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27 Cards in this Set
- Front
- Back
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Name some glaucoma drugs and their drug categories. |
Alpha agonists: epi, brimonidine (alpha2). Beta blockers: timolol, betaxolol, carteolol. Diuretics: acetazolamide. Cholinomimetics: pilocarpine, carbachol, physostigmine, echothiophate. Prostaglandins: latanoprost (PGF alpha2) |
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Which alpha agonists are used for glaucoma?
Describe the MOA and SE. |
Epi and brimonidine (alpha2)
MOA: decrease aqueous humor synthesis.
SE: mydriasis (do not use in closed-angle glaucoma) Blurred vision, ocular hyperemia and pruritus, sandy sensation in the eyes.
Remember, cholinomimetics cause miosis! |
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Which beta blockers are used for glaucoma?
Describe the MOA and SE. |
Timolol, betaxolol, carteolol.
MOA: decrease aqueous humor synthesis.
SE: no pupilary or vision changes. |
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Which cholinomimetics are used for glaucoma?
Describe the MOA and SE. |
Direct: pilocarpine, and carbachol. Indirect: physostigmine, echothiophate.
MOA: Increase outflow of aqueous humor via contraction of ciliary muscle and opening of trbecular meshwork into canal of Schlemm. Use pilocarpine for emergencies.
SE: Miosis and cyclospasm (contraction of ciliary muscles). Remember, alpha agonists cause mydriasis! |
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Which prostaglandin is used for glaucoma?
Describe the MOA and SE. |
Latanoprost (PGF alpha2).
MOA: increase outflow of aqueous humor.
SE: darkens the color of iris (browning). |
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Name some opioid analgesics. |
Morphine, fentanyl, codeine, heroin, methadone, meperidine, dextromethorphan, diphenoxylate. |
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What is the MOA of opioid analgesics? |
Mu receptor agonists. Remember, mu: morphine, delta: enkephalin, kappa: dynorphin.
Decrease cAMP, increase K conductance, decrease Ca conductance. Therefore, decrease synaptic transmission. This inhibits release of ACh, NE, 5-HT, glutamate. substance P. |
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What is the MOA of butorphanol? |
Mu opioid receptor partial agonist, and kappa opioid receptor agonist. Produces analgesia. |
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What is the clinical use of butorphanol? |
Used in cases of SEVERE pain (migraine, labor, etc).
Causes less respiratory depression than full opioid agonists. |
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What are the toxicities of butorphanol? |
Can cause opioid withdrawal sx if pt is also taking full opioid agonist (competition for opioid receptor).
OD is not easily reversed with naloxone. |
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What is the MOA of tramadol? What is it used for? |
Very weak opioid agonist. Also inhibits reuptake of 5-HT and NE.
Used for chronic pain. |
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What are the toxicities of tramadol? |
Similar to opioids. Also decreases seizure threshold. |
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What is the first line tx for simple partial seizure? |
Carbamazepine. |
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What is the first line tx for complex partial seizure? |
Carbamazepine. |
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What is the first line tx for generalized tonic-clinic seizure? |
Phenytoin, carbamazepine, or valproic acid. |
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What is the first line tx for absence seizure (generalized)? |
Ethosuximide. |
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What is the first line tx for status epilepticus? |
Benzos (diazepam or lorazepam).
Remember, phenytoin is 1st line for prophylaxis. |
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What is the first line tx for trigeminal neuralgia? |
Carbamazepine. |
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What is the first line tx for seizures in children? |
Phenobarbital. |
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What are the toxicities of carbamazepine? |
Agranulocytosis, aplastic anemia (always check CBC). P-450 inducer, liver toxicity, diplopia, ataxia, SIADH, Stevens-Johnson syndrome. Teratogenic. |
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What are the toxicities of ethosuximide? |
GI distress, fatigue, headache, urticaria, Stevens-Johnson syndrome. |
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What are the toxicities of phenobarbital? |
Inducer of P-450 system. |
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What are the toxicities of valproic acid? |
Hepatotoxicity (rare but can be fatal. Measure LFT's). GI distress, tremor, weight gain, alopecia. Teratogenic (causes spina bifida). |
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What are the toxicities of topiramate? |
Sedation, mental dullness, weight loss, kidney stones. |
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What is the MOA of phenytoin? |
Use-dependent Na channel blocker. Inhibits glutamate release from excitatory presynaptic neurons. |
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What are some clinical uses of phenytoin? |
Tonic-clonic seizures. Also a class IB antiarrhythmic. |
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What are the toxicities of phenytoin? |
Gingival hyperplasia, hirsutism, nystagmus, diplopia, ataxia, megaloblastic anemia, SLE-like syndrome, osteopenia, Stevens-Johnson syndrome, P-450 inducer, lymphadenopathy. Teratogenic (fetal hydantoin syndrome). |
