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Pharmacology > Pharm2 Sedative/Hypnotic; Anticonvulsants > Flashcards

Pharm2 Sedative/Hypnotic; Anticonvulsants Flashcards

1
Q

CI: porphyria

A

barbs

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2
Q

methohexital and thiopental?

A

barbs

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3
Q

nonbenzos - main use?

  • decreases rem?
  • no effect on rem?
  • long-term insomnia?
A

insomnia
zolpidem (ambien)
zaleplon
eszopiclone

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4
Q

misc sedative/hyp- has become a street drug?

A

meprobamate

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5
Q

misc sedative/hyp for GAD- CAN DRINK ALC

A

buspirone

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6
Q

only other for long term insomnia (besides eszopiclone); IS ONLY SED THAT’S NOT a ?

A

ramalteon, controlled substance!

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7
Q

IBS, high strung women w/ high BP?

A

diazepam

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8
Q

benzo PK

in liver no ? but extensive ?

A

induction, metabolism

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9
Q

benzos

  • T1?
  • near delivery?
A

fetal abn

floppy baby syn/hypotonia

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10
Q

main a/e in benzos?

A

cognitive impairment and dec motor fxn

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11
Q

2 drugs for hepatic disease? have no active metabolites/do not undergo?

A

oxazepam, lorazepam

glucoronidation

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12
Q

PO/IV for dental surgery, endoscopy, cardioversion? CI in ?

A

diazepam (also status eli, anxiety, alc w/drawal

closed angle GLC, m gravis

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13
Q

no active met, int half life, good for w/draw sx

A

lorazepam (everything else same as diazepam)

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14
Q

oral syrup for kids that would ned IV sedation; anxiety for med procedures?
black box?

A

midazolam

resp arrest

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15
Q

acute mania adjunct, long 1/2 life? also?

A

clonazepam

myoclonic, absence seizures

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16
Q

barbas
NOT ?, ?, or ?
can cause ? in elderly

A

analgesia (actually increases pain sensation!), anxiolytic, hypnotic
PARADOXICAL excitement

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17
Q

in barb OD inc excretion of drug by?

A

alkalinizing urine

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18
Q

used in convulsive d/o, status epi, alc w/draw, STRONG ODOR/BAD TASTE- can give IM/rectal

A

paraldehyde

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19
Q

insomnia for institutionalized, bedtime sed** (short half life), ‘knockout drops/slipping one a Mickie’

A

choral hydrate

20
Q 
slow onset- 1 week to kick in-GAD?
can drink alc
NO CROSS TOL/little abuse or addiction
MOA?
CI?
safe in?
A

buspirone
partial agonist at 5HT1a; D2 rec
kidney/liver dz
preggo!

21
Q

binds MT1/MT2 melatonin rec to reg circadian rhythm?

A

ramalteon

22
Q

tx agoraphobia?

A

alprazolam

23
Q

secondary TC different in Tx from simple/complex bc they also use ? and ?

A

phenobarb

primidone

24
Q

used only for complex partial?

A

clorazepate (benzo)

25
Q

primidone (barb) is met into ? actually like 3 drugs

A

PEMA, PHB

26
Q

? is used to tx west syn (infantile spasms)

A

vigabatrin

27
Q

misc- ok in hepatic and liver dz?

A

gabapentin (wt gain)

levetiracetam

28
Q

glycine antagonist on NMDA; misc anticonvulsant? s/e?

A

felbamate

aplastic anemia

29
Q

enhance GABA for anticonvulsants?

A 
benzos
barbs
tigabine
vigabatrin
valproate
30
Q

inhibit Ca channels?

A

zonisamide

ethosuximide

31
Q

increases Na channel INactivation

  • only works on active channel?
  • also inh Ca channels
  • at low levels- first order kin but at high levels?
  • protein bound?
  • monitor?
  • main s/e?
  • still used bc ?
A

phenytoin
zero order
90%
clotting factors (plasma levels), immunosuppression
-osteoporosis, nystagmus, ataxia; less common- hirsutism, gingival hyperplasia
-QID, efficacy, experience

32
Q

fosphenytoin

  • more exp and safer
  • only ?
A

parenteral

33
Q

carbamazepine

  • dont take w/ ?; will reduce levels
  • dont take w/?; toxicity
A

grapefruit, st john’s wort (induces CYP3A4)

macrolides, CCB, cimetidine, propxyphene (inhibit CYP3A4)

34
Q

clonazepam, phenytoin, lamotrigine, valproate, carbamazepine?

A

drugs metabolized by CYP3A4 (drug int)

35
Q

oxcarbazepine

-unlike carbamazepine, no?

A

autoinduction

no active metabolites!

36
Q

partial onset in older than 16?
no drug interactions!
100% BA

A

lacosamide

37
Q 
originally antifolate?
used in ?
safe in ? and ? 
no active metabolites
only drug int?
s/e?
A 
lamotrigine
ALL seizures (adjunct bc new)
elderly, preggo
valproate
rash- SJS
38
Q 
actions:
inhibit Na channel conductance
increase GABA
antagonize kainite and AMPA
RECENT BUT RARE s/e?
A

topiramate

myopia, GLC (immediate drug removal!)

39
Q

actions:
inhibit Na/K conductance
dec Ca influx
dec glutamate excitability

bad s/e?
still used in developing ctrs bc?

A

phenobarbital

sedation
cheap

40
Q

derivative of GABA uptake inhibitor- keeps GABA in synapse? (GABA transporter-1)
? acid
only ? seizures

A

tiaGABine
nipecotic
partial

41
Q

IRREVERSIBLE inhibition of GABA; toxic SO restricted to ?

neurotoxicity and visual impairment

A 
vigatrabine
Wests syn (infantile spasms)
42
Q

treats absence when it has TC too?

A

valproate

43
Q

adjunct in partial seiz for those >12yo?

A

zonisamide

44
Q

little/no action on GABA but looks exactly like it?

A

gabapentin

45
Q

good for liver and kidney dz? 2

also have NO DRUG INT

A

gabapentin (pregabalin)

levetiracetam

Pharmacology (21 decks)

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