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Neurology

FA complete review part 4 Pharmacology

QuestionAnswer
List of Epilepsy drugs: 1. Benzodiazepines 2. Carbamazepine 3. Ethosuximide 4. Gabapentin 5. Lamotrigine 6. Levetiracetam 7. Phenobarbital 8. Phenytoin, fosphenytoin 9. Tiagabine 10. Topiramate 11. Valproic acid 12. Vigabatrin
What is the main use for Benzodiazepines as an epileptic agent? Acute status epilepticus
What is the mechanism of action of Benzodiazepines? Increase GABA-A action
What epilepsy drugs can be used a secondary treatment of Eclampsia seizures? Benzodiazepines
What are side effects associated with Benzodiazepines? Sedation, tolerance, dependence, and respiratory depression
Which could be the most fatal or severe adverse effect of benzodiazepine overdose? Respiration depression
Which epilepsy drug(s) MOA is to increase the actions GABA-A? Benzodiazepines and Phenobarbital
What is the common use of Carbamazepine? Treatment of Partial (focal) seizures
Which type of generalized seizures can be treated, not commonly, with Carbamazepine? Tonic-clonic seizures
What is MOA of Carbamazepine? Blocks Na+ channels
Which partial seizure medication MOA is to block the sodium cation channels? Cabazempine
List of known adverse effects caused by Carbamazepine? 1. Diplopia 2. Ataxia 3. Blood dyscrasias 4. Liver toxicity 5. Teratogénesis 6. Induction of CYP450 7. SIADH 8. Stevens-Johnson syndrome
What is a severe cutaneous adverse effect of Carbamazepine? Stevens-Johnson syndrome
What are the common blood dyscrasias caused by Carbamazepine? Agranulocytosis and Aplastic anemia
What are the teratogenic side effects associated with the use of Carbamazepine? Cleft lip/palate, and spina bifida
A newborn with cleft lip and palate, and a turf of hair in the lower back, was born to a mother with seizure hx. What is the most likely medication she was taking? Carbamazepine
SIADH, SJS, and blood dyscrasias are known adverse effects of whichani-epilepsy drug? Carbamazepine
What is the 1st line of treatment for Trigeminal neuralgia? Carbamazepine
Besides focal seizures, what non-epileptic condition , is primarily treated with Carbamazepine? Trigeminal neuralgia
What is treated with Ethosuximide? Absence seizure
What drug is used to treat Absence seizures? Ethosuximide
MOA of Ethosuximide Blocks thalamic T-type Ca+ channels
Which anti-epilepsy drug works by blocking the Thalamic T-Type calcium cation channels? Ethosuximide
A list of all adverse effects associated with Ethosuximide: EFGHIJ: - Ethosuximide causes: Fatigue, GI distress, Headache, Itching (and urticaria) Stevens-Johnson syndrome
Thalamic T-type Ca2+ channel blocker epileptic Ethosuximide
Which the only type of seizures treated with Gabapentin? Partial (focal) seizures
What is the MOA of Gabapentin? Primarily inhibits high-voltage-activated Ca2+ channels
Which antiepileptic was designed as a GABA analog? Gabapentin
Inhibition of high-voltage-activated Ca2+ channels. MOA of Gabapentin
Common side effects of Gabapentin Ataxia and Sedation
What are non-epileptic uses of Gabapentin? 1. Peripheral neuropathy 2. Postherpetic neuralgia
Which seizures are can be treated with Lamotrigine? Partial seizures, Tonic-Clonic , and Absence seizures
MOA of Lamotrigine - Blocks voltage-gated Na+ channels - Inhibits the release of glutamate
What NT release is inhibited by Lamotrigine? Glutamate
Which channels are blocked by Lamotrigine? Voltage-gated Na+ channels
What is the associated adverse effect of Lamotrigine? Stevens-Johnson syndrome
How is SJS prevented when taking Lamotrigine? Slow titration
Blocks voltage-gated Na+ channels and inhibits release of glutamate. Mechanism of action of Lamotrigine
What is a possible effect of the mode of action of Levetiracetam? Possible modulation of GABA and glutamate release
What are the adverse effects seen with Levetiracetam? 1. Neuropsychiatric symptoms 2. Fatigue, drowsiness, and headache
Personality changes are seen in a person taking which antiepileptic? Levetiracetam
What is the mode of action of Phenobarbital? Increase GABA-A action
Phenobarbital share MOA with which other type of epilepsy medications? Benzodiazepines
First line of seizures (focal, tonic-clonic) in neonates is: Phenobarbital
What is probably the most severe side effect of Phenobarbital? Cardiorespiratory depression
As side effects, both, benzodiazepines and Phenobarbital have certain organ depressons: Benzodiazepines cause __________________ depression. Phenobarbital causes___________________ depression. Respiratory Cardiorespiratory
Which epilepsy drugs are known to cause induction of the CYP450 system? Carbamazepine and Phenobarbital
1st line of treatment for recurrent status epilepticus Phenytoin
What is Fosphenytoin? Water-soluble phenytoin prodrug used only in hospitals for the treatment of epileptic seizures.
