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BOARDS specific notecards > pharm 1 liners- CNS > Flashcards

pharm 1 liners- CNS Flashcards

1
Q

Ganglion blockers used in research; high affinity for neuronal nicotinic receptors

A

hexamethonium, trimethaphan

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2
Q

Two direct-acting cholinomimetics that increase aqueous outflow through ciliary muscle contraction and opening of trabecular meshwork

A

pilocarpine, carbachol

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3
Q

Two indirect-acting cholinomimetics that increase aqueous outflow through ciliary muscle contraction and opening of trabecular meshwork

A

physostigmine, echothiophate

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4
Q

Nonselective alpha agonist that decreases aqueous production

A

epinephrine

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5
Q

Selective alpha 2 agonist that decreases aqueous production

A

brimonidine

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6
Q

Three beta blockers that decrease aqueous production

A

timolol (nonselective), betaxolol 9selective), carteolol (nonselective)

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7
Q

Carbonic anhydrase inhibitor used to decrease aqueous humor production

A

acetazolamide

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8
Q

Prostaglandin E2 alpha analog used to increase aqueous humor outflow

A

latanoprost

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9
Q

Common side effect of sedative hypnotics

A

CNS depression

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10
Q

Mechanism of action of benzodiazepines

A

Increase frequency of GABA-mediated chloride ion channel (GABAA) opening

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11
Q

Main route of metabolism for benzodiazepines

A

hepatic

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12
Q

Useful side effect of benzodiazepines in patients undergoing stressful procedures or surgery

A

anterograde amnesia

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13
Q

Three benzodiazepines that are metabolized only by Phase II conjugation and therefore is useful in elderly patients

A

Lorazepam, oxazepam, and temazepam

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14
Q

Two benzodiazepines that have active metabolites with long half-lives

A

diazepam, chlordiazepoxide

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15
Q

Clinical uses of benzodiazepines (5)

A

Anxiety, insomnia, alcohol detoxification, status epilepticus, spasticity

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16
Q

Reason why benzodiazepines are safer than barbiturates

A

Benzodiazepines do not directly activate GABAA

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17
Q

Mechanism of action of barbiturates

A

Increase duration of GABAA chloride channel opening

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18
Q

Most serious side effects of barbiturates (2)

A

Respiratory and cardiovascular depression

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19
Q

Barbiturates may precipitate this hematologic condition

A

porphyria

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20
Q

Barbiturates decrease the effectiveness of many other drugs via this pharmacokinetic property

A

induce CYP450

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21
Q

Effect of benzodiazepines and barbiturates on sleep architecture

A

suppress REM

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22
Q

Three nonbenzodiazepine hypnotics that lack suppressive effect on REM and are preferred over benzodiazepines for the treatment of insomnia

A

Zolpidem, zaleplon, eszopiclone

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23
Q

Mechanism of action of zolpidem

A

Activates BZ1 subtype of GABAA receptor

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24
Q

Drug of choice for treatment of acute status epilepticus

A

benzodiazepine

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25
Q

Drug of choice for partial seizures

A

carbamazepine

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26
Q

Antiepileptic drug used as first line for trigeminal neuralgia

A

carbamazepine

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27
Q

Antiepileptic drug that can induce CYP450, is teratogenic, and can cause diplopia, ataxia, and blood dyscrasias; follows first order kinetics of elimination

A

crbamazepine

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28
Q

Drugs of choice for generalized tonic-clonic seizures

A

Carbamazepine, phenytoin, valproic acid

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29
Q

Mechanism of action of Phenytoin, Carbamazepine, Lamotrigine

A

blocks sodium channels

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30
Q

Antiepileptic agent that exhibits zero-order kinetics, causes fetal hydantoin syndrome, and induces CYP450

A

phenytoin

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31
Q

Side effects of phenytoin (4)

A

Gingival hyperplasia, nystagmus, diplopia and ataxia

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32
Q

Anticonvulsant used for absence seizures; also used to treat: bipolar disorder, myoclonic siezures and as migraine prophylaxis

