drugs Flashcards
what is the goal of glaucoma drugs
decreased intraocular pressure via decreasing the amount of aqueous humor production.
what does epinephrine do for glaucoma
decreases the production of aqueous humor synthesis via vasoconstriction.
When to not use epinephrine and why
in close-angle glaucoma. this will cause mydriasis and exacerbation
brimonidine for glaucoma
decreased aqueous humor production
what are the SE for brimonidine
blurry vision, ocular hyperremia, foreign body, pruritus or allergic reaction
what beta blockers are used for glaucoma
timolol, betaxolol and carteolol
How do the beta blockers work for glaucoma
reduce humor production.
When using beta blockers for glaucoma are there pupillary or vision changes
None.
what is the mechanism for acetazolamide in glaucoma
reduces production by inhibition of carbonic anhydrase
what are the direct cholinometics and how do they work for glaucoma
pilocarpine and carbachol. they increase the outflow of humor via contraction of the colliery muscle and opening of the trabecular meshwork.
what are the SE of the cholinometics
myosis and cyclospasm. contraction of the cilliary muscle.
what are the indirect cholinometics and how do they work in glaucoma
physostigmine and echothiophate. physostigmine is used in emergencies and is very effective at opening of the canal of schlemm.
what are the prostaglandin drugs for glaucoma
latanoprost. (PGF2alpha). increases the outflow of humor.
what are the SE of latanoprost
darkens the color of the iris.
what is tramadol and what is it used for
very weak opioid agonist, also inhibits serotonin and NE uptake. thesis for chronic pain.
what are the SE of tramadol
decreases seizure threshold.
what is phenytoin used for
focal simple and complex seizures; general tonic clonic seizures.
what is first line therapy for general tonic clonic seizures
phenytoin, carbamezepine, valproic acid
what is first line therapy for status epilepticus prophylaxis
phenytoin
what is first line therapy for status epilepticus acute
benzodiazepines (lorazepam or diazepam)
what is first line therapy for simple or complex partial seizures
carbamazepine
what else is carbamazepine used for
first line therapy for trigeminal neuralgia.
what are the therapies for simple or complex partial seizures,.
carbamazepine (1st line), phenytoin, lamotrigine, gabapentin, topiramate, phenobarbital, valproic acid, tiagabine, levetiracetam. j
what are the therapies for general tonic clonic seizures
carbamazepine (first line), phenytoin (first line), valproic acid (first line), lamotrigine, gabapentin, topiramate, pehnobarbital, levetiracetam.
what are the therapies for absence seizures
ethosuximide (first line), can also use valproic acid
what is used for seizures of pregnancy
MgSO4
what drug is used for migraine prevention
verapamil, topiramate, beta blockers
what are the SE for the benzo
sedation, tolerance, dependence.
what are the SE for carbamazepine
diplopia, ataxia, blood dycrasias, lover toxicity, teratogenesis, SIADH, SJS.
what are the SE for ethosuximide
GI distress, fatigue, HA, urticaria, SJS
what are the Se of the phenobarbs
sedation, tolerance, dependence, induction of cytochrome P450
what are the SE for phenytoin
nystagmus, diplopia, ataxia, sedation, gingival hyperplasia, hisutism, megaloblastic anemia, teratogenesis, SLE-like, lymphadenopathy, SJS
SE of valproic acid
Gi distress, hepatotoxicity, neural tube defects, tremor, weight gain,
what are the SE off lemotrigine
SJS
what are the SE of gaabpeitin
sedation and ataxia
what are the SE of topiramate,
sedation, mental dulling, kidney stones, weight loss.
what is succinylcholine
polarizing anesthetic strong ACh agonist. produces sustained depolarization and prevents muscle contraction.
is there an antidote for succinylcholine
not in phase I, but yes in phase 2. lots of neostigmine.
what are the complications of succinylchonline
malignant hyperthermia. Hypercalcemia, hyperkalemia
what is tubocurarine
nondepolarizing competitive ACh antagonist.
what drugs are similar to tubocurarine
atracurium, mivacurium, pancuronium, vecuronium, rocuronium,
what is the antidote for tubocurarine
reversal of the blockade with neostigmine, edrophonium, and other cholinesterase inhibitors.
what is the treatment of malignant hyperthermia
dantrolene
what is dantrolene
prevents Ca release from the sarcoplasmic reticulum, used for the treatment of malignant hyperthermia and neuroleptic malignant syndrome.
what are the dopamine agonists and what are they used for
bromocriptine, pramipexole, ropinirole. used to treat parkinsons in someone under 70 or functioning
what drugs can increase the availability of dopamine
amantidine and carb/levadopa.
what can prevent the breakdown of dopamine
MOAi and COMTi such as selegeline (MAOBi), entacapone(COMTi), tolcapone (comt),
what are the MAOBi
selegiline
what are the COMTi
entacapone, tolcapone
what can be used for the treatment of excess tremor and rigidity in Parkinsons
benztropine.
what is memantine used for
NMDA receptor antagonist that helps prevent the excitotoxicity of Alzheimers
what are the SE for memantine
hallucinations, dizziness and confusion.
what acetylcholinesterase inhibitors are used for Alzheimers
donepezil, galantamine, rivastigmine.
what are the SE of the AChesterase inhibitors
dizziness, nausea and insomnia./
why don’t we use phenytoin in pregnancy
because it can cause fetal hydantoin disease
what is fetal hydantoin
cleft lip and palate, short broad nose, malformed ears, microcephaly, wide-spaced eyes.
serotonin syndrome may occur with combinations of what drugs?
MAOi, dextramorphan, SSRIs/SNRIs, TCAs, meperidine
what causes lymphadenopathy, eosinophilia, truncal rash, and systemic syndromes
carbamazepine and phenytoin. DRESS syndrome
what are the teratogenic effects of carbamazepine?
cleft palate, cardiac defects, neural tube defects, skeletal abnormalities.
inhibits folate absorption
what drugs can cause neuroleptic malignant syndrome and what is the cause
atypical antipsychotics, such as riperidone, or olanzapine. caused by antagonization of the D2 receptor.
treatment for neuroleptic malignant sydnrome
dantrolene. bromocriptine, amantidine can all be used
what is the treatment for shingles
oral acyclovir or valacyclovir
