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Neuro First Aid USMLE Step 1 > Neuro First Aid Pharm > Flashcards

Neuro First Aid Pharm Flashcards

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USMLE® Step 1 flashcards
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)

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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?

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3
Q

Opioids

A

Morphine, Fentanyl, Codeine, Heroin, Methadone, Meperidine, Dextromethorphan, Diphenoxylate

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4
Q

Used for Diarrhea

A

Loperamide and diphenoxylate

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5
Q

Long lasting opioid agonist.

A

Methadone

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6
Q

Cough suppressant, analgesic.

A

Codeine

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7
Q

Abused as a halucinogen. Cough suppressant.

A

Dextromethorphan

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8
Q

Mech: Partial agonist at opioid mu receptors; agonist at kappa receptors.

A

Butorphanol

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9
Q

Very weak opioid agonist; inhibits serotonin and norepinephrine reuptake.

A

Tramadol

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10
Q

Maintenance programs for addicts.

A

Methadone uses?

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11
Q

Inhibits voltage-gated sodium channel activation (doesn’t block pores).

A

Carbamazepine

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12
Q

Mech: Inhibits thalamic T-type calcium channels

A

Ethosuximide

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13
Q

SE include GI distress, fatigue, headache, urticaria, Steven-Johnson syndrome

A

Ethosuximide

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14
Q

Used for Severe Pain (migraine, labor, etc). Causes less resp depression than full opioids.

A

Butorphanol.

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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

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15
Q

Less respiratory depression than full agonists; induces withdrawal if on a full opioid agonist (higher affinity, less effect).

A

Butorphanol side effects?

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16
Q

Used for Status epilepticus, tonic-clonic seizures. Class IB antiarrhythmic.

A

Phenytoin

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18
Q

Used for Chronic pain.

A

Tramadol uses?

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18
Q

Decreases seizure thresholds; similar to opioids.

A

Tramadol side effects?

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19
Q

Used for Tonic-clonic seizures, absence seizures. Bipolar disorder.

A

Valproic acid

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20
Q

Mech: Blocks voltage-gated sodium channels and glutamate receptors.</p>

A

Lamotrigine, felbamate

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21
Q

Trigeminal neuralgia, tonic-clonic seziures.

A

Carbamazepine uses?

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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?

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23
Q

Mech: GABA analog; inhibits HVA calcium channels.

A

Gabapentin

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24
Q

Absence seizures; ineffective for other types.

A

Ethosuximide uses?

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26
Q

Mech: Blocks sodium channels and increases GABA action.

A

Topiramate

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27
Q

GABA(A) agonist that increases DURATION of Cl- channel opening, thus decreasing neuron firing.

A

Barbituates mechanism of action?

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27
Q

First line antiepileptic in children and pregnant women. Rapid anesthesia induction.

A

Barbituates uses?

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28
Q

Use-dependent blockade of voltage-gated Na+ channels; increases refractory period; inhibition of glutamate release from excitatory presynaptic neuron.

A

Phenytoin mechanism of action?

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29
Q

Sedation, mental dulling, kidney stones, weight loss. Inhibits CYP-450.

A

Topiramate

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31
Q

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).

A

Benzodiazepines (-epam, -olam)

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32
Q

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.

A

Phenytoin side effects?

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33
Q

Used for All seizure types except absence.

A

Tiagabine, Lamotrigine, felbamate, Gabapentin

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34
Q

Mech: Irreversibly inhibits GABA transaminase; increases GABA levels.

A

Vigabatrin

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35
Q

Inhibits voltage-gated sodium channel activation, increases GABA concentration, inactivates T-type calcium channels.

A

Valproic acid mechanism of action?

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36
Q

Mech: Modulates GABA and glutamate release.

A

Levetiracetam

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37
Q

GI distress, rare but fatal hepatotoxicity (measure LFTs) , neural tube defects in fetus (spina bifida), tremor, weight gain. Contraindicated in pregnancy.

A

Valproic acid side effects?

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38
Q

Used to Prevent seziures of eclampsia.

A

MgSO4

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39
Q

SE include Myocardial depression, respiratory depression, nausea/emesis, increase cerebral blood flow (decrease cerebral metabolic demand).

A

Inhaled Anesthetics

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40
Q

Causes hepatotoxicity

A

Halothane

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41
Q

SE: Stevens-Johnson syndrome, hepatotoxicity and aplastic anemia

A

Lamotrigine, felbamate

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42
Q

Is a proconvulsant

A

Enflurane

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43
Q

Inhaled Anesthetics

A

“RANE”s plus Nitrous Oxide

- Halothane, Enflurane, Isoflurane, Sevoflurane, Methoxyflurane, Nitrous Oxide

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44
Q

Mech: NMDA antagonist; PCP analog

A

Ketamine (arylcyclohexylamines)

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45
Q

Sedation, ataxia.

A

Gabapentin side effects?

