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USMLE Step 1 > Pharmacology-- CNS > Flashcards

Pharmacology-- CNS Flashcards

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USMLE® Step 1 flashcards
1
Q

TOMS

A

Short-acting BDZs:
Triazolam
Onazelam
Midazolam

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2
Q

Butyrophenone

A

Derivatives include: Haloperidol & droperidol

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3
Q

Atypical D4

A

Clozapine-Thiroidazine-Olanzepine-Risperidone= Do not cause EPS

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4
Q

Flumazenil

A

BDZ antidote for OD

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5
Q

Methylphenidate

A

Tx for ADHD (trade name Ritalin)

mech: NE/DA reuptake inhibitor

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6
Q

Phenytoin

A

Antiepileptic, stabilizes the inactive state of voltage-gated Na-channels.
Causes aplastic anemia, gingival hyperplasia, cleft lip & palate
Zero order clearance

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7
Q

Thiopental

A

Short acting barbiturate

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8
Q

Carbamazepine

A

DOC for trigeminal neuralgia
Tx lennox gastaut syndrome in kids
tradename: tegretol (also used for BP)

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9
Q

Atypical DA antagonists

A

Thioridazine, Olanzapine, Clozapine

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10
Q

Pimozide

A

antipsychtoic, DA-antagonist

Tx Tourette’s, scz

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11
Q

Risperidone

A

Atypical antipsychotic, good for negative sx

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12
Q

Thioridazine

A

Most anticholinergic of the neuroleptics

atypical antipsychotic

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13
Q

Haloperidol

A

Typical antipsychotic

Neuroleptic malignant hyperthermia due to chronic DA-2R block. Give dantrolene and bromocriptine to tx

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14
Q

Imipramine

A

TCA

Tx: Enuresis

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15
Q

Clomipramine

A

TCA
Tx: OCD
See aggressive behavior w/ use

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16
Q

Trazodone

A

SARI – 5HT antagonist & reuptake inhibitor

May cause PRIAPISM

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17
Q

Buproprion

A

NE-DA reuptake inhibitor

Depression and smoking cessation**

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18
Q

SSRIS

A

MDE & OCD

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19
Q

Fluoxetine

A

SSRI

“good for negative sx”…the fuck does that mean?

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20
Q

Phenelzine

A

Irreversible MAO-I

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21
Q

Lithium

A

Tx: manic phase of BP
SEs:Causes goiter by inhibiting conversion of T4 to T3;Causes nephrogenic DI (thus can be used to tx SIADH);Low salf diet will lead to Li tox

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22
Q

Alprazolam

A

Short acting benzo

Tx: anxiety d/os (social phobia, PD, GAD, etc)

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23
Q

Propranolol

A

Nonselective beta-blocker

tx: performance anxiety

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24
Q

opioid kappa-receptor (κ-r)

A

Spinal analgesia. Euphoria. ++euphoria. ++sedation. Constipation.
Per wikipedia: analgesia, sedation, miosis, inhib. of ADH release, dysphoria

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25
Q

opioid mu-receptor (μ-r)

A

supraspinal analgesia?
μ1: analgesia,physical dependence
μ2: respiratory depression,miosis, euphoria, red.GI motilityphysical dependence
μ3: possible vasodilation

26
Q

Morphine & O2

A

Admin. is contraindicated for pt.s on morphine.

Sedation: Dec. CO2 sensitivity, and O2 admin can lead to dec. resp drive–> stop breathing

27
Q

Morphine

A

Opioid analgesic, acts predom. at mu-receptor

Inc ICP= do NOT give to pt w head trauma!

