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neuropharm Flashcards

1
Q

Epinephrine/Brimonidine

A

Alpha agonists -> vs glaucoma -> lead to vasoconstriction

Do not give vs closed angle glaucoma

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2
Q

Timolol

A

B blocker vs glacuoma

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3
Q

Acetazolamide

A

Vs glaucoma, decreased carbonic anhydrase

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4
Q

What is the best drug to use vs glaucoma in emergencies?

A

Pilocarpine -> ACh agonist -> opens trabecular meshwork into canal of schlemm

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5
Q

What drug vs glaucoma leads to darkening/browning of iris?

A

Latanoprost (prostaglandin)

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6
Q

Opioid analgesics

What does tolerance not develop to?
What is toxicity treated with?
What is the mechanism?
What mediates tolerance?

A

Tolerance does not develop to diarrhea or miosis

Toxicity treated with Naloxone

Mechanism - Increase K+ outflow, Dec. Ca2+ inflow -> Decreased release of nt

Tolerance is enhanced by glutamate

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7
Q

Butorphanol

A

Opioid receptor partial agonist

Causes less respiratory depression than full agonist

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8
Q

Tramadol

Side effects as well

A

Weak opioid agonist

Decreases reuptake of multiple neurotransmitters

Decreased seizure threshold

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9
Q

What drug is used as prophylaxis vs Status Epilepticus?

A

Phenytoin

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10
Q

What is the 1st line therapy vs Simple/Complex/Tonic-Clonic seizures?

A

Carbemazepine

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11
Q

What drug is used primarily vs simple and complex focal epilepsy?

A

Carbemazepine

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12
Q

What can be used 1st line vs tonic clonic seizures (list all)

A

Carbemazepine
Phenytoin
Valproic acid

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13
Q

What is used vs Abscence seizures (3mhz EEG)

A

Ethosuximide

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14
Q

What is used 1st line vs acute status epilepticus?

A

Benzodiazepines

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15
Q

What GABA analog also inhibits Ca2+ channels?

A

Gabapentin

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16
Q

What drug can be used vs myoclonic seizures?

A

Valproic acid

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17
Q

What is the mechanism for Ethosuxamide?

A

Blocks Thalamic T type Ca2+ channels

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18
Q

What anti epileptic can possibly lead to Steven Johnson Syndrome and is metabolized by the P450 system?

What drug leads to Steven Johnson syndrome but is not cleared by the P450 system?

A

Carbamazepine

Ethosuximide

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19
Q

What are the side effects of Ethosuximide?

A

EFGH

Ethosuximide - Fatigue, GI distress, Headache -> also steven Johnson

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20
Q

What anti epileptic drugs induce cytochrome p450

A

Carbemazepine/Phenobarbital/Phenytoin

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21
Q

What antiepileptic drugs can lead to Steven Johnson syndrome

A

Carbamazepine, Ethosuximide, Phenytoin, Lamotrigine

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22
Q

Phenytoin

A

Used vs Tonic clonic and prophylaxis vs Status Epilepticus

Induces P450

Teratogenic, gingival hyperplasia, megaloblastic anemia, Steven Johnson syndrome

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23
Q

Barbituates

Mechanism and toxicity

A

Mechanism -> Inc. duration of Cl- channel opening

Induce P450

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24
Q

How do barbituates differ from benzodiazepines in terms of mechanism?

A

Barbituates -> Increase duration of Cl- channel opening

Benzodiazepine -> Increase length of Cl- channel opening

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25
Q

What benzodiazepines have increased risk of addiction?

A

TOM

Triazolam

Oxazepam

Midazolam

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26
Q

How should benzodiazepine overdose be treated?

What is a contraindication vs benzodiazepines?

A

Contra - Alcohol. Used vs delirium tremors however

Flumazenil vs overdose

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27
Q

Zolpidem/Zaleplon/Eszopiclone

A

Used vs insomnia

Act at GABA receptor

Reversed by flumazenil

28
Q

If a drug is low solubility in blood and high solubility in lipids, how does this effect potency and induction time?

