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0
Q

Give 3 examples of cholinesterase inhibitors…

A

Donepezil Galantamine Rivastigmine

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1
Q

How do you treat Alzheimer’s?

A

Cholinesterase inhibitors Partial NMDAR antagonist

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2
Q

Give an example of Partial NMDAR antagonist…

A

Memantine

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3
Q

How do you treat Parkinson’s?

A

Levodopa DA receptor agonists MAO inhibitors COMT inhibitor Anticholinergics NMDAR antagonist Amantadine

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4
Q

Give 2 examples of Levodopa…

A

Sinemet Atamet Parcopa

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5
Q

Give 3 examples of DA receptor agonists…

A

Pramipexole Ropinirole Rotigotine

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6
Q

Give 2 examples of MAO inhibitors

A

Selegiline Rasagiline

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7
Q

Give 2 examples of COMT inhibitors…

A

Entacapone Tolcapone

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8
Q

Give 3 examples of Anticholinergics…

A

Trihexyphenidyl Benztropine Ethopropazine

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9
Q

Example of NMDAR antagonist…

A

Memantine

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10
Q

What does Amantadine do?

A

DA agonist NMDAR antagonist

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11
Q

How do you treat Anxiety? (Anxiolytics)

A

Antidepressants - SSRI, SNRI Benzodiazepines Barbiturates 5HT1A receptor agonists B adrenoceptor antagonists Antipsychotics Antiepileptics & antihistamines

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12
Q

What is the action of Benzodiazepines & Barbiturates?

A

GABAA Receptor Agonist

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13
Q

Give 2 examples of antidepressants…

A

Citalopram (SSRI) Venlafaxine (SNRI)

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14
Q

Example of a Benzodiazepine…

A

Nitrazepam

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15
Q

Example of a Barbiturate…

A

Phenobarbitone

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16
Q

Give 3 examples of 5HT receptor agonists…

A

Buspirone Ipsapirone Gepirone

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17
Q

Example of B adrenoceptor antagonist

A

Propanolol

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18
Q

Give 2 examples of Antipsychotics…

A

Olanzepine Risperidone

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19
Q

Anti epileptic examples

A

Gabapentin Pregabalin Valproate

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20
Q

Antihistamine examples

A

Diphenhydramine Promethazine

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21
Q

Hypnotic examples

A

Zopiclone Zolpidem Chloral hydrate

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22
Q

What anxiety disorder are 5HT receptor agonists best used in?

A

MILD anxiety

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23
Q

What anxiety disorders are Anti-psychotics best used in?

