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Pharm > Exam Three > Flashcards

Exam Three Flashcards

1
Q

What is GHB metabolized to?

A

GABA

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2
Q

Which two benzoes yield inactive, water-soluble glucoronide metabolites?

A

Lorazepam and oxazepam

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3
Q

What drug is used to treat an OD of benzodiazepines?

A

flumazenil

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4
Q

Which benzo is an antispasmodic?

A

Diazepam

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5
Q

What is the exact MOA of benzodiazepines?

A

increase frequency of chloride channel opening of GABA-A receptor

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6
Q

What two subunits of the GABA receptor do benzodiazepines bind?

A

alpha1

gamma2

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7
Q

What effects do the α1 subunits of the GABA receptor mediate?

A

sedation/amnesia/ataxic

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8
Q

Which two benzos are weakly active and short lived?

A

Alprazolam and triazolam

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9
Q

Which two benzodiazepines undergo Phase I metabolism that yields two relatively long-lasting metabolic products?

A

diazepam and flurazepam

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10
Q

Which two benzos kinetics are not influenced by age? Which benzo is influenced by age?

A

lorazepam and oxazepam

diazepam

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11
Q

Flumazenil may induce seizures in patients taking what other three drugs?

A

TCA

alcohol

barbiturates

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12
Q

What are the two newer benzodiazepine hypnotics?

A

Eszopiclone

Zolpidem

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13
Q

The newer benzodiazepines used for sleep only interact with what subunit of the GABA receptor?

A

α1

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14
Q

What CYP enzyme metabolizes the newer benzodiazepines?

A

3A4

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15
Q

Name three barbiturates. What are their functions?

A

Pentobarbital = medically induced coma

Phenobarbital = anti-convulsant

Thiopental = anesthesia

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16
Q

What is the difference between benzos and barbs regarding their metabolsim?

A

barbs dont have active metabolites

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17
Q

Are barbiturates weak acids or weak bases?

A

weak acids

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18
Q

What is the specific MOA of barbiturates?

A

increases open time of GABA chloride channel

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19
Q

What is the function of MT1?

A

sleep onset

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20
Q

What is the melatonin receptor agonist?

A

Ramelteon

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21
Q

What is the function of MT2?

A

circadian pattern

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22
Q

Where in the brain does Ramelteon work?

A

suprachiasmatic nuclei

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23
Q

What two CYP enzymes degrade Ramelteon?

A

2C9

1A2

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24
Q

Does Ramelteon produce dependence?

A

no

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25
Q

What is the 5HT agonist Anxiolytic? Which specific isoform? Agonist or antagonist?

A

Buspirone

5HT1A

agonist

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26
Q

What is an advantage of buspirone compared to benzodiazepines for treating anxiety?

A

Buspirone is only an anxiolytic

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27
Q

Which specific serotnin receptor isoform is Buspirone known to activate? What does activation of this receptor do to serotonin release?

A

5HT1A

decrease serotonin release

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28
Q

What are the two anti-histamine hypnotics?

A

diphenhydramine and hydroxyzine

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29
Q

Does Buspirone potentiate the effects of other CNS depressants?

A

no

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30
Q

What is the function of BDNF? What disease state can a decrease in BDNF be seen?

A

promote neural growth and survival

depression

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31
Q

What is the main adverse effect of 5HTreuptake blockade?

A

GI disturbances

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32
Q

What are the two non-selective MAO-A and MAO-B inhibitors? Reversible or irreversible?

A

phenelzine and Tranylcypromine

irreversible

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33
Q

What is the selective MAO-B inhibitor? What disease is treated at low dose? What disease is treated by high dose?

A

Selegiline

LOW = parkinsons

high = depression

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34
Q

What does MAO-A degrade?

A

serotonin

norepinephrine

dopamine

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35
Q

What does MAO-B degrade?

A

dopamine

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36
Q

Which MAO is preferentially used to treat Parkinsons?

A

Selegiline

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37
Q

What are the three tricyclics?