A

Low solubility in blood => More rapid induction

High solubility in lipids => More potency

29
Q

-Flurane

A

Inhaled anesthetic

Leads to depression of heart and respiratory

30
Q

Halothane

A

Inhaled anesthetic

31
Q

How does obesity affect Barbituates?

A

Increased lipids => Increased turnover rate and redistribution

32
Q

What are the intravenous anesthetics?

A

BB King on Opioids Propafol

Benzodiazepine
Barbituates
Ketamine
Opioids
Propafol
33
Q

What is the most commonly used benzodiazepine in endoscopy?

A

Midazolam

34
Q

Ketamine mechanism

A

IV anesthetic

PCP analog that blocks NMDA receptors

35
Q

How can an amide be differed from an ester?

A

Amides have 2 I’s in their name

36
Q

What types of nerve fibers are most rapidly anesthetiazed?

What type are slowest?

A

Fastest -> Small myelinated

Slowest -> Large unmyelinated

37
Q

What sensations are first to be lost with anesthetic?

What is last to be lost?

A

First to be lost - Pain

Last to be lost - Pressure

Pain, Temperature, Touch, Pressure

38
Q

Succinylcholine

How is its effects reversed?

A

ACh receptor agonist -> binds so strongly it prevents further depolarization

Succinylcholine reversal ->
Phase I - Binds too strongly vs ACh receptors, ACh esterase inhibitors will potentiate (supplement) the actions

Phase II - Effects starts to wear off, ACh esterase inhibitors will reverse effects of Succinylcholine at this point

39
Q

What is used to clear malignant hyperthermia?

What is its mechanism?

A

Dantrolene - Blocks Ca2+ release

40
Q

What drugs are used vs Parkinsons?

A

BALSA

Bromocriptine
Amantidine
L-Dopa
Selegiline
Antimuscarinics (Benztropine)
41
Q

Selegiline

A

MAO-B inhibitor, prevents Dopamine breakdown

42
Q

Benztropine

A

vs parkinsons

antimuscarinic

Helps vs tremor

43
Q

Bromocriptine

A

Dopamine agonist

44
Q

Amantidine

A

Increased dopamine release

45
Q

What is given with L-Dopa to increase CNS availability of dopamine?

A

Carbidopa

Stops peripheral dopamine decarboxylase

46
Q

What is the toxicity of Sumatriptan?

A

Sumatriptan is used vs migraines

Leads to coronary vasospasm

47
Q

Memantine

A

Used vs Alzheimer’s

NDMA antagonist -> prevents excitotoxicity

48
Q

Donepezil

A

ACh esterase inhibitor

Used in Alzheimer’s

49
Q

What is the principle of treatment in Huntington’s disease?

A

Decrease Dopamine

50
Q

Tetrabenazine & Reserpine

A

Used vs Huntington’s disease

Decrease dopamine release

51
Q

Haloperidol

A

Dopamine receptor antagonist

52
Q

Therapy vs ADHD

A

Methylphenidate, Atomoxetine

53
Q

PCP treatment

A

Benzodiazepine

54
Q

Heroin addiction: Long acting and partial agonist

A

Long acting - Methadone

Naloxone + buprenorphine are partial agonists

55
Q

Delirium tremens treatment

A

Benzodiazepines

56
Q

Anxiety treatment

A

SSRI, buspirone

57
Q

ADHD treatment

A

Methylphenidate, amphetamines

58
Q

Bipolar disorder

A

Lithium, valproic acid

59
Q

Bulimia

A

SSRI

60
Q

Depression

A

SSRI, TCA, busprone, Mirtazapine

61
Q

Obsessive-Compulsive disorder

A

SSRI, clomipramine

62
Q

Panic disorder

A

SSRI, vleafaxine

63
Q

PTSD

A

SSRI

64
Q

Schizophrenia

A

Antipsychotics

65
Q

Social phobia

A

SSRI

66
Q

Tourette’s syndrome

A

Haloperidol, Risperidone

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