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Neurology-First Aid 2017 > Pharmacology > Flashcards

Pharmacology Flashcards

1
Q

First line treatment for tonic-clonic seizures

A

Phenytoin/fosphenytoin or valproic acid

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2
Q

First line treatment for absence seizures

A

Ethosuximide

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3
Q

First line treatment for acute status epilepticus

A

Benzodiazepines

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4
Q

First line treatment for prophylaxis of status epilepticus

A

Phenytoin/fosphenytoin

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5
Q

Antiseizure not indicated for partial seizures

A

Ethosuximide

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6
Q

First line treatment for partial seizures

A

Carbamazepine

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7
Q

Drugs indicated for absence seizures

A

Ethosuximide, valproic acid, lamotrigine

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8
Q

Side effect of lamotrigine

A

Steven-Johnson syndrome

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9
Q

Antiepileptic with zero-order kinetics

A

Phenytoin/fosphenytoin

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10
Q

Antiepileptic that is first-line in neonates

A

Phenobarbital

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11
Q

Antiepileptics that induce P450

A

Phenobarbital, Carbamazepine, Phenytoin/fosphenytoin (PCP)

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12
Q

Antiepileptics that block T-type calcium channels

A

Ethosuximide, Gabapentin

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13
Q

Antiepileptics that block sodium channels

A

Topiramate, Lamotrigine, Carbamazepine, Valproic acid, Phenytoin/fosphenytoin

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14
Q

Antiepileptics that increase GABA

A

Levetiracetam, Gabapentin, Benzodiazepines, Topiramate, Phenobarbital, Valproic acid, Vigabatrin, Tiagabine

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15
Q

Antiepileptics that inhibits the release of glutamate

A

Lamotrigine via blocking of sodium channels

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16
Q

Antiepileptics that causes agranulocytosis

A

Carbamazepine

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17
Q

Antiepileptics that gingival hyperplasia

A

Phenytoin/fosphenytoin

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18
Q

Barbiturate indications

A

Anxiety, seizures, insomnia, anesthesia induction

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19
Q

Barbiturates

A

Have suffix -barbital except thiopental

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20
Q

Barbiturate used for anesthesia induction

A

Thiopental

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21
Q

Barbiturates MOA

A

Increase duration of chloride channel opening

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22
Q

Contraindication for barbiturates

A

Porphyrias

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23
Q

Short-acting benzos

A 
ATOM:
Alprazolam
Triazolam
Oxazepam
Midazolam
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24
Q

Long-acting benzos

A

Diazepam, lorazepam, temazepam, chlordiazepoxide

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25
Q

Benzos MOA

A

Increase frequency of chloride channel

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26
Q

Benzos indicated for status epilepticus

A

Diazepam and lorazepam

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27
Q

Benzos overdose treatment

A

Flumazenil

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28
Q

Non-benzos hypnotics

A

Zolpidem, Zaleplon, esZopiclone (all ZZZs put to sleep)

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29
Q

Non-benzos hypnotics indications

A

Insomnia

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30
Q

Non-benzos hypnotics MOA

A

BZ1 subtype of the GABA receptor

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31
Q

Non-benzos hypnotics effects reversed by what drug

A

Flumazenil

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32
Q

Suvorexant MOA

A

Orexin receptor antagonist

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33
Q

Suvorexant indications

A

Insomnia

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34
Q

Suvorexant contraindications

A

Narcolepsy, liver disease, and with strong CYP3A4 inhibitors

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35
Q

Ramelteon MOA

A

Melatonin receptor antagonist, binds MT1 and MT2 in suprachiasmatic nucleus

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36
Q

Ramelteon indications

A

Insomnia

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37
Q

Triptans MOA

A

5-HT1b/1d agonist
Inhibit trigeminal nerve activation
Prevent vasoactive peptide release
Induce vasoconstriction

