Week 3 - Neuro Drugs Flashcards

1
Q

addictive opioids

A

the most addictive opioids are the strongest Mu receptor agonists leading to euphoric effects

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2
Q

codeine

A

opioid, moderate mu agonist, not very addictive

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3
Q

pentacozine

A

opioid, mixed weak agonist / antagonist of mu receptor, kappa-sigma agonist, less addictive

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4
Q

merperidine

A

opioid, full mu receptor agonist

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5
Q

drugs the cause mydriasis (pupil dilation)

A

sympathomimetics and parasympathetic inhibitors

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6
Q

phenylephrine

A

dilates, alpha1 adrenergic stimulant, used in eye drops to dilate eyes, 2.5-10% solution, reverses Horner’s Syndrome ptosis (drooping eyelid)

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7
Q

epinephrine

A

dilates, 0.5-2% solution, Tx for glaucoma, increases aqueous humor outflow and inhibits formation, alpha1 adrenergic stimulant

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8
Q

nicotine

A

dilates, activates nicotinic receptor, also activates parasympathetics producing miosis (more common)

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9
Q

amphetamine

A

dilates, reverses axoplasmic pump causing NE release, response = normal postganglionic nerve

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10
Q

cocaine

A

dilates, blocks axoplasmic pump increasing NE near andrenergic receptor, only works if NE being released, used to diagnose Horner’s Syndrome instead of aniscoria

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11
Q

mydriatics

A

pupil dilation, muscarinic receptor antagonists

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12
Q

atropine

A

pupil dilation, produces cycloplegia, bella donna alkaloid, pharacological inhibition of parasympathetic by muscarinic receptor antagonism

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13
Q

Q - most likely to cause mydriasis (pupil dilation)

A

phenylephrine

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14
Q

nicotine

A

activates parasympathetics, miosis (pupil constriction)

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15
Q

pilocarpine

A

pupil constriction, muscarinic agonist, Tx glaucoma by increasing drainage by making more space near Schlemms canal, used to see if there is muscarinic receptor problem in eye

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16
Q

acetylcholine

A

pupil constriction, muscarinic agonist

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17
Q

physostigmine / ecothiophate

A

pupil constriction, inhibit AChE

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18
Q

terazosin

A

pupil constriction, not for eye disease but side effect, alpha1 antagonist

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19
Q

reserpine

A

pupil constriction, NE depleting, ocular side effect

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20
Q

Q - most likely to produce miosis (pupil constriction)

A

pilocarpine

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21
Q

Q - pt with miosis, best pharmacological Tx

A

atropine

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22
Q

timolol

A

Tx glaucoma, beta receptor blocker that reduces aqueous humor formation in ciliary body

23
Q

pilocarpine

A

Tx glaucoma, muscarinic receptor agonist, enhanced aqueous humor drainage through trabecular meshwork and canal of Schlemm by constricting pupil and making more room for drainage

24
Q

physostigmine / ecothiophate

A

Tx glaucoma, anticholinesterase, enhances aqueous humor drainage through trabecular meshwork and canal of schlemm

25
Q

latanoprost

A

Tx glaucoma, increases uveo-sceral outflow of aqueous humor, prostaglandin E derivative

26
Q

acetazolamide

A

Tx glaucoma, carbonic anhydrase inhibitor, CA makes bicarbonate in non-pigemented epithelium of ciliary bodies -> moved to pigmented epithelial cell layer in exchange for Na+ and Cl- which water follows

27
Q

Q - most likely to increase aqueous humor drainage

A

pilocarpine

28
Q

Q - most likely to precipitate closed angle gluacoma

A

phenylephrine

29
Q

strabismus

A

deviation of eyes due to muscle spasms

30
Q

blepharospasm

A

spasm leading to closed eyelid

31
Q

botulinum toxin

A

Tx muscle spams around eye, inhibits ACh release by cleaving synpatic associated proteins, can relieve strabismus or blepharospasm

32
Q

ptosis (drooping eyelid)

A

sympathetic nerve disruption via superior tarsal, can also be caused by skeletal muscle dysfunction and CN III palsy

33
Q

also cause drooping eyelid (ptosis)

A

myasthenia gravis, botulinism, occulomotor palsy, muscular dystrophy

34
Q

phyenylephrine

A

pupil dilation, alpha1 agonist

35
Q

atropine

A

pupil dilation, muscarinic antagonist

36
Q

amphetamine

A

pupil dilation, causes release of NE from nerve

37
Q

cocaine

A

pupil dilation, prevents NE reuptake into nerve

38
Q

phenylephrine

A

mydriatic - dilating, alpha1 receptor agonist, can precipitate closed angle gluacoma

39
Q

atropine

A

mydriatic - dilating, muscarinic antagonist, can precipitate closed angle gluacoma

40
Q

amphetamine

A

mydriatic - dilating, causes release of norepinephrine, can precipitate closed angle gluacoma

41
Q

cocaine

A

mydriatic - dilating, prevents norepiniphrine reuptake, can precipitate closed angle gluacoma

42
Q

pilocarpine

A

miotic - constricts, muscarinic agonist

43
Q

acetylcholine

A

miotic - constricts, muscarinic agonist

44
Q

terazosin

A

miotic - constricts, alpha1 adrenergic antagonist

45
Q

physostigmine

A

miotic - constricts, anticholinesterase

46
Q

nicotine

A

miotic - constricts

47
Q

cocaine

A

tests for intact sympathetic system, pupil dilation = nerves work, lack of pupil dilation = sympathetic defect (possibly Horner’s syndrome)

48
Q

amphetamine

A

tests for intact sympathetic system, pupil dilation if postganglionic nerve is intact (and contains norepinephrine)

49
Q

glaucoma Tx - enhancing aqueous humor flow

A

pilocarpine (muscarinic agonist), latanaprost (prostaglandins), epinephrine

50
Q

glaucoma Tx - suppress aqueous humor production

A

timolol (beta adrenergic antagonist), acetazolamide (carbonic anhydrase inhibitor)

51
Q

Tx muscle spasms (blephorospasm or strabismus)

A

botulinum toxin relaxes skeletal muscle by suppressing acetylcholine release

52
Q

Q - tests for sympathetic postganglionic nerve function

A

amphetamine

53
Q

Q - tests parasympathetic activity

A

atropine, pharmacological antagonist of muscarinic receptors

54
Q

Q - discriminates between CN III defect and ocular defect

A

pilocarpine - will stimulate parasympathetic part of CN III to sphincter pupillae and ciliary muscles