A

Imipramine

Amitriptyline

Desipramine

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38
Q

What two compounds does Imipramine inhibit the reuptake of?

A

5HT and NE

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39
Q

Why can TCAs cause lethal cardic arrhythmias?

A

blockade of sodium and calcium channels

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40
Q

Withdrawl of what drug can cause Discontinuation Syndrome?

A

SSRIs

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41
Q

What are the two main symptoms of Discontinuation Syndrome?

A

dizziness and paresthesias

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42
Q

What two compounds do the SNRIs inhibit the re-uptake of?

A

5HT and NE

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43
Q

What is a non-depressive symptom that SNRIs are used to treat?

A

chronic pain

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44
Q

What is the main 5HT2 antagonist? Which other receptor can trazodone block?

A

Trazodone

H1

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45
Q

What is the most common use for trazodone?

A

insomnia

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46
Q

What two compounds does Bupropion inhibit the re-uptake of? What is bupropion used to treat?

A

DA and NE

smoking cessation

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47
Q

What receptor does Mirtazapine block?

A

α2 antagonist

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48
Q

What two compounds Mirtazapine increase the release of?

A

5HT and NE

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49
Q

Other than α2, what three receptors can Mirtazapine block?

A

5HT2 and 5HT3 and H1

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50
Q

What is the treatment of choice for Bipolar disorder?

A

Lithium

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51
Q

What severe condition are valproic acid and carbamazepine used to treat?

A

acute mania

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52
Q

What is the most common side effect of lithium?

A

tremor

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53
Q

Other than tremor, what are three side effects of lithium?

A

nephrogenic diabetis insipidus

hypothyroidism

skin issues

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54
Q

What two drugs are contraindicated in lithium use? Why?

A

loop and thiazide

increase lithium absorption

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55
Q

Where in the kidney is the primary site of lithium absorption?

A

PCT

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56
Q

What is the most common site for the origination of a seizure?

A

temporal lobe

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57
Q

What are the two MOAs of valproic acid?

A

blocks GABA transaminase

blocks Na+ channels

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58
Q

What is the MOA of vigabatrin?

A

blocks GABA-transaminase

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59
Q

What are the two MOAs of gabapentin?

A

block L-type

increase GABA release

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60
Q

What is the MOA of tiagabine?

A

blocks GABA re-uptake

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61
Q

What drug do most anti-seizure drugs interfere with the synthesis of? Why?

A

oral contraceptives

induction of p450

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62
Q

What neurotransmitter can phenytoin enhance the release of?

A

GABA

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63
Q

What are the two main side effects of phenytoin?

A

nystagmus

gingival hyperplasia

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64
Q

Why can phenytoin cause anemic issues?

A

decreases folate levels

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65
Q

What is the drug of choice for trigeminal neuralgia?

A

carbamazepine

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66
Q

What are the two major side effects of carbamazepine?

A

leukopenia

SIADH

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67
Q

What is the drug of choice for seizures in infants?

A

phenobarbital

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68
Q

Other than treating seizures in infants, what condition is phenobarbital used to treat?

A

status epilepticus

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69
Q

Primodine is similar to what drug? What does primodine get converted into?

A

phenytoin

phenobarbital

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70
Q

What is the drug of choice for petit mal seizures? What patient population are petit mal seizures most often seen?

A

ethosuximide

children

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71
Q

What are the two MOAs of valproic acid?

A

inhibits Ca2+ influx

blocks GABA-T

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72
Q

What type of seizure is valproic acid used to treat?

A

petit mal

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73
Q

According to Duric, what are the two toxicities of valproic acid?

A

hepatotoxic

teratogenic

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74
Q

What is the preferred initial drug for status epilepticus?

A

Diazepam

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75
Q

What are the two MOAs of lamotrigine?

A

block Na+ and Ca2+ channels

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76
Q

What specific antiseizure drug does Duric say can cause Steven-Johnson Syndrome?

