Final Exam Mat. Flashcards
Abortive migraine therapy.
5HT1 receptor agonist
Sumatriptan (a SUMo wrestler TRIPs ANd falls on your HEAD)
For initial treatment of Parkinson’s disease:
Bromocriptine (dopamine agonist): Ropinirole, Pramipexole, Rotigotine are D2 agonists
PD drug, crosses BBB, direct precursor of dopamine, mainstay of treatment
L-dopa
PD drug, peripheral decarboxylase inhibitor, increases bioavailability of L-dopa in brain and limits peripheral side effects (orthostatic htn, nausea)
Carbidopa
PD drug, MAO-B inhibitors in the brain, increases availability of dopamine
Selegiline, rasagiline
PD drug, blocks muscarinic receptors, improves tremor and rigidity in early stages of disease
Benztropine, trihexyphenidyl
PD drug, COMT inhibitor, prevents methylation of L-DOPA by COMT (in periphery)
Entacapone
AD drug, acetylecholinesterase inhibitors
Donezpezil, rivastigmine, galantamine
AD drug, NMDA receptor antagonist, may slow progression of disease
Memantine
Stimulant, displaces monoamines
D-amphetamine
Stimulant, inhibits reuptake of NE and DA
Methylphenidate
Stimulant, inhibits NE and DA transports, Increases free 5-HT and glutamate, dec. GABA, low abuse potential
Modafinil
Seizure type: preservation of consciousness, sensory auras or limited unilateral motor convulsions, 20-60 seconds
Simple Partial Seizure
Seizure type: impaired consciousness, automatisms, post-ictal confusion, most common refractory seizure in adults (30s-2min)
Complex partial seizure
Seizure type: LOC, major convulsions, tonic spasm, followed by clonic jerking, prolonged post-ictal stupor, 1-2 min
Grand mal or Tonic Clonic seizures
Seizure type: abrupt interruptions of consciousness associated with staring and cessation of activities; lack of poast-ictal abnormalities (less than 30 sec).
Absence (petit mal) seizures
List the general mechanisms of Anti-seizure drugs:
Change ion channels, increase seizure threshold, increase GABA or decrease glutamate and therefore decrease spread of seizure
Seizure med, used for absence seizures, MoA on T-type Ca channels
Ethosuximide “Sux to have silent seizures”
What is the mnemonic for Ethosuximide side effects and what are they?
EFGHIJ: Ethosuximide causes Fatigue, GI distress, Headache, Itching, stevens-Johnson syndrome
Seizure med, used for tonic clonic, partial, and status epilepticus seizures, increase Na channel inactivation, need to monitor liver
Phenytoin
What are the more well known side effects of phenytoin?
Enlarged gums, hirsuitism, p450, nystagmus, yellow skin, teratogen, interferes with B12 metabolism, osteomalacia, neuropathy, Stevens-Johnson syndrome
Seizure med, increase Na channel inactivation, 1st line for trigeminal neuralgia, used for tonic clonic and partial seizures
Carbamazepine
What are the side effects of Carbamezepine?
SIADH (hyponatremia), SJS, diplopia, ataxia, liver toxicity, teratogen
Seizure med: increase Na channel inactivation, inc. GABA, 1st line in tonic clonic seizure, can be used to treat all seizures
Valproic acid
What are the side effects of Valproic acid?
Hepatotoxicity (inhibits hepatic enzymes, regular LFTs needed), termor, weight gain, teratogen
Seizure med: blocks voltage gated Na channels, may be used for all types of seizures
Lamotrigine
What are the side effects of Lamotrigine?
SJS
Anti-psychotic drug: typical, blocks D2 receptors to ameliorate POSITIVE symptoms. May cause tardive dyskinesia, hyperprolactinemia (and orthostatic HTN, weight gain, anticholinergic effects)
Haloperidol, chloropromazine
Anti-psychotic drug: atypical, blocks D2, S4 and 5HT receptors for POS and NEG symptoms. May cause hyperprolactin at high dose
Olanzapine
Anti-psychotic: atypical, blocks D4 more than D2, inverse agonist of 5HT, best for relieving symptoms. May cause agranulocytosis (need WBC weekly).
Clozapine (must watch CLOZapine CLOZely!)
Anti-psychotic: atypical, blocks D2 and 5HT receptors for POS and NEG symptoms, may cause hyperprolactinemia
Risperidone
Anti-psychotic: atypical, block 5HT more than D2, and also H1 for POS and NEG symptoms. May cause Prolactin side effects.
Quetipine, ziprasidone
Anti-psychotic: atypical, partial D2 agonist and 5HT
Aripiprazole
Mnemonic for Atypical antipsychotics:
It’s ATYPICAL for OLd CLOSets to QUIETly RISPER from A to Z.
ATYPICAL antipsychotics include: OLanzapine, CLOZapine, QUETIapine, RISPERidone, Aripiprazole, Ziprasidone
Sedative med, facilitates GABA(A) action by increasing duration of Cl- channel opening thus dec. neuronal firing, used for anxiety, seizures, insomnia, induction of anesthesia. Side effects include respiratory and CNS depression, drug interactions with cytochrome P450
Barbiturates: Phenobarbital, pentobarbital, thiopental, secobarbital
Sedative med, facilitates GABA(A) action by increasing frequency of Cl- channel opening, dec. REM sleep, used for anxiety, spasticity, status epilepticus, detox, night terrors, sleep walking, general anesthetic, and as a hypnotic. Side effects include dependence, additive CNS depression effects with alcohol but otherwise low risk of respiratory and CNS depression.
Benzodiazepines: Diazepam (Valium), Lorazepam (Ativan), Triazolam, Temazepam, Oxazepam, Midazolam, Chlorodiazepoxide, Alprozolam (Xanax)
What is used to treat Benzodiazepine overdose?
Flumazenil (competitive antagonist at GABA benzodiazepine receptor).
Clinical use of Alprazolam (Xanax)
A benzodiazepine used for anxiety
Use of clonazepam (Klonopin)
A benzodiazepine used for SEIZURES, mania, movement disorders
Use of diazepam (Valium)
A benzodiazepine used for anxiety, STATUS EPILEPTICUS, muscle relaxation, preanesthetic medication
Use of lorazepam (Ativan)
A benzodiazepine used for anxiety, STATUS EPILEPTICUS, preanesthetic medication
Centrally acting spasmolytic drug, used for spasticity and MSK problems. Adverse effects include sedation and respiratory depression in ALS.
Benzodiazepines: Diazepam and Clonazepam
Centrally acting spasmolytic drug, GABA(B) receptor agonists that reduces trasmitter release by increasing K+ permeability and inhibiting Ca 2+ influx into nerve terminals. Adverse effects include: drowsiness, inc risk seizures, CNS depression
baclofen (Lioresal)
Centrally acting spasmolytic drug, central alpha-2 recepotr agonist, increases pre and postsynaptic inhibition of motor neurons. Adverse effects include drowsiness, hypotension, dry mouth, weakness
tizanidine (Zanaflex)
Direct acting spasmolytic, decreases Ca2+ release from sarcoplasmic reticulum thereby inhibiting excitation-contraction coupling. Adverse effects include: general muscle weakness, sedation, rare but serious hepatotoxicity. Also used for malignant hyperthermia
dantrolene (Dantrium)
