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Step Uno > Neuro drugs > Flashcards

Neuro drugs Flashcards

1
Q

Glaucoma drugs

A

alpha agonists, beta blockers, diuretics, cholinomimetics, prostaglandin

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2
Q

alpha agonist names for glaucoma

A

epinephrine, brimonidine (alpha two)

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3
Q

alpha agonist mechanism for glaucoma

A

decrease humor synthesis via vasoconstriction

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4
Q

alpha agonist side effects in glaucoma

A

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

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5
Q

Beta blockers used in glaucoma

A

timolol, betaxolol, carteolol

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6
Q

beta blocker mechanism in glaucoma. sides?

A

decrease humor synthesis. no sides

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7
Q

Diuretic used in glaucoma

A

acetazolamide

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8
Q

mechanism of diuretics in glaucoma and sides

A

decrease humor synth by carbonic anhydrase inhibition. no sides

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9
Q

Cholinomimetics glaucoma

A

Direct: pilocarpine, carbachol. Indirect: physostigmine, echothiophate

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10
Q

Emergency acute glaucoma medicine

A

pilocarpine

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11
Q

how to cholinomimetics work in glaucoma

A

increase outflow by contrating ciliary muscle and opening trabecular mesh

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12
Q

Prostaglandin name, mech, and sides in glaucoma

A

latanoprost, outflow increase, darkens iris

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13
Q

opiod analgesics

A

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

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14
Q

opiod mechanism

A

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

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15
Q

opiod cough suppression

A

dextromtheorphan

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16
Q

opiod diarrhea

A

loperamide, diphenoxylate

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17
Q

Butorphanol

A

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

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18
Q

Tramadol

A

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

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19
Q

Steven Johnson syndrome

A

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

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20
Q

Simple Partial Seizure drugs

A

Carbamazepine but most anti-epileptics work

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21
Q

Complex Partial Seizure drugs

A

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

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22
Q

Tonic-Clonic (grand mal) seizure drugs

A

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

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23
Q

Absence seizure drugs

A

Ethosuximide 1st line. Valproate is second.

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24
Q

Status Epilepticus drugs

A

Phenytoin for prophylaxis. Benzodiazepines for acute.

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25
Q

Childhood seizure drug

A

Phenobarbital (barbiturates)

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26
Q

Seizures of Eclampsia drug

A

MgSO4 first line. Benzodiazepine second.

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27
Q

Side effects: Benzodiazepines

A

sedation (+EtOH), tolerance, dependence

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28
Q

Side effects: Carbamazepine

A

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

29
Q

Side effects: Ethosuximide

A

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

30
Q

Side effects: Phenytoin

A

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

31
Q

Side effects: Valproate

A

GI distress, fatal hepatotox, spina bifida

32
Q

Phenytoin mechanism

A

Use-dependent Na-channel blocker

33
Q

Barbiturates mechanism and classic drugs

A

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

34
Q

Side effects: Barbiturates (Phenobarbital + Thiopental)

A

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

35
Q

three things which bind GABAa receptor (ligand Cl channel)

A

Barbiturates, Benzodiazepines, Ethanol

36
Q

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

A 
Barb = increases duration open
Benzo= increase frequency of opening
37
Q

Benzodiazepines names

A

Diazepam, lorazepam, triazolam, temazepam, oxaepam

38
Q

Benzo clinical uses

A

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

39
Q

Nonbenzodiazepine hypnotics

A

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

40
Q

Hydrophobic properties make anesthetic ______

A

Potent

41
Q

Inhaled anesthetic which causes nephrotox

A

Methoxyflurane

42
Q

Inhaled anesthesia that causes hepatotoxic

A

Halothane

43
Q

Big inhaled anesthetic side effect and exception.

A

Malignant hyperthermia. Nitric oxide

44
Q

Intravenous anesthetics

A

BB King on OPIODS PROPOses FOOLishly

Barbiturates (thiopental), benzodiazepine (midazolam), ketamine, opiod, propofol (rapid)

45
Q

Ketamine mechanism

A

It is PCP! Blocks nmda receptor.

46
Q

How to distinguish local anesthetic amides from esters?

A

Amides have two “I”s

47
Q

local anesthetic mechainism

A

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

48
Q

what type of tissue requires more anesthetic and why?

A

infxn tissue cause it is acidic and local anesthetics are alkaline

49
Q

small vs large nerves: local anasthetics?

A

small > large

50
Q

myelinated vs unmyelinated local anaesthetics?

A

myelinated > unmyelinated

51
Q

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

A

small > myelination

52
Q

Neuromuscular block agent that is depolarizing: mech

A

Succinylcholine. Keeps depolarization going

53
Q

How to reverse neuromuscular block of succinylcholine?

A

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

54
Q

Nondepolarizing Neuromuscular block drugs?

A

Tubocurarine, _____curium

55
Q

How doe nondepolarizaing neuromuscular drugs work?

A

competetive antagonist for ACh Receptor

56
Q

Dantrolene mechainism

A

prevent Ca release Sarco

57
Q

Malignant hyperthermia treatment

A

dantrolene

58
Q

Parkinson’s main drugs and mech

A

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

59
Q

Essential tremor treatment

A

beta-blocker (propranolol)

60
Q

l-dopa mechanism

A

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

61
Q

what do you give with l-dopa and why?

A

carbidopa to prevent peripheral decarboxylation

62
Q

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

A

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

63
Q

Alzheimer drug names

A

Memantine, Donepezil, galantamine, rivastigmine

64
Q

Memantine mechainism

A

NMDA rec antagonist

65
Q

Donepezil, galantamine, rivastigmine mechanism

A

acetylecholinesterase inhibitor

66
Q

Huntington’s drugs and mech

A

tetrabenazine and resperine (inhibit VMAT-dopamine vesicle packagine)

Haloperidol (dopamine receptor antagonist)

67
Q

Sumatriptan mechainism

A

5HT receptor agonist which prevents trigeminal firing and causes vasoconstriction

68
Q

Sumatriptan use

A

acute migraine, cluster headaches

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