Pharmacology Flashcards
1
Q
First line treatment for tonic-clonic seizures
A
Phenytoin/fosphenytoin or valproic acid
2
Q
First line treatment for absence seizures
A
Ethosuximide
3
Q
First line treatment for acute status epilepticus
A
Benzodiazepines
4
Q
First line treatment for prophylaxis of status epilepticus
A
Phenytoin/fosphenytoin
5
Q
Antiseizure not indicated for partial seizures
A
Ethosuximide
6
Q
First line treatment for partial seizures
A
Carbamazepine
7
Q
Drugs indicated for absence seizures
A
Ethosuximide, valproic acid, lamotrigine
8
Q
Side effect of lamotrigine
A
Steven-Johnson syndrome
9
Q
Antiepileptic with zero-order kinetics
A
Phenytoin/fosphenytoin
10
Q
Antiepileptic that is first-line in neonates
A
Phenobarbital
11
Q
Antiepileptics that induce P450
A
Phenobarbital, Carbamazepine, Phenytoin/fosphenytoin (PCP)
12
Q
Antiepileptics that block T-type calcium channels
A
Ethosuximide, Gabapentin
13
Q
Antiepileptics that block sodium channels
A
Topiramate, Lamotrigine, Carbamazepine, Valproic acid, Phenytoin/fosphenytoin
14
Q
Antiepileptics that increase GABA
A
Levetiracetam, Gabapentin, Benzodiazepines, Topiramate, Phenobarbital, Valproic acid, Vigabatrin, Tiagabine
15
Q
Antiepileptics that inhibits the release of glutamate
A
Lamotrigine via blocking of sodium channels
16
Q
Antiepileptics that causes agranulocytosis
A
Carbamazepine
17
Q
Antiepileptics that gingival hyperplasia
A
Phenytoin/fosphenytoin
18
Q
Barbiturate indications
A
Anxiety, seizures, insomnia, anesthesia induction
19
Q
Barbiturates
A
Have suffix -barbital except thiopental
20
Q
Barbiturate used for anesthesia induction
A
Thiopental
21
Q
Barbiturates MOA
A
Increase duration of chloride channel opening
22
Q
Contraindication for barbiturates
A
Porphyrias
23
Q
Short-acting benzos
A
ATOM: Alprazolam Triazolam Oxazepam Midazolam
24
Q
Long-acting benzos
A
Diazepam, lorazepam, temazepam, chlordiazepoxide
25
Benzos MOA
Increase frequency of chloride channel
26
Benzos indicated for status epilepticus
Diazepam and lorazepam
27
Benzos overdose treatment
Flumazenil
28
Non-benzos hypnotics
Zolpidem, Zaleplon, esZopiclone (all ZZZs put to sleep)
29
Non-benzos hypnotics indications
Insomnia
30
Non-benzos hypnotics MOA
BZ1 subtype of the GABA receptor
31
Non-benzos hypnotics effects reversed by what drug
Flumazenil
32
Suvorexant MOA
Orexin receptor antagonist
33
Suvorexant indications
Insomnia
34
Suvorexant contraindications
Narcolepsy, liver disease, and with strong CYP3A4 inhibitors
35
Ramelteon MOA
Melatonin receptor antagonist, binds MT1 and MT2 in suprachiasmatic nucleus
36
Ramelteon indications
Insomnia
37
Triptans MOA
5-HT1b/1d agonist
Inhibit trigeminal nerve activation
Prevent vasoactive peptide release
Induce vasoconstriction
38
Triptans indications
Acute migraine, cluster headache attacks
39
Triptans contraindications
CAD and Prinzmetal angina
40
Triptans side-effects
Serotonin syndrome with other 5-HT agonist
41
Cause of parkinsonism
Loss of dopaminergic neurons and excess cholinergic activity
42
Amantadine MOA
Increase dopamine release, inhibit reuptake
43
Amantadine toxicity
Ataxia, livedo reticularis
44
Carbidopa MOA
Blocks peripheral conversion of L-DOPA increasing dopamine by blocking DOPA decarboxylase
45
Entacapone, tolcapone
Inhibit COMT preventing peripheral L-DOPA degradation to 3-OMD
46
Selegiline
Blocks MAO-B preventing conversion of dopamine to DOPAC
47
Tolcapone
Blocks COMT preventing conversion of dopamine to 3-MT
48
Indication for tetrabenazine and reserpine
Huntington disease
49
Tetrabenazine and reserpine MOA
Inhibit VMAT decreasing dopamine release
50
Haloperidol MOA
D2 receptor antagonist increasing dopamine turnover
51
Indication for riluzole
ALS (increases survival)
52
Riluzole MOA
Decrease glutamate excitotoxicity - mechanism unclear
53
Indication for memantine
Alzheimer disease
54
Memantine MOA
NMDA receptor antagonist - prevents calcium mediated excitotoxicity
55
Memantine adverse effects
Dizziness, confusion, hallucinations
56
AChE inhibitors used for Alzheimer disease
Donepezil, galantamine, rivastigmine, tacrine
57
Potency of lipophilic anesthetics
Increased potency
58
Solubility of anesthetics with rapid induction and recovery times
Decreased solubility in blood
59
Anesthetics with high lipid and blood solubility have what properties
High potency and slow induction
60
Anesthetics with decreased blood and lipid solubility have what properties
Fast induction and low potency
61
Life-threatening adverse reaction of inhaled anesthetics
