NEURO Flashcards
Alzheimer’s
(4)?
- ** THINK: You have to leave MEMOS when you have Alzheimer’s. ***
- ** THINK: I’m DONE with the puzzle, I’m going to the GALA, I’m going to be a DIVA regardless of my STIGMA.***
- Memantine (NMDA receptor antagonist. Prevents excitotoxicity mediated by Ca.) (Achase inhibitor. ↑Ach.) - Donepezil - Galantamine - Rivastigmine
Acute Migraine + Cluster Headache Attacks
Mech, Effects (3)?
Sumatriptan
(Can also give Inhaled Oxygen)
MECH = 5-HT agonist.
- Inhibits Trigeminal nerve (CN 5) activation
- Inhibits release of vasoactive peptide
- Vasoconstriction
Anaesthesia
(3 categories of Anesthetics, incl 5 IV)?
- Inhaled (-ane + NO)
- IV:
- Barbitruates (ie Thiopental):↓cerebral bl flow
- Benzos (ie Midazolam)
- Ketamine (PCP analog that blocks NMDA receptors.
CV stimulant.):↑cerebral bl flow - Opiates (ie Morphine, Fentanyl)
- Propofol
- Local (-caine: Amides + Esters) ** Amides have 2 Is in names **
Anaesthesia: induction and short surgical procedures
(2)?
- Profolol (Potentiates GABA. Less postop nausea.)
- Thiopental (High lipid solubility = high potency = rapid entry into brain. Effect terminated by rapid distribution into tis.)
Inhaled Anesthetics (-ane + NO)
Effects (3)?
- ↑cerebral blood flow (therefore↓cerebral metabolic demand)
- Myocardial & Resp depression
- Nausea / Emesis
Local Anaesthesia (-caine: Amides + Esters)
Mech, General Uses (2), Admin Indications (2)?
MECH = Na Channel BLOCKERS. Preferentially bind to ACTIVATED Na Channels, therefore most effective in rapidly-firing neurons
- Minor surgical procedures
- Spinal anaesthesia
- (Except for Cocaine) Give with Vasoconstrictor (ie Epinephrine) to
enhance local action:↑anaesthesia (↓systemic conc) & ↓bleeding. - If allergic to Esters, give Amides.
Bedwetting (Sleep Enuresis)
Desmopressin Acetate (DDAVP): mimics ADH
Bipolar Disorder
Gabapentin
Chronic Pain #1
First Line Drug, Mech (5)?
Amitriptyline (TCA)
- Strongly Anticholinergic
- Blocks a1
- Blocks Catecholamine reuptake
- Anti-Histamine
- Slows AV nodal conduction
Chronic Pain #2
Patient with shooting / stabbing pain
Drug & Mech?
Carbamazepine. ** “Drive by shootings happen out of cars.” **
Blocks Na channels
Chronic Pain #3
Patient with heart problems
Gabapentin
Chronic Pain #4
Severe pain
Mech
aa
Chronic Pain #5
Mech (2)?
Tramadol
- WEAK opioid agonist
- Inhibitor of Serotonin & NE reuptake
** LESS resp depression than full agonist **
CV Stimulant
Ketamine
Class 1B Antiarrhythmic
Phenytoin
Cough Suppression
Dextromethorphan
Detoxification (esp from alcohol)
Benzos
Diarrhea
(2)?
- Diphenoxylate
- Loperamide
Endoscopy (2)
Inhaled Anaesthetics + Benzos (Midazolam)
Essential / Familial Tremors
b-blocker (ie Propanolol)
Glaucoma #1
General Mech of Drugs (3 Subtypes)?
↓AQ HUMOR!!!
- ↓aq humor synthesis (thr vasoconstriction)
- ↓aq humor secretion (thr inhibition of carbonic anhydrase by
↓HCO3)
- ↑aq humor outflow (thr contraction of ciliary muscle &
opening of trabecular network)
Glaucoma #2
Drug Classes in each Mech Category (1, 2, 2)?
- ↓aq humor synthesis: a-agonists
- ↓aq humor secretion: b-blockers + Acetazolamide
- ↑aq humor outflow: Cholinomimetics + Latanoprost
Glaucoma #3
a-agonists (2)?
- Epinephrine
- Brimonidine
Glaucoma #4
b-blockers (3)?
- Timolol
- Betaxolol
- Carteolol
Glaucoma #5
Cholinomimetics (2 Direct, 2 Indirect)?