Water-soluble phenytoin Fosphenytoin
What is the mode of action of Phenytoin? Blocks Na+ channels
What is the order kinetics of Phenytoin? Zero
Zero order kinetics antiepileptic Phenytoin
Which antiepileptics or seizure medication block Na+ channels as mechanism of action? Carbamazepine, Phenytoin, and Topiramate
Blocks Na+ channels; zero order kinetics Phenytoin
List of side effects associated with Phenytoin: 1. P450 system induction 2. Hirturism 3. Enlarged gums 4. Nystagmus 5. Yellow-brown skin 6. Teratogenicity 7. Osteopenia 8. Inhibited folate absorption 9. Neuropathy
What rare adverse effects associated with Phenytoin? Stevens-Johnson syndrome, DRESS syndrome, and SLE-like syndrome
Phenytoin is used as 1st line of treatment of acute ----> Tonic-clonic seizures
Phenytoin is used as 1st line of treatment for which recurrent seizure type? Status epilepticus
What is the main agent used for prophylaxis of Status epilepticus? Phenytoin
Phenytoin is an inducer or inhibitor of the CYP450 system? Inducer
Which anti-seizure medication is associated with possible development of SLE-like syndrome? Phenytoin
What is the teratogenic effect caused by Phenytoin? Fetal hydantoin syndrome
A newborn with Fetal Hydantoin syndrome most likely had a mother that took what medication during pregnancy? Phenytoin
What is the common use of Tiagabine? Partial (focal ) seizures
What is the MOA of Tiagabine? Increasing GABA by inhibiting reuptake
MOA- inhibiting GABA reuptake, thus increasing GABA concentration. Tiagabine
What is the mode of action of Topiramate? 1. Blocks Na+ channels 2. Increases GABA action
This drug works by blocking Na+ channels and also by increasing GABA action. Topiramate
Valproic acid is 1st line of treatment of acute -----> Tonic-clonic seizures
What are the two parts of the MOA of Valproic acid? 1. Increases Na+ channel inactivation 2. Increases GABA concentration by inhibiting GABA transaminase
Which enzyme is inhibited by Valproic acid? GABA Transaminase
How does Valproic acid increases the concentration of GABA? Inhibiting GABA transaminase
Which antiepileptic works by Increasing the Na+ channel inactivation? Valproic acid
What are the associated adverse effects of Topiramate? Sedation, mental dulling, word-finding difficulty, kidney stones, weight loss, and glaucoma.
