neuropharm

Question 1

Epinephrine/Brimonidine

Answer 1

Alpha agonists -> vs glaucoma -> lead to vasoconstriction

Do not give vs closed angle glaucoma

Question 2

Timolol

Answer 2

B blocker vs glacuoma

Question 3

Acetazolamide

Answer 3

Vs glaucoma, decreased carbonic anhydrase

Question 4

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

Answer 4

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

Question 5

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

Answer 5

Latanoprost (prostaglandin)

Question 6

Opioid analgesics

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

Answer 6

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

Question 7

Butorphanol

Answer 7

Opioid receptor partial agonist

Causes less respiratory depression than full agonist

Question 8

Tramadol

Side effects as well

Answer 8

Weak opioid agonist

Decreases reuptake of multiple neurotransmitters

Decreased seizure threshold

Question 9

What drug is used as prophylaxis vs Status Epilepticus?

Answer 9

Phenytoin

Question 10

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

Answer 10

Carbemazepine

Question 11

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

Answer 11

Carbemazepine

Question 12

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

Answer 12

Carbemazepine
Phenytoin
Valproic acid

Question 13

What is used vs Abscence seizures (3mhz EEG)

Answer 13

Ethosuximide

Question 14

What is used 1st line vs acute status epilepticus?

Answer 14

Benzodiazepines

Question 15

What GABA analog also inhibits Ca2+ channels?

Answer 15

Gabapentin

Question 16

What drug can be used vs myoclonic seizures?

Answer 16

Valproic acid

Question 17

What is the mechanism for Ethosuxamide?

Answer 17

Blocks Thalamic T type Ca2+ channels

Question 18

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?

Answer 18

Carbamazepine

Ethosuximide

Question 19

What are the side effects of Ethosuximide?

Answer 19

EFGH

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

Question 20

What anti epileptic drugs induce cytochrome p450

Answer 20

Carbemazepine/Phenobarbital/Phenytoin

Question 21

What antiepileptic drugs can lead to Steven Johnson syndrome

Answer 21

Carbamazepine, Ethosuximide, Phenytoin, Lamotrigine

Question 22

Phenytoin

Answer 22

Used vs Tonic clonic and prophylaxis vs Status Epilepticus

Induces P450

Teratogenic, gingival hyperplasia, megaloblastic anemia, Steven Johnson syndrome

Question 23

Barbituates

Mechanism and toxicity

Answer 23

Mechanism -> Inc. duration of Cl- channel opening

Induce P450

Question 24

How do barbituates differ from benzodiazepines in terms of mechanism?

Answer 24

Barbituates -> Increase duration of Cl- channel opening

Benzodiazepine -> Increase length of Cl- channel opening

Question 25

What benzodiazepines have increased risk of addiction?

Answer 25

TOM Triazolam Oxazepam Midazolam

Question 26

How should benzodiazepine overdose be treated? What is a contraindication vs benzodiazepines?

Answer 26

Contra - Alcohol. Used vs delirium tremors however Flumazenil vs overdose

Question 27

Zolpidem/Zaleplon/Eszopiclone

Answer 27

Used vs insomnia Act at GABA receptor Reversed by flumazenil

Question 28

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

Answer 28

Low solubility in blood => More rapid induction High solubility in lipids => More potency

Question 29

-Flurane

Answer 29

Inhaled anesthetic Leads to depression of heart and respiratory

Question 30

Halothane

Answer 30

Inhaled anesthetic

Question 31

How does obesity affect Barbituates?

Answer 31

Increased lipids => Increased turnover rate and redistribution

Question 32

What are the intravenous anesthetics?

Answer 32

BB King on Opioids Propafol ``` Benzodiazepine Barbituates Ketamine Opioids Propafol ```

Question 33

What is the most commonly used benzodiazepine in endoscopy?

Answer 33

Midazolam

Question 34

Ketamine mechanism

Answer 34

IV anesthetic PCP analog that blocks NMDA receptors

Question 35

How can an amide be differed from an ester?

Answer 35

Amides have 2 I's in their name

Question 36

What types of nerve fibers are most rapidly anesthetiazed? What type are slowest?

Answer 36

Fastest -> Small myelinated Slowest -> Large unmyelinated

Question 37

What sensations are first to be lost with anesthetic? What is last to be lost?

Answer 37

First to be lost - Pain Last to be lost - Pressure Pain, Temperature, Touch, Pressure

Question 38

Succinylcholine How is its effects reversed?

Answer 38

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

Question 39

What is used to clear malignant hyperthermia? What is its mechanism?

Answer 39

Dantrolene - Blocks Ca2+ release

Question 40

What drugs are used vs Parkinsons?

Answer 40

BALSA ``` Bromocriptine Amantidine L-Dopa Selegiline Antimuscarinics (Benztropine) ```

Question 41

Selegiline

Answer 41

MAO-B inhibitor, prevents Dopamine breakdown

Question 42

Benztropine

Answer 42

vs parkinsons antimuscarinic Helps vs tremor

Question 43

Bromocriptine

Answer 43

Dopamine agonist

Question 44

Amantidine

Answer 44

Increased dopamine release

Question 45

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

Answer 45

Carbidopa Stops peripheral dopamine decarboxylase

Question 46

What is the toxicity of Sumatriptan?

Answer 46

Sumatriptan is used vs migraines Leads to coronary vasospasm

Question 47

Memantine

Answer 47

Used vs Alzheimer's NDMA antagonist -> prevents excitotoxicity

Question 48

Donepezil

Answer 48

ACh esterase inhibitor Used in Alzheimer's

Question 49

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

Answer 49

Decrease Dopamine

Question 50

Tetrabenazine & Reserpine

Answer 50

Used vs Huntington's disease Decrease dopamine release

Question 51

Haloperidol

Answer 51

Dopamine receptor antagonist

Question 52

Therapy vs ADHD

Answer 52

Methylphenidate, Atomoxetine

Question 53

PCP treatment

Answer 53

Benzodiazepine

Question 54

Heroin addiction: Long acting and partial agonist

Answer 54

Long acting - Methadone Naloxone + buprenorphine are partial agonists

Question 55

Delirium tremens treatment

Answer 55

Benzodiazepines

Question 56

Anxiety treatment

Answer 56

SSRI, buspirone

Question 57

ADHD treatment

Answer 57

Methylphenidate, amphetamines

Question 58

Bipolar disorder

Answer 58

Lithium, valproic acid

Question 59

Bulimia

Answer 59

SSRI

Question 60

Depression

Answer 60

SSRI, TCA, busprone, Mirtazapine

Question 61

Obsessive-Compulsive disorder

Answer 61

SSRI, clomipramine

Question 62

Panic disorder

Answer 62

SSRI, vleafaxine

Question 63

PTSD

Answer 63

SSRI

Question 64

Schizophrenia

Answer 64

Antipsychotics

Question 65

Social phobia

Answer 65

SSRI

Question 66

Tourette's syndrome

Answer 66

Haloperidol, Risperidone