Neuro drugs

Question 1

Glaucoma drugs

Answer 1

alpha agonists, beta blockers, diuretics, cholinomimetics, prostaglandin

Question 2

alpha agonist names for glaucoma

Answer 2

epinephrine, brimonidine (alpha two)

Question 3

alpha agonist mechanism for glaucoma

Answer 3

decrease humor synthesis via vasoconstriction

Question 4

alpha agonist side effects in glaucoma

Answer 4

don’t give to closed angle (mydriasis/blown pupil), blurry vision, foreign body sensation

Question 5

Beta blockers used in glaucoma

Answer 5

timolol, betaxolol, carteolol

Question 6

beta blocker mechanism in glaucoma. sides?

Answer 6

decrease humor synthesis. no sides

Question 7

Diuretic used in glaucoma

Answer 7

acetazolamide

Question 8

mechanism of diuretics in glaucoma and sides

Answer 8

decrease humor synth by carbonic anhydrase inhibition. no sides

Question 9

Cholinomimetics glaucoma

Answer 9

Direct: pilocarpine, carbachol. Indirect: physostigmine, echothiophate

Question 10

Emergency acute glaucoma medicine

Answer 10

pilocarpine

Question 11

how to cholinomimetics work in glaucoma

Answer 11

increase outflow by contrating ciliary muscle and opening trabecular mesh

Question 12

Prostaglandin name, mech, and sides in glaucoma

Answer 12

latanoprost, outflow increase, darkens iris

Question 13

opiod analgesics

Answer 13

morphine, fetanyl, codeine, heroin, methadone, meperidine, dextromethorphan, diphenoxylate

Question 14

opiod mechanism

Answer 14

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

Question 15

opiod cough suppression

Answer 15

dextromtheorphan

Question 16

opiod diarrhea

Answer 16

loperamide, diphenoxylate

Question 17

Butorphanol

Answer 17

mu-opiod partial agonist used for strong pain. less addictive, but naloxone doesn’t alleviate overdose

Question 18

Tramadol

Answer 18

weak opiod which also blocks reuptake of 5HT and NE (tram it all). used for chronic pain

Question 19

Steven Johnson syndrome

Answer 19

prodrome of malaise and fever, then rapid red itchy macules which begin to slough off

Question 20

Simple Partial Seizure drugs

Answer 20

Carbamazepine but most anti-epileptics work

Question 21

Complex Partial Seizure drugs

Answer 21

Carbamazepine but most anti-epileptics work (just like simple)

Question 22

Tonic-Clonic (grand mal) seizure drugs

Answer 22

Carbamazepine, Phenytoin, Valproate are all 1st line. Can still use most anti epileptic drugs

Question 23

Absence seizure drugs

Answer 23

Ethosuximide 1st line. Valproate is second.

Question 24

Status Epilepticus drugs

Answer 24

Phenytoin for prophylaxis. Benzodiazepines for acute.

Question 25

Childhood seizure drug

Answer 25

Phenobarbital (barbiturates)

Question 26

Seizures of Eclampsia drug

Answer 26

MgSO4 first line. Benzodiazepine second.

Question 27

Side effects: Benzodiazepines

Answer 27

sedation (+EtOH), tolerance, dependence

Question 28

Side effects: Carbamazepine

Answer 28

Diplopia, ataxia, aplastic anemia/blood stuff, liver tox, induces P450, teratogenesis, SIADH, Steven-Johnson syndrome

Question 29

Side effects: Ethosuximide

Answer 29

EGFH: Ethosux, Fatigue, GI, Headache.... Steven Johnson Syndrome

Question 30

Side effects: Phenytoin

Answer 30

Nystagmus, diplopia, ataxia, sedation, gingival hyperplasia, hirsutism, megaloblastic anemia, fetal hydantoin syndrome, SLE, P40, Steven Johnson

Question 31

Side effects: Valproate

Answer 31

GI distress, fatal hepatotox, spina bifida

Question 32

Phenytoin mechanism

Answer 32

Use-dependent Na-channel blocker

Question 33

Barbiturates mechanism and classic drugs

Answer 33

Opens Cl channels longer, to enhance GABA, thus decrease neuron firing. Phenobarbital and thiopental

Question 34

Side effects: Barbiturates (Phenobarbital + Thiopental)

Answer 34

Resp and CV depression (fatal), CNS depression (+EtOH), P450. Contraindicated in porphyria

Question 35

three things which bind GABAa receptor (ligand Cl channel)

Answer 35

Barbiturates, Benzodiazepines, Ethanol

Question 36

Difference between the effect of Barbiturates and Benzodiazepines on GABAa receptor?