A

valproic acid

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33
Q

Antiepileptic drug that can cause fatal hepatotoxicity and neural tube defects

A

valproic acid

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34
Q

Drug of choice for absence seizures

A

ethosuximide

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35
Q

Mechanism of action of Ethosuximide

A

Blocks T-type calcium channels

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36
Q

Antiepileptic drugs that may also be used for bipolar disorder (3)

A

Valproic acid, carbamazepine, lamotrigine

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37
Q

Antiepileptic drug used also for pain of neuropathic origin

A

gabapentin

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38
Q

Serious side effect of lamotrigine that makes it require slow titration

A

stevens-johnson syndrome

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39
Q

Mechanism of action of opioids on analgesia

A

activate mu receptors

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40
Q

Side effects of these drugs include nausea and vomiting, euphoria, dependence, tolerance, sedation, respiratory depression, constipation

A

opioids

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41
Q

Tolerance to all effects of opioid agonists can develop except (2)

A

miosis, constipation

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42
Q

Strong opioid agonists (4)

A

Morphine, methadone, meperidine, and fentanyl

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43
Q

Opioids used in anesthesia (2)

A

Morphine and fentanyl

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44
Q

Opioid that can be given PO, IV, IM, and intrathecal to relieve anxiety associated with pulmonary edema

A

morphine

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45
Q

Opioid available trans-dermally

A

fentanyl

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46
Q

Opioid with antimuscarinic activity

A

meperidine

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47
Q

Long-acting opioids used in the management of withdrawal states (2)

A

methadone, buprenorphine

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48
Q

Opioid that can cause hyperpyrexic coma with MAOI and serotonin syndrome with SSRI

A

meperidine

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49
Q

Moderate opioid agonists (3)

A

codeine, hydrocodone, oxycodone

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50
Q

Partial opioid agonist that has a long duration of action and is resistant to naloxone reversal

A

buprenorphine

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51
Q

Opioid antagonist that is given IV

A

naloxone

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52
Q

Opioid antagonist that is given orally

A

naltrexone

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53
Q

Opioids indicated for use as antitussive (2)

A

Dextromethorphan, Codeine

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54
Q

Opioids indicated for use as antidiarrheal (2)

A

Diphenoxylate, Loperamide

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55
Q

Directly proportional to the potency of inhalation anesthetics

A

lipid solubility

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56
Q

Inversely proportional to the potency of inhalation anesthetics

A

Minimal alveolar concentration (MAC)

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57
Q

Inversely proportional to the rate of induction and recovery of inhalation anesthetics

A

Blood:gas partition coefficient

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58
Q

Mechanism of action of inhalation anesthetics

A

Potentiation of GABA at GABAA receptors; also reduce Na and Ca influx

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59
Q

Currently the only non-halogenated inhalation anesthetic

A

Nitrous oxide

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60
Q

Inhalation anesthetic with the most analgesic activity

A

nitrous oxide

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61
Q

Inhalation anesthetic with the least respiratory and cardiovascular depression and therefore is used frequently as a component of balanced anesthesia

A

nitrous oxide

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62
Q

Inhalation anesthetic that can cause fatal hepatotoxicity and cardiac arrhythmia and is no longer used in the US

A

halothane

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63
Q

Inhalation anesthetic that is withdrawn from the market due to fatal nephrotoxicity

A

Methoxyflurane

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64
Q

Inhalation anesthetic that at high concentrations can produce CNS excitation, leading to seizures

A

enflurane

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65
Q

Rare, but fatal side effect associated with combination of halogenated inhalation anesthetic and depolarizing neuromuscular blocker

A

malignant hyperthermia

66
Q

Close to ideal inhalation anesthetic that exhibits rapid and smooth induction and recovery, with little organ system toxicity

A

sevoflurane

67
Q

Barbiturate used for the induction of anesthesia

A

thiopental

68
Q

A short-acting benzodiazepine commonly used adjunctively with inhalation anesthetics and opioid analgesics for a balanced anesthesia

A

midazolam

69
Q

Opioid safe for use of analgesia and anesthesia during cardiac surgery

A

fentanyl

70
Q

Produces both rapid anesthesia and recovery, has antiemetic activity, but may cause marked hypotension

