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