neuro drugs Flashcards

1
Q

Ethosuximide

A
  • blocks Ca channels (unique mechanism of action)
  • DOC for Absence
  • EFGHIJ: Ethosuximide causes fatigue, GI distress, HA, Itching and steven-Johson
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2
Q

Benzos

A
  • DOC for status epilepticus
  • potentiates GABA action
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3
Q

Phenytoin

A
  • DOC for partial seizures + tonic clonic
  • Na channel inactivation
  • gingival hyperplasia, hirsutism, fetal hydantoin syndrome, SLE-like syndrome, induces P450, SJ
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4
Q

Carbamazepine

A
  • DOC for partial seizures and tonic clonic
  • DOC for trigeminal neuralgia
  • Na channel inactivation
  • agranulocytosis + aplastic anemia, liver toxicity, teratogenicity, induce P450, SJ
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5
Q

Valproic acid

A
  • DOC for partial seizures and Tonic-Clonic
  • NA channel inactivation, increase GABA concentration
  • neural tube defects, hepatotoxicity
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6
Q

Gabapentin

A
  • adjuvant for partial and tonic-clonic seizures
  • inhibits Ca channels
  • also used for peripheral neuropathy, post-herpetic neuralgia, migrain prophylaxis
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7
Q

phenobarbital

A
  • partial and tonic-clonic seizures
  • increase GABA action
  • induce P450, cardioresp depression
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8
Q

Topiramate

A
  • Partial and tonic-clonic seizures
  • blocks Na channels
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9
Q

Lamotrigine

A
  • varied use
  • blocks Na chanenels
  • SJ syndrome
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10
Q

Tigabine

A
  • partial seizures
  • inhitis GABA reuptake
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11
Q

general principles of anesthetics

A
  • higher lipid solubility = higher potency (1/MAC)
  • lower blood solubility = rapid induction and recovery
  • NO2 has low blood and lipid solubility – rapid induction, low potency
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12
Q

inhaled anesthetics

A
  • Halothane - Hepatotoxicity
  • Methoxyflurane - Nephrotoxicity (meth=neph)
  • Enflurane - proconvulsant
  • isoflurane
  • sevoflurane
  • NO
  • SE common to all: myocardial and respiratory depression, Nausea, increased CBF
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13
Q

IV anesthetics

A
  • thiopental (barb): high potency and rapid induction but rapid redistribution
    • decreases CBF (brain sx)
  • Midazolam (benzo): endoscopy
  • Ketamine: PCP analog –> disassociative anesthesia and bad SE (bad trip)
    • increased CBF (lots of brain activity)
  • Morphine and fentanyl (Opiods) -adjuvant to prevent waking up from pain)
  • Propofol: rapid induction, short procedures (potentiates GABA)
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14
Q

local anesthetics

A
  • esters: cocaine, procaine, tetracaine
  • amides: lidocaine, mepivicaine, bupivicaine (2 i’s)
  • block Na channels
  • pain —> pressure (small myelinated—> large unmyelinated)
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15
Q

NMJ blocking drugs

A
  • succinylcholine = depolarizing (ACh receptor agonist)
    • phase I: prolonged depolarization (no antidote)
    • phase II: spent phase
  • tubucurarine, atracurium, rocuronium, vecuronium = non-depolarizing (ACh antagonists)
    • reversal of blockade with neostigmine (AChE inhibitor)
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16
Q

Dantrolene

A
  • tx malignant hyperthermia (from inhaled anesthetic and succinylcholine) and neuroleptic malignant syndrome (from antipsychotics)
  • blocks Ca release from skeletal muscle SR
17
Q

Drugs that increase Na channel inactivation

A
  • Phenytoin
  • Carbamazepine
  • Valproic acid (+ increased GABA concentration)
  • Topiramate
  • Lamotrogine

increasing Na channel inactivation makes neurons refractory –> can’t be depolarized again