Malignant hyperthermia
62
Mechanism of malignant hyperthermia
Defective ryanodine receptor cause release of calcium from sarcoplasmic reticulum
63
Treatment for malignant hyperthermia
Dantrolene
64
IV anesthetic used for endoscopy or adjuvant with gaseous anesthetic
Midazolam
65
Midazolam side effects
Decreased BP and anterograde amnesia
66
Midazolam overdose treatment
Flumazenil
67
IV anesthetic that is PCP analog that act as dissociative anesthetic
Ketamine
68
Ketamine MOA
Blocks NMDA receptors
69
Ketamine side effects
Disorientation, hallucination, unpleasant dreams
70
IV anesthetic used for sedation in ICU, rapid anesthesia induction and short procedures
Propofol
71
Propofol MOA
Potentiates GABA-A
72
Indication for IV morphine or fentanyl
Used with other CNS depressants during general anesthesia
73
Local anesthetics (esters)
Procaine, cocaine, Tetracaine, benzocaine
74
Local anesthetics (amides)
Lidocaine, mepivacaine, bupivacaine
75
Nerve fibers most affected by anesthetics
Small, myelinated fibers
76
Fibers least affected by anesthetics
Large, unmyelinated fibers
77
Order of loss of sensation by local anesthetics
Pain - temp - touch - pressure
78
Reason alkaline anesthetics cannot penetrate infected tissue
Infected tissue is acidic
79
Depolarizing NMJ blocking drugs
Succinylcholine
80
Succinylcholine MOA
ACh receptor agonist producing sustained depolarization and prevents muscle contraction
81
Reversal of Succinylcholine blockade
Phase I: Prolonged depolarization (no antidote)
| Phase II: ACh Repolarized but blocked (receptors avail but desensitized)
82
Effect of cholinesterase inhibitors on Phase I of Succinylcholine blockade
Potentiates blockade
83
Effect of cholinesterase inhibitors on Phase II of Succinylcholine blockade
Blockade may be reversed
84
Non-depolarizing NMJ drugs
Tubocurarine, atracurium, mivacurium, pancuronium, vecuronium, rocuronium (all have -cur in name)
85
Non-depolarizing NMJ drugs MOA
ACh receptor competitive antagonist
86
Non-depolarizing NMJ drug used to reverse blockade
Neostigmine (with atropine to prevent muscarinic effects); edrophonium, and other cholinesterase inhibitors
87
Dantrolene MOA
Binds ryanodine receptor stopping calcium release from sarcoplasmic reticulum in skeletal muscle
88
Dantrolene indications
Malignant hyperthermia and neuroleptic malignant syndrome
89
Baclofen MOA
Activates GABA-B receptors at spinal cord level causing skeletal muscle relaxation
90
Baclofen indications
Muscle spasms, MS
91
Cyclobenzaprine MOA
Related to TCAs that relaxes skeletal muscle
92
Cyclobenzaprine indications
Spasms
93
Opioid analgesic MOA
Agonist at opioid receptors inhibiting release of ACh, NE, serotonin, glutamate and substance P
94
Opioid used for diarrhea
Loperamide, diphenoxylate
95
Opioid used for pain and cough suppression
Dextromethorphan
96
Opioid used for acute pulmonary edema or for heroin addiction
Methadone or buprenorphine + naloxone
97
Drug used for opioid relapse prevention once detoxified
Naltrexone
98
Drug used to treat opioid toxicity
Naloxone
99
Naloxone MOA
Opioid receptor antagonist
100
Pentazocine MOA
k-opioid receptor agonist and u-opioid receptor weak antagonist or partial agonist
101
Pentazocine indication
Analgesia for moderate to severe pain
102
Pentazocine side effects
Opioid withdrawal symptoms if also taking full opioid antagonist
103
Butorphanol MOA
k-opioid receptor agonist and u-receptor partial agonist
104
Butorphanol indications
Severe pain
105
Butorphanol side effects
Opioid withdrawal symptoms if also taking full opioid antagonist
106
Tramadol MOA
Very weak opioid agonist; inhibits 5-HT and NE release
107
Tramadol indications
Chronic pain
108
Tramadol side effects
Decreases seizure threshold; Serotonin syndrome
109
Beta-blockers used to decrease aqueous humor synthesis
Timolol, betaxolol, carteolol
110
Diuretic used to decrease aqueous humor synthesis
Acetazolamide (carbonic anhydrase inhibitor)
111
Alpha-agonist used to decrease aqueous humor synthesis
Epinephrine (alpha-1) - via vasoconstriction
| Brimonidine (alpha-2)
112
Alpha-agonist contraindicated in closed-angle glaucoma
Epinephrine - mydriasis
113
Cholinomimetics used to increase outflow of aqueous humor via contraction of ciliary muscle and opening trabecular meshwork
Pilocarpine, carbachol (direct)
| Physostigmine, echothiophate (indirect)
114
Prostaglandins used to increase outflow of aqueous humor via decreased resistance of flow through uveoscleral pathway
Bimatoprost, latanoprost (PGF2-alpha)
