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Pharmacology for Neuro Flashcards

1
Q

What classes of drugs can be used to treat glaucoma? (5)

A 
a-agonists
b-blockers
diuretics
cholinomimetics
prostaglandin
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2
Q

When is epinephrine contraindicated for treating glaucoma?

A

Do not use for closed-angle glaucoma

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3
Q

What med should be used emergently to treat glaucoma?

A

Pilocarpine- very effective at opening meshwork into canal of schlemm

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4
Q

What drug used to treat glaucoma can cause darkening of the iris?

A

latanoprost (FGF2a- prostaglandin)

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5
Q

Morphine

A

Opioid analgesic

mu opioid receptor

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6
Q

Enkephalin

A

Opioid analgesic

delta opioid receptor

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7
Q

Dynorphin

A

Opioid analgesic

kappa opioid receptor

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8
Q

What opioid analgesics are used to treat diarrhea?

A

Loperamide, diphenoxylate

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9
Q

What opioid analgesics are used as a cough suppressant?

A

dextromethorphan

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10
Q

What is the mechanism of action of opioid analgesics?

A

modulate synaptic transmission (decr K+ channels, close Ca2+ channels)
inhibit release of ACh, norepinephrine, 5-HT, gultamate, substance P

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11
Q

What treats toxicity of opioid analgesics?

A

naloxone or naltrexone

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12
Q

What are two side effects of opioid analgesics that do not result in tolerance?

A

miosis and costipation

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13
Q

Butorphanol

A

mu-opioid receptor partial agonist and kappa-opioid receptor agonist

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14
Q

What is the advantage of butorphanol over full opioid agonists?

A

causes less respiratory depression

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15
Q

Tramodol

A

very weak opioid agonist; also inhibits serotonin and norepinephrine reuptake

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16
Q

What is an important side effect of tramodol

A

decreases seizure threshold

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17
Q

Mechanism of ethoxusimide

A

blocks thalamic T-type Ca2+ channels

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18
Q

What drugs are used to treat absence seizures

A

ethosuximide, valproic acid, lamotigrine

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19
Q

What drugs are used to treat status epilepticus?

A

diazepam, lorazepam, phenytoin

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20
Q

What is the first line treatment for simple seizures?

A

Carbamazepine

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21
Q

What is the first line treatment for complex seizures?

A

Carbamazepine

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22
Q

What is the first line treatment for tonic-clonic treatment?

A

Carbamazepine, phenytoin, valproic acid

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23
Q

What is the mechanism of phenytoin?

A

incr Na+ channel inactivation

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24
Q

What is the mechanism of carbamazepine?

A

Incr Na+ channel inactivation

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25
What is the mechanism of valproic acid?
Incr Na+ channel inactivation, incr GABA conc by inhibiting GABA transaminase
26
What is the mechanism of benzodiazepines?
incr GABAA action by incr frequency of Cl- channel opening
27
What is the mechanism of barbiturates?
facilitate GABAa action by incr duration of Cl- channel opening, decr neuron firing
28
With what disease are barbiturates contraindicated?
porphyria
29
What is used to treat overdose of benzodiazepines?
flumazenil
30
Zolpidem
nonbenziodiazepine hypnotic | used to treat insomnia
31
Zaleplon
nonbenziodiazepine hypnotic | used to treat insomnia
32
eszopiclone
nonbenziodiazepine hypnotic | used to treat insomnia
33
What are is the mechanism of nonbenziodiazepine hypnotics?
act via BZ1 subtype of GABA receptor
34
Compare the induction and potency of N20 and halothane and how these relate to blood and lipid solubility
N20- decr blood and lipid solubility; fast induction, low potency Halothane- incr lipid and blood solubility; high potency, slow induction
35
What is an important side effect of halothane?
hepatotoxicity
36
What is an important side effect of methoxyflurane?
nephrotoxicity
37
What is an important side effect of enflurane?
proconvlusant
38
What is an important side effect of nitrous oxide?
expansion of trapped gas in a body cavity
39
What is a life threatening complication of inhaled anesthetics? How is this treated?
malignant hyperthermia | dantrolene
40
What IV anesthetic is commonly used for induction of anesthesia and for short surgical procedures?
thiopental (barbiturate)
41
What is the mechanism of propofol?
potentiates GABAa
42
What is the mechanism of ketamine as an IV anesthetic?
Blocks NMDA receptors
43
What IV anesthetic causes isorientation, hallucination, bad dreams?
propofol
44
What IV anesthetic is commonly used for endoscopy?
midazolam (benzo)
45
Give examples of ester vs amide local anesthetics
Ester- procaine, cocaine, tetracaine | amide- lidocaine, mepivacaine, bupivacaine (amide= 2 I's)
46
What local anesthetic causes severe cardiovascular toxicity?
bupivacaine
47
In what order are nerve fibers lost by local anesthetics?
pain temp touch pressure
48
What is the mechanism of local anesthetics?
block Na+ channels by binding specific receptors in inner portion of channel. Preferentially bind activated Na+ channels (most effective in rapidly firing neurons)
49
Succinylcholine
depolarizing neuromusc blocking drug
50
What are the side effects of succinylcholine?
hypercalcemia, hyperkalemia, malignant hyperthermia
51
What are the two phases of blockade for succinycholine?
Phase I: prolonged depolarization | Phase II: repolarized but blocked; ACh receptors are available but desnsitized
52
Dantrolene
used to treat malignant hyperthermia and neuroleptic malignant syndrome prevents release of Ca2+ from sarcoplasmic reticulum of skeletal muscle
53
Tubocuranine, atrocurium...
nondepolarizing neuromusc blocking drugs
54
What is the mechanism of nondepolarizing neuromuscular blocking drugs
competitive antagonist, compete with ACh for receptors
55
Bromocriptine
ergot dopamine agonist | used to treat parkinsons
56
Pramipexole
non-ergot dopamine agonist | used to treat parkinsons
57
ropinirole
non-ergot dopamine agonist | used to treat parkinsons
58
Amatadine
increases dopamine release, used to treat parkinson (also works against influenza A and rubella)
59
What is the toxicity of amatadine?
ataxia
60
levodopa/caribidopa
dopamine analog | passes BBB and converted to dopamine in CNS
61
selegiline
prevents dopamine breakdown (selective MAO type B inhib) treat parkinson
62
benzotropine
antimuscarinic, improves tremor and rigidity but little effect on bradykinesia used to treat Parkinson's
63
Memantine
NMDA receptor antagonist | used to treat Alzheimers
64
Donepezil
AChE inhibitor | used to treat Alzheimer
65
Galantamine
AChE inhibitor | used to treat Alzheimer
66
Rivastigmine
AChE inhibitor | used to treat Alzheimer
67
Sumatriptan
5-HT1B/1D agonist; inhibits tigeminal nerve activation | treats acute migraine and cluster headache attacks

Step 1 (34 decks)

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