Neuro First Aid Pharm Flashcards
(130 cards)
1
Q
Mech: Opioid agonist. Open K+ channels, close Ca2+ channels; decreases synpatic transmission thus decreasing release of Ach, NE, 5-HT, glutamate, substance P.
A
Opioid Analgesics (Morphine, Fentanyl, Codeine, Heroin, Methadone, Meperidine, Dextromethorphan, Diphenoxylate, Loperamide)
2
Q
SE: Respiratory depression, miosis, CNS depression (additive with other drugs), constipation, addiction. Tolerance doesn’t develop to miosis and constipation. Treat overdose with naloxone. Increases ICP, contraindicate with head trauma.
A
Morphine, Fentanyl, Codeine, Heroin, Methadone, Meperidine, Dextromethorphan, Diphenoxylate, Loperamide side effects?
3
Q
Opioids
A
Morphine, Fentanyl, Codeine, Heroin, Methadone, Meperidine, Dextromethorphan, Diphenoxylate
4
Q
Used for Diarrhea
A
Loperamide and diphenoxylate
5
Q
Long lasting opioid agonist.
A
Methadone
6
Q
Cough suppressant, analgesic.
A
Codeine
7
Q
Abused as a halucinogen. Cough suppressant.
A
Dextromethorphan
8
Q
Mech: Partial agonist at opioid mu receptors; agonist at kappa receptors.
A
Butorphanol
9
Q
Very weak opioid agonist; inhibits serotonin and norepinephrine reuptake.
A
Tramadol
10
Q
Maintenance programs for addicts.
A
Methadone uses?
11
Q
Inhibits voltage-gated sodium channel activation (doesn’t block pores).
A
Carbamazepine
12
Q
Mech: Inhibits thalamic T-type calcium channels
A
Ethosuximide
13
Q
SE include GI distress, fatigue, headache, urticaria, Steven-Johnson syndrome
A
Ethosuximide
14
Q
Used for Severe Pain (migraine, labor, etc). Causes less resp depression than full opioids.
A
Butorphanol.
14
Q
SE include Sedation, tolerance, dependence, induction of cytochrome P-450, additive respiratory depression with alcohol. Contraindicate with porphyria because of P-450 induction
A
Barbituates
15
Q
Less respiratory depression than full agonists; induces withdrawal if on a full opioid agonist (higher affinity, less effect).
A
Butorphanol side effects?
16
Q
Used for Status epilepticus, tonic-clonic seizures. Class IB antiarrhythmic.
A
Phenytoin
18
Q
Used for Chronic pain.
A
Tramadol uses?
18
Q
Decreases seizure thresholds; similar to opioids.
A
Tramadol side effects?
19
Q
Used for Tonic-clonic seizures, absence seizures. Bipolar disorder.
A
Valproic acid
20
Q
Mech: Blocks voltage-gated sodium channels and glutamate receptors.</p>
A
Lamotrigine, felbamate
21
Q
Trigeminal neuralgia, tonic-clonic seziures.
A
Carbamazepine uses?
22
Q
Diplopia, ataxia, blood dyscrasias (agranulocytosis, aplastic anemia), liver toxicity, teratogenesis, induction of cytochrome P-450, SIADH, Stevens-Johnson syndrome. NTD in pregnancy.
A
Carbamazepine side effects?
23
Q
Mech: GABA analog; inhibits HVA calcium channels.
A
Gabapentin
24
Absence seizures; ineffective for other types.
Ethosuximide uses?
26
Mech: Blocks sodium channels and increases GABA action.
Topiramate
27
GABA(A) agonist that increases DURATION of Cl- channel opening, thus decreasing neuron firing.
Barbituates mechanism of action?
27
First line antiepileptic in children and pregnant women. Rapid anesthesia induction.
Barbituates uses?
28
Use-dependent blockade of voltage-gated Na+ channels; increases refractory period; inhibition of glutamate release from excitatory presynaptic neuron.
Phenytoin mechanism of action?