A

Generalised Anxiety Disorder & Post-traumatic Stress

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24
What effect do B-adrenoceptor antagonists have on Anxiety?
They remove peripheral symptoms - palpitations, sweating, tremor
25
What are the negatives of Benzodiazepines & Barbiturates?
TOLERANCE & PHYSICAL DEPENENCE (Also Barbiturates not recommended as high dose = anaesthesia & death)
26
Which group of anxiolytics should not be taken with alcohol?
Benzodiazepines cause respiratory depression
27
Which groups of anxiolytics are also sedatives & hypnotics?
Benzodiazepines & Barbiturates
28
Mechanism of MS
Inflammatory stage - autoimmune attack of oligodendrocytes Degenerative stage - loss of axons, CNS atrophy Remyelination FAILURE
31
Name 3 emerging ORAL therapies for MS...
Fingolimod Dimethylfumarate Teriflunomide
32
Name 2 emerging non-oral therapies for MS...
Natalizumab Alemtuzumab
33
Which is the only MS treatment to decrease disability not just reduce relapses? (Emerging drug)
Alemtuzumab
34
Do neurones take longer to remyelinate in the CNS or PNS?
CNS
35
How do you diagnose MS?
Oligoclonal bands in the CSF, but NOT in the blood
41
How do you treat MS?
Corticosteroid therapy - methylprednisolone Interferons & Glatiramer
47
What is the FIRST-LINE treatment for depression?
Selective serotonin reuptake inhibitors (fluoxetine, paroxetine, citalopram) OR Mirtazapine (a2adrenoceptor+5HTantag)
48
What is the SECOND-LINE treatment for depression?
Monoamine Oxidase Inhibitors (Iproniazid, Phenelzine, Moclobemide)
49
What is the 'cheese reaction'?
Irreversible MAO inhibitors inhibit the metabolism of amines (eg. Tyramine) in the gut -\> high levels tyramine in the blood -\> hypertension & intracranial haemorrhage as tyramine has sympathomimetic effect. NB.Tyramine found in cheese. Amphetamine, alcohol & pethidine (opioid) also counter-indicative
50
Main side effect of MAO inhibitors?
Cheese reaction
51
Main side effect of Tricyclic antidepressants?
Cardiotoxicity
52
What else can SSRIs be used to treat?
Anxiety
53
What is amytriptyline now more commonly used to treat than depression?
Chronic pain Migraine prophylaxis
54
First & second line treatment for manic depression (bipolar)?
1)Lithium or Carbamazepine 2)Valproate
55
First & Second line prophylaxis for manic depression (bipolar)?
1)Lithium or Olanzepine 2)Carbamazepine
56
How do you treat Schizophrenia?
Typical & Atypical Antipsychotics
57
What receptors do typical and Atypical antipsychotics block?
T: D2Rs At: D2, 5HT2a, 5HT2c
58
Examples of Typical Antipsychotics
Chlorpromazine Haloperidol Fluphenazine Flupenthixol Clopenthixol
59
Examples of Atypical Antipsychotics
Aripiprazole Clozapine Risperidone Sertindole Quetiapine Amisulpride Zotepine
60
Are typical or Atypical antipsychotics better? Why?
Atypical - fewer extra pyramidal side effects, efficacy in treatment resistant patients, treat positive AND negative symptoms?
61
Function of pathways: Mesocorticolimbic Nigrostriatal Tuberoinfundibular
Reward Motor control Hormone secretion
62
Neurotransmitter changes in schizophrenia:
DA hypErfunction 5HT hypErfunction Glutamate hypOfunction
63
Best Atypical antipsychotic? Why?
Aripiprazole D2R PARTIAL AGONIST Blocks D2Rs where DA high, Agonises D2Rs where DA low. Prevent total blockade i.e conserve nigrostriatal function
64
How long for Antipsychotics to take effect?
Weeks
65
First and second line antipsychotic treatment in schizophrenia...
1) Risperidone, Quetiapine, Zotepine 2) Clozapine Haloperidol in severe schizo
66
Action of anti-epileptic drugs...
Increase inhibitory synaptic transmission Decrease excitatory synaptic transmission
67