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46
Q

SE include CV stimulant; disorientation, hallucination, bad dreams (in children). Increases cerebral blood flow.

A

Ketamine (arylcyclohexylamines)

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47
Q

Mech: Potentiates GABA(A).

A

Propofol

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48
Q

Mech: Ester anesthetics. Block voltage gated sodium channels by stabilizng inactive form; selectively targets more rapidly firing neurons.

A

“Caine”s

- Procaine, cocaine, tetracaine

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49
Q

SE include Hypersensitivity. CNS excitation, severe cardiovascular toxicity (one?), hypertension, hypotension, arrhythmia (one?).

A

Procaine, cocaine, tetracaine, Lidocaine, mepivacaine, bupivacaine

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50
Q

Mech: Amide anesthetics. Block voltage gated sodium channels by stabilizng inactive form; selectively targets more rapidly firing neurons.

A

Lidocaine, mepivacaine, bupivacaine

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51
Q

Mech: Depolarizing neuromuscular blocker (NAChR). Strong ACh receptor agonist.

A

Succinylcholine

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52
Q

SE include Hypercalcemia, hyperkalemia, malignant hyperthermia. Contraindicate acetylcholinesterase inhibitors.

A

Succinylcholine

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53
Q

Used for Muscle paralysis in surgery.

A

Tubocurarine, atracurium, mivacurium, pancuronium, vecuronium, rocuronium

54
Q

Mech: Prevents Ca2+ release from SER by antagonizing the ryanodine receptor

A

Dantrolene

55
Q

Used for Malignant hyperthermia, neuroleptic malingant syndrome

A

Dantrolene

56
Q

Mech: Dopamine agonists

A

Bromocriptine (ergot), pramipexole and ropinirole (non-ergots); non-ergots are preferred

57
Q

Mech: Myocardial depression, respiratory depression, nausea/emesis, increase cerebral blood flow (decrease cerebral metabolic demand).

A

Enflurane mechanism of action?

58
Q

May increase dopamine release (Parkinson’s); also used as an antiviral against influenza A and rubella; toxicity = ataxia

A

Amantadine

59
Q

Mech: Dopamine agonist (1); inhibits DOPA decarboxylase peripherally(2) (Used for Parkinson’s)

A

L-dopa and carbidopa

60
Q

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

A

L-dopa/carbidopa

61
Q

Mech: Selective MAO B inhibitor. Decreases dopamine metabolism (Parkinson’s)

A

Selegiline

62
Q

Nephrotoxicity, malignant hyperthermia.

A

Methoxyflurane side effects?

63
Q

Mech: Peirpheral COMT inhibitor. Decreases dopamine metabolism. (Parkinson’s)

A

Entacapone and Tolcapone

64
Q

Mech: Anticholinergic

A

Benztropine

65
Q

Used for Parkinson’s disease; improves tremor and rigidity but no effect on bradykinesia.

A

Benztropine

66
Q

Mech: NMDA receptor antagonist.

A

Memantine

67
Q

Used for Alzheimer’s disease; helps prevent excitoxicity mediated by calcium.

A

Memantine

68
Q

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).

A

Procaine, cocaine, tetracaine uses?

69
Q

Mech: Acetylcholinesterase inhibitors

A

Donepezil, galantamine, and Rivastigmine

70
Q

Used for Alzhiemer’s disease

A

Donepezil, galantamine, and Rivastigmine

71
Q

Muscle paralysis in surgery.

A

Tubocurarine uses?

71
Q

Non-depolarizing neuromuscular blocker (NAChR). Competitive NAChR antagonist.

A

Atracurium mechanism of action?

72
Q

Mech: Amine depleting; lowers dopamine levels by inhibiting VMAT

A

Resperine and tetrabenzine

73
Q

Used for Huntington’s disease (caused by too much dopamine, too little GABA and ACh)

A

Resperine and tetrabenzine

74
Q

Reverse blockade with an acetylcholinesterase inhibitor.

A

Atracurium side effects?

75
Q

Used for Acute migraines, cluster headache attacks.

A

Sumatriptan

76
Q

Reverse blockade with an acetylcholinesterase inhibitor.

A

Mivacurium side effects?

78
Q

Non-depolarizing neuromuscular blocker (NAChR). Competitive NAChR antagonist.

A

Rocuronium mechanism of action?

79
Q

Used for Insomnia.

A

Zolpidem (Ambien), Zaleplon, Eszopiclone

80
Q

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

A

Zolpidem (Ambien), Zaleplon, Eszopiclone

81
Q

Dopamine agonist.

A

Pergolide mechanism of action?

82
Q

Used for Glaucoma.

A

Alpha agonists, Beta blockers, Diuretics, Cholinomimetics, and Prostaglandins

83
Q

SE: Darkens color of iris (browning).

A

Latanoprost

84
Q

Mech: Carbonic anhydrase inhibitor. Decreases aqueous humor secretion due to decrease in HCO3.

A

Acetazolamide

85
Q

SE: No pupillary or vision changes.

