Neuro l

Question 1

CNS imaging of choice unless it’s suspected meningitis, then do what?

Answer 1

MRI

lumbar puncture

Question 2

Cholinergic agonist indic for Glaucoma that acts on muscarinic-R

Answer 2

pilocarpine

Question 3

nicotine binds to ______ and induces what enzyme?

Answer 3

nicotinic-R

CYP1A2 - caffeine, theophylline, TCA’s, warfarin

Question 4

Overdose of Antipsychotics is called -_________

What is tx?

Answer 4

Neurolyptic Malignant Syndrome

Bromocriptine (dopamine agonist)

Question 5

Antipsychotics MOA

ADR’s

Answer 5

decrease dopamine
ADRs: tremors, tardive, blurred vision, hypotension, constipation, dry mouth, urinary retention, sexual dysfxn, drowsy, PROLACTIN

Question 6

Antipsych indic for psychosis, N/V, hiccoughs

Answer 6

prochlorperazine
decrease dopamine
ADR: PROLACTIN, tremors, tardive, etc.

Question 7

injectable Antipsychotic indic for Psychosis, Tourettes, Huntingtons

Answer 7

Haloperidol

+ H1 blockade so extra powerful!

Question 8

Indic for psychosis, schizo, bipolar

Caution in children

Answer 8

Respiradone
oral
p450

Question 9

No dopamine blocking are what category of antipsychotics

Answer 9

Atypical

Question 10

Why use SAM-E

Answer 10

used to make excitatory neurotransmitters

Question 11

Cocaine, Buproprion, Amphetamine, Benzatropine all do what?

Answer 11

block reuptake of dopamine so more dopamine around

Question 12

tricyclic and amphetamines all do what?

Answer 12

block reuptake of NE

Question 13

indic for depression, narcolepsy, phobias, and parkinson’s

Answer 13

MAO-I

Question 14

MAO-I MOA and drug?

Answer 14

block metabolism of dopa, NE, SE
suppresses REM sleep
phenelzine (nardil)

Question 15

What drug can increase seizure threshold and increases NE and DOPA

Answer 15

bupropion

Question 16

SSRI’s

Answer 16

fluoxetin (prozac)
sertraline
paroxetine - paxil
citalopram - celexa
Lexapro

Question 17

What AA can you use when tapering off or on SSRIs?

Answer 17

tryptophan

Question 18

Non-SSRI used for sleep commonly but ironic withdrawal sx

Answer 18

trazadone

- rebound insomnia

Question 19

SE syndrome

Answer 19

look sick

F, hyperreflexia, BP changes, coma, death

Question 20

enhance serotonin with what supps

Answer 20

B6/niacinamide, trypt, 5HTP

Question 21

if SSRI’s don’t work can try what drug?

Answer 21

Venlafaxine

modified 5HT effectors, SE & NE

Question 22

indic for neuropathic pain, fibro

Answer 22

pregabalin (lyrica)

Question 23

anxiolytic wo sedating or euphoric effects
does not act on GABA
SE, dopa, NE

Answer 23

buspirone

Question 24

GABA drugs (3):
have what kind of effect?

Answer 24

alcohol, barbs, benzos

amnesia effect

Question 25

``` Indic for anxiety, wound healing, muscle spasms class of drugs ```

Answer 25

glycine-R working w chloride | Caution in bipolar Pts because excitatory

Question 26

long-term tx of seizure drugs

Answer 26

phenytoin, carbamazapine | decrease movement of Na, Ca, K

Question 27

If first presenting with epilepsy, then must do what first?

Answer 27

MRI to ro tumor

Question 28

2 Bipolar Drugs

Answer 28

lithium - sodium ions in brain | gabapentin - GABA agonist

Question 29

LITHIUM ADR | Caution with ____

Answer 29

HYPOTHYROID, coma, KD probs | LOW SODIUM DIET

Question 30

if a kid is on ritalin (methylphenidate), put them on which supp?

Answer 30

zinc helps the drug to work

Question 31

DDX encephalitis vs meningitis

Answer 31

enc has a focal neuro deficit whereas menin does not | both have HA, F

Question 32

DDX GBS with what? Presentation of guillain barre Lab PROG

Answer 32

``` Botulism - previous hx of flu or viral infxn - leg weakness, paresthesias, DTR's decreased LAB - CSF protein increased Self-limiting disease ```

Question 33

GI sxs precede neuro deficits with no F

Answer 33

botulism | floppy baby

Question 34

MC brain tumor in adults | prog

Answer 34

Gliobastoma multiforme | DEADLY

Question 35

Wernicke korsakoff syndrome dt what problem?

Answer 35

B1 thiamine dt booze no short-term memory

Question 36

Niacin Xu can cause?

Answer 36

pellagra | 3D's: dementia, diarrhea, dermatitis, death

Question 37

C/I sumatriptan

Answer 37

Basilar Migraine base of skull radiatees up vasoconstricts

Question 38

Ergots MOA

Answer 38

vasoconstrict - alpha 1 | ADR: tachycardia, HTN

Question 39

Giant Cell Arteritis complication? | Do what test?

Answer 39

blindness - affects ophthalmic A | ESR > 1000

Question 40

pt wakes up in the AM with HA but then goes outside and is ok

Answer 40

carbon monoxide poisoning

Question 41

PAIN Relievers | CNS vs Peripheral

Answer 41

CNS: opioids, tylenol PNS: NSAIDs, steroids, gout meds

Question 42

Max dose of tylenol in 24 hrs

Answer 42

4 g

Question 43

5 g of pregn = ___g cortisone

Answer 43

20g | 4x

Question 44

Can you abruptly dc steroids?

Answer 44

no - death

Question 45

Anesthetic Amides, Ester?

Answer 45

amides - lidocaine, bupivacaine | Esters - procaine

Question 46

if too much anesthetics, what can happen?

Answer 46

heart block

Question 47

Can bupivacaine be given via IV?

Answer 47

no. half life is too long

Question 48

extreme weakness upon extertion, > rest | starts in head

Answer 48

Myasthenia Gravis | ACH-R antibodies

Question 49

resting tremor disappears at sleep

Answer 49

parkinson's

Question 50

Where is damage to brain with PD and Huntingtons?

Answer 50

basal nuclei PD - dopamine R HD - GABA-nergic R

Question 51

progn of Huntingtons Dz

Answer 51

death - die young, dementia

Question 52

ACh in Brain vs Periphery

Answer 52

memory vs muscle

Question 53

if syncope do what testing

Answer 53

EKG

Question 54

Cannabis MOA

Answer 54

dopamine | removes inhibition by GABA neurons

Question 55

Cocaine MOA

Answer 55

releases dopamine,NE, SE

Question 56

MDMA MOA

Answer 56

serotonin

Question 57

LSD MOA

Answer 57

like heavy boots jumping on serotonin R ---> hallucinations