A

Lamotrigine

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77
Q

What is the MOA of tigabine?

A

block reuptake of GABA

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78
Q

What are the two MOAs of topiramate?

A

block AMPA

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79
Q

What is the MOA of baclophen?

A

GABA-B agonist

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80
Q

What is the BG Coefficient?

A

a measure of a drugs solubility in blood

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81
Q

What is anesthetic potentcy correlated to?

A

fat solubility

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82
Q

Will increased cardiac output increase or decrease the induction of anesthesia?

A

decrease

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83
Q

What is the MAC?

A

[anethetic] in the inspired air at equilibrium when 50% of patients do not sense noxious stimuli

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84
Q

What is the most adverse side effect of halothane during anesthesia?

A

malignant hyperthermia

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85
Q

What is the most adverse side effect of halothane during postop?

A

hepatitis

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86
Q

What is the most adverse effect of enflurane?

A

CNS induced seizuring

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87
Q

What are the two constituents of the diencephalon?

A

thalamus and hypothalamus

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88
Q

What are the three monoamines in the brain?

A

NE, 5HT, dopamine

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89
Q

Which benzo can be used as a date drug? Why?

A

flunitrazepam

induction of amnesia

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90
Q

Is selegilie reversible or irreversible?

A

irreversible

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91
Q

What condition is high dose selegiline used to treat?

A

depression

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92
Q

What are the two main side effects of all MAOIs? Antagonization of which receptor mediates these effects?

A

orthostatic hypotension and weight gain

H1

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93
Q

Which class of drug can be used to treat neuropathic pain?

A

TCAs

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94
Q

What two transporters do TCAs block?

A

SERT and NET

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95
Q

What three receptors can TCAs directly antagonize?

A

cholineric, histaminergic and α-adrenergic

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96
Q

What is Imipramine used to treat? Why?

A

enuresis

Imipramine is anti-cholinergic

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97
Q

What is the result of TCAs antagonizing cholinergic receptors?

A

GI issues

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98
Q

What is the result of TCAs antagonizing histamine receptors?

A

sedation

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99
Q

What is the result of TCAs antagonizing α1-adrenergic receptors?

A

orthostatic hypotension

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100
Q

What can TCAs produce in elderly patients?

A

delirium

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101
Q

What ion channels can TCAs effect? What can this lead to?

A

Na/K ATPase

arrhythmias

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102
Q

What are the three C’s of TCAs?

A

coma

convulsion

cardiac arrhythmias

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103
Q

What is the short term side effect of SSRIs?

A

GI disturbances

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104
Q

What is the long-term effect of SSRIs?

A

sexual dysfunction

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105
Q

Which SSRI is most likely to produce Serotonin Syndrome?

A

Fluoxetine

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106
Q

What are the two SNRIs?

A

venlafaxine and duloxetine

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107
Q

What other drug is the side effect profile of SNRIs similar to? What is the difference

A

TCAs

not as severe

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108
Q

What is the side effect profile of 5HT2?

A

GI disturbances

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109
Q

Which two classes of anti-depressants should never be combined?

A

TCAs and SSRI

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110
Q

Which two drugs can be added to lithium to treat Bipolar Disorder?

A

valproic acid

carbamazepine

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111
Q

Which lobe of the brain is most susceptible to developing a seizure?

A

temporal lobe

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112
Q

What three drugs are used for partial seizures?

A

Carbamazepine, Phenytoin, Valproate

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113
Q

What three drugs are used to treat tonic clonic seizures?

A

carbamazepine, phenytoin, valproate

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114
Q

What two drugs are used to treat Petit Mal seizures?

A

Ethosuximide and valproate

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115
Q

What two drugs are used to treat myoclonic seizures?

A

Clonazepam and valproate

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116
Q

What four drugs are used to treat status epilepticus?

A

lorazepam, diazepam, phenytoin, fosphenytoin

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117
Q

Which anti-epileptic is considered safest during pregnancy?

