Neuro drugs 2

Question 1

contrast the MOA of barbs and benzos

Answer 1

Barbs - inc duration of Cl channel opening -dec neuron firing
benzos - inc frequency of Cl - channel firing

both facilitate GABA action

Question 2

What else binds the GABAa receptor

Answer 2

ETOH - can exacerbate effects of barbs only

benzos are used as competitive inhibitor of ETOH for detox

Question 3

What are the only short acting Benzos, what are the risks of using them

Answer 3

ATOM - short fuse

Alprazolam
triazolam
oxazepam
midazolam

higher addictive potential

Question 4

What is used in overdose of benzos

Answer 4

flumazenil

Question 5

Name the three nonbenzo hypnotics used for insomnia

Answer 5

zolpidem
zaleplon
eszopiclone

ZZZzzZzs

Question 6

What are some of the long acting benzos? why are they used and what are their risks

Answer 6

diazepam, flurazepam, chlordiazepoxide

less addictive potential, but inc risk of falling in elderly

Question 7

MOA of nonbenzo hypnotics

Answer 7

bind BZ1 GABA

Question 8

Describe the relationship of potency and induction time

Answer 8

inc potency, slow induction

dec solubility in the blood = low potency = fast induction

Question 9

What are the inhaled anesthetics

Answer 9

“fluranes” + halothane + N20

Question 10

what effects do the inhaled anesthetics have

Answer 10

cardioresp depression

inc cerebral blood flow

Question 11

What is malignant hyperthermia and what causes it

Answer 11

inhaled anesthetics besides N20, succinylcholine

fever, severe muscle contractions - inherited defect of ryanodine receptor

Question 12

what is the treatment for malignant hyperthermia , how does it work

Answer 12

dantrolene - blocks ca release from SR of skeletal muscle

Question 13

which Barb is used for IV anesthetic, what is its use

Answer 13

thiopental

induction and short surgical procedures

Question 14

What benzo is used for IV anesthetic, what is its most common use

Answer 14

midazolam

most common drug for endoscopy

Question 15

Name the PCP analog that causes dissociative anesthesia, hallucinations and bad dreams

Answer 15

ketamine

Question 16

What drug is used for sedation in ICU and for rapid anesthesia, how is it different than thipental

Answer 16

propofol - less post op nausea

Question 17

What are the local anesthetics

Answer 17

esters: procaine, cocaine, tetracaine
amides: lidocaine, mepivacaine, bupivacine - 2 Is

Question 18

how do the local anesthetics work

Answer 18

bind to activated Na+ channels and block them

Question 19

In infected tissue how should you change the use of local anesthetics?

Answer 19

need to inc dose - acidic envt - cant penetrate

Question 20

Describe the order of nerve blockade

Answer 20

small before large
myelinated before unmyelinated
**small takes precedence (so small umyelinated first to go)

1. pain
2. temp - preg people get cold
3. touch
4. pressure -why in giving birth this is the worstq

Question 21

What local anesthetic can cause methemoglobinemia

Answer 21

benzocaine

Question 22

what drug is a depolarizing NM blocker

Answer 22

succinylcholine

Question 23

how do you reverse succinylcholine

Answer 23

phase 1 - cant do anything

phase 2 - use cholinesterase blockers

Question 24

What are the nondepolarizing NM blockers, how do they work?

Answer 24

“curares”

competitive inhibitors of Ach

Question 25

how do you reverse nondepolarizing NM blockade

Answer 25

neostigmine

need to give with atropine to prevent bradycardia

Question 26

baclofen MOA and use

Answer 26

inhibits GABAb at spinal cord level - induces skeletal muscle relaxation - for muscle spasms

Question 27

cyclobenzaprine MOA and use

Answer 27

central acting skeletal muscle relaxant - also for muscle spasms

Question 28

what are the s/e of cyclobenzaprine

Answer 28

similar to TCAs

“cyclo”

Question 29

What are the 5 main parkinson drugs and MOA

Answer 29

BALSA

bromoscriptine - dopamine agonist
amantadine - inc dopamine release and dec uptake
levodopa/ carbidopa - inhibits DOPA decarboxylase
Selegiline - blocks MAOB
Antimuscarinic = benztropine

Question 30

what is amantadine also used for

Answer 30

antiviral for influenza

Question 31

What are the COMT inhibitors

Answer 31

central - tolcapone

peripheral - entacapone and tolcapone

Question 32

What are other dopamine agonists besides bromoscriptine

Answer 32

pramipexole and ropinrole - actually preferred because they are non-ergots

Question 33

Fill in this sentence: unlike dopamine, LDOPA can ____

Answer 33

cross the BBB and is converted by dopa decarboxylase in the CNS to dopamine

Question 34

why is carbidopa given with Ldopa

Answer 34

peripheral DOPA decarboxylase inhibitor - inc bioavailability and dec peripheral s/e

Question 35

what are the s/e of L dopa

Answer 35

arrythmias from inc peripheral formation of catecholamines

can lead to dyskinesia

Question 36

what are the two types of alzheimer drugs

Answer 36

1. memantine - think memory

2. AchE inhibitors - donepezil, galantamine, rivastigmine, tacrine

Question 37

MOA of memantine

Answer 37

NMDA antagonist = prevents excitotoxicity

Question 38

what are the NT changes in

1. parkinsons
2. huntingtons

Answer 38

1. parkinsons: dec D2, inc Ach

2. huntingtons: dec GABA, dec Ach, inc dopamine

Question 39

What are the three main drugs for huntingtons, MOA?

Answer 39

tetrabenzine and reserpine inhibit VMAT - dec D2 release

haloperidol - D2 antagonist

Question 40

MOA of sumatriptans and use

Answer 40

5HT 1b/d agonists - inhibit Trigem activation , induce vasoconstriction
used for acute migraines and cluster headache attacks

Question 41

when are sumatriptans contraindicated

Answer 41

CAD or prinzmental angina

Question 42

adding carbidopa to levodopa regimen can decrease what s/e

Answer 42

1. tachyarrythmias
2. postural hypotension
3. nausea and vomiting

DOES NOT decrease anxiety and agitation effect