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38
Q

Triptans indications

A

Acute migraine, cluster headache attacks

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39
Q

Triptans contraindications

A

CAD and Prinzmetal angina

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40
Q

Triptans side-effects

A

Serotonin syndrome with other 5-HT agonist

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41
Q

Cause of parkinsonism

A

Loss of dopaminergic neurons and excess cholinergic activity

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42
Q

Amantadine MOA

A

Increase dopamine release, inhibit reuptake

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43
Q

Amantadine toxicity

A

Ataxia, livedo reticularis

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44
Q

Carbidopa MOA

A

Blocks peripheral conversion of L-DOPA increasing dopamine by blocking DOPA decarboxylase

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45
Q

Entacapone, tolcapone

A

Inhibit COMT preventing peripheral L-DOPA degradation to 3-OMD

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46
Q

Selegiline

A

Blocks MAO-B preventing conversion of dopamine to DOPAC

47
Q

Tolcapone

A

Blocks COMT preventing conversion of dopamine to 3-MT

48
Q

Indication for tetrabenazine and reserpine

A

Huntington disease

49
Q

Tetrabenazine and reserpine MOA

A

Inhibit VMAT decreasing dopamine release

50
Q

Haloperidol MOA

A

D2 receptor antagonist increasing dopamine turnover

51
Q

Indication for riluzole

A

ALS (increases survival)

52
Q

Riluzole MOA

A

Decrease glutamate excitotoxicity - mechanism unclear

53
Q

Indication for memantine

A

Alzheimer disease

54
Q

Memantine MOA

A

NMDA receptor antagonist - prevents calcium mediated excitotoxicity

55
Q

Memantine adverse effects

A

Dizziness, confusion, hallucinations

56
Q

AChE inhibitors used for Alzheimer disease

A

Donepezil, galantamine, rivastigmine, tacrine

57
Q

Potency of lipophilic anesthetics

A

Increased potency

58
Q

Solubility of anesthetics with rapid induction and recovery times

A

Decreased solubility in blood

59
Q

Anesthetics with high lipid and blood solubility have what properties

A

High potency and slow induction

60
Q

Anesthetics with decreased blood and lipid solubility have what properties

A

Fast induction and low potency

61
Q

Life-threatening adverse reaction of inhaled anesthetics

A

Malignant hyperthermia

62
Q

Mechanism of malignant hyperthermia

A

Defective ryanodine receptor cause release of calcium from sarcoplasmic reticulum

63
Q

Treatment for malignant hyperthermia

A

Dantrolene

64
Q

IV anesthetic used for endoscopy or adjuvant with gaseous anesthetic

A

Midazolam

65
Q

Midazolam side effects

A

Decreased BP and anterograde amnesia

66
Q

Midazolam overdose treatment

A

Flumazenil

67
Q

IV anesthetic that is PCP analog that act as dissociative anesthetic

A

Ketamine

68
Q

Ketamine MOA

A

Blocks NMDA receptors

69
Q

Ketamine side effects

A

Disorientation, hallucination, unpleasant dreams

70
Q

IV anesthetic used for sedation in ICU, rapid anesthesia induction and short procedures

A

Propofol

71
Q

Propofol MOA

A

Potentiates GABA-A

72
Q

Indication for IV morphine or fentanyl

A

Used with other CNS depressants during general anesthesia

73
Q

Local anesthetics (esters)

A

Procaine, cocaine, Tetracaine, benzocaine

74
Q

Local anesthetics (amides)

A

Lidocaine, mepivacaine, bupivacaine

75
Q

Nerve fibers most affected by anesthetics

A

Small, myelinated fibers

76
Q

Fibers least affected by anesthetics

A

Large, unmyelinated fibers

77
Q

Order of loss of sensation by local anesthetics

A

Pain - temp - touch - pressure

78
Q

Reason alkaline anesthetics cannot penetrate infected tissue

A

Infected tissue is acidic

79
Q

Depolarizing NMJ blocking drugs

A

Succinylcholine

80
Q

Succinylcholine MOA

A

ACh receptor agonist producing sustained depolarization and prevents muscle contraction

