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Neurology > Pharmacology > Flashcards

Pharmacology Flashcards

1
Q

What class is carbamazepine

A

Na channel blocker

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2
Q

what is the indication of carbamazepine

A

Focal epileptic seizures

Trigeminal neuralgia

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3
Q

What are the side effects of carbamazepine

A 
diplopia
ataxia
blood dycrasias
tertogenic 
hyponatraemia
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4
Q

What drug class is phenytoin

A

Na channel blocker

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5
Q

What is the indication of phenytoin

A

Status epilepticus

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6
Q

What are the side effects of phenytoin

A 
Gingival hyperplasia
peripheral neuropathy 
nystagmus
ataxia, sedation 
teratogenic
enzyme inducer 
double vision 
hirsutism
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7
Q

what class is Lamotrigine

A

Na channel blocker

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8
Q

What is the indication of lamotrigine

A

Generalised and focal seizures

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9
Q

What are the side effects of lamotrigine

A

rash and steven johnson syndrome - therefore takes a long time to build up dose
NOT teratogenic
double vision

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10
Q

Drug class of Na valproate

A

Na channel blocker with increased GABA concentration

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11
Q

Indications of Na valproate

A

General epileptic seizures

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12
Q

Side effects of Na valproate

VALPROATE

A 
Teratogenic 
Balding 
Fattening
tremor 
ataxia 
liver dysfunction/toxicity
oedema 
thrombocytopaenia
enchephalopathy
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13
Q

what are the 5 mechanisms of action of analgesia

A

reduce inflammation at site of injury
suppressing nerve conduction
suppressing synaptic transmission
activating descending inhibitory controls
targeting ion channels upregulated (GABA) in nerve damage

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14
Q

what is the difference between opiates and opioids

A 
opiates = plant based drug eg morphine
opioid = any agent that acts upon opioid receptors eg morphine, endogenous substances like endorphins and enkephalins
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15
Q

where is periaqueductal grey found

A

midbrain

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16
Q

where is locus ceruleus found

A

pons

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17
Q

where is nucleus raphe magnus found

A

medulla

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18
Q

excitation of PAG causes profound analgesia/pain

A

analgesia

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19
Q

what substances are released from NRM

A

5HT and enkephalins

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20
Q

what substance is released from LC

A

NA

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21
Q

what happens when endogenous chemicals are released from the NRM and LC

A

they act on the dorsal horn of the spinal cord and inhibit nociceptive transmission

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22
Q

what type of receptor mediates opioid action

A

GPCR

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23
Q

what does GPCR signalling produce and what subunits are responsible

A

inhibition of voltage gated Ca channels to prevent release of neurotransmitter - Gi/o Bgamma subunit pre synaptically
opening of K channels to suppress excitation of post synaptic neuron - Gi/o Bgamma subunit
inhibition of adenylyl cyclase - Gi/o alpha subunit

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24
Q

what are the opioid receptos

A

mu
delta
kappa

25
Q

adverse effects of opioids

A 
addiction 
N+V 
respiratory depression 
postural hypotension 
constipation 
confusion, euphoria, dysphoria, hallucinations, myoclonus
26
Q

what receptor do opioid agonists mostly work on

A

mu receptors

27
Q

how is morphine metabolised

A

liver

28
Q

methods of morphine administration

A

PO, SC, IM, IV, epidural, intrathecal

29
Q

what is heroin

A

diamorphine

30
Q

diamorphine has a rapid/slow onset of action when administered IV

A

rapid

31
Q

codeine can be given IV, true or false

A

FALSE

only given orally

32
Q

when is pethidine used

A

in acute pain eg labour

33
Q

pethidine is suitable for chronic pain, true or false

A

false

it has a short duration

34
Q

buprenorphine is a partial/full agonist

A

partial

35
Q

tramadol is a weak/strong mu agonist

A

weak

36
Q

how is tramadol administered

A

PO

37
Q

in which neurological condition is tramadol contraindicated

A

epilepsy

38
Q

methadone has a long/short half life making it effective as in drug withdrawal

A

long half life

39
Q

how strong is etorphine

A

VERY

only used in large animals

40
Q

fentanyl is used in chronic/acute pain states

A

chronic

41
Q

pethidine should not be used in conjunction with MAO inhibitors, true or false

A

true

42
Q

what is a neurotoxic metabolite of pethidine

A

norpethidine

43
Q

what is naloxone

A

complete opioid mu receptor antagonist

44
Q

how is naloxone administered

A

IM, IV, SC

45
Q

what is naltrexone

A

opioid receptor antagonist

46
Q

how is naltrexone administered

A

PO

47
Q

naltrexone has a shorter half life than naloxone, true or false

A

false

half life of naltrexone is longer than that of naloxone

48
Q

NSAIDs act centrally/peripherally

A

both!

49
Q

what adverse effects arise from
COX 1 inhibition
COX 2 inhibition

A

COX 1 - Peptic ulcer disease

COX 2 - nephrotoxicity

50
Q

selective COX 2 inhibitors are anti/pro thrombotic

A

PRO thrombotic - lead to heart disease

51
Q

subtypes of ACh receptors

A

nicotinic

muscarinic

52
Q

where are nicotinic receptors found

A 
skeletal muscle
parasympathetics
sympathetics
spinal cord 
NMJ
53
Q

where are muscarinic receptors found

A

target organ

peripheral tissues

54
Q

nicotinic receptors are ionotropic/metabotropic and are slow/fast

A

ionotropic

fast

55
Q

muscarinic receptors are ionotropic/metabotropic and are slow/fast

A

metabotropic

slow

56
Q

GABA a mediates

A

Cl-

57
Q

GABA b mediates

A

K+

58
Q

side effects of topiramate

A

cognitive problems

weight loss

59
Q

what is the difference between nociceptive and neuropathic pain

A

nociceptive - response to painful stimulus with an intact nervous system
neuropathic - inappropriate response caused by dysfunctional nervous system

Neurology (25 decks)

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