A person with a seizure disorder started to complain about not remembering or finding the right words. She had been an avid writer and poet. What medication can cause this? Topiramate
What is an non-seizure related use of Topiramate? Migraine prevention
What are other uses for Valproic acid, other than as antiepileptic medication? Myoclonic seizures, bipolar disorder, migraine prophylaxis
What teratogenic defects are expected for the use of Valproic acid? Neural tube defects
Irreversible GABA transaminase inhibitor. Vigabatrin
What is the associated black box warning of Vigabatrin? Permanent visual loss
Permanent visual loss may be caused by which antiepileptic? Vigabatrin
What are some common Barbiturates? Phenobarbital, pentobarbital, thiopental, and secobarbital
What is the detailed MOA of Barbiturates? Facilitate GABA-A action by increasing DURATION of Cl- channel opening, thus decreasing neuron firing.
Barbiturates increase or decrease, duration of Cl- opening? Increase
Which type of drugs are known to increase DURATION of Cl-channel opening? Barbiturate
What is the result of the increased duration of Cl- channel opening by Barbiturates? Facilitation of GABA-A action
What are the clinical uses for barbiturates? Sedative for anxiety, seizures, insomnia, induction of anesthesia
Which barbiturate is used as to induce anesthesia? Thiopental
Thiopental is a _____________________. Barbiturate
Increase duration of Cl- channel opening Barbiturate
Barbiturates are to be avoided in people with _________________. Porphyria
A patient with a known porphyria should avoid which type of drugs? Barbiturate
CNS depression by barbiturates can be exacerbated by: Alcohol use
What is the overdose by Barbiturates treatment? Supportive (assist respiration and maintain BP)
List of common Benzodiazepines: Diazepam, Lorazepam, Triazolam, Temazepam, Oxazepam, Midazolam, Chlordiazepoxide, Alprazolam
What is the mechanism of action of Benzodiazepines? Facilitate GABA-A action by increasing frequency of Cl- channel opening
Which, benzodiazepines or barbiturates, enhance GABA-A action, by increasing the frequency of Cl- channel opening? Benzodiazepines
Most Benzodiazepines have: Long half-lives and active metabolites
Which mnemonic may be used to remember those Benzodiazepines with SHORT half-lives? ATOM
What does the mnemonic ATOM stands for? Short half-life benzodiazepines Alprazolam, Triazolam, Oxazepam, Midazolam
What is a risk or adverse effect of short half-live benzodiazepines? Higher addictive potential
Which drugs are known to increase the frequency of Cl- channel opening? Benzodiazepines
What drugs and substances bind to GABA-A receptors? Benzodiazepines, Barbiturates, and Alcohol
GABA-A receptor is a : Ligand-gated Cl- channel
Why are Oxazepam, Temazepam, and Lorazepam used to treat alcohol withdrawal safer than other benzodiazepines? Due to minimal first-pass metabolism
What are some important Nonbenzodiazepine hypnotics? Zolpidem, Zaleplon, and esZopiclone
What is the MOA of nonbenzodiazepines hypnotics? Act via BZ1, subtype of GABA receptor
What is the GABA subtype used by nonbenzodiazepine hypnotics? BZ1
Nonbenzodiazepine hypnotic effects are reversible with: Flumazenil
Why are nonbenzodiazepines hypnotics used for sleep? They affect less the sleep cycle as compared to Benzodiazepines
Clinical use for Zolpidem? Insomnia
What is the mechanism of action of Suvorexant? Orexin (hypocretin) receptor antagonist
Orexin receptor antagonist Suvorexant
What is the clinical use for Suvorexant? Insomnia
Suvorexant is contraindicated in patients with _________________. Narcolepsy
What are conditions are have Suvorexant administration contraindicated? 1. Narcolepsy 2. Liver disease 3. Strong CYP3A4 inhibitors
What is the MOA of Ramelteon? Melatonin receptor agonist, binds MT1 and MT2 in suprachiasmatic nucleus.
