Neurology

Question 1

Mechanism of action of phenytoin

Answer 1

Blocks Na channel

Question 2

Mechanism of action of carbamazepine

Answer 2

Blocks Na channel

Question 3

Mechanism of action of lamotrigine

Answer 3

Blocks Na channel

Question 4

Mechanism of action of levetiracetam

Answer 4

Blocks synaptic vesicle protein2A

Question 5

Mechanism of action of gabapentinoids

Answer 5

Blocks Ca channel

Question 6

Mechanism of action of topiramate

Answer 6

Blocks Na channel and potentiates GaBA

Question 7

Mechanism of action of valproate

Answer 7

Blocks Ca and Na channels and GABA transaminase

Question 8

Mechanism of action of ethosuximide

Answer 8

Blocks Ca channel

Question 9

Mechanism of action of barbiturates

Answer 9

Facilitate GABA action by increasing duration of Cl channel opening thus decrease neuron firing
(Barbidurates)

Question 10

Mechanism of action of benzodiazepines

Answer 10

Facilitate GABA action by increasing frequency of Cl channel opening thereby decreasing neuron firing
(Frenzodiazepines = frequency)

Question 11

Mechanism of action of non-benzo hypontoics e.g zolipdem

Answer 11

Act via BZ1 subtype of GABA receptor

Question 12

Mechanism of action of suvorexant (non-benzo hypnotic)

Answer 12

Orexin receptor antagonist

Question 13

Mechanism of action of ramelteon (non-benzo hypnotic)

Answer 13

Melatonin receptor agonist

Question 14

Mechanism of action of triptans

Answer 14

5HT agonist

Question 15

Alzheimers disease drugs and their action

Answer 15

Donepezil, rivastigmine and galatamine all inhibits AChE
(Dona riva dances at the gala)
Memantine - NMDA antagonist

Question 16

Mechanism of action of local anaesthetics

Answer 16

Blocks neurotransmission by binding to voltage gaged Na channels on the inner portion of the channel along nerve fibres

Question 17

Mechanism of action of general anaesthetics; propofol, etomidate, ketamine

Answer 17

Propofol - potentiates GABA and inhibits NMDA receptors
Etomidate - potentiates GABA receptor
Ketamine - inhibits NMDA receptor

Question 18

Mechanism of action of opioid analgesics

Answer 18

Agonist at opioid receptors - closes Ca channels, opens presynaptic K channels.
Inhibits release of ACh, norepinephrine, 5HT, glutamate, substance P

Question 19

Mechanism of action of tramadol

Answer 19

Weak opioid agonist and also inhibits reuptake of serotonin and norepinephrine

Question 20

Muscle relaxants- where do they target
(Baclofen, cyclobenzaprine, danteolene, tizantadine)

Answer 20

Baclofen - back
Cyclobenzaprine - centrally
Danteolene - direct
Tizantadine - direct

Question 21

Mechanism of action of non-depolarising muscle relaxants

Answer 21

(“Cur” drugs i.e. rocuronium)
Competitive Nm nicotinic antagonist

Question 22

Mechanism of action of depolarising muscle relaxants

Answer 22

(Succinylcholine)
Strong Nm receptor agonist

Question 23

what receptors do opioids attach to

Answer 23

mu, delta and Kappa

Question 24

Features of DRESS syndrome

Answer 24

108 weeks after exposure to medications i.e. anti epileptics
Fever
Rash
Facial swelling
Lynphadenopathy
Eosinophillia

Question 25

what is a contraindication to triptan use?

Answer 25

ischaemic heart disease

Question 26

action of flumazenil

Answer 26

Flumazenil is a competitive antagonist at γ-aminobutyric acid receptor

Question 27

what medication can be added to valproic acid for concomittant therapy for generalised seizures

Answer 27

leveteracitam

Question 28

parkinson medication associated with hallucinations

Answer 28

dopamine agonists e.g. ropinorole

Question 29

parkinson medication associated with pulmonary fibrosis

Answer 29

cabergoline and bromocriptine

Question 30

medication that is useful in treating tremor associated with drug induced parkinsons

Answer 30

procyclidine inhibits Ach

Question 31

parkinson medication associated with greatest improvement in motor symptoms

Answer 31

levodopa

Question 32

medication used to help sleepiness in parkinsons

Answer 32

modafinil inhibits GABA

Question 33

medication used to help postural hypotension in parkinsons and its action

Answer 33

midodrine acts on peripheral alpha-adrenergic receptors to increase arterial resistance

Question 34

how to manage patients parkinsons medication if they are on oral levodopa and are admitted to hospital and unable to take oral medications

Answer 34

dopamine agonist patch

Question 35

parkinsons medication that can cause levido reticularis

Answer 35

amantadine

Question 36

antiepileptic that can cause megaloblastic anaemia

Answer 36

phenytoin

Question 37

what medication can precipitate myaesthenia crisis

Answer 37

Pretty Little Penny Bets All the time that Myaesthenia Crises Like Provoking Queers Penicillamine Lithium Phenytoin Betablockers Antibiotics Procanamide Quinidine

Question 38

what anticonvulsant can cause angle closure glaucoma

Answer 38

topiramate

Question 39

what anticonvulsant can cause pancreatitis

Answer 39

Na valproate

Question 40

what anticonvulsant can cause SIADH

Answer 40

carbamazepine

Question 41

what anticonvulsant can cause psyhciatric complications

Answer 41

leveteracetam

Question 42

medication used for huntingtons disease

Answer 42

deutabenazine + tetrabenazine inhibit vesicular monoamine transporter (VMAT) which decreases dopamine vesicle packaging and release

Question 43

what type of drug is latanoprost and mode of action

Answer 43

prostaglandin, used in glaucoma increases outflow of aqeous humour via decreased resistance of flow through uveoscleral pathways

Question 44

side effects of prostaglandins i.e. lanatoprost

Answer 44

darkens colour of iris eyelash growth

Question 45

what occular treatment should be avoided in closed angle glaucoma and why

Answer 45

alpha agonists i.e. epinephrine, brimonidine they cause mydriasis which would worsen closed angle glaucoma

Question 46

occular treatment for glaucoma which can cause occular allergic reactions and pruiritus

Answer 46

alpha agonists i.e. epinephrine, brimonidine, apraclonidine

Question 47

what antiepileptic has risk of life threatening rash

Answer 47

lamotrigine