neuro - pharm Flashcards
drugs to use in glaucoma
epi (NOT IN CLOSED ANGLE) Brimonidine timolol, betaxolol, carteolol acetazolamide pilocarpine, carbachol physostigmine, echothiphate latanoprost
SE of brimonnidine
blurry vision, ocular hyperemia, forgein body sensation, ocular allergic reaction, ocular pruitus
MOA of opioid
opens K channels, close Ca channels to decrease synaptic tranmission
opiod that causes less respiratory depression
butoprphanol
tox of butorphanol
can cause opioid wd sx if taken with full opiod agonist
very weak opioid agonist that inhibits Seotinin and NE reuptake
tramadol
tox of tramadol
decreases seizure threshold
1st line for tonic-clonic sezioures
phenytoin, carbamazepine, valporic acid
1st line for complex and simple seziures
carbamazepine
1st line for absence seuires
ethosuximide
1st line for status epilepticus
phenytoin for prevention, benzo for acute (diazepam/lorezapam)
MOA of phenytoin and carbemazepine
increases Na channel activation
1st line for trigeminal neuralgia
carbamazapine
non seizure uses for gabapentin
used for peripheral neuropathy, neuralgia, migrane prophylaxis, bipolar
MOA of gabapentin
inhibits voltage gated Ca channels
valproic acid MOA
Na channel inactivation, increases GABA
ethosuximide MOA
blocks thalmic t-type Ca channels
tx for eclampsia seizures
benzo and MgSO4
Tox of carbamazepine
diplopia, ataxia, agranulocytosis, aplastic anemia, liver tox, SIADH, stevens-johnson
tox of ethosuximide
GI distress, fatigue, headache, stevens-johnson
tox of phenytoin
gingval hyperplasia, hirsuitism, SLE-like syndrome,sedation, nystagmus
tox of valpoic acid
GI distress, rare but fatal heptotox, tremor and weight gain
seziure drug NOT to be used in pregnancy
valproic acid
gabapentin tox
sedation, ataxia
MOA of barbos
facilitate GABA action by increasing duration of Cl-channel opening
contraindications of barbos
porphyria, EtOH use
MOA of benzos
faciliate GABA action by increasing frequency of Cl- channel opening
use of benzos,
anxiety, spasticity, status elipticus, EtOH detox,
treat OD of benzo with
flumazenil
non benzo hypnotics
zolpidem, zalaplon, eszoplicone
MOA of non benzo hypnotics
act via BZ1 subtype of GABA receptor
property of potent anesthetics
lipid solulability, 1/MAC
MAC def.
minimum alveolar concentration that 50% of population is anethestized
effects of inhaled anesthetics
myocardial/resp depression, n/v, higher cerebral blood flow
tox of halothane
hepatotix
tox of methoxyflurane
nephrotox
tox of enflurane
proconvulsant
tox of all inhaled anethetics
malignant hyperthermia (not NO)
high potency, rapid effect anesthetic with short duration
thiopental (Barbo)
use of thiopental
induction and short procedures
use of midzolam
endoscopy
tox of midzolam
severe resp depression, low BP, and amnesia
use of propofol
sedation in ICU, rapid inductin, short procedures (less nausea than thipental)
Local anethetic esters
procaine, cocaine, tetracaine (one I)
local anesthetic amides
anything with 2 Is
MOA of local anesthetics
Blocks Na channels FROM THE INSIDE of the channel. preferentially bind actiaved Na channels.
given with local anethetics to increase local action
epi
problem with giving local anesthetics to infected tissue
infected tissue is acidic. The drugs are alkaline, so can’t penetrate the membrane and you have to give more
nerves that are blockaded first
small-diameter and myelnated fibers
(order of loss: Pain, temp, touch, pressure
tox of local anesthetics
CNS excititaion, CV tox, nypertension, hypotension
Tox of bupivicane
Cardiotox
depolarizing neuromusclular blocker
succinocholine
MOA of succinylcholine
strong ACh receptor agonist - produces sustained depolarization and prevents muscular contraction
antidote for phase II succ
neostigmine
nondepolarizing NM blockers
tubocurarine, -curiums, s
nondepolarizing NM blockers MOA
competitive ACh blockers
reversal of nondepolarizing NM blockers
neostigmine edrophonium and cholinesterase inhibitors
use of dantrolene
reverse malignant hyperthermia and neuroleptic malignint syndrome
parkinson dopamine agonists
bromocriptine, pramipexole
parkinson dopamine increasers
amantadine, L-dopa/carbidopa
parkinson drugs to decrease breakdown of dopamine
selegilinem entcaponem tolacapone
parkinson drugs to curb excess cholingernic activity
benztropine
tox of amantadine
ataxia
tox of l-dopa/carbipoda
arythmias, long term dyskinesias
tox of selegiline
may enhance L-dopa adverse effects
MOA of selegiline
MAO-B inhibitor (slows metabolism of dopamine)
MOA of memantine
NMDA receptor antagonist, prevents Ca++ exitotox
SE of memantidine
dizziness, confusion, hallucinations
MOA of donezepil, galantamine, rivastigmine
AChE inibitors
tox of AChE inhibitors for alzheimers
Nausea, dizziness, insomnia
tx for huntington’s
tetrabenzine/reserpine (inhibit VMAT release of dopamine)
haldol (dopamine receptor antagonist)
tox of sumatriptan
coronary vasospasm