Ramelteon binds to: MT1 and MT2 in the Suprachiasmatic nucleus
What is the clinical use of Ramelteon? Insomnia
What is the most common Triptan? Sumatriptan
Common 5-HT 1B/1D agonist. Sumatriptan
What is the MOA of Triptans? Inhibit trigeminal nerve activation Prevent vasoactive peptide release Induce vasoconstriction
What is the clinical use for Triptans? - Acute migraine - Cluster headache attacks
What some adverse effects of Triptan therapy? Coronary vasospasm, mild paresthesia, and serotonin syndrome
Which type of patients are at higher risk of coronary vasospasms due to Triptan intake? CAD and/or Prinzmetal angina paites
When is it possible to develop serotonin syndrome with the use of Triptans? When used in combination with other 5-HT agonists.
List of Na+ channel blocker epileptics: 1. Carbamazepine 2. Fosphenytoin 3. Lamotrigine 4. Phenytoin 5. Topiramate 6. Valproic acid
SV2A receptor blocker (antiepileptic). Levetiracetam
List of GABA-A agonists: 1. Benzodiazepines 2. Topiramate 3. Phenobarbital 4. Propofol
Which epileptics are Ca2+ channel blockers? Ethosuximide and Gabapentin
GABA reuptake inhibitor epileptic Tiagabine
Which antiepileptics are GABA transaminase inhibitors? Valproic acid and Vigabatrin
Parkinsonism is due to: Loss of dopaminergic neurons and excess cholinergic activity
Parkinson drugs are categorized in strategies, which are: 1. Dopamine agonists 2. Increase dopamine availability 3. Increase L-DOPA availability 4. Prevent dopamine breakdown 5. Curb excess cholinergic activity
The Dopamine agonists used for Parkinson disease are divided into: 1. Ergot and, 2. Non-ergot
Which type of Dopamine agonist are preferred in treating of Parkinson disease? Non-ergot
Which is the Ergot dopamine agonist used for Parkinson disease? Bromocriptine
What are the Non-ergot dopamine agonists in Parkinson disease treatment? Pramipexole and Ropinirole
Ropinirole and Pramipexole are: Non-ergot Dopamine agonists
What are symptoms are included in Non-ergot dopamine agonist toxicity? Impulse control disorder, postural hypotension, and hallucinations/confusion.
A person with a movement disorder is treated with a commonly used drug for such, but later develops a gambling problem. What are the more likely drugs given? Pramipexole and Ropinirole
Parkinson drug that works by increasing dopamine availability. Amantadine
How does Amantadine increase dopamine availability? Increase dopamine release and decrease dopamine uptake
What are signs of Amantadine toxicity? Ataxia and livedo reticularis
What is the mode of action of drugs that increase L-DOPA availability? Prevent peripheral (pre-BBB) L-DOPA degradation, which increases the L-DOPA entering the CNS ---> increase central L-DOPA available for conversion to dopamine
What are the main drugs that increase L-DOPA availability? Levodopa, Carbidopa, and Entacapone
Levodopa and Entacapone --> Increase L-DOPA availability
MOA of Carbidopa: Blocks peripheral conversion of L-DOPA to dopamine by inhibiting DOPA decarboxylase
Which enzyme is inhibited by Carbidopa? DOPA decarboxylase
How does Entacapone prevent peripheral L-DOPA degradation? Inhibiting COMT
Which drug is used in conjunction with Entacapone? Levodopa
Which enzyme is inhibited by Entacapone? COMT
Peripheral COMT is inhibited by ____________________. Entacapone
Entacapone prevents the degradation of L-DOPA into: 3-O-methyldopa (3-OMD)
A reduction in 3-OMD levels might be seen with the use of which Parkinson disease drug? Entacapone
Agents that inhibit or prevent dopamine breakdown, work pre- or post-BBB? Post-BBB
Which are the two types of agents that prevent dopamine breakdown post-BBB? MAO-B inhibitors and Central COMT inhibitor
A central COMT inhibitor means: It prevents that breakdown of Dopamine post BBB into 3-methoxytyramine (3-MT)
Central or Peripheral COMT inhibitors prevent conversion of dopamine into 3-MT? Central COMT inhibitors
Which is a common central COMT inhibitor used in Parkinson disease? Entacapone
What is the overall purpose of Selegiline and Rasagiline? Prevent dopamine breakdown post-BBB
How does Selegiline prevent Dopamine breakdown? Block conversion of dopamine into DOPAC by selectively inhibiting MAO-B.
