treatments- LL Flashcards
Essential tremor treatments?
“Players play the girl behind closed doors”
Propranolol: B2, brady, lightheaded, impotant
Primidone: sedation
Topiramate: Na channel, Concentration difficult
Gabapentin: Ca channel not a GABA rx, gait problmes
Botulism: head/voice tremor
Clonazepam: dependancy
Huntington disease treatment? “ben hunts for Oro”
Benazine: Deplete monoamine (dopa) = depression
Haloperidol: reduce dopamine = schizo, chorea, and tourettes
Fluphenazine: ???
Olanzapine: 5HT receptor= Schizo, tourettes (aripiprazole), QT Prolong
Tourettes tx? “ Erin Howlers profanity, but rarely acts”
Education Pimozide: failed occular accomidation Haloperidol: D2 decrease, extra-pyramidal = parkinson like Botulism: focal motor, or voic Risparidone/Aripaprazole (tourette like)
RLS tx? “Lovers blend role playing games outside”
Intermit: Levo and benzos
Persist: (dope agonist) pramipexole, Ropinorole, gabapentin
Refractory: opioids
Wilsons disease Tx? “D-pen’s ring is trimed with iron and copper but not zinc”
D-penicillinamine: sulfa ring, give extra pyridozine
Trientine: Pulls Fe and Cu, low Fe = renal dx, high Fe= liver dx
Oral zinc = GI upset
ALS tx? “ Pertissis killed Ryan’s gluts, Butts take dedication.
Rilozule: inhibits glut, pertusis rxn Edaravone: free radical antioxidant Badofen: gaba agonist: sedation Tizanidine: DAD = drowsi, asthenia (weak), dizzy Diazepam
MG TX? “ MY GOD! SLUDGEy diahhrea sticks on mine”
Pyridostigmine, Neostigmine: anticholinesterases = SLUDGE: salivation, lacrimation, urine, diah, GI, emisis
CNS effects
Idiosyncratic.
Idk what this means but brubs harped about his for a while.
In general are mono or multi anti seizure meds preferred?
mono
GABA and barbiturates have the same of different binding sites?
Different, but do basically the same thing. Gabas are drug B = No coma or death. Barbs are drug A = coma or death.
Generalized abscence Tx? “Even Val Lost Consciousness Tonight”
Ethosuximide: only Generalized, block Ca T channel, Ade= blood issues
Valproate: GABA, Box = Hepato, terato, pancreato
Lamotrigene: Na chan block, BOX = skin and diplopia
Clonazepam: Only infantil, sedation
Topiramate: Na chan block, confusion, conc. diff
Tonic-clonic meds? “ Lame Tory Leven has Behavioral issue”
Lamotrigene, Topiramate,
Levetriacetem - SV2A Decrease GLUT, behavioral issues
Focal siezure tx? “Chris Pine Lost Videos of The Genovian Princess “
Carbamazepine: Na channel, BOX= serious skin rash, HLA allele in asians, alopecia, Trigeminal neuraglia
Lamotrigene = Na, Box: skin and apolecia
Phenytoin = Na, decrease GLUT, BOX: CVD w/ rapid infusion, Nystagmus, Hirsutism, Gingival hyperplasia
Phenobarbital: enhance Gaba, sedation, behavioral
Topiramate: Na channel, conc. difficult
Valproate: BOX: hepato, terato, pancreato. mimics GABA
Gabapentin: decrease GLUT, Ataxia, weight gain
refractory focal meds? “Perry took viagra for Pauline
Pregabalin: same as gabapentin
Tiagabin: decrease conc. increase appetite
Peramparel: Rampage! = BOX: pschy and behavior issues
Vigabatrin: Box: perminant eye lose = poked in the eye
Myotonic Meds? “Val tried zipplinging and levetating”
Valporate
Zonisamide: Ca and Na channel, Sulfa rxn, kidney stones
Topiramate: Na, conc. difficulty,
Levetriacetam: SV2A, decrease GLUT, behavrioal
Canniboids
Think Lennox Gausaut and dravet light up
Stiripentol
Dravet loves to strip
What is status epilepticus?
siezure >30 mins and no baseline mental status regained
Why care about status?
Kill you, sustained depolarization = neuronal death
Status tx with 30 mins? (BENZOs)
Loraz = Preffered for CNS Midaz = IM/ IN/ Buccal, preffered Diaz = Rectal
Status tx 30-60 mins?
Hydrate! Phebes very loose and limber
1st line = Hydantoins (Posphytoins)
2nd line = Phenobartibal, valproate
3rd line = Lacosamide, levetiracetam
Status tx >120 mins?
“1st, Mix penta patrons, then keep hydrating and inhale keto foods vivacously!”
1st - midazelam, pentobartibal, propofel
Then - Ketamine, hypothermia, anesthetic inhaled, keto diet and vagal stim
What do you monitor with (status epi) Diazepam fosphenotoin (hillary) Lorazepam Pentobarbital (>120)
Diazepam = vitals, EKG fosphenotoin = vitals, EKG Lorazepam = propylene dose Pentobarbital = vitals, EKG
How can you give midazolam? (status epi, >120)
buccal, IV, IN, IM
What turns on REM sleep?
