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40 Cards in this Set
- Front
- Back
- 3rd side (hint)
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Acetaminophen (Tylenol)
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CNS prostaglandin synthesis inhibitor
Migraine abortion Nociceptive pain Tension-type HA abortion |
S/E: liver toxicity
High rebound HA potential |
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Amantadine
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NMDA receptor blocker
Fatigue PD (reduce peak dose dyskinesia from levodopa) |
S/E: confusion, hallucinations
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Amitriptyline
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Tertiary TCA
NE > 5-HT reuptake inhibitor NaCB Muscarinic receptor blocker Adrenergic α1 blocker Diabetic neuropathic pain Emotional lability Insomnia Major depression Migraine prophylaxis Mixed HA prophylaxis Neuropathic pain Panic disorder Tension-type HA prophylaxis |
C/I: pregnancy, constipation, glaucoma, elderly with confusion
S/E: sedation, dry mouth, constipation, urinary retention, weight gain, OH, sexual dysfunction, tachycardia, QT prolongation, convulsions, coma, respiratory depression, hyperpyrexia High efficacy migraine prophylaxis |
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Atropine
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Muscarinic receptor blocker
AChE toxicity (organophosphate insecticides, nerve gas) Bradycardia Mycetism (mushroom poisoning) |
Does not cross BBB (must use very high dose to cross BBB in AChE toxicity)
C/I: glaucoma, BPH Atropine overdose (anticholinergic toxidrome): xerostomia, xerophthalmia, anhidrosis, mydriasis, tachycardia, constipation, urinary retention, confusion |
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Azathioprine
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Purine synthesis inhibitor
MG |
None
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Baclofen
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GABA-B agonist
Generalized dystonia Neuropathic pain RLS Spasticity Trigeminal neuralgic pain |
S/E: sedation, dizziness, hypotension
Do not stop abruptly (seizures) |
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Botulinum toxin
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Hydrolysis of SNARE proteins inhibits exocytosis of ACh
Focal or segmental dystonia Hyperhidrosis Migraine prophylaxis Spasticity Tremor |
S/E: local pain, hematoma, mydriasis, decreased secretions, tachycardia, constipation, skeletal muscle weakness
Moderate efficacy migraine prophylaxis |
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Carbamazepine
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Classic AED
NaCB Bipolar disorder Diabetic neuropathic pain First-line for generalized tonic-clonic seizures First-line for partial seizures with or without secondary generalization First-line for trigeminal neuralgia Muscle spasms RLS Trigeminal neuralgic pain |
Liver metabolism, P 450 enzyme inducer
C/I: absence seizures, pregnancy Common S/E: sedation, diplopia, vertigo, rash, liver toxicity, contraceptive failure, osteoporosis, hyponatremia, ataxia Other S/E: hyponatremia, neural tube defects, atrioventricular conduction defect, ventricular automaticity Idiosyncratic S/E: blood dyscrasias (leukopenia, aplastic anemia) Decreasing response over time |
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Chlorpromazine
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Typical antipsychotic
Dopamine D2 receptor blocker Adrenergic α1 blocker Acute mania Migraine abortion Psychosis Schizophrenia |
Low potency → more non neurologic side effects
S/E: EPS effects (acute dystonia, akinesia, akathisia, tardive dyskinesia), parkinsonism, OH, sedation, dry mouth, constipation, hyperprolactinemia, NMS |
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Clonazepam
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Classic AED
Benzodiazepine GABAA agonist Anxiety disorders Not insomnia alone Intermittent RLS Pain RBD Seizures Spasticity Tremor Vertigo |
C/I: glaucoma, history of drug addiction
Common S/E: sedation, ataxia, rash Other S/E: tolerance, dependence Idiosyncratic S/E: confusion, falls, impotence, depression |
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Cocaine
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Amphetamine
NaCB ester NE > 5-HT, DA reuptake inhibitor ADHD Local anesthesia for minor surgery Narcolepsy Spinal anesthesia |
Liver metabolism
S/E: CNS excitation, HTN, hypotension, palpitations, anger, irritability, loss of attention, thought disorder, addiction |
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Codeine
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μ opioid receptor agonist
(0.1 MED) Intermittent RLS Nociceptive pain |
S/E: constipation, sedation, impaired ventilation, toxicity > 1.5 mg/kg
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Dantrolene sodium
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Ryanodine receptor blocker (Ca2+ release inhibitor from sarcoplasmic reticulum in skeletal muscle)
Malignant hyperthermia Spasticity |
S/E: liver toxicity
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Deep brain stimulation
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Target GPi for dystonia
Target STN and/or GPi for PD Target Vim for tremor Generalized dystonia PD Tremor |
PD criteria for DBS:
1. Clinically definite PD with > 3 years of symptoms 2. Moderate to severe PD, but still ambulatory 3. Levodopa responsive with clearly defined on and off periods 4. Persistent disabling motor fluctuations despite best drug treatment 5. Intact cognition measured by neuropsychological testing 6. No active disturbances 7. No medical C/I or intracranial abnormalities |
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Diazepam
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Benzodiazepine
GABA-A agonist Early status epilepticus Intermittent RLS Seizures of eclampsia Spasticity Vertigo |
C/I: history of drug addiction
S/E: sedation, tolerance, dependence |
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Dihydroergotamine
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Serotonin 5-HT2 receptor blocker
Migraine abortion Status migrainous Tension-type HA abortion |
SC, IM, or IV for cluster HA abortion
IM or IV for migraine abortion IV for status migrainous C/I: IHD, PVD, HTN, pregnancy, liver disease, recent use of 5-HT1 agonist (24 hr) or MAO blocker (2 wk), basilar or hemiplegic migraine Low rebound HA potential |
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Donepezil
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Reversible tertiary AChE inhibitor
Cognitive impairment LBD Mild to moderate AD |
Good oral absorption