Which enzyme is selectively inhibited by selegiline and rasagiline, in the treatment of Parkinson disease? MAO-B
How do MAO-B inhibitors help in treating Parkinson disease symptoms? Prevent dopamine breakdown post-BBB
Which Parkinson drugs are known to curb excess cholinergic activity? Benztropine, trihexyphenidyl
Benztropine and Trihexyphenidyl are ________________________. Antimuscarinics
How do antimuscarinics help in Parkinson symptoms relief? Improve tremors and rigidity but has little to no effect in bradykinesia
What is intended to "better" by the use of Benztropine in Parkinson disease? Tremor and rigidity
What enzyme in the CNS converts L-DOPA into dopamine? DOPA decarboxylase
What long term adverse effects of Levodopa/Carbidopa administration? Dyskinesia following administration ("on-off" phenomenon), akinesia between doses
What is the function of MAO-B? Metabolize dopamine
What is a possible adverse effect of Selegiline and Rasagiline? May enhance adverse effects of L-DOPA
Tetrabenazine and Reserpine clinical uses are: Huntington chorea and Tardive dyskinesia
MOA of Tetrabenazine and reserpine: Inhibit vesicular monoamine transporter (VMAT) dopamine
What is the result of the inhibition of VMAT dopamine? Decrease vesicle packaging and release
Which drugs may cause decrease vesicle packaging and release due to VMAT dopamine inhibition? Tetrabenazine and reserpine
What is the use for Riluzole? ALS
MOA of Riluzole? Decreased neuron glutamate excitotoxicity
What medication is used to treat Lou Gehrig disease? Riluzole
List of common Alzheimer drugs: 1. Memantine 2. Donepezil, Rivastigmine, and Galantamine
What is the mechanism of action of Memantine? NMDA receptor antagonist
NMDA receptor antagonist used to treat Alzheimer? Memantine
What are the two types of Alzheimer disease drugs? 1. NMDA receptor antagonists 2. AChE inhibitors
CNS drugs must be: 1. Lipid soluble, in order to cross the BBB, or, 2. Actively transported across the BBB
Drugs with low solubility in blood = Rapid induction and recovery times
Drugs with high solubility in lipids = Increase in potency
1 -------------- = MAC Potency
What does MAC in anesthetics stand for? Minimal Alveolar Concentration
What is MAC? Minimal Alveolar Concentration required to prevent 50% of subjects from moving in response to noxious stimulus
Which anesthetic is an example of decreased blood and lipid solubility? Nitrous oxide (N2O)
Halothane, propofol, and thiopental have: Increase lipid and blood solubility, and thus high potency and slow induction.
Which anesthetics have high potency and slow induction? Halothane, propofol, and thiopental
What are inhaled anesthetics examples? Desflurane, halothane, enflurane, isoflurane, sevoflurane, methoxyflurane, and N2O.
What are the physiological effects of inhaled anesthetics? Myocardial depression, respiratory depression, nausea/emesis, increased cerebral blood flow.
Halothane adverse effect Hepatotoxicity
What adverse effect is seen with Methoxyflurane? Nephrotoxicity
Which inhaled anesthetics are proconvulsant if toxic levels are reached? Enflurane and Epileptogenic
What is a possible adverse effect of the use of N2O as an inhaled anesthetic? Expansion of trapped gas in a body cavity
What is Malignant hyperthermia? Rare, life-threatening condition in which inhaled anesthetics or succinylcholine induce fever and severe muscle contractions.
What are the genetic principles associated with Malignant hyperthermia? The susceptibility of Malignant hyperthermia, is often inherited as AD with variable penetrance.
