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STEP > Neuro drugs > Flashcards

Neuro drugs Flashcards

1
Q

pentazocine uses

A

analgesia for moderate to severe pain

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2
Q

pentazocine AE’s

A

Can cause opioid withdrawal symptoms if patient is also taking full opioid antagonist (competition for opioid receptors)

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3
Q

butorphanol mechanism

A

K-agonist + mu- partial agonist

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4
Q

butorphanol uses and caveat

A

1) severe pain (eg, migraine, labor).

2) less respiratory depression than full opioid agonists.

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5
Q

butorphanol AE’s

A

1) withdrawal

2) overdose not easily reversed with naloxone

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6
Q

tramadol MOA

A

1) weak opioid agonist

2) inhibits 5-HT and NE reuptake.

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7
Q

tramadol use

A

chronic pain

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8
Q

tramadol AE’s

A

1) decreases seizure threshold

2) serotonin syndrome

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9
Q

ethosuximide AE’s

A 
Fatigue
Gi distress
Headache
Itching
stevens-johnson syndrome
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10
Q

receptor targeted by benzos

A

GABA A (increase)

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11
Q

other use for benzos?

A

eclampsia seizures

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12
Q

phenobarbital receptor

A

GABA *A (increase)

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13
Q

1st line treatment for seizures in neonates?

A

phenobarbital

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14
Q

other drug like phenytoin?

A

fosphenytoin

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15
Q

teratogenic syndrome caused by phenytoin…

A

fetal hydantoin syndrome

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16
Q

phenytoin AE’s

A

1) nystagmus
2) diplopia
3) ataxia
4) sedation
5) peripheral neuropathy
6) hirsutism
7) SJS
8) gingival hyperplasia
9) DRESS syndrome
10) osteopenia
11) SLE-like syndrome
12) megaloblastic anemia

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17
Q

DRESS syndrome

A

o Code: Anna by the counter: /Drug Reaction with Eosinophilia and Systemic Symptoms. She’s sweating profusely + face is edematous + she’s topless with a morbilloform rash + has an edematous face/presentation = fever + generalized lymphadenopathy + facial edema + diffuse morbilliform skin rash. Bennett behind the counter + ryan O’connell + big aloe plant in the middle of the store + Ivan + bathtub of minos + geyser going off by entrance/associated with anticonvulsants (phenytoin + carbamazepine) + allopurinol + sulfonamides (sulfasalazine) + minocycline + vancomycin. Giant Andrew black standing in corner/MOA = thought to be drug-induced herpesvirus reactivation followed by clonal expansion of T cells that cross-react with the drug. /typically occurs 2-8 weeks after exposure to high-risk drugs.
o Location: Urban Outfitters in Portland, walls lined with dresses

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18
Q

osteopenia

A

Condition in which bone mineral density is lower than normal. Precursor to osteoporosis.

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19
Q

Carbamazepine AE’s

A

1) diplopia
2) ataxia
3) agranulocytosis + aplastic anemia
4) liver toxicity
5) teratogenic
6) SIADH
7) SJS

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20
Q

valproic acid mechanism

A

1) increased Na channel inactivation

2) *increased GABA concentration by inhibiting GABA transaminase

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21
Q

valproic acid AE’s

A

1) GI distress
2) hepatotoxicity
3) pancreatitis
4) NTDs
5) tremor
6) weight gain

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22
Q

vigabatrin mechanism

A

Increases GABA by irreversibly inhibiting GABA transaminase

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23
Q

Gabapentin MOA

A

GABA analog that primarily inhibits high-voltage-activated Ca2+ channels.

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24
Q

Gabapentin AE’s

A

sedation + ataxia

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25
Q

other uses for gabapentin?

A

peripheral neuropathy

26
Q

treatment for postherpetic neuralgia?

A

Gabapentin

27
Q

topiramate MOA

A

1) blocks sodium channels

2) increases GABA action

28
Q

topiramate AE’s

A

1) sedation
2) mental dulling
3) kidney stones
4) weight loss

29
Q

levetiracetam MOA

A

unknown; may modulate GABA and glutamate release

30
Q

tiagabine MOA

A

Increases GABA by inhibiting reuptake.

31
Q

First line for simple partial seizures?

A

carbamazepine

32
Q

First line for simple complex seizures?

A

carbamazepine

33
Q

First line for tonic-clonic seizures

A

Phenytoin
OR
Valproic acid

34
Q

first line for acute status epileptics?

A

benzos

35
Q

first line for status epilepticus prophylaxis?

A

phenytoin/fosphenytoin

36
Q

Drugs used only for partial seizures?

A

vigabatrin
gabapentin
tiagabine

37
Q

other barbiturate?

A

secobarbital

38
Q

barbiturates target..

A

GABA*A

39
Q

When are barbiturates contraindicated?

A

porphyria

40
Q

barbiturates uses

A

1) sedative for anxiety
2) seizures
3) insomnia
4) thiopental used for induction of anesthesia

41
Q

barbiturate overdose treatment?

A

supportive (assist respiration + maintain BP)

42
Q

barbiturates AE’s

A

1) respiratory/CV/CNS depression

2) dependence

43
Q

What is the GABA A receptor?

A

Ligand-gated Cl- channel

44
Q

General pharmacokinetic rule about Benzos…

A

Most have long half-lives and active metabolites except (ATOM –> alprazolam, triazolam, oxazepam, midazolam, which are all short acting)

45
Q

Problem with short acting benzos?

A

Higher addictive potential

46
Q

benzos to use for status epilepticus

A

lorazepam

*diazepam

47
Q

other use for benzos

A

hypnotic for insomnia

48
Q

Risk of flumazenil?

A

Can precipitate seizures by causing acute benzo withdrawal.

49
Q

nonbenzo hypnotics…

A

zolpidem
zaleplon
esZopiclone

50
Q

nonbenzo hypnotics MOA

A

act via BZ1 subtype of GABA receptor

51
Q

nonbenzo hypnotics antagonist

A

flumazenil

52
Q

Nice thing about nobenzo hypnotics…

A

Don’t affect sleep cycle as much and unlike older sedative-hypnotics, cause only modest day-after psychomotor depression and a few amnestic effects. Also less risk of dependence.

53
Q

nonbenzo hypnotics

A

1) ataxia
2) headaches
3) confusion

54
Q

nonbenzo hypnotics pharmacologic caveat

A

Short duration because of rapid metabolism by liver enzymes

55
Q

What determines recovery time?

A

Decreased solubility = more rapid recovery time

56
Q

What determines potency?

A

solubility in lipids. INCREASED solubility = higher potency (can cross BBB better)

57
Q

potency for anesthetics described by..

A

1/MAC

58
Q

What is MAC?

A

minimal alveolar concentration required to prevent 50% of subjects from moving in response to noxious stimuli

59
Q

Nitrous oxide pharmacokinetics

A

Decreased blood and lipid solubility. Thus has a fast induction and low potency.

60
Q

Halothane pharmacokinetics

A

High lipid and blood solubility and thus high potency and slow induction.

STEP (85 decks)

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