29
Sedation, mental dulling, kidney stones, weight loss. Inhibits CYP-450.
Topiramate
31
SE include Sedation, tolerance, dependence. Short acting agents = TOM (Triazolam, Oxazepam, Midazolam; highest addictive potential). Long acting agents = CCDF (chlordiazepoxide, chlorazepate, diazepam, flurazepam.) Long lasting agents have higher risk of daytime drowsiness and risk of falls (CI with parkinson's).
Benzodiazepines (-epam, -olam)
32
SE: Pseudolymphoma (generalized LAD), nystagmus, diplopia, ataxia, sedation, gingival hyperplasia, hirsutism, peripheral neuropathy, megaloblastic anemia, teratogenesis (fetal hydantoin syndrome), SLE-like syndrome, induction of cytochrome P-450. NTD in pregnancy.
Phenytoin side effects?
33
Used for All seizure types except absence.
Tiagabine, Lamotrigine, felbamate, Gabapentin
34
Mech: Irreversibly inhibits GABA transaminase; increases GABA levels.
Vigabatrin
35
Inhibits voltage-gated sodium channel activation, increases GABA concentration, inactivates T-type calcium channels.
Valproic acid mechanism of action?
36
Mech: Modulates GABA and glutamate release.
Levetiracetam
37
GI distress, rare but fatal hepatotoxicity (measure LFTs) , neural tube defects in fetus (spina bifida), tremor, weight gain. Contraindicated in pregnancy.
Valproic acid side effects?
38
Used to Prevent seziures of eclampsia.
MgSO4
39
SE include Myocardial depression, respiratory depression, nausea/emesis, increase cerebral blood flow (decrease cerebral metabolic demand).
Inhaled Anesthetics
40
Causes hepatotoxicity
Halothane
41
SE: Stevens-Johnson syndrome, hepatotoxicity and aplastic anemia
Lamotrigine, felbamate
42
Is a proconvulsant
Enflurane
43
Inhaled Anesthetics
"RANE"s plus Nitrous Oxide
| - Halothane, Enflurane, Isoflurane, Sevoflurane, Methoxyflurane, Nitrous Oxide
44
Mech: NMDA antagonist; PCP analog
Ketamine (arylcyclohexylamines)
45
Sedation, ataxia.
Gabapentin side effects?
46
SE include CV stimulant; disorientation, hallucination, bad dreams (in children). Increases cerebral blood flow.
Ketamine (arylcyclohexylamines)
47
Mech: Potentiates GABA(A).
Propofol
48
Mech: Ester anesthetics. Block voltage gated sodium channels by stabilizng inactive form; selectively targets more rapidly firing neurons.
"Caine"s
| - Procaine, cocaine, tetracaine
49
SE include Hypersensitivity. CNS excitation, severe cardiovascular toxicity (one?), hypertension, hypotension, arrhythmia (one?).
Procaine, cocaine, tetracaine, Lidocaine, mepivacaine, bupivacaine
50
Mech: Amide anesthetics. Block voltage gated sodium channels by stabilizng inactive form; selectively targets more rapidly firing neurons.
Lidocaine, mepivacaine, bupivacaine
51
Mech: Depolarizing neuromuscular blocker (NAChR). Strong ACh receptor agonist.
Succinylcholine
52
SE include Hypercalcemia, hyperkalemia, malignant hyperthermia. Contraindicate acetylcholinesterase inhibitors.
Succinylcholine
53
Used for Muscle paralysis in surgery.
Tubocurarine, atracurium, mivacurium, pancuronium, vecuronium, rocuronium
54
Mech: Prevents Ca2+ release from SER by antagonizing the ryanodine receptor
Dantrolene
55
Used for Malignant hyperthermia, neuroleptic malingant syndrome
Dantrolene
56
Mech: Dopamine agonists
Bromocriptine (ergot), pramipexole and ropinirole (non-ergots); non-ergots are preferred
57
Mech: Myocardial depression, respiratory depression, nausea/emesis, increase cerebral blood flow (decrease cerebral metabolic demand).