What type of mutations induced or cause increase levels of Ca2+ release from Sarcoplasmic Reticulum? Voltage-sensitive Ryanodine receptor (RYR1 gene) mutations
A mutated RYR1 gene causes --> Increase release of Ca2+ from SR
A mutated RYR1 gene may increase the subject's susceptibility to develop which anesthetic-induced emergency? Malignant hyperthermia
What is the treatment for Malignant hyperthermia? Dantrolene
Dantrolene is used to treat: Malignant hyperthermia
A person under surgery spikes fever > 104 F and has muscle twitches, is going to be treated with: Dantrolene
What is the MOA of Dantrolene? Ryanodine receptor antagonist
Ryanodine receptor antagonist Dantrolene
Is malignant hyperthermia associated with Intravenous (IV) or Inhaled anesthetics? Inhaled anesthetics
What are the common Intravenous anesthetics? Thiopental, Midazolam, Propofol, and Ketamine
Thiopental is a _______________________ anesthetic. Intravenous anesthetic
Which IV anesthetic is a barbiturate? Thiopental
Which IV anesthetic is a Benzodiazepine? Midazolam
NMDA receptor antagonist IV anesthetic Ketamine
What is the mode of action of Propofol? Pontentiates GABA-A
Which GABA receptor type, is targeted by IV anesthetics, A or B? GABA-A
Thiopental is used for long or short, surgical procedures? Short
How is the effect of Thiopental quickly terminated? Rapid redistribution into tissue and fat
Cerebral blood flow with Thiopental is increased or decreased? Decreased
Which IV anesthetic decreases cerebral blood flow? Thiopental
What are severe or significant adverse effects of IV anesthetic, Midazolam? Severe postoperative respiratory depression, hypotension, and anterograde amnesia
What kind of amnesia may be provoked as adverse effect of Midazolam? Anterograde amnesia
What are the common uses for Midazolam? 1. Procedural sedation (endoscopy) 2. Anesthesia induction
Which IV anesthetic may be used in the ICU setting? Propofol
Which IV anesthetic is used to rapid anesthesia induction? Propofol
MOA of Ketamine NMDA receptor antagonist
What are the anesthetic uses of Ketamine? 1. Dissociative anesthesia 2. Sympathomimetic
Increased or Decreased. Cerebral blood flow with Ketamine? Increased
What is a possible emergence reaction to Ketamine anesthesia? Disorientation, hallucination, and vivid dreams
Which IV anesthetic is known to increase the cerebral blood flow? Ketamine
What are the two types of local anesthetics? Esters and Amides
List of Ester Local anesthetics: Procaine, Tetracaine, Benzocaine, and Chloroprocaine
List of Amide Local anesthetics: Lidocaine, Mepivacaine, Bupivacaine, and Ropivacaine
What is the MOA of Local anesthetics? Block Na+ channels by dingin to specific receptors on inner portion of channels
On which neuros a local anesthetics the most effective? Rapidly firing neurons
What can be given along with a local anesthetic to enhance the local action? Epinephrine
How does the co administration of local anesthetic + epinephrine help to enhance effect? Decrease bleeding, increase anesthesia by systemic concentration
What is the order of loss when a local anesthetic is administered? Pain --> Temperature --> Touch --> Pressure
What is the first scenario that is loss or blocked by local anaesthetics? Pain
What type of anesthetics are used for spinal anesthesia? Local anesthetics
What is an bupivacaine specific adverse effect? Cardiovascular toxicity
Which local anesthetic is known to cause Methemoglobinemia? Benzocaine
Selective for Nm nicotinic receptors at NMJ but not autonomic Nn receptors. Neuromuscular blocking drugs
Neuromuscular blocking drugs are divided into ________________ and _________________. Depolarizing and Non-depolarizing
What are complications of Depolarizing neuromuscular blocking drugs? Hypercalcemia, hyperkalemia, and malignant hyperthermia.