Anti-epileptics increase inhibition by: 4 ways
Potentiate GABA action at GABAA receptors Inhibit GABA reuptake Inhibit GABA transaminase & SSA dehydrogenase (degradation) Activate K+ channels = hyperpolarisation
68
Anti-epileptics decrease excitation by: 2 ways
Block Na+ & Ca2+ channels Antagonise AMPA & NMDA receptors
69
Anti-epileptics that Potentiate GABA action at GABAA receptors:
Benzodiazepines (clobazam, midazolam, diazepam, lorazepam) Sodium Valproate Phenobarbitone Felbamate
70
Anti-epileptics that Inhibit GABA reuptake:
Tiagabine
71
Anti epileptics that Inhibit GABA transaminase & SSA dehydrogenase (degradation):
1)Vigabatrin 2)Sodium valproate
72
Anti epileptics that Activate K+ channels:
Retigabine
73
Antiepileptics that Block Na+ & Ca2+ channels:
Na: carbamazepine, oxcarbazepine, phenytoin, sodium valproate, lamotrigine, zonisamide Ca: ethosuximide, sodium valproate, lamotrigine, phenytoin, gabapentin
74
Antiepileptics that antagonise AMPA & NMDA receptors:
Perampanel Felbamate
75
Other Antiepileptics:
Topiramate - blocks Na Ca channels, potentiates GABA, block AMPA Levetiracetam - prevents glutamate exocytosis
76
Learn which Antiepileptics to use for which type of seizure???????????
?????
77
What clinical use does Lignocaine have?
Local anaesthetic - surface, infiltration, intravenous, nerve block, spinal, epidural
78
What clinical use does Prilocaine have?
Local anaesthetic - surface, infiltration, intravenous, nerve block, spinal
79
What clinical use does tetracaine have?
Local anaesthetic - spinal (+ all of them do infiltration and nerve block)
80
What clinical use does benzocaine have?
Local anaesthetic - surface (+ infiltration and nerve block)
81
What clinical use does Bupivacaine have?
Local anaesthetic - epidural (+ infiltration and nerve block)
82
Name the injectable general anaesthetics...
General: Thiopental, propofol, etomidate Dissociative: ketamine, pcp Sedative: benzodiazepines
83
Name the inhalational general anaesthetics...
Nitrous oxide Halothane Enflurane, isoflurane, desflurane, sevoflurane, methoxyflurane
84
Name some opioids...
Morphine, dimorphine (heroin), codeine, methadone, tramadol
85
How do you treat depression?
Typical and Atypical Antidepressants
86
Typical antidepressants are:
Mono amine oxidase inhibitors Tricyclic antidepressants SSRIs SNRIs
87
Atypical Antidepressants are:
Serotonin-noradrenaline reuptake inhibitors Serotonin (5HT2) antagonists + SNRI/SSRI a2 adrenoceptor + 5HT antag Melatonin agonist + 5HT antag
88
Give 2 examples of MAO inhibitors...
Iproniazid Moclobemide
89
Give 4 examples of Tricyclic Antidepressants
Imipramine Amitriptyline (NA/5HT) Clomipramine (5HT) Desipramine (NA)
90
3 examples of SSRIs...
Fluoxetine Paroxetine Citalopram
91
Example of a SNRI...
Reboxetine
92
Example of a S&N reuptake inhibitor...
Venlafaxine
93
Example of a 5HT antag + SNRI/SSRI...
Nafezedone
94
Example of 5HT antag + SSRI...
Trazodone
95
Example of a2 adrenoceptor & 5HT antag
Mianserin Mirtazapine
96
Example of melatonin agonist + 5HT antag
Agomelatine
97
Which med treats Atonic and Tonic epilepsy fits? (And what happens in the fit?)
Sodium Valproate (A= fall limp. T= fall stiff)
98
Which meds treat Tonic Clonic epilepsy fits? (And what happens in the fit?)
Carbamazepine, Oxcarbazepine, Lamotrigine, Sodium Valproate (Jerks of whole body) \* C, azepine.
99
Which meds treat Myoclonic epilepsy fits? (And what happens in the fit?)
Levitiracetam, Topiramate, Sodium Valproate (Jerks of body parts) YOyo, LEVItate, spinning TOP
100
Which meds treat Absence epilepsy fits? (And what happens in the fit?)
Lamotrigine, Ethosuximide, Sodium Valproate (Staring, blinking) \*mary Lost her LAMb, it SUX.
101
