Exam 2 part 2 antiepileptic, parkinson's, opiates, CNS stimulants

Question 1

used to treat grand mal and partial seizures but not petit mal by inhibiting Na+ channels in brain

Answer 1

phenytoin- toxicity: teratogenic (fetal hydrantoin syndrome); life threatening rash (Stevens-Johnsons disease)

Question 2

drug of choice for partial seizures; acts on Na+ channels; induces P450

Answer 2

carbamazepine toxicity: blurred vision, drowsiness, fetal effects (spinebifida), apastic anemia

Question 3

used for all but petit mal; activates GABAergic neurons; sedation; induces P450

Answer 3

Phenobarbital (a barbituate)

Question 4

activates GABAergic neurons to treat seizures

Answer 4

diazepam (a benzodiazepine)

Question 5

carbonic anhydrase inhibitor; may increase CO2 in brain to decrease activity; used in treatment of seizure

Answer 5

acetazolamide (also a diuretic)

Question 6

drug of choice for petit mal; inhibits Ca2+ channels in CNS; GI upset and drowsiness

Answer 6

ethosuximide- a succinimide

Question 7

for all seizure types; multiple mech. decrease GABA breakdown and increase synthesis toxic: GI upset, CNS sedation, tremors, potentially fatal hepatitis; fetal damage

Answer 7

sodium valproate

Question 8

agents used to treat partial seizures that act on GABA

Answer 8

topiramate gabapentin tigabine vigabatrin

Question 9

agents used to treat partial seizures that act on Na+ channels

Answer 9

lamotrigine zonisamide rufinamide lacosamide

Question 10

agent used to treat partial seizures that acts on Ca2+ channels

Answer 10

pregabalin

Question 11

agent used to treat partial seizures that acts on K+ channels

Answer 11

ezogabine

Question 12

agent used to treat partial seizures that blocks glutamate activity

Answer 12

perampanel

Question 13

treatment of Status Epilepticus

Answer 13

diazepam given IV

Question 14

MAO_B inhibitor used to slow progression of Parkinson symptoms

(2 of them)

Answer 14

Segeline- metabolized into methamphetamine

and

Rasagiline

Question 15

treatment for Parkinson’s

used with a DOPA decarboxylase inhibitor

SE- nausea, postural hypotension, hallucinations, confusion, dyskinesia, worsens closed angle glaucoma

Answer 15

L DOPA plus carbidopa

Question 16

COMT inhibitors for Parkinson’s

Answer 16

tolcapone

and

entacapone

(both alway used with L-DOPA)

Question 17

Stimulates DA₂ receptors

s.e.-nausea, hallucinations, hypotension

used to treat Parkinson’s

Answer 17

bromocryptine

Question 18

DA agonist used to treat restless leg syndrome

notes in Parkinson’s section

Answer 18

pramipexole

and

ropinirole

Question 19

DA agonnist for Parkinson’s treatment given with a patch

Answer 19

rotigotine

Question 20

DA agonist given by injection; causes severe nausea

treatment of Parkinson’s

Answer 20

apomorphine

Question 21

muscarinic blockers that restore DA/ACh balance in parkinson’s

se-memory loss and hallucinations

Answer 21

trihexyphenidyl and benztropine

Question 22

antiviral agent that increases release of stored DA

insomnia and restlessness can result

used to treat imbalance of DA and ACh found in Parkinson’s

Answer 22

amantadine

Question 23

High Potency

First generation antipsychotics

strong affinity for D2 receptors; some affinity for H1 (histamine) receptors

Answer 23

haloperidol

and

pimozide

Question 24

Low Potency

First generation antipsychotics

strong affinity for D2 receptors; some affinity for H1 (histamine) receptors

Answer 24

thioridazine

chlorpromazine

fluphenazine

perphenazine

prochlorperazine

trifluoperazine

thiothixene

Question 25

"atypical" newer antipsychotics act on D2 receptors + H1 receptors + 5HT receptors

Answer 25

aripiprazole quetiapine loxapine asenapine cloz**apine** olanzapine risperi**done** iloperidone paliperidone lurasidone ziprasodone

Question 26

First generation antidepressants tricyclic inhibit NE reuptake

Answer 26

imipramine and amitriptyline

Question 27

Second generation antidepressants SSRI's selective serotonin reuptake inhibitors

Answer 27

fluoxetine sertraline paroxetine fluvoxamine citalopram escitalopram vilazodone vortioxetine

Question 28

Third generation antidepressants SNRI's selective norepinephrine and serotonin reuptake inhibitors

Answer 28

venlafaxine duloxetine milnacipram desvenlafaxine

Question 29

other antidepressant agenets

Answer 29

buproprion nefazodone mirtazapine

Question 30

monamine oxidase inhibitors antidepressants -don't take with indiract acting amine → hypertensive crisis

Answer 30

tranylcypromine phenelzine isocarboxazid

Question 31

drugs to treat bipolar (manic) depression

Answer 31

phenothiazine haloperidol

Question 32

decreases NE release may alter glutamate metabolism used to treat bipolar (manic) depression may cause edema

Answer 32

lithium

Question 33

Natural opiate analog used parenterally because of first pass effect

Answer 33

Morphine

Question 34

partial agonist with low antinociceptive effects natural opiate analog antitussive effect

Answer 34

codeine

Question 35

5x as effective as morphine; semisynthetic agent synthesized as a cure for morphine addiction

Answer 35

heroin

Question 36

other semisynthetic opiate agonists

Answer 36

hydromorphone- 10x potency Oxycodone- oral form; partial agonist w/ .5x potency

Question 37

synthetic analogs of opate receptors

Answer 37

Fentanyl- 80 to 100x potency Sufentanil- 500-600x Alfentanil- 500-600x remifentanil- 500-600x

Question 38

Synthetic analog opiate agonist no pupil constriction half as potent as morphine

Answer 38

Meperidine

Question 39

Partial opiate agonist

Answer 39

Pentazocine

Question 40

Opiate receptor blockers antagonists

Answer 40

Naloxone Naltrexone Methylnaltrexone

Question 41

Agents that act as both narcotics and SSRIs

Answer 41

Tramadol Tapentadol

Question 42

CNS stimulants that are reuptake inhibitors

Answer 42

modafinil armodafinil

Question 43

other CNS stiumulants that inhibit DA reuptake

Answer 43

dexmethylphenidate methylphenidate- used for ADD

Question 44

THC containing drugs used for their antiemetic and appetite stimulant effect

Answer 44

dronabinol nabilone