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Neuro drugs Flashcards

1
Q

Brimonidine?

A

Alpha 2 agonist– used for glaucoma– dec AH synthesis

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2
Q

This drug should not be used in closed angle glaucoma?

A

Epinephrine –dec AH synthesis

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3
Q

Beta blockers used for glaucoma?

A

Timolol, betaxolol, carteolol– dec AH synthesis

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4
Q

Diuretic used to treat glaucoma?

A

Acetazolamide– dec AH synthesis

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5
Q

MOA of cholinomimetics for glaucoma?

A

increase outflow of aqueous humor via contraction of ciliary muscle

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6
Q

Cholinomimetic used in emergencies to treat glaucoma?

A

Pilocarpine– opens canal of schlemm

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7
Q

Direct cholinomimetics used for glaucoma?

A

Pilocarpine and carbachol

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8
Q

Indirect cholinomimetics used for glaucoma?

A

physostigmine and echothiophate

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9
Q

Prostaglandin used for glaucoma?

A

Latanoprost– inc outflow of aqueous humor– darkens color of iris

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10
Q

Glaucoma drug that darkens the iris (browning)

A

Latanoprost– prostaglandin drug for glaucoma– first line therapy

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11
Q

Meperidine?

A

opioid

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12
Q

diphenoxylate

A

opioid– used for diarrhea

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13
Q

fentanyl

A

opioid

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14
Q

MOA of opioids?

A

Open K channels, close Ca channels–>dec synaptic transmission…. inhibit release of ACh, NE, seretonin, glutamate, substance P

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15
Q

Opioid toxicity treated with?

A

Naloxone or naltrexone

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16
Q

Partial mu opioid agonist and kappa opioid full agonist?

A

Butorphanol– used for severe pain (migraines, labor)–OVERDOSE NOT EASILY REVERSED WITH NALOXONE

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17
Q

Opioid used for severe pain that has less respiratory depression effects thatn other opioids?

A

Butorphanol

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18
Q

Weak opioid agonist that also inhibits seretonin and NE reuptake?

A

Tramadol– used for chronic pain–DECREASES SEIZURE THRESHOLD

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19
Q

Opioid agonist which DEC seizure threshold?

A

Tramadol

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20
Q

Used for trigeminal neuralgia?

A

Carbamazepine

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21
Q

1st line for status epilepticus?

A

Benzos and Phenytoin

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22
Q

Seizure drug used for postherpetic neuralgia, bipolar do, peripheral neuropathy?

A

Gabapentin (for your PENis)

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23
Q

1st line seizure medication in children?

A

Pehnobarbital

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24
Q

Ethosuximide? MOA?

A

Blocks thalamic Ca cahnnels– used for absence seizures

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25
Q

Epileptic that causes sedation tolerance and dependance?

A

Benzos, phenobarbital

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26
Q

Epileptic that causes stevens johnson?

A

Benzos and Carbamazepine, Lamotrigine

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27
Q

Epileptic that causes agranulocytosis, aplastic anemia?

A

Carbamazepine– also SIADH, Stevens johnson

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28
Q

Epileptic that causes hives?

A

Ethosuximide (EFGH, Fatigue, GI, Headache)

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29
Q

Epileptic that causes nystagmus, diplopia, ataxia,?

A

PHENYTOIN

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30
Q

Epileptic that causes gingival hyperplasia and hirsutism?

A

Phenytoin (Penny causes Gingy)

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31
Q

Epileptic that causes megaloblastic anemia?

A

Phenytoin– also causes osteopenia

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32
Q

Epileptic that can cause fatal hepatoxicity and neural tube defects?

A

Valproic acid (If Val Kilmer was a FAT Alcoholic with NO HAIR, you wouldn’t want to get PREGNANT with his baby)–

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33
Q

Epileptic that causes SLE like syndrome?

A

Phenytoin

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34
Q

Epileptics that cause ataxia?

A

Gabapentin and Phenytoin

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35
Q

Epileptic that causes kidney stones and weight loss?

