Neuro Flashcards
Name the classes of drugs and how they function to treat glaucoma
- alpha agonists - dec aqueous humor synthesis
- beta blockers - dec aqueous humor synthesis
- acetazolamide - dec aqueous humor synthesis
- cholinomimetics - inc outflow - contraction of ciliary muscle opening trabecular network
- PGF2a - latonoprost - inc aq humor
What drug do you use in emergencies for glaucoma
pilocarpine - direct cholinmimetic
What are the other cholinmimetics for glaucoma
direct - pilocarpine, carbachol
indirect - physostigmine, echothiophate
What are the two alpha agonist drugs for glaucoma
epinephrine, brimonidine
What are the three beta blockers used for glaucoma
timolol
betaxolol,
carteolol
When cant you use an alpha agonist for glaucoma
closed angle - causes mydriasis
What glaucoma drug can cause iris darkening
latanoprost
MOA of opioids?
open K+ and ca2+ channels - block synaptic transmission of ach, epi, 5HT, glutamate, substance P
Which opioids are used for diarrhea
loperamide, diphenoxylate
What is the maintenance regimen for heroin addicts
methadone + naloxone + buprenorphine
MOA of butorphanol, use?
k agonist, partial mu agonist
used for severe pain - causes less resp depression
s/e of butorphanol
can cause opioid withdrawal syndrome with other opioids - competition for receptors
MOA and use of tramadol
weak opioid agonist, inhibits 5HT, NE uptake
use for chronic pain
s/e of tramadol
similar to opioids also dec seizure threshold and can cause serotonin syndrome
What is the first line treatment for absence seizures
ethosuximide
what is the first line treatment acutely for status epilepticus
benzos - diazepam and lorazepam
what is the first line treatment for prophylaxis of status epilepticus
phenytoin
what are three first line treatments for tonic clonic seizure
- phenytoin
- carbamazepine
- valproic acid
what drug is the first line treatment for complex seizures
carbamazepine
what drug is the first line treatment for simplex seizures
carbamazepine
carbamazepine is the first line treatment for what seizures
simple
complex
tonic clonic
What drug is first line in neonates
phenobarbital
How would you treat eclampsia seizures
MgSO4 or benzos
What would you treat trigem neuralgia with
carbamazepine
Which seizure drugs can cause SJS
- Ethosuximide
- phenytoin
- carbamazepine
- lamotrigine
What seizure drugs are contraindicated in pregnancy? why?
- valproic acid - can cause NT defects
- carbamazepine - teratogen
- phenytoin - fetal hydantoin syndrome
What is another major s/e of valproic acid - what do you need to do while taking this drug
rare but fatal hepatotoxicity - measure LFTs
MOA of ethosuximide
blocks thalamic T ca2 channels
MOA of benzos
inc GAA
Phenytoin MOA
inc na channel activation
what other drug inc Na+ activation
besides phenytoin - carbamazepine and valproic acid
What seizure drug is also used for migraine prevention
topiramate
What seizure drug is also used for bipolar disorder
valproic acid, carbamazapine
if you dont know the MOA of the other seizure drugs what should you smartly guess
inc GABA
which drugs should you not use for generalized/ myoclonic seizures
narrow spectrum drugs: carbamazepine, barbs, phenytoin, gabapentin
which drugs should you not use for generalized/ myoclonic seizures
narrow spectrum drugs: carbamazepine, barbs, phenytoin, gabapentin
what seizures are valproate especially good for
combined tonic clonic and absence
myoclonic
s/e of phenytoin
- ataxia and nystagmus
- gingival hyperplasia, hirsuitism
- megalobalstic anemia
- induces P450
- fetal hydantoin syndrome
