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USMLE
Comprehensive Pharm 2
| 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 status epilepticus |
| 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 |
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Asclepius
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