A

propofol

71
Q

Produces dissociative anesthesia but has significant analgesic activity

A

ketamine

72
Q

Mechanism of action of ketamine

A

block NMDA receptor

73
Q

Side effects of dissociative anesthetic, ketamine (4)

A

Cardiovascular stimulation, increased cerebral blood flow, vivid dreams, hallucinations

74
Q

Neuroleptanesthesia can be produced by a combination of these two agents

A

Fentanyl and droperidol

75
Q

Mechanism of action of local anesthetics

A

Block voltage-gated sodium channels

76
Q

This condition(environment) may necessitate larger doses of local anesthetics because the drugs become ionized and cannot penetrate the neuronal membranes

A

low pH

77
Q

Almost all local anesthetics have this property and sometimes require the administration of vasoconstrictors to prolong activity

A

vasodilation

78
Q

The only local anesthetic with vasoconstrictive property, but due to abuse potential, only occasionally used for nasal surgery

A

cocaine

79
Q

This type of local anesthetic is more likely to cause hypersensitivity reactions

A

Ester-type (local anesthetic with one “I” in name)

80
Q

Local anesthetic most widely used for obstetric anesthesia but causes the most cardiac depression

A

Bupivacaine

81
Q

Side effect of most local anesthetics

A

CNS excitation

82
Q

Common side effect of antipsychotics, MPTP (contaminant in illicit meperidine analog), and cholinergic excess

A

drug-induced parkinsonism

83
Q

Precursor of dopamine that can cross the blood-brain-barrier and used to alleviate motor dysfunction in Parkinson’s disease

A

levodopa (L-dopa)

84
Q

Inhibits peripheral DOPA decarboxylase, reduces peripheral side effects of dopamine precursor and enhances its delivery to the brain

A

carbidopa

85
Q

Two fluctuations in clinical response associated with long-term use of dopamine precursor

A

“Wearing off” and “on-off-phenomenon”

86
Q

Inhibits monoamine oxidase type B (MAO-B), used as monotherapy for early or mild Parkinson’s disease or adjunct to improve motor function in patients with fluctuations in clinical response

A

Selegiline

87
Q

Inhibits of catechol-O-methyltransferase (COMT), used as adjunct to improve motor function in Parkinson’s patients with fluctuations in clinical response

A

Entacapone, tolcapone

88
Q

Ergot type 2 dopamine receptor (D2) agonist, used as adjunct to improve motor function in Parkinson’s patients with fluctuations in clinical response

A

bromocriptine

89
Q

Non ergot type 2 dopamine receptors (D2) agonist, used for Parkinson’s and restless legs syndrome

A

Pramipexole and ropinirole

90
Q

An antiviral that enhances dopamine release from nigrostriatal neurons

A

amantadine

91
Q

A centrally-acting anticholinergics useful for tremor and rigidity but have little effect on bradykinesia in patients with Parkinson’s

A

benztropine

92
Q

Drug of choice indicated for familial or essential tremors

A

propranolol

93
Q

Two drugs that inhibit vesicle monoamine transporter used for Huntington’s

A

tetrabenazine, resrpine

94
Q

An antipsychotic with dopamine receptor antagonist activity used for Huntington’s

A

haloperidol

95
Q

Three centrally-acting cholinesterase inhibitors used for Alzheimer’s

A

Donepezil, rivastigmine, galantamine

96
Q

Noncompetitive antagonist of NMDA receptors used for Alzheimer’s

A

memantine

97
Q

Three main classes of CNS depressant drugs of abuse

A

alcohol, opioid, barbituates/benzodiazepine

98
Q

Agent that is metabolized by alcohol dehydrogenase or microsomal ethanol-oxidizing system (MEOS) to acetaldehyde; displays zero-order kinetics of elimination

A

ethanol

99
Q

Enzyme that is induced through chronic exposure to alcohol, may contribute to tolerance

A

microsomal ethanol oxidizing system (MEOS)