81
Q

Reversal of Succinylcholine blockade

A

Phase I: Prolonged depolarization (no antidote)

Phase II: ACh Repolarized but blocked (receptors avail but desensitized)

82
Q

Effect of cholinesterase inhibitors on Phase I of Succinylcholine blockade

A

Potentiates blockade

83
Q

Effect of cholinesterase inhibitors on Phase II of Succinylcholine blockade

A

Blockade may be reversed

84
Q

Non-depolarizing NMJ drugs

A

Tubocurarine, atracurium, mivacurium, pancuronium, vecuronium, rocuronium (all have -cur in name)

85
Q

Non-depolarizing NMJ drugs MOA

A

ACh receptor competitive antagonist

86
Q

Non-depolarizing NMJ drug used to reverse blockade

A

Neostigmine (with atropine to prevent muscarinic effects); edrophonium, and other cholinesterase inhibitors

87
Q

Dantrolene MOA

A

Binds ryanodine receptor stopping calcium release from sarcoplasmic reticulum in skeletal muscle

88
Q

Dantrolene indications

A

Malignant hyperthermia and neuroleptic malignant syndrome

89
Q

Baclofen MOA

A

Activates GABA-B receptors at spinal cord level causing skeletal muscle relaxation

90
Q

Baclofen indications

A

Muscle spasms, MS

91
Q

Cyclobenzaprine MOA

A

Related to TCAs that relaxes skeletal muscle

92
Q

Cyclobenzaprine indications

A

Spasms

93
Q

Opioid analgesic MOA

A

Agonist at opioid receptors inhibiting release of ACh, NE, serotonin, glutamate and substance P

94
Q

Opioid used for diarrhea

A

Loperamide, diphenoxylate

95
Q

Opioid used for pain and cough suppression

A

Dextromethorphan

96
Q

Opioid used for acute pulmonary edema or for heroin addiction

A

Methadone or buprenorphine + naloxone

97
Q

Drug used for opioid relapse prevention once detoxified

A

Naltrexone

98
Q

Drug used to treat opioid toxicity

A

Naloxone

99
Q

Naloxone MOA

A

Opioid receptor antagonist

100
Q

Pentazocine MOA

A

k-opioid receptor agonist and u-opioid receptor weak antagonist or partial agonist

101
Q

Pentazocine indication

A

Analgesia for moderate to severe pain

102
Q

Pentazocine side effects

A

Opioid withdrawal symptoms if also taking full opioid antagonist

103
Q

Butorphanol MOA

A

k-opioid receptor agonist and u-receptor partial agonist

104
Q

Butorphanol indications

A

Severe pain

105
Q

Butorphanol side effects

A

Opioid withdrawal symptoms if also taking full opioid antagonist

106
Q

Tramadol MOA

A

Very weak opioid agonist; inhibits 5-HT and NE release

107
Q

Tramadol indications

A

Chronic pain

108
Q

Tramadol side effects

A

Decreases seizure threshold; Serotonin syndrome

109
Q

Beta-blockers used to decrease aqueous humor synthesis

A

Timolol, betaxolol, carteolol

110
Q

Diuretic used to decrease aqueous humor synthesis

A

Acetazolamide (carbonic anhydrase inhibitor)

111
Q

Alpha-agonist used to decrease aqueous humor synthesis

A

Epinephrine (alpha-1) - via vasoconstriction

Brimonidine (alpha-2)

112
Q

Alpha-agonist contraindicated in closed-angle glaucoma

A

Epinephrine - mydriasis

113
Q

Cholinomimetics used to increase outflow of aqueous humor via contraction of ciliary muscle and opening trabecular meshwork

A

Pilocarpine, carbachol (direct)

Physostigmine, echothiophate (indirect)

114
Q

Prostaglandins used to increase outflow of aqueous humor via decreased resistance of flow through uveoscleral pathway

A

Bimatoprost, latanoprost (PGF2-alpha)

Neurology-First Aid 2017 (5 decks)

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