A

Phenobarbital

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118
Q

What is the difference between phenytoin and fosphenytoin?

A

fosphenytoin is more water soluble

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119
Q

Which antiepileptic possesses zero order elimination kinetics?

A

Phenytoin

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120
Q

What neurotransmitter does phenytoin promote the secretion of? Decrease the release of?

A

GABA

glutamate

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121
Q

What are the CNS defects in phenytoin?

A

ataxia and nystagmus

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122
Q

Which anti-epileptic is a teratogen?

A

Phenytoin

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123
Q

What are the two MOAs of carbamazepine?

A

sodium channel blocker

GABA receptor agonist

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124
Q

What is the new metabolite of carbamazepine?

A

Oxacarbazepine

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125
Q

What is the drug of choice for trigeminal neuralgia?

A

carbamazepine

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126
Q

What drug can cause SIADH?

A

carbamazepine

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127
Q

What three drugs can carbamazepine have potential interactions with?

A

Phenytoin,

valproate

phenobarbital

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128
Q

What drug is metabolized into phenobarbital?

A

Primidone

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129
Q

What is the MOA of Ethosuximide?

A

block T-type Ca2+ channels

130
Q

What are the two main side effects of valproate?

A

liver damage and teratogen

131
Q

Which anti-epileptic can prevent neuropathic pain?

A

Gabapentin

132
Q

What is the MOA of pregabalin?

A

functions similar to GABA

133
Q

What is the MOA of baclofen?

A

GABA-B agonist

134
Q

How does diazepam reduce spasticity?

A

increases descending inhibition of α-MNs

135
Q

What is the MOA of ketamine?

A

NMDA receptor antagonist

136
Q

Does ventilation rate effect the drugs more with higher or lower soluibilities?

A

higher

137
Q

Does a lower solubility make a drugs concentration in the blood rise faster or slower?

A

faster

138
Q

Does a higher cardiac output mean a drug will reach the brain faster or slower?

A

slower

139
Q

Does being less soluble mean a drug is eliminated faster or slower?

A

faster

140
Q

What are the three side effects of halothane?

A

decreased CO/hypotension

hepatitis

141
Q

What is the side effect of enflurane?

A

jerking/twitching

142
Q

What is the advantage of sevoflurane?

A

can be used in those with airway disease

143
Q

When is ketamine contraindicated?

A

pt’s with psychiatric history

144
Q

Where is a spinal block injected? Is a spinal block reversible?

A

subarachnoid space

No

145
Q

Where is an epidural block injected?

A

extradural space

146
Q

Do amides have one or two I’s?

A

two

147
Q

Do ester have one or two I’s?

A

one

148
Q

Are all local anesthetics weak bases or acids?

A

bases

149
Q

Which has a shorter half life, ester or amides?

A

esters

150
Q

Where are amides metabolized? By what enzyme?

A

liver

p450

151
Q

Where are esters metabolized? By what enzyme?

A

blood

butrylcholinesteras

152
Q

Which are more sensitive to local anesthetics, myelinated or unmyelinated nerves?

A

myelinated

153
Q

Does a higher pH means more or less of a local anesthetic is needed?

A

higher = less is needed

154
Q

What does calcium do to local anesthetic dose?

A

high calcium requires more local

155
Q

Would a LA ester or amide more likely cause an allergic rxn?

A

ester

156
Q

Which metabolite of local anesthetics can cause an allergic reaction?

A

PABA

157
Q

Which preservative used in local anesthetics can cause an allergic reaction?

A

methylparaben

158
Q

Which local anesthetic can cause systemic allergic reaction with particular cardiac toxicity?

A

Bupivicaine

159
Q

Which drug is used to treat an allergic reaction to a local anesthetic?

A

IntraLipid

160
Q

What is the clinical use of bupivacaine?

A

labor analgesia

161
Q

Which local anesthetic is used in its topical form only? Why?

A

benzocaine

methemoglobinemia

162
Q

What is the only use of chloroprocaine?