100
Q

Complications of the gastrointestinal system associated with chronic alcohol use

A

Mallory-Weiss syndrome, hepatitis, cirrhosis, pancreatitis

101
Q

Neurological abnormality caused by chronic alcohol use and thiamine deficiency

A

Wernicke-Korsakoff syndrome

102
Q

The most common neurologic abnormality in chronic alcoholics

A

Neurologic deficits (Peripheral neuropathy)

103
Q

Life-threatening alcohol withdrawal syndrome that peaks at 5 days after the last drink

A

delirium tremens

104
Q

Inhibits aldehyde dehydrogenase and used as deterrent for alcohol use

A

disulfiram

105
Q

Opioid receptor antagonist used to prevent alcohol abuse

A

naltrexone

106
Q

Competes for alcohol dehydrogenase and is used in methanol or ethylene glycol poisoning

A

Fomepizole, ethanol

107
Q

Most commonly abused opioids

A

Heroin, morphine, oxycodone

108
Q

Respiratory and CNS depression, pinpoint pupils, seizures, and needle track marks are symptoms of this intoxication

A

opioid

109
Q

Opioid receptor antagonist that is used to treat opioid intoxication, may cause more rapid and intense symptoms of withdrawal

A

naloxone

110
Q

Opioids used for long-term maintenance from opioid withdrawal

A

methadone, buprenorphine

111
Q

Most widely abused sedative hypnotics

A

short-acting barbiturates (pentobarbital)

112
Q

Two date rape drugs that work through enhancement of GABA receptors in the brain

A

Flunitrazepam, GHB (γ-hydroxybutyrate)

113
Q

Benzodiazepine antagonist used to treat benzodiazepine intoxication

A

flumazenil

114
Q

Four major CNS stimulant drugs of abuse

A

Caffeine, nicotine, cocaine, amphetamines

115
Q

Treatments available for nicotine addiction

A

Patch, gum, lozenge, bupropion, varenicline

116
Q

CNS stimulant that acts by inhibiting reuptake of neurotransmitters; may cause pupil dilation, alter tactile sensation, irregular breathing, and cardiac toxicity

A

cocaine

117
Q

Amphetamine derivatives commonly abused

A

Methamphetamine (crystal meth), MDMA (methylenedioxymeth-amphetamine, or ecstasy)

118
Q

Drug of abuse that was developed as a dissociative anesthetic; intoxication leads to both horizontal and vertical nystagmus, analgesia, psychosis, delirium, and seizures

A

PCP (phencyclidine, or angel dust)

119
Q

Synthetic ergot derivative that can produce perceptual hallucinations and used as an illicit drug; may cause paranoia

A

LSD (lysergic acid diethylamide)

120
Q

Active ingredient is tetrahydrocannabinol (THC); side effects include impairment of judgment, altered sense of time, increased appetite, and hallucinations

A

marijuana

121
Q

Use of all antipsychotic medication in this group of patients is associated with increased risk of deaths

A

Elderly with dementia-related psychosis

122
Q

Antipsychotics that repress primarily the positive symptoms of schizophrenia

A

typical antipsychotics

123
Q

Primary mechanism of action of typical antipsychotics

A

inhibits D2 receptors

124
Q

Common endocrine side effects of all typical antipsychotic drugs

A

Hyperprolactinemia, galactorrhea

125
Q

Two low potency, typical antipsychotic drugs

A

Chlorpromazine, thioridazine

126
Q

Typical antipsychotic associated with retinopathy and cardiac toxicity

A

thioridazone

127
Q

Common side effects of low potency typical antipsychotic drugs

A

Dry mouth (anticholinergic), sedation (antihistamine), hypotension (α1 block)

128
Q

Three high potency, typical antipsychotic drugs

A

Haloperidol, fluphenazine, trifluoperazine

129
Q

Typical antipsychotic that can also be used for Tourette syndrome

A

haloperidol

130
Q

Side effects more commonly associated with high potency typical antipsychotic drugs

A

Dystonia, akathisia, bradykinesia, tardive dyskinesia (extrapyramidal symptoms)

