Neurology Drugs- Firstaid

Front 1

What are the toxic side effects of phenobarbital

Back 1

Sedation, tolerance, dependence, induction of P450, porphoryia, CV and respiratory depression

Front 2

What are the toxic side effects of phenytoin?

Back 2

Nystagmus, diplopia, ataxia, sedation, gingival hyperplasia, hirsutism, megaloblastic anemia, teratogenesis, SLE-like syndrome, induction of P450

Front 3

What are the toxic side effects of valproic acid?

Back 3

Hepatotoxicity, neural tube defects, CX in pregnancy (inhibits folic acid)

Front 4

What are the side effects of lamotrigine?

Back 4

SJS

Front 5

What are the side effects of Topiramate?

Back 5

Kidney stones, mental dullness, sedation

Front 6

Barbiturates (phenobarbital, thiopental, secobarbital, pentobarbital)

Back 6

Mechanism- Increase duration of Cl channel closing to facilitate GABA action
Use- Sedative for anxiety, seizures, insomnia, induction of anesthesia (thiopental), hyperbilirubinemia due to Criger Najaar Type II
Toxicity- Respiratory depression, induce P450, dependence, additive depression with alcohol, contraindicated in porphyria

Front 7

Benzodiazepines

Back 7

Mechanism- Facilitate GABA by increasing the frequency of Cl-channel opening, decrease REM sleep

Front 8

What are the short acting benzos?

Back 8

TOM Thumb!!- Triazolam, Oxazepam, Midazolem

Front 9

What inhalational anesthetic is the most potent?
Which one is the fastest acting?

Back 9

Potent- Halothane
Fastest- N2O

Front 10

Which inhalational anesthetic causes hepatotoxicity?

Back 10

Halothane

Front 11

Epinephrine (use in glaucoma)
Brimonidine

Back 11

Epinephrine inecreases aqueous humor synthesis due to vasoconstriction. Cannot use in closed angle glaucoma because it causes mydriasis. Brimonidine has no pupillary or vision changes.

Front 12

Beta-blockers (use in glaucoma)

Back 12

Include Timolol, betaxolol, carteolol
Decrease aqueous humor secretion. Can get systemic effects

Front 13

Acetazolamide, mannitol (use in glaucoma)

Back 13

Decrease aqueous humor secretion due to decreased HCO3 (via inhibition of carbonic anhydrase)

Front 14

Direct cholinomimetics (pilocarpine, carbachol) and indirect cholinomimetics (physostigmine, echothiophate) use in glaucoma

Back 14

Increase outflow of aqueous humor; contract ciliary muscle and open trabecular meshwork; Pilocarpine is used in emergencies. Causes miosis and cyclospasm

Front 15

Prostaglandins (PGF2a)- Latanaprost

Back 15

Increase outflow of aqueous humor, darkens the color the iris and lengthens the eyelashes!!!

Front 16

Opioid analgesics

Back 16

Mechanism- Open K channels, close Ca channels, decrease synaptic transmission and inhibit release of Ach, NE, 5-HT, glutamate, and substance P
Use- Cough suppression (dextromethorphan), diarrhea (loperamide, diphenoxylate), acute pulmonary edema, addicts (methadone)
Toxicity- Respiratory depression, constipation, miosis, addtive CNS depression with other drugs. Treat with naloxone/naltrexone

Front 17

Butorphanol

Back 17

Mechanism- partial agonist at opioid mu receptors, agonist at kappa receptors
Use- Labor and delivery pain, migraines

Front 18

What are the toxic effects of carbamazepine?

Back 18

Dipolopia, ataxia, agranulocytosis, aplastic anemia, liver toxicity, teratogen, induction of P450, SIADH, SJS

Front 19

What are the toxic effects of ethosuximide?

Back 19

GI distress, fatigue, headache, urticaria, SJS

Front 20

Sumatriptan

Back 20

Mechanism- 5-HT1B/1D agonist, causes VC, inhibition of trigeminal activation and vasoactive peptide release. Half life < 2 hours
Use- Acute migraine, cluster headaches
Toxicity- Coronary vasospasm

Front 21

What are the nonbenzodiazepine hypnotics?

Back 21

Zolpidem, Zalepon, eszopiclone
-All used for insomnia and have short duration of action because of rapid liver metabolism

Front 22

What affects the onset of action of an inhaled anesthetic?

Back 22

Blood solubility: High blood solubility means more gas required to saturate blood and SLOWER onset of action.
AV concentration gradient: Higher means SLOWER onset of action

Front 23

What affects the potency of an inhaled anesthetic?

Back 23

Lipid solubility: high means HIGH potency (1/MAC)

Front 24

Inhaled anesthetics

Back 24

Effects: Myocardial depression, respiratory depression, N/V, INCREASED cerebral blood flow (decreased cerebral metabolic demand), decreased hepatic/renal flow

Front 25

Which inhaled anesthetic causes nephrotoxicity?

Back 25

Methoxyfluorane

Front 26

Which inhaled anesthetic causes convulsions?

Back 26

Enflurane

Front 27

Memantine

Back 27

Mechanism- NMDA receptor antagonist; helps lower excitotoxicity (mediated by Ca)
Use- Alzheimer's
Toxicity- Dizziness, confusion, hallucinations

Front 28

What drugs are used to treat Huntington's

Back 28

Reserpine + tetrabenazine (amine depleting)
Haloperidol

Front 29

Why do you need a higher dose of local anesthetics in infected tissues?

Back 29

They are charged because they are alkaline and the tissue is acidic so they cannot penetrate the membrane effectively

Front 30

What is the order of nerve blockade in local anesthetics?

Back 30

Small-diameter myelinated > small unmyelinated > large myelinated > large unmyelinated

Pain > temperature > touch > pressure