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Pharmacology 1 Brandon's additional Cards > Neuro 3 > Flashcards

Neuro 3 Flashcards

1
Q

how long can anxiety and sleep disturbances persist after alcohol withdrawl?

A

can persist for several months

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2
Q

how long at risk of seizures and hallucinations after stopping alcohol?

A

1-5 days

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3
Q

When do DTs start?

A

48-72hrs after stopping alochol

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4
Q

Goals of drug therapy in alcohol withrawal?

A

prevent seizures, delirium, & arrhythmias

correct electrolyte balances K Mg PO4 (as fast as kidneys allow)

substitute long acting sedative-hypnotic for alcohol and then taper the dose

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5
Q

What are the preferred benzos for alcohol withdrawal?

A

Chlordiazepoxide (Librium)
Diazepam (Valium)

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6
Q

What are shorting acting benzos you can use for alcohol withdrawl and why are they used?

A

Ativan (Lorazepam)
Oxezapam (Serax)

would use in presence of compromised liver function to avoid active metabolites of benzos

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7
Q

mech of action of alcohol?

A

enhance GABAa actions (some GABAa antagonists can attenuate alcohols effects here)

block glutamate on NMDA receptors

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8
Q

which mech of action of alcohol explains blackouts?

A

blocking glutamate on NMDA receptors

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9
Q

What is Wernicke-Korsakoff syndrome?

A

paralysis of external eye muscles, ataxia, confusion, that can progress to coma and death.

caused by thamine defeciency

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10
Q

effect of acute alcohol consumption in cold enviorments?

A

market vasodilation

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11
Q

another name for carbmazepine?

A

monohydroxy derivative (MDH)

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12
Q

3 mech of action of anti seizure drugs?

A
  1. Enhance inhibitory tranmission (GABAergic)
  2. Reduce excitatory (glutamergic)
  3. modify ion conductance
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13
Q

Two types of seziures?

A

focal onset (partial) and Generalized

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14
Q

how are focal onset (partial) seizures treated?

A

all types are treated with the same drugs

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15
Q

how are generalize seizures treated?

A

drugs are specific to seizure subtype

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16
Q

Are anti seizure drugs highly protein bound?

A

yes, except for 3

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17
Q

what 3 antiseizure drugs are not highly protein bound?

A

Tiny Pink Vagin

Tiagabine
Phenytoin
Valproic Acid

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18
Q

Anti seizure pharmaco kinetics

A

single drug therapy preferred
low therapeutic index
^ risk of congenital malformations if used in pregancy
can taper if no seizures for 3-4 years
avoid abrupt withdrawl
well absorbed, 80-100% reach circulation
medium to long acting

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19
Q

How many types of anti sezure drugs?

A

5 classes and 3 drugs

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20
Q

what are the 5 drug classes of anti seizure meds?

A

Barbiturats
Hydantoins
Oxazolidinedions
Succinimides
Aceylureas

21
Q

what are the 3 antiseizure drugs?

A

carbmazepine
valproic acid
Benzos

22
Q

What kind of seizures does phenytoin / dilantin treat?

A

partial and generalized tonic-clonic seizure

23
Q

Phenytoin Mech of action?

A

alter Na K and Ca conductance
decrease glutamate and increase GABA

24
Q

Phenytoin main mech of action?

A

alter Na channel to inhibit rapidly repetitive APs

25
Q

Can phenytoin cause paradoxical excitation in some cerebral neurons?

A

yes

26
Q

how is phenytoin eliminated via first or zero order kinetics?

A

first order kinetics

27
Q

When does phenytoin cause toxicity?

A

after liver hits max capactity

28
Q

S/S of phenytoin toxicity?

A

diplopia
ataxia
nystagmus
gingivial hyperplasia
hirsutism
sedation (only at high levels)

29
Q

what two S/S of phenytoin toxicty require dose adjustments?

A

diplopia and ataxia

30
Q

Effects of long term phenytoin use?

A

coarsening facial features
mild peripheral neuropathy
osteomalacia
Vit D deficiency
low folate
megablastic anemia ( ^ RBCs)

31
Q

How to typical antipsychotics work?

A

D2 antagonists

32
Q

do typical antipsychotics treat + or - symptoms?

A

+

33
Q

Which kind of antipsychotics increase risk of EPS?

A

typical antipsychotics

34
Q

What are the two types of typical antipsychotics?

A

Phenotiazines
Chlorpromazine (prototype for typical antipsychotics)

butyrophenone derivatives
Haloperidol (Haldol)

35
Q

Who soon will you have relapse of schizophrenia if you stop taking antipsychotic meds?

A

Within 6 months except for clozapine, will have rapid and severe relapse after DC

36
Q

What conditions are antipsychotics used for?

A

schizoprenia, bipolar, depression,

organic psychosis
senile psychosis
drug induce psychosis

37
Q

Explain how antipsychotic drugs have longer clincal actions than their half life?

A

because of prolonged occupancy of D2 receptors

38
Q

Toxicity of anipsychotics

A

severe sedation
anticholinergic (greater in typical)
tardive dyskinesia
hyperlactinemia (from blocking dopamine)
hypotension (alpha blockade)

39
Q

mech of action of atypical antipsychotics?

A

mild D2 antagonists

40
Q

do atypical antipsychotics have EPS?

A

no

41
Q

Clozapine mech of action?

A

weak D2 antagonist

inverse at 5HT2A receptor (this blocks excitatory release of glutamate)

some alpha, muscarinic, and H1 blockade

42
Q

What is clozapine used to treat?

A

+ and - symptoms of schizophrenia

agitation in Alzheimer’s and Parkinson’s

43
Q

what is the most common form of psychosis?

A

scizophrenia

44
Q

is psychosis present at all times in all patients with scizophrenia?

A

no

45
Q

what receptor mediates + symptoms of schizophrenia?

A

D2

46
Q

what receptor mediates - symptoms of schizophrenia?

A

5HT, especially 5HT2A

47
Q

how many schizophrenic patients are typically drug resistant?

A

20-25% but this can also just be from non compliance

48
Q

genetic aspect of scizophrenia to know?

A

high inheritability but no single gene is involved

Pharmacology 1 Brandon's additional Cards (7 decks)

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