131
Q

Treatment for drug-induced acute extrapyramidal symptoms

A

Benztropine, diphenhydramine

132
Q

Life-threatening side effect associated with typical antipsychotic drugs

A

Neuroleptic malignant syndrome

133
Q

Treatment for drug-induced neuroleptic malignant syndrome

A

dantrolene

134
Q

Advantage of atypical over typical antipsychotics

A

Less extrapyramidal symptoms, more effect against negative symptoms of schizophrenia

135
Q

Primary mechanism of action of atypical antipsychotics

A

Inhibit 5-HT2 receptors

136
Q

Atypical antipsychotic that can produce potentially fatal agranulocytosis and increase incidence of seizures

A

clozapine

137
Q

Two atypical antipsychotics that can cause weight gain

A

Clozapine, olanzapine

138
Q

Two atypical antipsychotics that can prolong the QT interval

A

Risperidone, ziprasidone

139
Q

Atypical antipsychotic that can increase prolactin levels and cause gynecomastia and irregular menstruation in men and women, respectively

A

risperidone

140
Q

Atypical antipsychotic that can also be used to treat irritability in autistic children

A

Aripiprazole

141
Q

Tricyclic antidepressants

A

-iptyline, -ipramine, doxepin, amoxapine

142
Q

Mechanism of action of tricyclic antidepressants

A

Block serotonin and norepinephrine reuptake

143
Q

Common side effects of tricyclic antidepressants

A

Autonomic (block muscarinic and α1), sedation

144
Q

Tricyclic secondary amines that produce less sedation and autonomic side effects (compared with tricyclic tertiary amines)

A

Nortriptyline, desipramine

145
Q

Three life-threatening side effects associated with tricyclic antidepressants

A

convulsion, cardiotoxicity, coma (3 C’s)

146
Q

Tricyclic antidepressant used for enuresis

A

imipramine

147
Q

Tricyclic antidepressant used in obsessive compulsive disorder

A

clomipramine

148
Q

Tricyclic antidepressant with antihistamine effect and is indicated for insomnia

A

doxepin

149
Q

Class of antidepressants that has fewer sedative and autonomic side effects than tricyclic antidepressants and indicated for panic disorder, generalized anxiety disorder, social phobias, bulimia, obsessive compulsive behavior, and post-traumatic stress disorder

A

SSRI

150
Q

Four selective serotonin reuptake inhibitors

A

Fluoxetine, paroxetine, sertraline, citalopram

151
Q

Serious side effect of selective serotonin reuptake inhibitors when used with other drugs such as monoamine oxidase inhibitors, serotonin-norepinephrine reuptake inhibitors, or tricyclic antidepressants

A

serotonin syndrome

152
Q

Two selective serotonin-norepinephrine reuptake inhibitors

A

Duloxetine, venlafaxine

153
Q

Class of drugs that is most useful in patients with anxiety, hypochondriasis, and depression that is refractory to other antidepressants

A

monoamine oxidase inhibitors

154
Q

Mechanism of action of isocarboxazid, phenelzine, and tranylcypromine

A

Irreversible inhibition of monoamine oxidase A and B

155
Q

Mechanism of action of selegiline

A

Selectively inhibits monoamine oxidase B

156
Q

A fatal condition that results from combination of monoamine oxidase inhibitors with tyramine-containing foods

A

Hypertensive crisis

157
Q

Antidepressant that non-selectively inhibits neuronal reuptake; less likely to cause sedation, autonomic, cardiovascular, or sexual dysfunction; also used for smoking cessation

A

Bupropion

158
Q

Antidepressant that inhibits serotonin reuptake but also antagonizes 5HT-2 receptors; causes priapism

A

trazodone

159
Q

Antidepressant that inhibits alpha 2, 5HT-2, and 5HT-3 receptors to increase release of norepinephrine and serotonin

A

mirtazapine

160
Q

First line drug for classic bipolar disorder with euphoric mania

A

lithium

161
Q

Major route of elimination for Lithium

A

kidneys

162
Q

Side effects of lithium (4)

A

Tremor, hypothyroidism, nephrogenic diabetes insipidus, fetal cardiac defects

BOARDS specific notecards (42 decks)

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