A

Topiramate– also causes mental dulling

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36
Q

MOA of phenytoin?

A

Blockade of Na channels; inhibits glutamate realease from presynaptic neurons

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37
Q

Epileptic that is also a class 1B antiarrhythmic?

A

Phenytoin

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38
Q

MOA of barbiturates?

A

Increase DURATION of Cl- opening leading to decreased neuronal firing– contraindicated in porphyrias

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39
Q

Contraindicated in porphyria?

A

Barbidurates

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40
Q

List the benzos?

A

anything that ends in “azepam” or “olam” and chlordiazepoxide

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41
Q

MOA of benzos?

A

Increase frequency of Cl- channel opening, decreases REM sleep

Have active metabolites

42
Q

Used in alcohol withdrawal?

43
Q

Treat overdose of Benzos with?

A

Flumazenil

44
Q

Nonbenzo hypnotics?

A

Zolpidem (ambien); zaleplon, eszopiclone

45
Q

Zolpidem? MOA?

A

Ambien– act via BZ1 subtype of GABA receptor

46
Q

1st line epileptics for partial seizures?

A

Carbamazepine

47
Q

Used for seizures of ecclampsia?

A

Benzoes (1st line is MgSO4)

48
Q

May be used for induction of anesthesia?

A

Barbiturates (thiopental)

49
Q

anesthetics with dec solubility in blood

A

have rapid induction and recovery times

50
Q

Drugs with increased solubiility in lipids?

A

Have increased potency

51
Q

How is high potency measured in anesthetics?

A

1/MAC (minimal alveolar concentration in which 50% of population is anesthetized)

52
Q

N2O as an anesthetic?

A

low blood solubility and therefore fast induction time and low potency

53
Q

Halothane as an anesthetic?

A

high lipid solubility and therefore high potency and low induction

54
Q

Inhaled anesthetics?

A

Halothane and “flurane”s and Nitrous oxide

55
Q

Anesthetics that increase cerebral blood flow and cause myocardial depression?

A

Inhaled anesthetics (ahlothane and fluranes)

56
Q

Can cause malignant hyperthermia?

A

Inhaled anesthetics

57
Q

May lead to severe hepatotoxicity (anesthetic)?

58
Q

Anesthetic that can lead to nephrotoicity?

A

Methoxyflurane

59
Q

Barbiturtes and anesthesia?

A

IV anesthetics– thiopenal is used for induction– has high potency and high lipid solubility

60
Q

Effects of this anesthetic are terminated by rapid redistribution into tissue? such as skeletal msucle and fat?

A

Thiopental– also decreases cerebral flow

61
Q

Most common drug used for endoscopy?

62
Q

MOA of ketamine?

A

Blocks NMDA receptor– cardiovascular stimulant and increases cerebral blood flow

63
Q

Used for short procedures and rapid anesthesia induction?

64
Q

Local anesthetic esters?

Amides?

A 
Esters= procaine, cocaine, tetracaine
Amides= LIdocaIne, mepIvicaIne, bupIvicaIne, amides have 2 i's
65
Q

MOA of local anesthetics?

A

Block Na channels on inner portion of channel; preferentially bind activated Na channels. Tertiary amines penetrate membrane in uncharged form and then bind to ion channels as charged form

66
Q

What are local anesthetics given with?

A

vasoconstrictors– dec bleeding, inc anesthesia by dec systemic concentration

67
Q

Order of pain loss in locals?

A

Pain, temp, touch pressure (PTTP)

68
Q

Order of nerve block in locals?

A

small>large fibers

Myelinated>unmyelinated

69
Q

Local anesthetic with severe cardiotoxicity?

A

bupivacaine

70
Q

SE of cocaine?

A

Arrhythmias

71
Q

Succinylcholine?

A

Strong ACh receptor agonist; produces sustained depolarizations and prevents muscle contraction–NOT DEGRADED BY ACETYLCHOLINESTERASE

72
Q

Reversal of blockade in depolarizing agents?