Treat withdrawal:
Alpha 2 adrenoceptor Agonists (Clonidine, lofexidone)
102
Treat craving:
NMDAR Antagonists (baclofen, acamprosate) Anti-epileptics (topiramate, lamotrigine)
103
Treat opioid addiction:
Methadone Naltrexone
104
Treat alcohol addiction:
Disulfiram makes alcohol aversive: causes flushing, tachycardia, hyperventilation, panic. (Inhibits aldehyde dehydrogenase leading to build up of acetaldehyde)
105
# Reversed Cholinesterase inhibitors Partial NMDAR antagonist
How do you treat Alzheimer's?
106
# Reversed Donepezil Galantamine Rivastigmine
Give 3 examples of cholinesterase inhibitors...
107
# Reversed Memantine
Give an example of Partial NMDAR antagonist...
108
# Reversed Levodopa DA receptor agonists MAO inhibitors COMT inhibitor Anticholinergics NMDAR antagonist Amantadine
How do you treat Parkinson's?
109
# Reversed Sinemet Atamet Parcopa
Give 2 examples of Levodopa...
110
# Reversed Pramipexole Ropinirole Rotigotine
Give 3 examples of DA receptor agonists...
111
# Reversed Selegiline Rasagiline
Give 2 examples of MAO inhibitors
112
# Reversed Entacapone Tolcapone
Give 2 examples of COMT inhibitors...
113
# Reversed Trihexyphenidyl Benztropine Ethopropazine
Give 3 examples of Anticholinergics...
114
# Reversed Memantine
Example of NMDAR antagonist...
115
# Reversed DA agonist NMDAR antagonist
What does Amantadine do?
116
# Reversed Antidepressants - SSRI, SNRI Benzodiazepines Barbiturates 5HT1A receptor agonists B adrenoceptor antagonists Antipsychotics Antiepileptics & antihistamines
How do you treat Anxiety? (Anxiolytics)
117
# Reversed GABAA Receptor Agonist
What is the action of Benzodiazepines & Barbiturates?
118
# Reversed Citalopram (SSRI) Venlafaxine (SNRI)
Give 2 examples of antidepressants...
119
# Reversed Nitrazepam
Example of a Benzodiazepine...
120
# Reversed Phenobarbitone
Example of a Barbiturate...
121
# Reversed Buspirone Ipsapirone Gepirone
Give 3 examples of 5HT receptor agonists...
122
# Reversed Propanolol
Example of B adrenoceptor antagonist
123
# Reversed Olanzepine Risperidone
Give 2 examples of Antipsychotics...
124
# Reversed Gabapentin Pregabalin Valproate
Anti epileptic examples
125
# Reversed Diphenhydramine Promethazine
Antihistamine examples
126
# Reversed Zopiclone Zolpidem Chloral hydrate
Hypnotic examples
127
# Reversed MILD anxiety
What anxiety disorder are 5HT receptor agonists best used in?
128
# Reversed Generalised Anxiety Disorder & Post-traumatic Stress
What anxiety disorders are Anti-psychotics best used in?
129
# Reversed They remove peripheral symptoms - palpitations, sweating, tremor
What effect do B-adrenoceptor antagonists have on Anxiety?
130
# Reversed TOLERANCE & PHYSICAL DEPENENCE (Also Barbiturates not recommended as high dose = anaesthesia & death)
What are the negatives of Benzodiazepines & Barbiturates?
131
# Reversed Benzodiazepines cause respiratory depression
Which group of anxiolytics should not be taken with alcohol?
132
# Reversed Benzodiazepines & Barbiturates
Which groups of anxiolytics are also sedatives & hypnotics?
133
# Reversed Inflammatory stage - autoimmune attack of oligodendrocytes Degenerative stage - loss of axons, CNS atrophy Remyelination FAILURE
Mechanism of MS
134
# Reversed Fingolimod Dimethylfumarate Teriflunomide
Name 3 emerging ORAL therapies for MS...
135
# Reversed Natalizumab Alemtuzumab
Name 2 emerging non-oral therapies for MS...
136
# Reversed Alemtuzumab
Which is the only MS treatment to decrease disability not just reduce relapses? (Emerging drug)
137
# Reversed CNS
Do neurones take longer to remyelinate in the CNS or PNS?
138
# Reversed Oligoclonal bands in the CSF, but NOT in the blood
How do you diagnose MS?
139
