Neuro drugs Flashcards
Glaucoma drugs
alpha agonists, beta blockers, diuretics, cholinomimetics, prostaglandin
alpha agonist names for glaucoma
epinephrine, brimonidine (alpha two)
alpha agonist mechanism for glaucoma
decrease humor synthesis via vasoconstriction
alpha agonist side effects in glaucoma
don’t give to closed angle (mydriasis/blown pupil), blurry vision, foreign body sensation
Beta blockers used in glaucoma
timolol, betaxolol, carteolol
beta blocker mechanism in glaucoma. sides?
decrease humor synthesis. no sides
Diuretic used in glaucoma
acetazolamide
mechanism of diuretics in glaucoma and sides
decrease humor synth by carbonic anhydrase inhibition. no sides
Cholinomimetics glaucoma
Direct: pilocarpine, carbachol. Indirect: physostigmine, echothiophate
Emergency acute glaucoma medicine
pilocarpine
how to cholinomimetics work in glaucoma
increase outflow by contrating ciliary muscle and opening trabecular mesh
Prostaglandin name, mech, and sides in glaucoma
latanoprost, outflow increase, darkens iris
opiod analgesics
morphine, fetanyl, codeine, heroin, methadone, meperidine, dextromethorphan, diphenoxylate
opiod mechanism
agonist against opiod receptors (mu=morphine) to open K channels and close Ca channels thus decrease synaptic transmission. in particular they decrease release of ACh, NE, 5HT, Glu, substance P
opiod cough suppression
dextromtheorphan
opiod diarrhea
loperamide, diphenoxylate
Butorphanol
mu-opiod partial agonist used for strong pain. less addictive, but naloxone doesn’t alleviate overdose
Tramadol
weak opiod which also blocks reuptake of 5HT and NE (tram it all). used for chronic pain
Steven Johnson syndrome
prodrome of malaise and fever, then rapid red itchy macules which begin to slough off
Simple Partial Seizure drugs
Carbamazepine but most anti-epileptics work
Complex Partial Seizure drugs
Carbamazepine but most anti-epileptics work (just like simple)
Tonic-Clonic (grand mal) seizure drugs
Carbamazepine, Phenytoin, Valproate are all 1st line. Can still use most anti epileptic drugs
Absence seizure drugs
Ethosuximide 1st line. Valproate is second.
Status Epilepticus drugs
Phenytoin for prophylaxis. Benzodiazepines for acute.
Childhood seizure drug
Phenobarbital (barbiturates)
Seizures of Eclampsia drug
MgSO4 first line. Benzodiazepine second.
Side effects: Benzodiazepines
sedation (+EtOH), tolerance, dependence
Side effects: Carbamazepine
Diplopia, ataxia, aplastic anemia/blood stuff, liver tox, induces P450, teratogenesis, SIADH, Steven-Johnson syndrome
Side effects: Ethosuximide
EGFH: Ethosux, Fatigue, GI, Headache…. Steven Johnson Syndrome
Side effects: Phenytoin
Nystagmus, diplopia, ataxia, sedation, gingival hyperplasia, hirsutism, megaloblastic anemia, fetal hydantoin syndrome, SLE, P40, Steven Johnson
Side effects: Valproate
GI distress, fatal hepatotox, spina bifida
Phenytoin mechanism
Use-dependent Na-channel blocker
Barbiturates mechanism and classic drugs
Opens Cl channels longer, to enhance GABA, thus decrease neuron firing. Phenobarbital and thiopental
Side effects: Barbiturates (Phenobarbital + Thiopental)
Resp and CV depression (fatal), CNS depression (+EtOH), P450. Contraindicated in porphyria
three things which bind GABAa receptor (ligand Cl channel)
Barbiturates, Benzodiazepines, Ethanol
Difference between the effect of Barbiturates and Benzodiazepines on GABAa receptor?
Barb = increases duration open Benzo= increase frequency of opening
Benzodiazepines names
Diazepam, lorazepam, triazolam, temazepam, oxaepam
Benzo clinical uses
Detox from various drugs (EtOH, stimulants), anxiety, spasticity, status epilepticus, night terrors and sleepwalking (disrupts REM sleep),
Nonbenzodiazepine hypnotics
Zolpidem (ambien) act on BZ1 type GABA Recptor. Also flumazenil reversible. New and act shorter
Hydrophobic properties make anesthetic ______
Potent
Inhaled anesthetic which causes nephrotox
Methoxyflurane
Inhaled anesthesia that causes hepatotoxic
Halothane
Big inhaled anesthetic side effect and exception.
Malignant hyperthermia. Nitric oxide
Intravenous anesthetics
BB King on OPIODS PROPOses FOOLishly
Barbiturates (thiopental), benzodiazepine (midazolam), ketamine, opiod, propofol (rapid)
Ketamine mechanism
It is PCP! Blocks nmda receptor.
How to distinguish local anesthetic amides from esters?
Amides have two “I”s
local anesthetic mechainism
block active Na channels. amines cross as uncharged then act as charged
what type of tissue requires more anesthetic and why?
infxn tissue cause it is acidic and local anesthetics are alkaline
small vs large nerves: local anasthetics?
small > large
myelinated vs unmyelinated local anaesthetics?
myelinated > unmyelinated
more important for nerve block with local anasthetic: myelin vs size
small > myelination
Neuromuscular block agent that is depolarizing: mech
Succinylcholine. Keeps depolarization going
How to reverse neuromuscular block of succinylcholine?
During Phase I (prolonged depolarization) is not reversible. Phase II (desensitized ACh R): give cholinesterase inhibitor neostigmine.
Nondepolarizing Neuromuscular block drugs?
Tubocurarine, _____curium
How doe nondepolarizaing neuromuscular drugs work?
competetive antagonist for ACh Receptor
Dantrolene mechainism
prevent Ca release Sarco
Malignant hyperthermia treatment
dantrolene
Parkinson’s main drugs and mech
BALSA: Bromocriptine (dopamine agonist), Amatadine (dopamine releaser), L-dopa (replacement), Selegiline (MAO inhibitor), Venztropine (Antimuscarinic -ACh)
Essential tremor treatment
beta-blocker (propranolol)
l-dopa mechanism
can cross BBB (unlike dopamine) and is converted by dopa decarboxylase to dopaine.
what do you give with l-dopa and why?
carbidopa to prevent peripheral decarboxylation
which MAO is most important for parkinsons and what targets it?
MAO-B targets dopamine more than NE and 5HT. Selegine blocks it.
Alzheimer drug names
Memantine, Donepezil, galantamine, rivastigmine
Memantine mechainism
NMDA rec antagonist
Donepezil, galantamine, rivastigmine mechanism
acetylecholinesterase inhibitor
Huntington’s drugs and mech
tetrabenazine and resperine (inhibit VMAT-dopamine vesicle packagine)
Haloperidol (dopamine receptor antagonist)
Sumatriptan mechainism
5HT receptor agonist which prevents trigeminal firing and causes vasoconstriction
Sumatriptan use
acute migraine, cluster headaches