Crosses BBB S/E: excessive salivation, nausea, abdominal cramps, diarrhea, insomnia, muscle cramps, bradycardia Do not stop abruptly (confusional state) |
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Duloxetine
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NE > 5-HT reuptake inhibitor
Diabetic neuropathic pain |
None
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Enflurane
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Tissue relaxer
(↓ cell-cell coupling and other mechanisms) Inhaled anesthesia |
S/E: myocardial depression, respiratory depression, nausea, emesis, ↑ cerebral blood flow, malignant hyperthermia
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Entacapone
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COMT inhibitor
PD (prolong T1/2 of levodopa) |
S/E: diarrhea, orange urine/saliva/sweat
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Eszopiclone
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NBBRA
Insomnia |
Intermediate-acting NBBRA
S/E: sleep walking, complex sleep behaviors (eating, driving) |
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Ethosuximide
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Classic AED
Postsynaptic CCB T channel blocker First-line for absence seizures |
Common S/E: sedation, fatigue, HA, nausea, vomiting, GI distress, urticaria
Other S/E: aggressiveness, psychosis, Stevens-Johnson syndrome Idiosyncratic S/E: blood dyscrasias, rash Do not stop abruptly (absence status) |
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FentanylFentanyl
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μ and δ opioid receptor agonist
(100 MED) IV anesthesia Nociceptive pain |
S/E: sedation, CNS depression, respiratory depression, constipation, miosis, dependence
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Fludrocortisone
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Mineralocorticoid (aldosterone) agonist
OH |
None
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Fosphenytoin
(prodrug of phenytoin) |
Classic AED
NaCB Early status epilepticus |
IV
Longer half-life |
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Gabapentin
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New AED
Presynaptic CCB (α2δ subunit) Agitation Diabetic neuropathic pain Generalized tonic-clonic seizures Migraine prophylaxis Muscle spasms Neuropathic pain Partial seizures with or without secondary generalization in elderly, on multiple drugs, or with liver failure Refractory RLS Tremor Trigeminal neuralgic pain |
Renal excretion, no drug interactions
S/E: sedation, fatigue, dizziness, ataxia, weight gain Moderate efficacy migraine prophylaxis |
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Galantamine
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Reversible tertiary AChE inhibitor
LBD Mild to moderate AD |
Good oral absorption
Crosses BBB S/E: excessive salivation, nausea, abdominal cramps, diarrhea, bradycardia Do not stop abruptly (confusional state) |
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Glatiramer acetate
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T cell suppressor (MHC molecule binding competes with myelin antigens for presentation)
MS |
S/E: transient flushing, chest tightness, palpitations, anxiety
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Halothane
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Tissue relaxer
(↓ cell-cell coupling and other mechanisms) Inhaled anesthesia |
S/E: myocardial depression, respiratory depression, nausea, emesis, ↑ cerebral blood flow, liver toxicity, malignant hyperthermia
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Hydromorphone
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μ opioid receptor agonist
(5 MED) Nociceptive pain |
S/E: constipation, sedation, impaired ventilation
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Ibuprofen
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NSAID
Migraine abortion Nociceptive pain Tension-type HA abortion |
C/I: end of third trimester of pregnancy
S/E: gastropathy, platelet inhibition, kidney and liver dysfunction High rebound HA potential |
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Indomethacin
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NSAID
Cluster HA prophylaxis Migraine abortion Tension-type HA abortion |
S/E: GI upset
Low rebound HA potential |
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Interferon β-1a
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Immunomodulator (natural inflammatory marker)
MS |
S/E: myalgias, fever, malaise
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Interferon β-1b
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Immunomodulator (natural inflammatory marker)
MS |
S/E: myalgias, fever, malaise, depression, local rejection reactions
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Isoflurane
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Tissue relaxer
(↓ cell-cell coupling and other mechanisms) Inhaled anesthesia |
S/E: myocardial depression, respiratory depression, nausea, emesis, ↑ cerebral blood flow, malignant hyperthermia
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IV immunoglobulin
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Pooled IgG from many donors
MG acute attack AIDP (Guillain-Barré) CIDP |
None
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Ketamine
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Arylcyclohexylamine (PCP analog)
NMDA receptor blocker IV anesthesia Neuropathic pain |
S/E: CV stimulation, disorientation, hallucinations, bad dreams, ↑ cerebral blood flow
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Lamotrigine
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New AED
NaCB Glutamate release inhibitor Generalized tonic-clonic seizures Neuropathic pain Partial seizures with or without secondary generalization Trigeminal neuralgic pain |
C/I: liver disease
S/E: sedation, abnormal thinking, dizziness, ataxia, diplopia, nausea, weight gain, rash, HA, Stevens-Johnson syndrome Perform regular platelet and coagulation tests |
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Levetiracetam
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New AED
Glutamate release inhibitor at presynaptic terminal Partial seizures with or without secondary generalization in elderly, on multiple drugs, or with liver failure |
Renal excretion, no drug interactions
S/E: sedation |
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Levodopa/carbidopa
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Levodopa = dopamine precursor (act on D1 and D2 receptors)
Carbidopa = decarboxylase inhibitor Generalized dystonia Intermittent RLS PD Tremor |
Most effective PD treatment
Drug of choice for PD in elderly, severely debilitated, cognitively impaired S/E: nausea, OH, dyskinesias, late motor fluctuations (10%/year), confusion |