What turns off REM sleep?
on = cholinergic (parasymp) Off = norepi
Do teens have a hard time falling asleep and old people have a hard time staying asleep?
Yeah
What can cause short term insomnia? (Dirty jobs and college sucks)
Death, jobs, exams, separation
Sedation vs hypnotics?
Sedation = anxiolytic, relax you Hypnotics = sets the mood... to sleep
What are the fat soluable vitamins?
ADEK
What benzo is MC used for insomnia?
eszopiclone = lunesta, but flurazepam is a true hypnotic. (Her flow is hypnotic) Triazolam = homicide ideation (tried PA school)
Where are benzo recepters found? Lck th Cl**
Limbic, thalamus, cerebral cortex
What benzos have no metabolites? Lord OZark
Lorazepam, oxazepam, zolpidem
what is antegrade amnesia? think Ruffi-colata
Cant remember anything after the hit.
This is on the test
What is the antidote for all benzos? “Nil”
Flumazenil
Are Zolpidem, Zalephon, and eszopiclone Benzos?
No
What is a barbiTAL? tall glass
Like Liquor, drug class A (coma and death) that binds to GABA at a site DIFFERENT than Benzos
Barbiturates ADE? Think alcohol
porphyria = so much chemical (blood-alcohol) that your increase anticoagulation
Doxepin is used for what? think Duped
Duped the body into staying awake = sleep maintannatce insomnia
What are the 2 sleeping antidepressants?
Mitrazapine, trazodone (priapism)
What does suvorexant do?
OFF SIGNAL -
Turns off wake signal from Orexin (hypocretins)
cataplexy, narcolepsy like sxs
Melatonin, think Circadian rhythmic sleep
melanie’s got circular rhythm
Valerian
herbal root that smells like gym socks
What are the 4 types of Narcolepsy.
What do Narcos do to pass the time? Play CHES
Cataplexy, Hallucinate, Excess daytime sleepiness, Sleep paralysis
What are the EDS Meds? Excessive daytime sleepiness = Much more asleep
Modafinil, Armodafinil, methylphenidate (only for EDS not cataplexy)
Modafinil and aRmodafinil are the R or L dimer
R dimer
Cataplexy meds? (Freak out when you cant move) TSSM
Tricyclic, SSRI, SNRI, MAOI
What causes hypersomnolance and cataplexy
Seregiline = decrease REM sleep and latency
What does Na oxybate do?
Makes you sleep Shitty, changes sleep architeture, never add to another sleep med
When do you give prophylatic IE drugs?
Gingival and gum bleeding procedures
What is the MC entorococcus isolate?
E. faecalis, fecal = entero
What does the sulbactam do in augmentin?
protects the beta ring
What do you monitor for Daptomycin Gentamicin Linezolid Rifampin vanco
Daptomycin - rhabdo = CPK
Gentamicin - OTOtoxic, Nephro, NM block -
Linezolid - Thrombo, optic, peri neurophy - plateles
Rifampin - hepato - LFTs
Vanco -Redman, nephro conc. 15
Prophylactic IE treat oral is? and when do you do it?
Amoxi
PV, Hx IE, unrepair congenital heart defect, transplant
Anticholinergic ADE for many disease is…
Metallic taste and the dry as a hat bs
What is the triple spray for COPD?
LABA + LAMA + ICS
What does Roflumilast do in COPD?
Stop Pulmonary Remodeling!!
PDE4
What are the 5 As of quitting smoking?
Ask, Advise, Assess, Assist, Arrange
What are normal Sa02 and Pa02 values
Sa02 >88% or Pa02 >55
Meds that trigger ASTHMA?
BANANAS
Benzalkonium ca Acetaminophen, Non- selective b blocker Asa NSAID Astham Sulfites
Astham triad?
NTI, narrow, tightness, inflammation
Beta 2 agonists are (ATM)?
Albuterol, terbutaline, metaproternol
What reverses CVD from theophylline?
Beta blockers
1st line therapy for moderate to severe Astham is?
Corticosteroids (Bel, bud, dex, flunis, fluti, mome)
Astham corticosteroids ADEs?
Fungal candica, adrenal suppresion, mild growth retardation in kids (not perminant)
Why is Zileuton good for athletes?
No excessive, ASA allergy induced asthma
Do you avoid cough suppressants and antibiotics for Acute bronchitis?
Yes - its a virus
kids get acute bronchitis from what virus?
paraflu
Bacterial Acute bronchitis is mostly due to?
Mycoplasma pneumonia
RSV in acute bronchiolitis is treated by
Palivizumab (kids = ribavirin)
Hallmark of Chronic bronchitis?
Cough, sputum, bacteria - Psuedomonas give aztrenam for 28 then torbimycin for 28
CAP meds
healthy
comorbid viral and bacterial
Elderly
healthy = macro or tetracyline
comorbid viral and bacterial =osel/tamivir, MB or F
Elderly = Piper taco, or carb, cephalosporin or MB or F
CAP meds
Non-ICU (comorbid)
Non-ICU - MB or F