- Direct
- Carbachol
- Pilocarpine: ** use in emergencies ** - Indirect
- Physostigmine
- Ecothiophate
Huntington’s
General Mech of drugs (2 Subtypes, 2 drugs in 1st subtype)?
(Huntington’s = ↑Dopamine,↓Ach + GABA)
- Amine-Depleting: Reserpine + Tetrabenazine
(inhibit VMAT => inhibit dopamine packaging + release) - Dopamine receptor Antagonist: Haloperidol
Malignant Hyperthermia + Neuroleptic Malignant Sx
Dantrolene
Mechanical Ventilation
Neuromuscular Blocking Drugs:
Depolarizing (Succinylcholine) + Nondepolarizing (Tubocurarine, -curium, -curonium)
(Selective for motor nicotinic receptors)
Migraines
Prophlaxis (2), Abortive Therapy?
- Prophylaxis -> Propanolol, Topiramate
- Abortive -> -triptans
Muscle Paralysis in Surgery
Neuromuscular Blocking Drugs: Depolarizing + Nondepolarizing
MS (3)
- Baclofen (GABA receptor agonist = GABA-ergic effects)
- b-Interferon
- Natalizumab
Opiate effect + block of Catecholamine reuptake,
GI pain, Gallstones (doesn’t mess with CCK),
Abused by physicians (no pinpoint pupils)?
Meperidine
Parkinson’s #1
General Mech of drugs (2 Subtypes, 3 Categories in 1st subtype)?
- Dopamine “Increasers”
- ↑Dopamine
- Dopamine Agonists
- ↓Dopamine b/d - Cholinergic “Curbers” (curb excess cholinergic activity)
Parkinson’s #2
Dopamine Agonists (1 ergot + 2 non-ergots)?
- Ergot: Bromocriptine
- Non-Ergot (preferred): Pramipexole + Ropinirole
Parkinson’s #3
Dopamine “Increasers” (2)?
- Amantadine
- L-dopa (converted to dopamine in CNS) + Carbidopa
Parkinson’s #4?
Dopamine B/D “Reducers” (2 Classes, 2 drugs in 2nd class)?
- Selective MAO Type B Inhibitor: Selegiline
- COMT Inhibitors (-capone) (prevent L-dopa degradation):
Entacapone + Tolcapone
Parkinson’s #5
Cholinergic “Curbers”
Benztropine
Improves rigidity + tremor but little effect on bradykinesia
Peripheral Neuropathy
Gabapentin
Seizures #1: Partial Seizures
1st Line?
Carbamazepine
Seizures #2: Generalized Seizures
- “The General goes to the VA to live.” *
1st, 2nd, 3rd Lines?
- 1st line = Valproic Acid
- 2nd line = Topiramate
- 3rd line = Lamotrigine
Seizures #3: Tonic-Clonic Seizures
1st Line (3)?
- Phenytoin
- Carbamazepine
- Valproic Acid
Seizures #4: Absence Seizures
1st, 2nd Lines (2)?
- 1st line = Ethosuximide
- 2nd lines = Lamotrigine + Valproic Acid
Seizures #5: Status Epilepticus
1st Line for Acute, 1st Line for Prophylaxis?
- 1st line for acute = Benzos (Diazepam + Lorazepam)
- 1st line for prophylaxis = Phenytoin
Seizures #6
1st Line in children?
Phenobarbital
Seizures #7: Seizures of Eclampsia
1st Line, 2nd Line?
- 1st line = MgSO4
- 2nd line = Benzos
Seizures #8: Myoclonic Seizures
Valproic Acid
Seizures #9
General Mech of Drugs (3)?
- Na channel inactivation / blockage
- Ca channel inhib / blockage
- ↑GABA (GABA analog,↑GABA conc / action,
inhib GABA transaminase, inhib GABA reuptake)
Seizures #10
Na Channel “Inactivators / Blockers” (5)
- Phenytoin
- Carbamazepine
- Lamotrigine
- Topiramate
- Valproic Acid
Seizures #11
GABA “Increasers” (7: 5 + 2)
(↑GABA conc / action OR↓GABA breakdown / reuptake)
- Gabapentin (GABA analog)
- Topiramate
- Phenobarbital
- Valproic Acid
- Benzos
- Tigabine
- Vigabatrin
Sleepwalking + Night Terrors
Benzos
Spasticity
Benzos
ISCHEMIC Stroke
Indications (2)?
tPA
INDICATIONS:
- If NO hem
- If within 3 - 4.5 hrs of onset
Trigeminal Neuralgia
1st Line?
Carbamazepine