A

epidural

163
Q

What is contained in Exaprel-Liposome? Why is this special?

A

Bupivicaine

time-released

164
Q

What two drugs are contained within EMLA?

A

lidocaine and prilocaine

165
Q

What three drugs are contained within TAC?

A

tetracaine, adrenalin and cocaine

166
Q

What two regions in the brain have profound loss of neurons during Alzheimers disease?

A

cortical and hippocampal neurons

167
Q

What type of neurons and where are lost during Huntingtons Disease?

A

dopaminergic from basal ganglia

168
Q

What type of neurons and where are lost during Parkinsons Disease?

A

dopaminergic from basal ganglia

169
Q

What two proteins accumulate during Alzheimers?

A

β-amyloid

Tau

170
Q

What is the precursor protein for β-amyloid?

A

β-amyloid precursor protein

171
Q

What protein accumulates during Parkinsons?

A

α-synuclein

172
Q

What neurotransmitter is hypothesized to be deficient during Alzheimers? What is the significance of this?

A

acetylcholine

loss of acetylcholine correlates to severity of disease

173
Q

What chromosome is β-amyloid precursor protein located on?

A

21

174
Q

Does β-amyloid accumulation correlate to disease severity?

A

no

175
Q

What two proteins are defective during early Onset Alzheimers? What is the consequence of this?

A

PSEN1 and PSEN2

overproduction of β-amyloid

176
Q

What protein is defective during Late Onset Alzheimers? What is the consequence of this?

A

ApoE

accumulation of β-amyloid

177
Q

What is the post-translational modification made to tau proein during Alzheimers?

A

hyper-phosphorylation

178
Q

Current treatments for Alzheimers aim to slow down the activity of what two enzymes?

A

acetylcholinesterase and butrylcholinesterase

179
Q

What is another name for Donepizil?

A

aracept

180
Q

Which Alzheimers drug inhibits AchE and ButE?

A

Rivastigmine

181
Q

What is the advantage of Rivastigmine over Donepezil?

A

rivastigmine has less GI issues

182
Q

What is the MOA of Galantamine?

A

potentiates nAchR

183
Q

What is the MOA of memantine? What disease?

A

non-competitive antagonist of NMDA

Alzheimers

184
Q

What disease is Memantine used to treat?

A

Alzheimers

185
Q

What anti-depressant should be used in Alzheimers?

A

SSRIs

186
Q

Which anti-depressant should be avoided in Alzheimers?

A

TCAs

187
Q

What are the two characteristics of Psychosis?

A

delusions and hallucinations

188
Q

Rearding Schizophrenia, what is a positive symptom?

A

manifestation of abnormal behavior

189
Q

Rearding Schizophrenia, what is a negative symptom?

A

absence of normal behavior

190
Q

What three other receptors are implicated during Schizophrenia?

A

5HT2A

5HT2C

NMDA

191
Q

In addition to D2, what other two receptors are inhibited by atypical antipsychotics?

A

5HT2A

5HT2C

192
Q

Which endocrine disorder can antipsychotics produce?

A

Hyperprolactinemia

193
Q

Which two antipsychotics can cause weight gain?

A

Clozapine and Olanzapine

194
Q

Which antipsychotic is known to cause the most Extra-pryamidal syndrome side effects ?

A

risperidone

195
Q

Which two antiepileptics are associated with the least effect on EPS?

A

clozapine and quetiapane

196
Q

Which cytochrome enzyme works on most opiates?

A

CYP2D6

197
Q

Which Phase II metabolism is done tomost opiates?

A

Glucoronidation

198
Q

Which G-protein are most opioid receptors coupled to?

A

Gi

199
Q

Which type of interneuron can opioids block?

A

GABAergic

200
Q

Where in the body can opiates can reflexive cerebral vasodilation? What situation would make their use contraindicated?

A

reflexive cerebral vasodilation

head trauma

201
Q

What part of the brain do opiates activate that can suppress the cough?

