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Pharmacology > Neurology > Flashcards

Neurology Flashcards

1
Q

Atropine

A

anticholinergic

inhibits Ash and muscarinic receptors–> increased heart contraction strength and heart rate, relaxed GI and respiratory and GU systems, decreased gland secretions

Use for bradycardia

se: 6 A M

Agitated brain
Anhidrosis
Airway relax
Accelerated heart beat
Avid thirst with dry mouth
Atonic bowel and bladder

Mydriasis with increased ocular pressure

ci: glaucoma, MG, obstructive GI/GU

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2
Q

Tolterodine

A

Anticholinergic/muscarinic

Overactive bladder

similar side effects: dry mouth, diarrhea, dyspepsia, constipation, anxiety, abnormal vision, dry eye, urinary retention

Do not take with AZITHROMYCIN, AZOLE ANTIFUNGALS, CYCLOSPORINE, other anticholinergics/antimuscarinics

ci: UC, toxic megacolon, BPH, glaucoma, MG, pregnancy

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3
Q

Dextroamphetamine

A

noncatecholamine amphetamine

Narcolepsy and ADHD

leads to anorexia, insomnia, high bp, low libido, palpitations

Antacids increase absorption

ci: hyperthyroid, glaucoma, hypertension, arteriosclerosis, agitates states, MAOI

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4
Q

Methyphenidate

A

ritalin

catecholamine norepinephrine release

ADHD, narcolepsy

se: anxiety, insomnia, tremor, euphoria, hypertension, angina, arrhythmias, anorexia, diarrhea, emesis, tolerance, abuse, dependence

Ci: anxiety, glaucoma, tourettes, serious heart issues, within 2 weeks of MAOI– severe hypertensive reaction

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5
Q

Oxymetazoline

A

direct acting sympathomimetic

vasocontricts mucosal blood vessels when applied topically
nasal congestion

local irritation, rebound congestion

ci: glaucoma, hyperthyroid, heart disease, less than 6yo

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6
Q

Pseudoephedrine

A

alpha adrenergic agonist

(alpha-vasoconstriction, B- bronchial relaxation and increased heart rate/contractility)

nasal congestion

rebound congestion, insominia anxiety, anorexia, GI upset, heart issues

Increased risk of hypertension and arrhythmias with cardiac glycosides and TCA, vasoconstriction with trots

do not give with MAOI

ci: severe hypertension, pheochromocytoma

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7
Q

Phenylephrine

A

nasal spray

alpha adrenergic agonist (sympathomimetic)

vasoconstriction of nasal mucosa

can be used for mydriasis in an eye dropper

se: anxiety, heart stuff, corneal clouding, tissue necrosis

increase beta blockers, MAOI hypertension possible

ci: hypertension, ventricular tachycardia, glaucoma

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8
Q

Phentermine

A

indirect alpha and beta adrenergic

weight loss drug

decreases appetite

se: hives, GI upset, heart issues, anxiety, low libido

decrease excretion with antacids, risk of arrhythmias with TCA

ci: pulmonary hypertension, arteriosclerosis, glaucoma

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9
Q

Nicotine

A

smoking cessation

cholinergic

ganglionic and CNS stimulant, stimulates respiratory system and then paralyses all autonomic ganglia

se: headache, flu like, skin reactions with patch

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10
Q

Varenicline

A

chantix

nicotinic acetylcholine receptor partial agonist

acts on mesolimbic dopamine system, stimulates nicotine activity but less

se: nausea, insomnia

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11
Q

Donepezil

A

anti alzheimers

cholinesterase inhibitor: decreases the break down of acetylcholine

slows cognitive decline in alzheimers

se: GI irritation, dizzy, headache, bradycardia, broncho constriction
give atropine if Mrs G gets into the bottle and takes too much and overdoses!

relative ci: arrhythmia, abnormal heart rate, asthma, COPD

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12
Q

Rivastigmine

A

antialzheimers

cholinergic

basically same as donepezil

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13
Q

Alprazolam

A

xanax

short acting benzodiazepine

increases effect of GABA- anxiolytic, mm relaxant, antidepressant, anticonvulsant

se: drowsy, fucked up

don’t take with alcohol or opiates

ci: glaucoma, sleep apnea, preexisting CNS/Respiratory depression, pregnancy and lactation

abrupt stop can cause seizures

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14
Q

Diazepam

A

long acting benzodiazepine

enhances effects of GABA

se: DIASepam

Drowsy
Dependence
Impaired judgement
Anterograde Amnesia
Suppression of respiration and circulation, even death

may decrease effectiveness of levodopa, hypothermia with lithium

ci: MG, less than 6months, pregnancy and lactation

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15
Q

Buspirone

A

anxiolytic
Azaspirodecanedione

high affinity for 5HT1, 5HT2, moderate affinity for dopamine d2

GAD

much lower side effect and risk profile than benzos

MAOI hypertension

ci: under 18, MAOI, epilepsy, severe renal or liver disease

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16
Q

Zolpidem

A

ambien

hypnotic

increased sedation and incoordination with TCA

ci: severe hepatic insufficiency

17
Q

Carbamazepine

A

Neuronal Na+ channel blocker
slows down neuronal firing

MZP: Mania, seiZures, Pain (nerve)

se: ataxia, hyponatremia

Caution with OCP efficacy and shortens half life of doxycycline, decreases warfarin

