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Neuro 2 > Pharm 3 > Flashcards

Pharm 3 Flashcards

1
Q

Mydriasis

A

SNS - alpha 1

from sup cervical gang

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2
Q

Ciliary relaxation

A

distance vision
SNS - beta 2
(from sup cervical gang)

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3
Q

Secretion at ciliary body (aqueous humor)

A

SNS - alpha 2, beta 2

from sup cervical gang

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4
Q

Miosis

A

PSNS - M3

travels w. CN 3 from edinger westphal nuc

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5
Q

Lacrimal secretion

A

PSNS M3, M3

CN 7

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6
Q

What do opiates cause in the eye?

A

Pinpoint pupils

- block inhibitory interneurons of E-W nut so it’s always constricting

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7
Q

Muscarinic antagonists and the eye

A
  • for optic neuritis and uveitis
  • cause mydriasis and loss of accommodation
  • not for glaucoma
  • AE: inc. intraocular P, systemic antichol effects
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8
Q

Atropine

A

muscarinic antag for iritis/uveitis in the eye,

causes mydriasis and loss of accommadation

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9
Q

Muscarinic antags for the eye

A 
Atropine
Homotripine
Tropicamide
Cyclopentolate
Scopolamine
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10
Q

Glaucoma treatments

A 
PG analogs
Beta blockers
Diuretics
Cholinomimetics
Alpha Agonists
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11
Q

Dipivefrin, Phenylephrine, Apraclonidine, Brimonidine, Naphazoline, Tetrahydrozoline

A
  • alpha agonists for glaucoma
  • dec. aqueous humor synthesis via vasoconstriction
  • AE: mydriasis, blurry vision, hyperemia, foreign body sensation, hypersensitivity
  • ## Caution in hyperthyroid, HTN, DM, CAD, asthma
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12
Q

Timolol, Levobunolol, Metipranolol, Carteolol

A
  • beta blockers for glaucoma
  • ## blocks ciliary body production of aqueous humor by dec. cAMP and pKA or dec. ocular blood flow
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13
Q

Dorzolamide, Brinzolamide

A
  • carbonic anhydrase inhibitors for glaucoma
  • blocks production of H20 and CO2 from Carbonic acid
  • less water = less aqueous humor
  • Dorzolamide, Brinzolamide
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14
Q

Latanoprost, Travoprost, Bimatoprose

A
  • PG analogs for glaucoma treatment
  • inc. outflow of aqueous humor
  • darkens color of iris, causes hypertrichosis
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15
Q

Afliberecept, Pegaptanib, Ranibizumab, Bevacizumab

A
  • anti VEGF for macular degeneration

- AE: bleeding, thrombosis, stroke, MI

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16
Q

Verteporfin

A
  • for macular degeneration
  • systematized and when hit with a laser causes free radicals and destroys new blood vessels
  • AE: HA, photosensitivity, visual disturbanceq
17
Q

Rx that cause ototoxicity

A

Aminoglycosides (apoptosis by caspase/non)
Cisplatin (caspase apop)
Loop diuretics (block Na/K/2Cl channels)

18
Q

Meclizine

A
  • antihistamine/antichol antiemetic
  • H1 and M1
  • vestibular and vagal blocker
  • CYP2D6 metab
  • AE: drowsiness/dizziness
  • caution in elderly
19
Q

Promethazine

A
  • antihistamine/antichol antiemetic
  • H1 and M1
  • vestibular and vagal blocker
  • CYP2D6 metab
  • AE: drowsiness/dizziness
  • caution in elderly
  • BBW for IV use
20
Q

Diphenhydramine

A
  • antihistamine/antichol antiemetic
  • H1 and M1
  • vestibular and vagal blocker
  • CYP2D6 metab
  • AE: drowsiness/dizziness
  • caution in elderly
21
Q

Scopolamine

A
  • anticholin antiemetic
  • prophylaxis for motion sickness
  • blocks M1 activation and stimulation of CN8 that fires cholinergic to VC
  • patch behind the ear
  • AE: sedation, dry mouth, drowsiness
22
Q

Chlorpromazine

A
  • antidopaminergic (+antihis and antichol) antiemetic
  • not for CINV
  • hepatic metab
  • AE: blood dyscrasias, QT prolongation
23
Q

Prochlorperazine

A
  • antidopaminergic (+antihis and antichol) antiemetic
  • not for CINV
  • hepatic metab
  • AE: blood dyscrasias, QT prolongation
24
Q

Ondansetron

A
  • strongest antiemetics!!
  • 5HT3 antagonist in SI, stomach, CTZ
  • sometimes with dexamethasone to increase potency
  • hepatic metab via CYPs
  • AE: QT prolongation, constipation
  • *dose adjustment with hepatic dysfunction**
25
Q

Granisetron

A
  • strongest antiemetics!!
  • 5HT3 antagonist in SI, stomach, CTZ
  • sometimes given with dex to inc potency
  • hepatic metab via CYPs
  • AE: QT prolongation, constipation
26
Q

Dolasetron

A
  • strongest antiemetics!!
  • 5HT3 antag in SI, stomach, CTZ
  • sometimes given with dex to inc potency
  • heptaic metab via CYPs
  • AE: QT prolongation, constipation
27
Q

Palonesetron

A
  • strongest antiemetics!!
  • 5HT3 antag in SI, stomach, CTZ
  • sometimes given with dex to inc potency
  • hepatic metab via CYPs
  • AE: QT prolongation, constipation
28
Q

Dromabinol or delta 9 tetrahydrocannabinol

A
  • major active substance of marijuana that stimulates CB1 receptor
  • last resort, usually for chemo pts
29
Q

Corticosteroids

A

their own antiemetic effect is though to be due to dec. PG’s

- but usually given with other anti emetics to inc their effects

30
Q

aprepitant/fosaprepitant

A
  • antiemetic
  • Substance P/NK1 receptor antag
  • used adjunct for chemo N/V
  • crosses BBB so acts centrally
  • CYP3A4
31
Q

Benzos as antiemetics

A

Diazepam

  • adjunctive with other anti emetics
  • useful in pts with anticipatory vomiting b/c they cause somnolence/amnesia lasting hours
  • given prior to chemo
32
Q

AG mechanism of ototoxicity

A

enters outer hair cells –> AG-Fe –> reacts with electron donors to produce ROS –> ROS activates JNK –> JNK translocates to nucleus and activates apop genes –> mito –> CytC –> a pop

33
Q

CP mechanism of ototoxicity

A

enters outer hair cells –> aquated to form MHC –> MHC and CP activate NOX-3 producing ROS –> ROS may activate JNK –> nucleus –> mito –> CytC –> a pop

34
Q

Where is the central emesis center?

A
  • lateral reticular formation of mid brainstem adjacent to CTZ and AP at the bottom of the 4th ventricle and STN
  • *no BBB**

Neuro 2 (6 decks)

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