A

CTZ

202
Q

Why can opiates cause urticaria?

A

degranulation of mast cells

203
Q

Opiates used in combination with MAOIs can cause what two severe reactions? Which opiate specifically?

A

HTN and hyperpyrexia

Meperidine

204
Q

Which opiates metabilite can act as a convulsant?

A

Meperidine

205
Q

Which opiate can also inhibit the reuptake of 5HT/NE?

A

Tramadol

206
Q

Which opiate is 7-10x more potent than morphine?

A

hydromorphone

207
Q

By causing inhibition of GABAergic interneurons, opioids lead to the enhanced release of what neurotransmitter? What can this lead to?

A

dopamine

dependence

208
Q

What is the clinical use of doxapram? What two factors does doxapram increase?

A

respiratory stimulant

rate and tidal volume

209
Q

What is the main clinical use of Theophylline?

A

bronchial smooth muscle activator

210
Q

What two drugs should be avoided if taking amphetamines?

A

SSRIs and MAOIs

211
Q

How do analeptic drugs function?

A

decrease inhibitory neurotransmitter release

212
Q

How do methylxanthines function?

A

decrease release of adenosine

213
Q

What three neurotransmitters does Cocaine inhibit the reuptake of?

A

DA/5HT/NE

214
Q

What part of the brain is activated by cocaine?

A

Ventral Tegmental Area

215
Q

Which stimulant can cause Steven Johnson Syndrome? What patient population is this drug not FDA approved for?

A

modafinil

kids

216
Q

What percent of ADHD is hyperactive predominant?

A

10%

217
Q

What percent of ADHD is Inattentive predominant?

A

30-40%

218
Q

What percent of ADHD is combined predominant?

A

50-60%

219
Q

What two lobes of the brain are particularly effected during ADHD?

A

frontal lobe and temporal lobe

220
Q

Which specific part of the frontal lobe is particularly affected during ADHD? Where does this part of the brain project?

A

Dorsolateral prefrontal cortex

ACC

221
Q

What is the MOA of atomoxetine?

A

NE reuptake inhibitor

222
Q

What is the MOA of Modafinil?

A

releases histamine from Tuberomamillary Body of the hypothalamus

223
Q

Where does the VTA project to in order to produce drug addiction?

A

Nucleus Accumbens

224
Q

What is the relative risk of CNS depressants?

A

3

225
Q

What three organs are responsible for elimination of alcohol?

A

Liver, Kidneys and Lungs

226
Q

What is the difference between women and men in the processing of ethanol?

A

women have lower first pass effect

227
Q

What enzyme is inhibited by Fomepozil?

A

alcohol dehydrogenase

228
Q

When is MEOS activated?

A

chronic alcohol consumption

229
Q

What does ethylene alcohol get oxidized to? What enzyme?

A

oxalate crystals

Alcohol Dehydrogenase

230
Q

What enzyme does Disulfarim inhibit?

A

Aldehyde Dehydrogenase

231
Q

What are the two CNS MOAs of ethanol?

A

potentiates GABA-A

inhibits NMDA

232
Q

Which receptor does alcohol inhibit that produces its amnesiac effects?

A

antagonize NMDA

233
Q

What drug can ethanol potentiate? What compound is created?

A

cocaine

cocaethylene

234
Q

What drug can reduce the risk of alcohol relapse? What type of drug is this?

A

Naltrexone

mu-opioid antagonist

235
Q

What three benzos are most likely to be abused?

A

Alprazolam/Diazepam/Flunitrazepam

236
Q

How can benzos produce dependence? Which GABA receptor?

A

disinhibition of dopaminergic neurons of VTA

GABA-A

237
Q

What is the MOA of GHB?

A

same as benzo but via GABA-B

238
Q

Which receptor does MDMA block?

A

SERT

239
Q

What are two major side effects of MDMA?

A

hyperthermia and dehydration

240
Q

What neurotransmitter does LSD increase the release of? Where is this accomplished? Via what structure?