# Reversed Corticosteroid therapy - methylprednisolone Interferons & Glatiramer
How do you treat MS?
140
# Reversed Selective serotonin reuptake inhibitors (fluoxetine, paroxetine, citalopram) OR Mirtazapine (a2adrenoceptor+5HTantag)
What is the FIRST-LINE treatment for depression?
141
# Reversed Monoamine Oxidase Inhibitors (Iproniazid, Moclobemide)
What is the SECOND-LINE treatment for depression?
142
# Reversed Irreversible MAO inhibitors inhibit the metabolism of amines (eg. Tyramine) in the gut -\> high levels tyramine in the blood -\> hypertension & intracranial haemorrhage as tyramine has sympathomimetic effect. NB.Tyramine found in cheese. Amphetamine, alcohol & pethidine (opioid) also counter-indicative
What is the 'cheese reaction'?
143
# Reversed Cheese reaction
Main side effect of MAO inhibitors?
144
# Reversed Cardiotoxicity
Main side effect of Tricyclic antidepressants?
145
# Reversed Anxiety
What else can SSRIs be used to treat?
146
# Reversed Chronic pain Migraine prophylaxis
What is amytriptyline now more commonly used to treat than depression?
147
# Reversed 1)Lithium or Carbamazepine 2)Valproate
First & second line treatment for manic depression (bipolar)?
148
# Reversed 1)Lithium or Olanzepine 2)Carbamazepine
First & Second line prophylaxis for manic depression (bipolar)?
149
# Reversed Typical & Atypical Antipsychotics
How do you treat Schizophrenia?
150
# Reversed T: D2Rs At: D2, 5HT2a, 5HT2c
What receptors do typical and Atypical antipsychotics block?
151
# Reversed Chlorpromazine Haloperidol Fluphenazine Flupenthixol Clopenthixol
Examples of Typical Antipsychotics
152
# Reversed Aripiprazole Clozapine Risperidone Sertindole Quetiapine Amisulpride Zotepine
Examples of Atypical Antipsychotics
153
# Reversed Atypical - fewer extra pyramidal side effects, efficacy in treatment resistant patients, treat positive AND negative symptoms?
Are typical or Atypical antipsychotics better? Why?
154
# Reversed Reward Motor control Hormone secretion
Function of pathways: Mesocorticolimbic Nigrostriatal Tuberoinfundibular
155
# Reversed DA hypErfunction 5HT hypErfunction Glutamate hypOfunction
Neurotransmitter changes in schizophrenia:
156
# Reversed Aripiprazole D2R PARTIAL AGONIST Blocks D2Rs where DA high, Agonises D2Rs where DA low. Prevent total blockade i.e conserve nigrostriatal function
Best Atypical antipsychotic? Why?
157
# Reversed Weeks
How long for Antipsychotics to take effect?
158
# Reversed 1) Risperidone, Quetiapine, Zotepine 2) Clozapine Haloperidol in severe schizo
First and second line antipsychotic treatment in schizophrenia...
159
# Reversed Increase inhibitory synaptic transmission Decrease excitatory synaptic transmission
Action of anti-epileptic drugs...
160
# Reversed Potentiate GABA action at GABAA receptors Inhibit GABA reuptake Inhibit GABA transaminase & SSA dehydrogenase (degradation) Activate K+ channels = hyperpolarisation
Anti-epileptics increase inhibition by: 4 ways
161
# Reversed Block Na+ & Ca2+ channels Antagonise AMPA & NMDA receptors
Anti-epileptics decrease excitation by: 2 ways
162
# Reversed Benzodiazepines (clobazam, midazolam, diazepam, lorazepam) Sodium Valproate Phenobarbitone Felbamate
Anti-epileptics that Potentiate GABA action at GABAA receptors:
163
# Reversed Tiagabine
Anti-epileptics that Inhibit GABA reuptake:
164
# Reversed 1)Vigabatrin 2)Sodium valproate
Anti epileptics that Inhibit GABA transaminase & SSA dehydrogenase (degradation):
165
# Reversed Retigabine
Anti epileptics that Activate K+ channels:
166
# Reversed Na: carbamazepine, oxcarbazepine, phenytoin, sodium valproate, lamotrigine, zonisamide Ca: ethosuximide, sodium valproate, lamotrigine, phenytoin, gabapentin
Antiepileptics that Block Na+ & Ca2+ channels:
