Neuro Meds and treatments Flashcards
Drug of choice for absence seizures
ethosuximide
First-line treatment for eclampsia
Magnesium sulfate
Anti-seizure drugs that blocks sodium channels
Phenytoin Carbamazepine Lamotrigene Topiramate Valproic acid
Decreased action potential in neurons
Anti-seizure drugs that increase GABA activity
Gabapentin Phenobarbital Valproic acid Benzodiazepines Tigabine Vigabatrin Levetiracetam
Decrease excitability of neurons
Anti-seizure drugs that block T type calcium channels
Gabapentin
ethosuximide
Phenytoin (at very high dose)
Decreased action potentials in neurons
Drug of choice for generalized seizures according to SANAD trial
valproic acid
Drug of choice for partial seizures according to SANAD trial
lamotrigene
Side effects of phenytoin
"Phenytoin Has Given MDs Frustration" Peripheral neuropathy Hirsutism Gingival hyperplasia Megaloblastic anemia due to decreased folate absorption Drug-induced lupus Steven Johnson syndrome Fetal hydantoin syndrome (cleft lip/pallet, congenital heart disease, intellectual disabilities with developmental delay)
Antiepileptics that are teratogens
Phenytoin
carbamazepine
valproic acid - spina bifida, ppx 4 mg folate daily
Drugs that cause Steven Johnson syndrome
Seizure drugs: ethosuximide, lamotrigine, carbamazepine, phenytoin, phenobarbital
Antibiotics: sulfonamides, penicillins
Allopurinol
Drug known to cause a agranulocytosis
carbamazapine
clozapine
colchicine
PTU and methimazole
Hepatotoxic antiepileptic drugs
valproic acid
carbamazepine
Drugs that induce CYP450
“Coronas, Guinness, and PBRS induce CHRONIC ALCOHOLISM”
carbamazepine griseofulvin phenytoin barbiturates rifampin St. john wort chronic alcoholism
Main medication in managing parkinsonian symptoms
Levodopa/ carbidopa
MAO-B inhibitor used in early Parkinson disease, neuroprotective effects
Selegiline
more dopamine longer
COMT inhibitors
potentiate levodopa in parkinson dz
entacapone
tolcapone
2nd line dopamine agonists in Parkinson disease
Bromocriptin - ergot compound
non-ergot D3 stimulators:
pramipexole
ropinirole
rotigotine (transdermal)
Apomorphine (subQ) - rescue therapy for sudden akinetic episodes
Anticholinergics used in Parkinson disease
for tremor
trihexyphenidyl
Benztropine
Drug use in short-term monotherapy in mild Parkinson disease
Amantadine - increase dopamine release
Cholinesterase inhibitors used in Alzheimer’s disease
Donepezil
Galantamine
Rivastigmine
NMDA receptor blocker used in Alzheimer’s disease
Memantine
Initial empiric therapy in ER for patient with loss of consciousness
Thiamine first
Glucose - presumed hypoglycemia
Naloxone - presumed overdose
Antihistamines used as sleep aid
Diphenhydramine
Associated with poor sleep quality, next day fatigue
Trazodone for sleep aid
Antidepressant, anticholinergic/antihistamine effects
Next a fatigue
TCAs used for sleep aid
amitriptyline
doxepin
Antidepressant, anticholinergic Side effects - avoid in elderly (confusion)
Benzodiazepines used as sleep aids
triazolam
temazepam
lorazepam
clonazepam
Bind to GABA receptors, addictive, increase N2, decrease N3 and REM
Nonbenzodiazepines used as sleep aids
Zolpidem - longest acting
Zaleplon - shortest acting
Eszopiclone
Act at the specific GABA type A receptor, rebound insomnia when discontinued, sleepwalking
Orexin receptor antagonist used as a sleep aid
Suvorexant
Orexin A and B are hypothalamic neuropeptides that promote wakefulness - blocking promotes sleepiness
Ramelteon for sleep aid
Agonist at melatonin receptor - non-habit forming
Drugs used in restless legs syndrome
Dopamine agonists: pramipexole, ropinirole
gabapentin
Pregabalin
severe: levodopa/carbidopa
Topical acetazolamide- open angle glaucoma
reduce aqueous humor production
Prostaglandins - open angle glaucoma
latanoprost - increased outflow aqueous humor
B-blockers - open angle glaucoma
timolol - inhibit aqueous humor production
alpha 2 - adrenergic agonist -open angle glaucoma
apraclonidine, brinomidine - reduce aqueous humor production and increase outflow
Cholinergic agonists - open angle glaucoma
pilocarpine - cause miosis and open trabecular meshwork -> increased outflow of aqueous humor
