sedative for anxiety, seizures, insomnia, induction of anesthesia -SE: dependence, additive CNS depression effects with alcohol, resp/cardiac depression (death), cytochrome p-450–> TX overdose with symptom management
Succinylcholine
-SE: hyperkalemia, -calcemia - Reversal: Phase I: prolonged depolarization- no antidote; block potentiated by Che inhibitors Phase II: depolarized but blocked ;antidote CHE inhibitors
Tubocurarine, atracurium, mivacurium, pancuronium, vecuronium, rocuronium.
-Competitive with ACh receptors -Reverse with neostigmine, endrophonium, and other CHE inhibitors
Parkinson drugs
Bromocriptine
L-dopa (levadopa)/ Carbidopa
^ Da in brain; L-Dopa crosses and converted by dopa decarboxylase in CNS to DA -For Parkinsonianism - Arrythmias; LT->dyskenesia following admin, akinesia between doses. Carbidopa given to be a peripheral decarboxylase inhibitor to increase bioavailability of L-dopa in brain and limit peripheral side effects
Selegiline
-Selectively inhibits MAO-B, which preferentially metabolizes DA over NE and 5HT Adjunctive agent to L-Dopa in Parkinson’s -SE: may enhance L-Dopa adverse effects
Memantine
-NMDA receptor antagonist; helps prevent excitotoxicity (mediated by ca2+) -SE: dizziness, confusion, hallucinations
Donezapil, galantamine, rivastigmine
-Acetylcholinesterase inhibitors -SE: Nausea, dizziness, insomnia
Huntington Drugs
-Disease ^ dopamine, dec GABA +Ach -Reserpine +tetrabenazine–amine depleting -Haloperidol- DA receptor antagonist
Sumatriptan
-5ht ib/id agonist; causes vasoconstriction, inhibition of trigeminal activation and vasoactive peptide release. Half life s angina) mld tingling
Epinephrine
-Glaucoma drug -a-agonist -Dec aqueous humor synthesis due to vasoconstriction - SE: mydriasis, stinging; do not use in closed-angle glaucoma
Timelol, Betaxolol, Carteolol
-Glaucoma drug -B-blocker -Dec aqueous humor secretion -SE: no pupillary or visual changes