A

Phase 1= prolonged depolarization– no antidote– block potentiated by cholinesterase inhibitors

Phase 2= Repolarized but blocked; ACh receptors are available but sensitized– antidote consists of cholinesterase inhibitor (neostigmine)

Complications of depolarizing agents– hypercalcemia hyperkalemia, and malignant hyperthermia

73
Q

Complications of depolarizing agents?

A

Hypercalcemia, hyperkalemia, malignant hyperthermia

74
Q

Nondepolarizing neuromuscular agents?

A

tubocurarine, atracurium, mivacurium, pancuronium, ….

competitive ACh antagonists

75
Q

Reversal of blockade for tubocurarine and atracurium?

A

neostigmine, edrophonium, and other cholinesterase inhibitors

76
Q

Prevents release of Ca2+ from the sarcoplasmic reticulum of skeletal muscle

A

dantrolene

77
Q

Patient receives inhalation anesthetics (or succinylcholine) and his fever spikes up to 41degrees– what’s the antidote?

A

Dantrolene– also used in neuroleptic malignant syndrome

78
Q

Parkinsons?

A

Loss of dopaminergic and excess cholinergic activity

79
Q

Dopamine agonists? ergot? nonergot?

A

Nonergots preferred= pramipexole, ropinirole

Ergot= bromocriptine

80
Q

Increases dopamine release and side effect is ataxia?

A

Amantidine— also used against flu and rubella

81
Q

Ldopa/carbidopa?

A

Converted to dopamine in CNS

82
Q

Prevent dopamine breakdown?

A

Selegiline (MAO b inhibitor); Entacapone, tolcapone (comt inhibitors)

83
Q

Curb excess cholinergic activity?

A

Benztropine (antimuscarininc; improves tremor and rigidity but has little effect on bradykinesia_

84
Q

Improves tremor and rigidity in parkinsons but has little effect on bradykinesia

A

Benztropine

85
Q

Carbidopa?

A

Peripheral decarboxylase inhibitor– limits peripheral side effects of Ldopa

86
Q

Toxicity of Ldopa/carbidopa?

A

Arrhythmias from increased peripheral formation of catecholamines– akinesia between doses

87
Q

MOA of Selegiline?

A

selectively inhibits MAO B, which preferentially metabolizes dopamine over NE and 5HT– may enhance adverse effects of L-dopa

88
Q

Memantine MOA?

A

Alzheimer drug– NMDA receptor antagonist– helps prevent excitotoxicity (mediated by Ca)

89
Q

Memantine side effects?

A

Dizziness, confusion HALLUCINATION

90
Q

Donepezil?

A

Alzheimer drug– acetylcholinesterase inhibitor

91
Q

Galantamine?

A

Acetylcholinesterase inhibitors

92
Q

Rivastigmine?

A

Acetylcholinesterase inhibitors

93
Q

Acetylcholinesterase inhibitors?

A

Donepezil; galantamine; rivastigmine

94
Q

Drugs for huntingtons?

A

Tetrabenazine and reserpine inhibit VMAT

Haloperidol is a dopamine antagonist

95
Q

Tetrabenazine and reserpine?

A

Inhibit VMAT–limit dopamine vesicle packaging and release– huntingtons

96
Q

SumatriptanMOA? uses?

A

5Ht agonist– inhibits trigeminal nerve activation; USED IN MIGRAINE AND CLUSTER HEADACHES– SUMO WRESTLER TRIPS AND FALLS ON YOUR HEAD

97
Q

Sumatriptan is contraindicated in?

A

coronary vasospasm– may cause mild tingling

98
Q

Partial seizures?

A

Carbamezapin

99
Q

Myoclonic seizures?

A

Valproic acid– suppressed GABA and NMDA

100
Q

Absence seizures?

A

Valproate and Ethosuximide

101
Q

Antiseizure that causes siadh?

A

Carbamezapine

Elliot Step 1 (32 decks)

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