A

glutamate

cortex

thalamus

241
Q

What receptor is activated by LSD? Activation of this receptor is correlated to what property of the drug?

A

5HT2A

potentcy

242
Q

Does LSD stimulate dopamine release?

A

no

243
Q

What receptor does ketamine block? What two areas of the brain does ketamine decrease activity?

A

NMDA

cortex and limbic system

244
Q

How do opiates produce euphoria? Which isotype?

A

inhibition of GABAergic neurons onto VTA

mu

245
Q

How do opiates produce dysphoria? Which isotype?

A

inhibition of VTA dopaminergic neurons

kappa

246
Q

How is morphine formed from codeine?

A

demethylation

247
Q

How is morphine formed from heroin?

A

de-acetylated

248
Q

What is the MOA of cannabinoids to produce euphoria?

A

disinhibits VTA dopaminergic neurons

249
Q

What is the MOA of nicotine to produce euphoria? What two parts of the brain?

A

NAchR on VTA dopaminergic neurons

Nucleus accumbens and PFC

250
Q

What two drugs have been known to aid in smoking sessation ?

A

Bupropion

Varenicline

251
Q

Which TCA is used to treat neuropathic pain?

A

Desipramine

252
Q

What is the side effect of Imipramine?

A

sedation

253
Q

Which two SSRIs are at the greatest risk of Discontinuation Syndrome?

A

Paroxetine and Sertraline

254
Q

Which SNRI has mixed affinity? Which has a higher affinity for NE?

A

Duloxetine = balanced

Venlafaxine = higher affinity for SERT

255
Q

Which SNRI can be used for chronic pain?

A

Duloxetine

256
Q

Which two p450 enzymes do anti-depressants particularly effect?

A

2D6 and 3A4

257
Q

Which three antidepressants are potent inhibitors of 2D6?

A

Paroxetine

Fluoxetine

Fluvoxamine

258
Q

What is Primary Epilepsy? Secondary?

A

Primary = idiopathic

Secondary = identifiable

259
Q

What is a Complex Partial seizure ?

A

seizure that starts in one part of the brain and moves to others

260
Q

Atonic seizures are most often seen in what patient population?

A

children

261
Q

Which antiepileptic can cause hirsutism?

A

phenytoin

262
Q

Which antiepileptic can cause osteomalacia?

A

phenytoin

263
Q

Which antiepileptic is a potent inducer of p450?

A

carbamazepine

264
Q

What two drugs should lamotrigine not be administered with ?

A

Valproate

Carbamazepine

265
Q

Which benzo is used for pre-op anxiolysis?

A

Midazolam

266
Q

What kind of complications can Nitrous Oxide produce in a female?

A

pregnancy complications

267
Q

What is a potential drawback to Isoflurane? WHat is the good thing about Isoflurane?

A

long duration of action during post-op

can be used in pt’s with poor liver/kidney function

268
Q

Does desflurance have a fast or slow onset?

A

fast

269
Q

Does desflurance have a fast or slow recovery?

A

fast

270
Q

What is the potential drawback to desflurane?

A

bronchial irritant

271
Q

Which anesthetic can cause a macrocytic anemia?

A

Nitrous oxide

272
Q

Which drug can replace propofol as an induction agent? When?

A

Midazolam

pt’s with CV of pulmonary issues

273
Q

What is the MOA of most local anesthetics?

A

blockade of voltage gated Na+ channels

274
Q

Where do most toxins bind voltage gated Na+ channels?

A

extracellular

275
Q

What is the clincal use of articaine?

A

dental anesthetic

276
Q

What is the clinical use of cocaine?

A

ENT anesthetic

277
Q

What is exaprel?

A

long lasting bupivicaine

278
Q

Is lidocaine an injectable or topical?

A

both

279
Q

According to Duric, what three parts of the brain can Parkinsons spread to?

A

brainstem

cortex

hippocampus

280
Q

Where does the substantia nigra project?

A

striatum

281
Q

What are the two parts of the striatum?