167
# Reversed Perampanel Felbamate
Antiepileptics that antagonise AMPA & NMDA receptors:
168
# Reversed Topiramate - blocks Na Ca channels, potentiates GABA, block AMPA Levetiracetam - prevents glutamate exocytosis
Other Antiepileptics:
169
# Reversed ?????
Learn which Antiepileptics to use for which type of seizure???????????
170
# Reversed Local anaesthetic - surface, infiltration, intravenous, nerve block, spinal, epidural
What clinical use does Lignocaine have?
171
# Reversed Local anaesthetic - surface, infiltration, intravenous, nerve block, spinal
What clinical use does Prilocaine have?
172
# Reversed Local anaesthetic - spinal (+ all of them do infiltration and nerve block)
What clinical use does tetracaine have?
173
# Reversed Local anaesthetic - surface (+ infiltration and nerve block)
What clinical use does benzocaine have?
174
# Reversed Local anaesthetic - epidural (+ infiltration and nerve block)
What clinical use does Bupivacaine have?
175
# Reversed General: Thiopental, propofol, etomidate Dissociative: ketamine, pcp Sedative: benzodiazepines
Name the injectable general anaesthetics...
176
# Reversed Nitrous oxide Halothane Enflurane, isoflurane, desflurane, sevoflurane, methoxyflurane
Name the inhalational general anaesthetics...
177
# Reversed Morphine, dimorphine (heroin), codeine, methadone, tramadol
Name some opioids...
178
# Reversed Typical and Atypical Antidepressants
How do you treat depression?
179
# Reversed Mono amine oxidase inhibitors Tricyclic antidepressants SSRIs SNRIs
Typical antidepressants are:
180
# Reversed Serotonin-noradrenaline reuptake inhibitors Serotonin (5HT2) antagonists + SNRI/SSRI a2 adrenoceptor + 5HT antag Melatonin agonist + 5HT antag
Atypical Antidepressants are:
181
# Reversed Iproniazid Moclobemide
Give 2 examples of MAO inhibitors...
182
# Reversed Imipramine Amitriptyline (NA/5HT) Clomipramine (5HT) Desipramine (NA)
Give 4 examples of Tricyclic Antidepressants
183
# Reversed Fluoxetine Paroxetine Citalopram
3 examples of SSRIs...
184
# Reversed Reboxetine
Example of a SNRI...
185
# Reversed Venlafaxine
Example of a S&N reuptake inhibitor...
186
# Reversed Nafezedone
Example of a 5HT antag + SNRI/SSRI...
187
# Reversed Trazodone
Example of 5HT antag + SSRI...
188
# Reversed Mianserin Mirtazapine
Example of a2 adrenoceptor & 5HT antag
189
# Reversed Agomelatine
Example of melatonin agonist + 5HT antag
190
# Reversed Sodium Valproate (A= fall limp. T= fall stiff)
Which med treats Atonic and Tonic epilepsy fits? (And what happens in the fit?)
191
# Reversed Carbamazepine, Oxcarbazepine, Lamotrigine, Sodium Valproate (Jerks of whole body) \* C, azepine.
Which meds treat Tonic Clonic epilepsy fits? (And what happens in the fit?)
192
# Reversed Levitiracetam, Topiramate, Sodium Valproate (Jerks of body parts) YOyo, LEVItate, spinning TOP
Which meds treat Myoclonic epilepsy fits? (And what happens in the fit?)
193
# Reversed Lamotrigine, Ethosuximide, Sodium Valproate (Staring, blinking) \*mary Lost her LAMb, it SUX.
Which meds treat Absence epilepsy fits? (And what happens in the fit?)
194
# Reversed Alpha 2 adrenoceptor Agonists (Clonidine, lofexidone)
Treat withdrawal:
195
# Reversed NMDAR Antagonists (baclofen, acamprosate) Anti-epileptics (topiramate, lamotrigine)
Treat craving:
196
# Reversed Methadone Naltrexone
Treat opioid addiction:
197
# Reversed Disulfiram makes alcohol aversive: causes flushing, tachycardia, hyperventilation, panic. (Inhibits aldehyde dehydrogenase leading to build up of acetaldehyde)
Treat alcohol addiction:

Neuro drugs (2 decks)

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