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Neuro > Neuro: Pharm - Glaucoma and Opioids > Flashcards

Neuro: Pharm - Glaucoma and Opioids Flashcards

1
Q

Glaucoma drugs MOA:

A

decrease IOP via decreasing amount of aqueous humor (inhibit synthesis/secretion or increase drainage)

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2
Q

Epinephrine: MOA

A

Glaucoma drug - alpha agonist
decreases aqueous humor synthesis via vasoconstriction
SE: mydriasis; do NOT use in closed-angle glaucoma

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3
Q

Brimonidine: MOA

A

alpha 2 agonist - for glaucoma

decreases aqueous humor synthesis

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4
Q

Brimonidine: SE

A

blurry vision, ocular hyperemia, foreign body sensation, ocular allergic reactions, ocular pruritis

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5
Q

Timolol: MOA

A

beta blocker - for glaucoma
decreases aqueous humor synthesis
SE: no pupillary or vision changes

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6
Q

Betataxolol: MOA

A

beta blocker - for glaucoma
decreases aqueous humor synthesis
SE: no pupillary or vision changes

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7
Q

Carteolol: MOA

A

beta blocker - for glaucoma
decreases aqueous humor synthesis
SE: no pupillary or vision changes

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8
Q

Acetazolamide: MOA

A

diuretic - for glaucoma
decreases aqueous humor synthesis via inhibition of carbonic anhydrase
SE: no pupillary or vision changes

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9
Q

Direct cholinomimetics:

A

Pilocarpine, Carbachol

Tx glaucoma

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10
Q

Pilocarpine: MOA

A

Direct cholinomimetic - for glaucoma

increases outflow of aqueous humor via contraction of ciliary muscle and opening of trabecular meshwork

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11
Q

Pilocarpine: SE

A

Miosis and cyclospasm (contraction of ciliary muscle)

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12
Q

Carbachol: MOA

A

Direct cholinomimetic - for glaucoma

increases outflow of aqueous humor via contraction of ciliary muscle and opening of trabecular meshwork

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13
Q

Carbachol: SE

A

Miosis and cyclospasm (contraction of ciliary muscle)

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14
Q

Indirect cholinomimetics:

A

Physostigmine, Echothiophate

Tx glaucoma

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15
Q

Physostigmine: MOA

A

Anticholinesterase –> indirect cholinomimetic

increases outflow of aqueous humor via contraction of ciliary muscle and opening of trabecular meshwork

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16
Q

Physostigmine: SE

A

miosis and cyclospasm (contraction of ciliary muscle)

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17
Q

Echothiophate: MOA

A

AChE inhibitor –> indirect cholinomimetic

increases outflow of aqueous humor via contraction of ciliary muscle and opening o trabecular meshwork

18
Q

Echothiophate: SE

A

Miosis and cyclospasm (contraction of ciliary muscle)

19
Q

Glaucoma emergencies: what drug?

A

Pilocarpine - very effective at opening meshwork into canal of Schlemm

20
Q

Latanoprost: MOA?

A

PGF2alpha analogue

Increases outflow of aqueous humor

21
Q

Latanoprost: SE

A

darkens color of iris (browning)

22
Q

Prostaglandin analogue used to treat glaucoma?

A

Lotanoprost (PGF2alpha)

23
Q

Opioid analgesics:

A

morphine, fentanyl, codeine, loperamide, methadone, meperidine, dextromethorphan, diphenoxylate

24
Q

Opioid analgesic MOA:

A

Agonist at opioid receptors to modulate synaptic transmission: open K+ channels, close Ca2+ channels –> decreased synaptic transmission; inhibit release of ACh, NE, 5-HT, gluatamate, and substance P.

25
Q

Opioid analgesic Uses:

A

pain, cough suppression (dextromethorphan), diarrhea (loperamide and diphenoxylate), acute pulmonary edema, maintenance programs for heroin addicts (methadone, buprenorphine + naloxone).

26
Q

Opioid toxicity:

A

addiction, respiratory depression, constipation, miosis (pinpoint pupils), additive CNS depression with other drugs.

27
Q

Opioid tolerance does not develop to what SE?

A

miosis and constipation

28
Q

Opioid toxicity is treated with what?

A

Naloxone or Naltrexone (opioid receptor antagonist)

29
Q

Drug used to decrease post-op shivering?

A

Meperidine

K receptor agonist

30
Q

Buprenorphine: MOA

A

partial agonist at mu receptors

31
Q

Naloxone: MOA

A

opioid antagonist. Not orally bioavailable, so withdrawal symptoms occur only if injected (decreases abuse potential))

32
Q

Naltrexone: MOA

A

long-acting opioid antagonist used for relapse prevention once detoxified

33
Q

Methadone: MOA

A

long-acting oral opiate for heroin detoxification and long term maintenance

34
Q

Butorphanol: MOA

A

mu-opioid receptor partial agonist and kappa-opioid receptor agonist; produces analgesia

35
Q

Butorphanol: Uses

A

severe pain: migraine, labor

Less respiratory depression than full opioid agonists

36
Q

Butorphanol: Toxicity

A

Can cause opioid withdrawal symptoms if pt is also taking full opioid agonist (competition for opioid receptors).
Overdose NOT easily reversed with naloxone

37
Q

Tramadol: MOA

A

Very weak opioid agonist

inhibits serotonin and NE reuptake (works on multiple neurotransmitters - “tram it all” in with tramadol)

38
Q

Tramadol: Uses

A

chronic pain

39
Q

Tramadol Toxicity

A

Similar to opioids.
Decreases seizure threshold.
Serotonin syndrome

40
Q

Sertonin syndrome:

A

Hyperthermia, confusion, myoclonus, cardiovascular instability, flushing, diarrhea, seizures.
Tx: cyproheptatine (5-HT2 antag)

Neuro (10 decks)

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