Enflurane mechanism of action?
58
May increase dopamine release (Parkinson's); also used as an antiviral against influenza A and rubella; toxicity = ataxia
Amantadine
59
Mech: Dopamine agonist (1); inhibits DOPA decarboxylase peripherally(2) (Used for Parkinson's)
L-dopa and carbidopa
60
SE include Arrhythmias from peripheral conversion to dopamine. Long-term use can increase dyskinesia following administration, akinesia between doses. Carbidopa limits peripheral side effects. Contraindicate with B6 since it increases peripheral metabolism of levodopa
L-dopa/carbidopa
61
Mech: Selective MAO B inhibitor. Decreases dopamine metabolism (Parkinson's)
Selegiline
62
Nephrotoxicity, malignant hyperthermia.
Methoxyflurane side effects?
63
Mech: Peirpheral COMT inhibitor. Decreases dopamine metabolism. (Parkinson's)
Entacapone and Tolcapone
64
Mech: Anticholinergic
Benztropine
65
Used for Parkinson's disease; improves tremor and rigidity but no effect on bradykinesia.
Benztropine
66
Mech: NMDA receptor antagonist.
Memantine
67
Used for Alzheimer's disease; helps prevent excitoxicity mediated by calcium.
Memantine
68
Only cocaine causes vasoconstriction; the rest must be administered with vasoconstrictors to enhance local action. Targets small myelinated nerves first; pain > temperature > touch > pressure (last).
Procaine, cocaine, tetracaine uses?
69
Mech: Acetylcholinesterase inhibitors
Donepezil, galantamine, and Rivastigmine
70
Used for Alzhiemer's disease
Donepezil, galantamine, and Rivastigmine
71
Muscle paralysis in surgery.
Tubocurarine uses?
71
Non-depolarizing neuromuscular blocker (NAChR). Competitive NAChR antagonist.
Atracurium mechanism of action?
72
Mech: Amine depleting; lowers dopamine levels by inhibiting VMAT
Resperine and tetrabenzine
73
Used for Huntington's disease (caused by too much dopamine, too little GABA and ACh)
Resperine and tetrabenzine
74
Reverse blockade with an acetylcholinesterase inhibitor.
Atracurium side effects?
75
Used for Acute migraines, cluster headache attacks.
Sumatriptan
76
Reverse blockade with an acetylcholinesterase inhibitor.
Mivacurium side effects?
78
Non-depolarizing neuromuscular blocker (NAChR). Competitive NAChR antagonist.
Rocuronium mechanism of action?
79
Used for Insomnia.
Zolpidem (Ambien), Zaleplon, Eszopiclone
80
SE include Ataxia, headaches, confsuion. Short duration due to liver metabolism. Modest day-after psychomotor depression and few amnestic side effects. Lower dpeenence risk than benzodiazepines
Zolpidem (Ambien), Zaleplon, Eszopiclone
81
Dopamine agonist.
Pergolide mechanism of action?
82
Used for Glaucoma.
Alpha agonists, Beta blockers, Diuretics, Cholinomimetics, and Prostaglandins
83
SE: Darkens color of iris (browning).
Latanoprost
84
Mech: Carbonic anhydrase inhibitor. Decreases aqueous humor secretion due to decrease in HCO3.
Acetazolamide
85
SE: No pupillary or vision changes.
Acetazolamide
86
Mech: Direct cholinergic agonists. Increases outflow fo aqueous humor; contract ciliary muscle and open trabecular meshwork; use pilocarpine in emergencies; ery effect at opening canal of Schlemm.
Pilocarpine, carabachol
87
Dopamine agonist.
Amantadine mechanism of action?
88
Mech: Indirect cholinergic agonists; acetylcholinesterase inhibitor. Increases outflow fo aqueous humor; contract ciliary muscle and open trabecular meshwork
Physostigmine, echothiophate
89
Mech: Beta-blocker; decreases aqueous humor secretion by acting on the ciliary epithelium
Timolol, betaxolol, carteolol
90
Used for Open-angle glaucoma.
