Epilepsy, spasm, spasticity, local anesthetics
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| MOA of antiepileptics - broadest spectrum | decrease Na influx, decrease Ca influx, increase GABA
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| broadest spectrum antiepileptic | valproic acid = VPA
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| valproic acid ADRs | hepatatoxic, teratogenic, pancreatitis, NO CNS EFFECT
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| broad spectrum, most preferred antiepileptic | carbamazepine
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| MOA valproic acid | decrease Na/Ca influx, increase GABA
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| MOA carbamazepine | selectively inhibit Na channels
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| carbamazepine unique metabolism | increases the rate of its own metabolism
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| drug for partial seizures/tonic-clonic seizures | phenytoin
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| phenytoin dosing problem | small dose change can result in HUGE increase in serum levels
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| absence/petit-mal antiepileptic | ethoxsuximide
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| additional antiepileptics | lamotrigine
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| additional antiepileptic that can cause oral-cleft abnormalities if fetus exposed | topiramate
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| MOA of local anesthetics | block Na channels, non-selective action in PNS
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| name an ester local anesthetic that can be used with epinephrine | procaine
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| name an alkaloid ester that CANNOT be used with epinephrine and CANNOT be used in cardiac pts | cocaine
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| name an amide local anesthetic that is widely used | lidocaine
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| muscle spasm - 2 centrally acting drugs | diazepam, tizanidine
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| what drug is effective for BOTH spasm and spasticity | diazepam
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| what centrally acting spasm drug is hepatatoxic | tinzanidine
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| what is the MOA of muscle spasticity | it is of CNS origin - like MS, CP, CVA, spinal cord trauma
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| 3 centrally acting drugs for spasticity | baclofen, diazepam, dantrolene
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| baclofen | spasticity agent, no antidote
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| diazepam | spasm AND spasticity - mimics GABA
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| dantrolene | spasticity drug, hepatatoxic, suppresses release of Ca from SR
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| other local anesthetics - name regconition | tetracaine, chlorprocaine, bezocaine, dibucaine, bupivacaine, mepivacaine, pilocaine, articaine, levobupivacaine, ropivacaine
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| which class of local anesthetic has a lower incidence of allergic reactions? | amide class, as in lidocaine
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| general SEs of local anesthetics | CNS: excitation followed by sedation
CV: brady, hypoTN
L&D: uterine contractions, depress fetus as above
allergic reactions
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| why do we admin epinephrine with ester anesthetic procaine? | prolongs duration (vasocon) with some SEs from eop
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| what local anesthetic has allergic reaction ADR | ester-based procaine has this ADR
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| what locale anesthetic indicated for dysrhythmias | lidocaine
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| Indication for cocaine | EENT procedures
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| MOA for centrally acting muscle relaxants | unclear - inhibition at presynaptic motor neurons in CNS, global CNS sedation, suppression of spinal motor reflext
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| MOA diazepam | enhanced GABA
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| MOA tizanidine | Alpha-2 agonist in skeletal muscle
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| MOA Baclofen | acts in spinal cord to suppress hyeractive reflexts. No direct effect on skeletal muscle
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| which antiepileptics have SE of CNS effect, starting with nystagmus | carbamazepine, phenytoin (and maybe ethoxsuximide which also has CNS SEs)
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| which antiepileptic interacts with grapefruit juice | carbamazepine
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| MOA of ethoxsuximide | inhibit Ca channels in hypothalamus
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| name recognition anti-epileptics | oxcabazepine, gabapentin, pregabalin, tiagabine, levetiracetam, vigabatrin, zonisamide, felbamate
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