USMLE

Description:	Comprehensive Pharm 2
Category:	USMLE
Created by:	Asclepius on 2008-10-22

Question	Answer
MOA phenytoin	Increases Na channel inactivation
MOA carbamazepine	Increases Na channel inactivation
MOA lamotrigine	blocks voltage gated Na channels
MOA gabapentin	increases GABA release
MOA topiramate	Blocks Na channels, increases GABA release
MOA phenobarbital	increases GABA
MOA valproic acid	increases GABA, blocks Na channels
MOA ethosuxamide	blocks ca channels in thalamus
MOA benzos	increases GABA
uses for phenytoin	everything but absence seizures. status epilepticus prophylaxis
usees for lamotrigine	everything but absence and status
uses for carbamazepine	everything but absence and status
uses for gabapentin	all seizures except absence and status peripheral neuropathy
uses for topirimate	everything but absence and status
uses for phenobarbital	everything but absence and status
uses for valproic acid	everything but status
uses for ethosuxamide	absence
uses for benzos in epilepsy	acute status
which anti-epileptic drugs are 1st line in pregnancy and children	phenobarbital
which epi drug is 1st line for trigeminal neuralgia	carbamazepine
which drug is used to treat peripheral neuropathy	gabapentin
which drug is used to treat myoclonic seizures	valproic acid
which drug is used to treat seizures in eclampsia	MgSO4 (1st line) benzos
which epileptic drug --> sedation, tolerance, and dependence?	benzos
which epileptic drug --> aplastic anemia, liver toxicity, and teratogenesis?	carbamazepine
which epileptic drug --> diplopia, ataxia?	carbamazepine phenytoin
which epileptic drug --> GI distress, lethargy, headache?	ethosuxamide
which epileptic drugs --> stevens johnson syndrome	ethosuxamide lamotragine
which epileptic drug --> nystagmus, gingival hyperplasia, hirsutism?	phenytoin
which epileptic drug --> SLE like sydnrome	phenytoin
which epi drug --> spina bifida and other NTDs	valproic acid
which epi drug --> kidney stones	topiramate
which epilepsy drug --> malignant hyperthermia?	phenytoin
how do you treat OD of barbiturates?	symptom management
how do you treat OD of benzos?	flumazenil (competitive antagonist at GABA receptor)
other than for epilepsy, what can phenytoin be used for?	anti-arrhythmic
which is more dangerous in overdose: benzos or barbiturates?	barbiturates (longer t1/2 and more respiratory/cv depression)
MOA l-dopa	l dopa crosses bbb (dopamine doesn't) so it is converted to dopamine by dopa decarboxylase in CNS
carbidopa	peripheral decarboxylase inhibitor in order to increase bioavailability in brain and decrease peripheral side effects (since the conversion to dopamine won't occur peripherally)
toxicity of l-dopa?	arrhythmias from peripheral conversion of DA dyskinesia following lt admin akinesia between doses
MOA selegiline	selectively inhibits MAO-B, increasing availability of DA
use of selegiline	adjunctive to l-dopa in parkinsons
toxicityy of selegeliene	enhances l-dopa toxicity
MOA sumatriptan	5-HT1D agonist --> vasoconstriction
use of sumatriptan	acute migraine cluster headache attacks
what type of drug is bethanechol?	direct cholinergic agonist
what type of drug is carbechol	direct cholinergic agonist
what type of drug is pilocarpine	direct cholinergic agonist
what type of drug is methacholine	direct cholinergic agonist
what is the difference between direct cholinergic agonsts and indirect?	direct directly stimulate cholinergic receptors and indirect inhibit their breakdown via AChE
uses of bethanechol	activates bladder and bowel smooth muscle (used post-op for ileus and urinary retention)
uses of carbechol	glaucoma pupillary contraction release of intraocular pressure
uses of pilocarpine	potent stimulator for saliva, sweat, and tears
uses of methacholine	challenge test for asthma dx
action of methacholine	stimulates muscarinic receptors in airway
class: neostigmine	indirect cholinomimetic
class pyrodostigmine	indirect cholinomimetic
class: edrophonium	indirect cholinomimetic
class: physostigmine	indirect cholinomimetic
class: echothiophate	indirect cholinomimetic
uses for neostigmine	post-op and neurogenic ileus and uriNAry retention MG reversal of NM junction blockade
uses for pyridostigmine	MG
uses for edrophonium	to dx MG
uses for physostigmine	glaucoma and atropine OD
uses for echothiophate	glaucoma
which indirect ACh agonist penetrates CNS	physostigmine