A

caudate and putamen

282
Q

During Parkinsons, there is a reflex increase in what neurotransmitter?

A

acetylcholine

283
Q

Which pathway is overactive during Parkinsons?

A

indirect

284
Q

What neurotransmitter is released in excess during Parkinsons? What part of the brain?

A

glutamine

Subthalamic Nuclei

285
Q

What drug is L-dopa coadministered with? What is the MOA of this drug? What two symptoms does L-DOPA treat?

A

Cardidopa

inhibits DOPA decarboxylase in periphery

bradykinesia and rigidity

286
Q

What B vitamin is a cofactor for DOPA decarboxylase?

A

B6

287
Q

What three drugs are dopamine receptor agonists?

A

Pramipexole

Ropinirole

Apomorphine

288
Q

What are the two MOA-B Inhibitors used to treat Parkinsons?

A

Rasagline

Selegiline

289
Q

What is the peripheral COMT Inhibitor?

A

Entacapone

290
Q

What is the central and peripheral COMT Inhibitor? What is the toxicity of this drug?

A

Tolcapone

liver toxicity

291
Q

Which antiviral has anti-PD effects?

A

amantidine

292
Q

What is the side effect of amantidine?

A

Livedo Reticularis

293
Q

What are the two anti-muscarinics to treat PD?

A

Benztropine

Trihexyphenidyl

294
Q

What two effects are reduced by Benztropine and Trihexyphenidyl?

A

tremor and rigidity

295
Q

What effect of PD is not reduced by Benztropine and Trihexyphenidyl?

A

Bradykinesia

296
Q

Excessive activity of the of brain system is hypothesized to cause psychosis? Which neurotransmitter?

A

excessive limbic activity

dopamine

297
Q

Which type of antagonist can exacerbate the psychosis of schizophrenia?

A

NMDA antagonist

298
Q

What are the two serious consequences of Neuroleptic Malignant Syndrome?

A

HTN and hyperthermia

299
Q

Which two CV effects do opioids produce?

A

bradycardia

hypotension

300
Q

What is the medical use of caffeine?

A

apnea of prematurity

301
Q

What is the MOA of atomexitine?

A

NE reuptake blocker

302
Q

What drug has the fastest onset and recovery of the general anesthetics?

A

Desflurane

303
Q

Are higher frequency or lower frequency nerves more sensitive to local anesthetics?

A

higher

304
Q

What are the thre anti-psychotics used to treat Alzheimers?

A

Risperidone, Clonzapine, Quietapine

Atypical

305
Q

What do Lewy Bodies contribute to the formation of?

A

free radicals

306
Q

What is the #1 main adverse effect of L-DOPA?

A

GI disturbances

307
Q

Which two antipsychotics are least associated with EPS?

A

clonzapine and quietapine

308
Q

Which beverage can contain tyramine?

A

chianti

309
Q

What is venlafaxine used to treat?

A

severe depression

310
Q

What is duloxetine used to treat?

A

neuropathic pain

311
Q

Which anesthetic can produce strange dreams?

A

ketamine

312
Q

What is the use of apomorphine?

A

rescue drug for L-dopa induced dyskinesia

313
Q

Which two drugs are contraindicated in pt’s suffering from psychosis? Why?

A

ketamine and phenylcyclidine

NMDA antagonists

314
Q

What is the main side effect of neuroleptics?

A

extra-pyrimidal symptoms

315
Q

Why are atypicals used more than typicals?

A

atypicals have less EPS syndromes

316
Q

Atypical antipsychotics antagonize what receptor?

A

5HT2A and D2

317
Q

Do opioids reduce or increase the threshold for seizures?

A

reduce

318
Q

How is fentanyl administered? How long does it last?

A

transdermal patch

72 hours

319
Q

Which amphetamine carries a potential suicide risk in children?

A

atomexitine

320
Q

Which general anesthetic has excellent minute to minute control?

A

Desflurane

Pharm (12 decks)

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