A

Acetazolamide

86
Q

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.

A

Pilocarpine, carabachol

87
Q

Dopamine agonist.

A

Amantadine mechanism of action?

88
Q

Mech: Indirect cholinergic agonists; acetylcholinesterase inhibitor. Increases outflow fo aqueous humor; contract ciliary muscle and open trabecular meshwork

A

Physostigmine, echothiophate

89
Q

Mech: Beta-blocker; decreases aqueous humor secretion by acting on the ciliary epithelium

A

Timolol, betaxolol, carteolol

90
Q

Used for Open-angle glaucoma.</p>

A

Epinephrine

91
Q

SE: Mydriasis, stinging; do not use in closed-angle glaucoma.

A

Epinephrine

92
Q

Mech: Precursor to phenobarbital; anticonvulsant that acts via inhibition of voltage gated sodium channels.

A

Primidone

93
Q

Dizziness, confusion, hallucinations.

A

Memantine side effects?

93
Q

Nausea, dizziness, insomnia.

A

Donepezil side effects?

94
Q

Acetylcholinesterase inhibitor.

A

Rivastigmine mechanism of action?

97
Q

Huntington’s disease (caused by too much dopamine, too little GABA and ACh).

A

Resperine + tetrabenzine uses?

98
Q

Acute migraines, cluster headache attacks.

A

Sumatriptan uses?

100
Q

Rebound headaches; more severe side effecst than sumatriptan; angina, vasoconstriction (gangrene, thrombosis).

A

Ergotamine side effects?

104
Q

GABA(B) agonist (K+ efflux)

A

Baclofen mechanism of action?

104
Q

Ataxia, headaches, confsuion. Short duration due to liver metabolism. Modest day-after psychomotor depression and few amnestic side effects. Lower dpeenence risk than benzodiazepines.

A

Zolpidem side effects?

105
Q

Glaucoma.

A

Acetazolamide, Pilocarpine, carabachol, Physostigmine, echothiophate, Timolol, betaxolol, carteolol

106
Q

BDZ1 agonist on GABA(A) receptors.

A

Eszopiclone mechanism of action?

106
Q

Muscle relaxant.

A

Cyclobenzaprine uses?

106
Q

Darkens color of iris (browning).

A

Latanoprost side effects?

107
Q

Carbonic anhydrase inhibitor. Decreases aqueous humor secretion due to decrease in HCO3.

A

Acetazolamide mechanism of action?

109
Q

No pupillary or vision changes.

A

Acetazolamide side effects?

110
Q

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.

A

Pilocarpine, carabachol mechanism of action?

111
Q

Miosis, cyclospasm.

A

Pilocarpine, carabachol side effects?

111
Q

Indirect cholinergic agonists; acetylcholinesterase inhibitor. Increases outflow fo aqueous humor; contract ciliary muscle and open trabecular meshwork.

A

Physostigmine, echothiophate mechanism of action?

112
Q

Miosis, cyclospasm.

A

Physostigmine, echothiophate side effects?

113
Q

Beta-blocker; decreases aqueous humor secretion by acting on the ciliary epithelium.

A

Timolol, betaxolol, carteolol mechanism of action?

114
Q

No pupillary or vision changes.

A

Timolol, betaxolol, carteolol side effects?

115
Q

Alpha/beta agonist; decreases aqueous humor synthesis due to vasoconstriction.

A

Epinephrine mechanism of action?

116
Q

Open-angle glaucoma.

A

Epinephrine uses?

116
Q

Mydriasis, stinging; do not use in closed-angle glaucoma.

A

Epinephrine side effects?

117
Q

Alpha-agonist; decreases aqueous humor synthesis.

A

Brimonidine mechanism of action?

118
Q

Glaucoma.

A

Brimonidine uses?

118
Q

No pupillary or vision changes.

A

Brimonidine side effects?

119
Q

Precursor to phenobarbital; anticonvulsant that acts via inhibition of voltage gated sodium channels.

A

Primidone mechanism of action?

120
Q

Partial mu agonist.

A

Pentazocine mechanism of action?

121
Q

May precipitate withdrawal symptoms. Pain management with little to no abuse potential.

A

Pentazocine uses?

122
Q

Serotonin agonist.

A

Methysergide mechanism of action?

123
Q

Used for migraine headaches

A

Methysergide uses?

124
Q

Retroperitoneal fibrosis.

A

Methysergide side effects?

125
Q

Blocks TTX sensitive sodium channels.

A

Riluzole mechanism of action?

126
Q

ALS

A

Riluzole uses?

127
Q

NMDA antagonists; GABA agaonists

A

Acamprosate mechanism of action?

128
Q

Alcoholism

A

Acamprosate uses?

129
Q

Acetylcholinesterase inhibitor.

A

Tacrine mechanism of action?

130
Q

Alzheimer’s disease.

A

Tacrine uses?

Neuro First Aid USMLE Step 1 (1 decks)

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