Answer 36

``` Barb = increases duration open Benzo= increase frequency of opening ```

Question 37

Benzodiazepines names

Answer 37

Diazepam, lorazepam, triazolam, temazepam, oxaepam

Question 38

Benzo clinical uses

Answer 38

Detox from various drugs (EtOH, stimulants), anxiety, spasticity, status epilepticus, night terrors and sleepwalking (disrupts REM sleep),

Question 39

Nonbenzodiazepine hypnotics

Answer 39

Zolpidem (ambien) act on BZ1 type GABA Recptor. Also flumazenil reversible. New and act shorter

Question 40

Hydrophobic properties make anesthetic ______

Answer 40

Potent

Question 41

Inhaled anesthetic which causes nephrotox

Answer 41

Methoxyflurane

Question 42

Inhaled anesthesia that causes hepatotoxic

Answer 42

Halothane

Question 43

Big inhaled anesthetic side effect and exception.

Answer 43

Malignant hyperthermia. Nitric oxide

Question 44

Intravenous anesthetics

Answer 44

BB King on OPIODS PROPOses FOOLishly | Barbiturates (thiopental), benzodiazepine (midazolam), ketamine, opiod, propofol (rapid)

Question 45

Ketamine mechanism

Answer 45

It is PCP! Blocks nmda receptor.

Question 46

How to distinguish local anesthetic amides from esters?

Answer 46

Amides have two "I"s

Question 47

local anesthetic mechainism

Answer 47

block active Na channels. amines cross as uncharged then act as charged

Question 48

what type of tissue requires more anesthetic and why?

Answer 48

infxn tissue cause it is acidic and local anesthetics are alkaline

Question 49

small vs large nerves: local anasthetics?

Answer 49

small > large

Question 50

myelinated vs unmyelinated local anaesthetics?

Answer 50

myelinated > unmyelinated

Question 51

more important for nerve block with local anasthetic: myelin vs size

Answer 51

small > myelination

Question 52

Neuromuscular block agent that is depolarizing: mech

Answer 52

Succinylcholine. Keeps depolarization going

Question 53

How to reverse neuromuscular block of succinylcholine?

Answer 53

During Phase I (prolonged depolarization) is not reversible. Phase II (desensitized ACh R): give cholinesterase inhibitor neostigmine.

Question 54

Nondepolarizing Neuromuscular block drugs?

Answer 54

Tubocurarine, _____curium

Question 55

How doe nondepolarizaing neuromuscular drugs work?

Answer 55

competetive antagonist for ACh Receptor

Question 56

Dantrolene mechainism

Answer 56

prevent Ca release Sarco

Question 57

Malignant hyperthermia treatment

Answer 57

dantrolene

Question 58

Parkinson's main drugs and mech

Answer 58

BALSA: Bromocriptine (dopamine agonist), Amatadine (dopamine releaser), L-dopa (replacement), Selegiline (MAO inhibitor), Venztropine (Antimuscarinic -ACh)

Question 59

Essential tremor treatment

Answer 59

beta-blocker (propranolol)

Question 60

l-dopa mechanism

Answer 60

can cross BBB (unlike dopamine) and is converted by dopa decarboxylase to dopaine.

Question 61

what do you give with l-dopa and why?

Answer 61

carbidopa to prevent peripheral decarboxylation

Question 62

which MAO is most important for parkinsons and what targets it?

Answer 62

MAO-B targets dopamine more than NE and 5HT. Selegine blocks it.

Question 63

Alzheimer drug names

Answer 63

Memantine, Donepezil, galantamine, rivastigmine

Question 64

Memantine mechainism

Answer 64

NMDA rec antagonist

Question 65

Donepezil, galantamine, rivastigmine mechanism

Answer 65

acetylecholinesterase inhibitor

Question 66

Huntington's drugs and mech

Answer 66

tetrabenazine and resperine (inhibit VMAT-dopamine vesicle packagine) Haloperidol (dopamine receptor antagonist)

Question 67

Sumatriptan mechainism

Answer 67

5HT receptor agonist which prevents trigeminal firing and causes vasoconstriction

Question 68

Sumatriptan use

Answer 68

acute migraine, cluster headaches