ci: bone marrow depression, pregnancy, MAOI within 14 days

18
Q

Phenytoin

A

neuronal na+ channel blocker

anticonvulsant

use: GPS
Generalized tonic clonic seizures
Partial seizures
Status epileptic

SE: F  PHENyTOIN
Folate antagonist
Peripheral neuropathy
Hyperplasia of gingiva, Hirsutism
Enlarged LN
Nystagmus
Teratogen
Osteomalacia
Inhibits insulin
Nausea vomiting

ci: sinus bradycardia, heart block, pregnancy

19
Q

Gabapentin

A

structurally similar to GABA but neither an agonist nor antagonist

use for epilepsy and neuropathic pain

se: DASH
Dizzy, drowsy
Ataxia
Somnolesence
Headache

Ci: lactation

20
Q

Pregabalin

A

Gaba analogue, reduces pain signal going from the brain to the periphery

ci; pregnancy, lactation

21
Q

Modafinil

A

nonamphetamine CNS stimulant

Improves EDS in narcolepsy

se: headache, rhinitis, insomnia, personality disorders

Interactions: careful with OCP, increase metabolism of cyclosporin,

ci: hypertension, arrhtyhmias, chest pain, mitral valve prolapse

22
Q

Carisoprodol

A

mm relaxant

carbamate derivative, blocks interneuronal synaptic activity in the descending reticular formation and spinal cord

se: dizzy, drowsy
ci: opiods, intermittent porphyria, lactation

23
Q

Ketamine

A

NMDA receptor antagonist

direct action on the cortex and limbic system, dissociative

anesthesia

se: hypertension, increased CO, increased intracranial pressure, hallucinations,
ci: psychotic disorders, eye injury, raised IOP, cerebrovascular event history

24
Q

Cyclobenzaprine

A

mm relaxant

similar to TCAs

se: drowsy, dry mouth
ci: recent MI

25
Q

Levodopa-carbodop

A

parkinsons

levodopa becomes dopamine, carbadopa prevents the metablism of levodopa

se: depression, dyskinesia,
ci: lactation, glaucoma, MI

26
Q

Pramipexole

A

parkinsons

dopamine agonist

non ergot derivative dopamine receptor agonist
adjunct to levodopa

parkinson’s and RLS

se: narcolepsy, nausea, constipation, drowsy
ci: stops lactation

antagonizes antipsychotics

27
Q

Aripiprazole

A

psychotropic

blocks 5HT2 and dopamine receptors

use: schizophrenia, bipolar, adjunctive treatment of MDD, irritability with autism
se: CNS effects, Gi effects, weight gain
inter: increased by fluoxetine, decreased by carbamazepine

monitor DM

ci: CVD, cerebrovascular disease, seizures, pregnancy

28
Q

Risperidone

A

antipsychotic
benzisoxazole

blocks 5HT2 and D2, blocks H1 and alpha adrenoreceptors

use: schizophrenia
se: aggressive, dizzy, extrapyramidal reactions, insomnia,

Inter: decreases dopamine agonists,

ci: lactation, CVD, renal, hepatic injury, pregnancy, hypotension

29
Q

Prochlorperazine

A

antiemetic, antipsychotic, anxiolytic

blocks D2 receptors,

se: sedation and dizzy

can lead to irreversible tardive dyskinesia

ci: CNS depression, comatose patients, Bone marrow depression, pheochromocytoma, prolactin tumors, under 2, pregnancy and lactation

30
Q

Haloperidol

A

phenylbutylpiperidine, dopamine antagonist
1st gen antipsychotic

lot of undesirable side effects due to blocking H1, cholinergic, and alphadrenergic receptors – newer models do less of this!

treats delusions and hallucinations in schizophrenia, tourettes syndrome and can be used in sedation of patients who are severely agitated

se:
Early sx: parkinsonism, acute dystonia, akathisia,
Late: tardive dyskinesia, neuroleptic malignant syndrome, anticholinergic side effects

inter: fluoxetine can lead to sever extrapyramidal side effects, lithium can decrease lethargy and confusion in high doses
ci: parkinsons, neuroleptic malignant syndrome, seizures, CNS depression

31
Q

Amitriptyline

A

TCA
converts to nortriptyline

blocks neuronal reuptake of serotonin greater than norepinephrine which allows more of the neurotransmitters

do not prescribe with MAOI (2 WEEKS), SSRI (5 WEEKS)

SE: lethargy, orthostatic hypotension, anticholinergic effects, wide QRS complex with overdose

avoid clonidine - can cause hypertensive crisis

ci: CVD, benzo sensitivity

when depressed patients begin to feel better, risk of suicide increases
take at bedtime

32
Q

Escitalopram

A

SSRI

MDD, GAD, OCD, ED

fatal with MAOI

bradycardia with beta blockers

ci: suicide ideation, mania, seizures, renal or hepatic impairment, pregnancy

33
Q

Fluoxetine

A

SSRI

Depression, OCD, panic disorder, bulimia, social phobia

SE: SSRI
Sexual dysfunction
Sick stomach
restless
insomnia

increased risk for GI bleed with warfarin and NSAIDS

34
Q

Buproprion

A

SARI

depression and smoking cessation

se: GAPSS
GI upset
Agitation
Psychosis
Somnolence
Seizures

ci: seize disorder, MAOIS, history of ED,

35
Q

Trazodone

A

Triazolopyridine derivative
SARI

depression and panic anxiety

Pharmacology (8 decks)

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