What is the most common Depolarizing neuromuscular blocking agent? Succinylcholine
Succinylcholine is a strong___________________________________. ACh receptor agonist
MOA of Succinylcholine: ACh receptor agonist that produces sustained depolarizing and prevents muscle contraction
The reversal of blockade caused by Succinylcholine is reversed in how many phases? 2 phases
Which phase pf Succinylcholine blockade is definced a prolonged depolarization? Phase I
Phase II of Succinylcholine blocked is: Repolarized but blocked; ACh receptors are available, but desentized
What some common Nondepolarizing Neuromuscular blocking drugs? Atracurium, Cisatracurium, Pancuronium, and Vecuronium
What is MOA of Non-depoloarizing nuromulsclar blcking agents? Competitive with ACh for receptors
What are some drugs used to reverse the Nondepolarizing neuromuscular drug blockade? Neostigmine and Edrophonium
Why is neostigmine must be given with atropine or glycopyrrolate? To prevent muscarinic effects such as bradycardia
Which drugs must be administered with Neostigmine in order to prevent muscarinic effects? Atropine or Glycopyrrolate
_______________________, prevents the release of Ca2+ from the SR of skeletal muscle by binding to the ryanodine receptor. Dantrolene
What are the two clinical sues for Dantrolene? 1. Malignant hyperthermia, 2. Neuroleptic malignant syndrome
What is a severe toxicity of antipsychotic drugs treated with Dantrolene? Neuroleptic malignant syndrome
MOA of Baclofen: Skeletal muscle relaxant. GABA-B receptor agonist in spinal cord
What is the clinical use for Baclofen? Muscle spasticity, dystonia, and multiple sclerosis
GABA-B receptor agonist in spinal cord Baclofen
Which GABA receptor is used by Baclofen? GABA-B
Skeletal muscle relaxant that acts within CNS Cyclobenzaprine
What is the clinical use for Cyclobenzaprine? Muscle spasms
List of antispasmodics or Spasmolytics: - Baclofen - Cyclobenzaprine - Dantrolene - Tizanidine
What is the mechanism of action of Tizanidine? a-2 agonist, acts centrally
What conditions which produce spams, are treated with Tizanidine? Muscle spasticity, multiple sclerosis, ALS, and cerebral palsy
Which spasmolytics work centrally? Cyclobenzaprine and Tizanidine
Back muscle pain/spasm is commonly treated with: Baclofen
On which opioid receptors does opioid analgesics work? u, g, and k
Which is the B-endorphin opioid receptor? u
What is mechanism of action of opioid analgesics? Agonists at opioid receptors to modulate synaptic transmission, which leads to closure of presynaptic Ca2+ channels and open K+ channels leading to a decrease in synaptic transmission.
What are common Opioid analgesics Full agonists? Morphine, heroin, meperidine, methadone, codeine, and fentanyl
Which is a common Opioid analgesics Partial agonist? Buprenorphine
Mixed agonist/antagonist opioid analgesics? Nalbuphine, pentazocine, and butorphanol
Common Opioid analgesics antagonists Naloxone, naltrexone, and methylnaltrexone
Clinical uses for Opioid analgesics: - Moderate to severe or refractory pain - Diarrhea - Acute pulmonary edema - Maintenance programs for heroin addicts
Which opioid analgesics are used for maintenance programs for heroin addicts? Methadone, buprenorphine + naloxone
What are some adverse effects of opioid analgesics? N/V, pruritus, addiction, respiratory depression, constipation, sphincter of Oddi spasms, miosis, additive CNS depression with other drugs
What is used to treat Opioid analgesic toxicity? Naloxone
What is used to treat relapse of a detoxified Opioid analgesic? Naltrexone
What are the two common Mixed and antagonist opioid analgesics? Pentazocine and Butorphanol
What is the mechanism of action of PENTAZOCINE? 1. k-opioid receptor agonist and , - u-opioid receptor weak antagonist or partial agonist
What is the clinical use for Pentazocine? Analgesia for moderate to severe pain
What is a severe adverse effect or result from the use of Pentazocine? Opioid withdrawal symptoms if patient is also taking full opioid agonist.