28
Q

Morphine OD

A

Signs: pin-point pupils, Dec. respiration, coma
Tx: Naloxone

29
Q

Meperidine

A

Mu receptor agonist, some kappa activity
Anesthetic used during labor
aka Demerol

30
Q

Hydromorphone

A

mu-r agonist (morphine deriv)

used in renal failure…why? it’s cleared renally

31
Q

Tramadol

A

Ambulatory tx for mod-severe pain

Mech:weak μ-r agonist, induces 5HT release, and inhibits the reuptake of NE

32
Q

Naloxone

A

Tx for Opiod OD, opiate R antagonist
Reverses respiratory dep
Used in suboxone–> no oral availability

33
Q

Pentazocine

A

“mixed agonist-antagonist narc”–>Part κ(+) & part μ(-)

Tx: pain

34
Q

Butorphanol

A

Part κ(+) & part μ(-)

Intranasal for migraine, oral for pain

35
Q

Nalbuphene

A

Part κ(+) & part μ(-)

36
Q

Inc GABA

A

Decrease seizure focus = barbs and benzos

37
Q

Decreased Fast Na Channel Activity

A

Dec electrical activity spread= phenytoin & carbamazepine

38
Q

Methoxyflurane

A

Volatile inhaled anesthetic

Can be nephrotoxic. Needs low MAC (min. alveolar concen.) for anesthetic induction

39
Q

Enflurane

A

Volatile inhaled anesthetic
Can be nephrotoxic
Can cause tonic/clonic muscle spasms

40
Q

Isoflurane

A

Volatile inhaled anesthetic

can cause bronchospasm

41
Q

Halothane

A

Volatile inhaled anesthetic

Can cause ventricular extrasystoles & Malignant hyperthermia & Hepatitis

42
Q

Nitrous Oxide

A

Volatile inhaled anesthetic (N2O…NOT NO!!)

No effect on HR. Needs High MAC for anesthetic induction

43
Q

Thiopental

A

Short acting barb

44
Q

Ketamine

A

Dissociative anesthetic

45
Q

Droperidol

A

Can be used in combo w fentanyl for neuroleptoanalgesic effect
Used transdermally for chronic pain
Anti-DA drug

46
Q

Fentanyl

A

Can be used in combo w Droperidol for neuroleptoanalgesic effect. Neuroleptic tranq, has mild alpha block

47
Q

Midazolam

A

pre-anesthetic. Induces amnesia

48
Q

Primidone

A

Biotransformed to phenobarb

49
Q

C& A delta fibers

A

first fibers to be blocked w anesthesia

50
Q

Esters

A

Local anesthetics
Procaine, Tetracain, benzocaine. Break down and yield PABA (allergen)
“caines” are locals

51
Q

Amides

A

Local anesthetics
Lidocaine, Mepivaciane, Bupivaciane, Etidocaine= “i” before “caine” always an amide
metabolized in the liver

52
Q

Amphetamine

A

DA reuptake inhibitor. MAOI,

Parkinson’s Tx

53
Q

Bromocriptine

A

D2 agonist. Used w L-Dope for “on-off” phenomenon in Parkinson’s

54
Q

Benzotropine

A

Anti muscarinic w some Da reuptake inhibition. Tx: Parkinson’s

55
Q

Amantadine

A

Dec Da reuptake centrally. Tx: Parkinson’s

Can cause livido reticularis = skin mottling

56
Q

Diphenhydramine (DPH)

A

First gen anti-histamine,
Tx: early parkinson’s for antichoinergic effects
Rxed for sleep disturbance

57
Q

Pergolide

A

More effective and longer acting than bromocriptine for Pd. DA and 5HT agonist
WITHDRAWN FROM US MARKET IN 2007
(no ergoline derivs on market)

58
Q

Ethosuximide

A

DOC for absence seizures

Mech poorly understood

59
Q

Tranylcypromine

A

MAOI

60
Q

SSRI & MAOI

A

fatal combo, especially w Paroxetine or fluoxetine plus tranylcypromine

61
Q

Labor opioids

A

Meperidine and nalbuphine

62
Q

Desipramine

A

TCA

Causes sudden cardiac death in children!

USMLE Step 1 (9 decks)

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