Neuropharmacology

Question 1

Drugs that cause aplastic anemia?

Answer 1

Carbamazepine

Question 2

Phenytoin MOA? 1st Line?

Answer 2

MOA: Increased Na+ channel inactivation

1st Line: Tonic-Clonic Seizures and Prophylaxis of Status Epilepticus

Question 3

Phenytoin AE?

Answer 3

1. Induction of cytochrome p450
2. Zero Order Elimination (toxic builds up faster)
3. Gingival hyperplasia and Hirsutism

Question 4

What other drugs have zero order elimination?

Answer 4

PEA
Phenytoin
Ethanol
Aspirin

Question 5

Carbamazepine MOA? 1st Line?

Answer 5

MOA: Increased Na+ channel inactivation

1st Line: Trigeminal Neuralgia; Simple, Complex and Tonic-Clonic Seizures

Question 6

Carbamazepine AE?

Answer 6

1. Induction of cytochrome p450
2. SIADH=>Edema (Check ADH)
3. Bone Marrow Suppression (Blood count)
4. Check LFTs

Question 7

Valproic Acid MOA? 1st Line?

Answer 7

MOA: Increased Na+ channel inactivation and Increases GABA by inhibiting GABA transaminase

1st Line: Tonic-Clonic Seizures and Bipolar Disorder
Can be used for both tonic clonic+absence

Question 8

Valproic Acid AE?

Answer 8

PHIG

1. Hepatotoxicity (Measure LFTs)
2. Inhibition of cytochrome p450
3. Contraindicated in Pregnancy
4. GI distress

Question 9

EthoSUXimide MOA? 1st Line?

Answer 9

MOA: Blocks Thalamic T-type Ca2+ channels

1st Line: Absence Seizures

Question 10

Phenobarbital MOA? 1st Line?

Answer 10

MOA: facilitate GABAa action by increasing DURATION of Cl- channel opening

1st line: in neonates

Question 11

Barbiturates consist of?

Answer 11

Phenobarbital, pentobarbital, thiopental, secobarbital

Question 12

Barbiturates MOA, AE?

Answer 12

MOA: facilitate GABAa action by increasing DURATION of Cl- channel opening

AE: Contraindicated in porphyria (Induction of cytochrome p450), Everything Depression, Inhibits Complex 1 of ETC=>Decreased ATP

Depresses Porphyria
Depresses everything
Depresess Complex 1 of ETC

Question 13

Barbiturate withdrawal leads to?

Answer 13

Life threatening Seizures

Question 14

Benzodiazepines end in?

Answer 14

-zepam or -zolam

Question 15

Benzodiazepines MOA, 1st Line, AE?

Answer 15

MOA: facilitate GABAa action by increasing FREQUENCY of Cl- channel opening

1st Line: Acute Status Epilepticus

AE: Depression much like Barbs

Question 16

Short Acting Benzos?

Answer 16

ATOM

Alprazolam, Triazolam, Oxazepam, and Midazolam

Question 17

Increase in Frequency means?

Answer 17

Increased potency

Question 18

Antidote to Benzo?

Answer 18

Flumazenil

Question 19

Felbamate MOA?

Answer 19

MOA: NMDA receptor antagonist

Question 20

Lamotrigine MOA?

Answer 20

MOA: Blocks voltage gated Na+ channels

Question 21

Zolpidem, Zaleplon and esZopicolne MOA? Use?

Answer 21

MOA: BZ1 subtype in GABA=> Puts you to ZZZ
Use: Insomnia

Question 22

Halothane vs Nitrous Oxide, which do you need less of?

Answer 22

Halothane=>needs less, less MAC needed=>Increased potency, more lipid soluble and higher Blood gas and slow

Question 23

Inhaled anesthetics are?

Answer 23

Halothane+ -fluranes

Question 24

AE of halothane and -Fluranes? Antidote?

Answer 24

1. Malignant Hyperthermia
2. Fulminant hepatitis

Antidote: Dantrolene

Question 25

Dantrolene MOA?

Answer 25

MOA: Prevents release of Ca2+ from the sarcoplasmic reticulum of skeletal muscle

Question 26

How are barbiturates used as IV anesthetics and which one is used?

Answer 26

Thiopental, induction | of anesthesia and short surgical procedures

Question 27

How are Benzos used as IV anesthetics and which one is used?

Answer 27

Midazolam most common drug used for endoscopy

Question 28

Ketamine (Arylcyclohexylamines) MOA? Use? AE?

Answer 28

MOA: Blocks NMDA receptors Use: dissociative anesthetics=>hallucinations AE: Cardio stimulant, Hallucinations

Question 29

Ketamine is like?

Answer 29

PCP

Question 30

Drug that looks like milk? What is unique about this drug? MOA?

Answer 30

Propofol MOA: Potentiates GABAa Unique=>antiemetic

Question 31

Local anesthetics are divided into?

Answer 31

Amides and Esters

Question 32

How do you identify amides?

Answer 32

They have i before caine (like sugar caine)

Question 33

Local anesthetics MOA?

Answer 33

Block Na+ channels by binding to specific receptors on inner portion of channel

Question 34

Which fibers do they block first and last?

Answer 34

First: Small myelinated fibers=> dull pain Last: Large unmyelinated fibers

Question 35

Why do the anesthetic esters have allergy?

Answer 35

PABA

Question 36

Which fibers do they lose first?

Answer 36

SPinothalamic then DCML Pain then Temp (1) pain, (2) temperature, (3) touch, (4) pressure.

Question 37

NO explain its MAC, B/G ratio and Lipid?

Answer 37

Low Lipid=>Decreased Blood/Gas ratio=>Rapid Induction=>More MAC needed Increased MAC for RAPID INDUCTION

Question 38

Thiopental rapidly redistributes or metabolizes?

Answer 38

redistributes

Question 39

Where does Thiopental Redistribute?

Answer 39

Skeletal muscle