What are the mechanisms of action of Butorphanol? 1. k-opioid receptor agonist and, 2. u-opioid receptor partial agonist
What are common instances in which Butorphanol is used? In severe pain such as migraines and labor.
What is the MOA of Tramadol? Very weak opioid agonist
Which opioid analgesic is known to inhibit the reuptake of norepinephrine and epinephrine? Tramadol
Very weak opioid agonist Tramadol
What is the use for Tramadol? Chronic pain
What are two specifics adverse effects of Tramadol? - Decreases seizure threshold - Serotonin syndrome
What is the purpose of Glaucoma therapy? Decreases IOP via decreased amount of aqueous humor
How is the aqueous humor decreased in Glaucoma therapy? Inhibition of synthesis/ secretion or increase drainage of aqueous humor.
Which drug classes are in Glaucoma therapy are used to decrease aqueous humor synthesis? B-blockers, a-agonists, and diuretics.
Which beta-blockers are used in Glaucoma? Timolol, betaxolol, and carteolol
How do beta-blockers mechanism of action work for Glaucoma treatment? Decreases aqueous humor synthesis
Which are common alpha-agonists used in Glaucoma therapy? Epinephrine, apraclonidine, and Brimonidine
Decreases aqueous humor synthesis via vasoconstriction. Epinephrine
Which a-agonist is contraindicated in treatment of closed-angle glaucoma? Epinephrine
What is an adverse effect of Epinephrine in association of Glaucoma treatment? Mydriasis
What are the adverse effects seen with Apraclonidine and Brimonidine, as they treat glaucoma? Blurry vision, ocular hyperemia, foreign body sensation, ocular allergic reactions, and ocular pruritus.
Which a common diuretic used for Glaucoma? Acetazolamide
How does Acetazolamide help in treating glaucoma? Decreases aqueous humor synthesis via inhibiting carbonic anhydrase
Which common prostaglandins are used in treating Glaucoma? Bimatoprost, and Latanoprost
How do Prostaglandins MOA contribute to Glaucoma treatment? 1. Increase outflow of aqueous humor via a decreaed resistace of flow through uveoscleral pathway
What are adverse effects of Glaucoma treating Prostaglandins? 1. Darkens color of iris (browning) 2. Eyelash growth
Direct Cholinomimetics that are used to treat Glaucoma: Pilocarpine and Carbachol
Pilocarpine and Carbachol are: Direct cholinomimetics that are used to treat glaucoma
Which receptor are the cholinomimetics use to treat glaucoma? M3
Which are the Indirect cholinomimetics that treat glaucoma? Physostigmine and Echothiophate
MOA of Cholinomimetics treating Glaucoma: Increase outflow of aqueous humor via contraction of ciliary muscle and opening of trabecular meshwork
Why is Pilocarpine widely used in Closed-angle glaucoma? Very effective at opening meshwork into canal of Schlemm
Which cholinomimetic is very effective in treatment of Closed-angle glaucoma? Pilocarpine
What are the two main adverse effects of Glaucoma-treating cholinomimetics? Miosis and cyclospasm
What causes the cyclospasms when using Cholinomimetics to treat glaucoma? Contraction of ciliary muscle
Which muscle is stimulated to contract in order for cholinomimetics to treat Glaucoma? Ciliary muscle
Which Glaucoma therapy drug classes work by increasing the outflow of aqueous humor? Prostaglandins and Cholinomimetics (M3)
Created by: rakomi
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You can also use your keyboard to move the cards as follows:

If you are logged in to your account, this website will remember which cards you know and don't know so that they are in the same box the next time you log in.

When you need a break, try one of the other activities listed below the flashcards like Matching, Snowman, or Hungry Bug. Although it may feel like you're playing a game, your brain is still making more connections with the information to help you out.

To see how well you know the information, try the Quiz or Test activity.

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