Epinephrine
91
SE: Mydriasis, stinging; do not use in closed-angle glaucoma.
Epinephrine
92
Mech: Precursor to phenobarbital; anticonvulsant that acts via inhibition of voltage gated sodium channels.
Primidone
93
Dizziness, confusion, hallucinations.
Memantine side effects?
93
Nausea, dizziness, insomnia.
Donepezil side effects?
94
Acetylcholinesterase inhibitor.
Rivastigmine mechanism of action?
97
Huntington's disease (caused by too much dopamine, too little GABA and ACh).
Resperine + tetrabenzine uses?
98
Acute migraines, cluster headache attacks.
Sumatriptan uses?
100
Rebound headaches; more severe side effecst than sumatriptan; angina, vasoconstriction (gangrene, thrombosis).
Ergotamine side effects?
104
GABA(B) agonist (K+ efflux)
Baclofen mechanism of action?
104
Ataxia, headaches, confsuion. Short duration due to liver metabolism. Modest day-after psychomotor depression and few amnestic side effects. Lower dpeenence risk than benzodiazepines.
Zolpidem side effects?
105
Glaucoma.
Acetazolamide, Pilocarpine, carabachol, Physostigmine, echothiophate, Timolol, betaxolol, carteolol
106
BDZ1 agonist on GABA(A) receptors.
Eszopiclone mechanism of action?
106
Muscle relaxant.
Cyclobenzaprine uses?
106
Darkens color of iris (browning).
Latanoprost side effects?
107
Carbonic anhydrase inhibitor. Decreases aqueous humor secretion due to decrease in HCO3.
Acetazolamide mechanism of action?
109
No pupillary or vision changes.
Acetazolamide side effects?
110
Direct cholinergic agonists. Increases outflow fo aqueous humor; contract ciliary muscle and open trabecular meshwork; use pilocarpine in emergencies; ery effect at opening canal of Schlemm.
Pilocarpine, carabachol mechanism of action?
111
Miosis, cyclospasm.
Pilocarpine, carabachol side effects?
111
Indirect cholinergic agonists; acetylcholinesterase inhibitor. Increases outflow fo aqueous humor; contract ciliary muscle and open trabecular meshwork.
Physostigmine, echothiophate mechanism of action?
112
Miosis, cyclospasm.
Physostigmine, echothiophate side effects?
113
Beta-blocker; decreases aqueous humor secretion by acting on the ciliary epithelium.
Timolol, betaxolol, carteolol mechanism of action?
114
No pupillary or vision changes.
Timolol, betaxolol, carteolol side effects?
115
Alpha/beta agonist; decreases aqueous humor synthesis due to vasoconstriction.
Epinephrine mechanism of action?
116
Open-angle glaucoma.
Epinephrine uses?
116
Mydriasis, stinging; do not use in closed-angle glaucoma.
Epinephrine side effects?
117
Alpha-agonist; decreases aqueous humor synthesis.
Brimonidine mechanism of action?
118
Glaucoma.
Brimonidine uses?
118
No pupillary or vision changes.
Brimonidine side effects?
119
Precursor to phenobarbital; anticonvulsant that acts via inhibition of voltage gated sodium channels.
Primidone mechanism of action?
120
Partial mu agonist.
Pentazocine mechanism of action?
121
May precipitate withdrawal symptoms. Pain management with little to no abuse potential.
Pentazocine uses?
122
Serotonin agonist.
Methysergide mechanism of action?
123
Used for migraine headaches
Methysergide uses?
124
Retroperitoneal fibrosis.
Methysergide side effects?
125
Blocks TTX sensitive sodium channels.
Riluzole mechanism of action?
126
ALS
Riluzole uses?
127
NMDA antagonists; GABA agaonists
Acamprosate mechanism of action?
128
Alcoholism
Acamprosate uses?
129
Acetylcholinesterase inhibitor.
Tacrine mechanism of action?
130
Alzheimer's disease.
Tacrine uses?
