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159 Cards in this Set

  • Front
  • Back
agonize dopamine receptors
bromocriptine, pramipexole, ropinirole
increase dopamina
amantadine, l-dopa/carbidopa
prevent dopamine breakdown
selegiline, entacapone, tolcapone
prevent dopa methylation in periphary that leads to competitive antagonism of BBB uptake
entacapone, tolcapone
MAO type B inhibitor
curb excess cholinergic activity
what is benztropine good for?
tremors and rigidity
what is benzotropine not good for
what is the overall effect of benzotropine
toxicities of l-dopa/carbidopa
arrythmias, dyskinesia following administration, akinesia between administraitons
5-HT1D agonist
migraines, cluster headaches
toxicity of sumatriptan
hypertensive crises
why does sumatriptan contraindicated in CAD patients?
it's a vasoconstrictor
1st line for tonic-clonic
1st line for prophylaxis of status epiplepticus
1st line for trigeminal neuralgia
1st line in pregnant women and children
myoclonic seizures
valproic acid
1st line absence seizures
1st line acute status epilepticus
first line seizures of preeclampsia
magnesium sulfate
how does ethosuximide work?
blocks thalamic T-type calcium channels
what is an antiepileptic that works for seizures of preeclampsia?
toxicity: kidney stones, weight loss
how does topiramate work?
blocks sodium channels, increase GABA action
induce p-450, teratogen, liver toxicity, agranulocytosis, aplastic anemia
urticaria, stevens johnson
sedation, tolerance, induce p-450
gingivial hyperplasia
megaloblastic anemia
SLE-like snydrome
what two anti-epileptics are teratogens?
phenytoin, carbamazzapine
what 3 anti-epileptics induce p-450
phenytoin, carbamazepine, barbituates
neural tube defects
valproic acid
weight gain, tremors
valproic acid
rare but fatal hepatotoxicity (need to measure LFTs)
valproic acid
two drugs that cause stevens johnson
lamotrigine and ethosuximide
how does phenytoin work?
increase sodium channel inactivation
how does carbamazepine work
increase sodium channel inactivation
how does lamotrigine work?
blocks voltage-gated sodium channels
how does gabapentin work?
increases GABA release
how does phenobarbital work?
incrases GABA action
what drug can be used for peripheral neuropathy
used for alcohol withdrawal (DTs)
used for anxiety and spasticity (anti-epileptic)
less risk of respiratory depression than barbituates
treatment for benzo overdose
name 4 antipsychotics
thioridazine, haloperidol, fluphenazine, chlorpromazine
mechanism for neuroleptics
blocks D2 receptors
describe evolution of EPS side effects in neuroleptics?
4 hours acute dystonia, 4 days akinesia, 4 weeks akathisia, 4 months tardive dyskinesia (irreversible)
clinical uses for neuroleptics (4)
schizophrenia (only positive syndromes), psychosis, acute mania, Tourette's
how do you treat neuroleptic malignant syndrome?
dantrolene, dopamine agonists
what are 4 factors in neuroleptic malignant syndrome?
rigidity, myoglobinuria, hyperpyrexia, autonomic instability
what drug causes hyperprolactinemia and gynecomastia?
3 general side effects for neuroleptics
muscarinic blocker (dry mouth, constipation), alpha blocker (hypotension), histamine blocker (sedation)
define tardive dyskinesia
sterotypic oral-facial movements
what is the mechanism for tardive dyskinesia?
dopamine receptor sensitziation due to upregulation (long-term antipsychotic use)
name 3 atypical antipsychotics
clozapine, olanzapine, risperidone
what is the mechanism of atypical antipsychotics
blocks 5-HT2 and dopamine receptors
what 5 disorders is olanzapine useful for?
OCD, anxiety disorder, depression, mania, tourette's
what are atypical antipsychotics used for?
good for negative and positive symptoms of schizophrenia
what is a side effect of clozapine
mechanism of lithium
blocks phosphoinositol cascade
what is lithium used for?
mood stabilizer for bipolar disorder
causes nephrogenic diabetes insipidus
causes polyuria
ADH antagonist
is lithium a teratogen?
why do you need to closely monitor lithium levels?
narrow therapeutic window
name 4 SSRIs
fluoxetine, sertraline, paroxetine, citalopram
how long does it take for antidepressants to work?
2-3 weeks
how do SSRI's work?
seratonin-specific reuptake inhibitor
what 2 things can SSRI treat?
OCD, endogenous depression
side effect: anorgasmia
side effect: seratonin syndrome
define seratonin syndrome
hyperhtermia, msucular rigidity, cardiovascular collapse
what two combos cause seratonin syndrome?
SSRI + MAO inhibitors, beta-agonists + MAO inhibitors
name 6 tricyclic antidepressants
imipramine, desipramine, clomipramine, amitriptyline, nortriptyline, doxepin
mechanism of tricyclics
block NE and seratonin
general use for TCAs
major depression
specific use for imipramine
specific use for clomipramine
what drug causes atropine-like (anticholinergic side effects)
what are some atropine-like side effects?
tachycardia, urinary retention
what has more anticholinergic effects, amitriptyline or nortriptylne?
what is the least sedating TCA
name the 5 main side effects of TCAs
convulsions, coma, convulsions (arrythamias ) 3 C's + respiratory depression and hyperpyrexia
what side effects are found in elderly with TCAs
confusions and hallucinations
what TCA do you switch to when you see elderly side effects?
alternative function for bupropion
smoking cessation
mechanism for bupropion
not known
major toxicity of bupropion
seizures in bulemic patients
what heterocyclic can you use that does not cause sexual side effects?
heterocylic also used for generalized anxiety disorder
mechanism: inhibts seratonin, norepinephrine, dopamine reuptake
major venlafaxine side effect
stimulant side effects
mechanism of mirtazapine
alpha2 anatagonist (increases relaease of NE and seratonin) + 5-HT2 and 5-HT3 antagonist
3 side effects of mirtazapine
increased appetite, weight gain, dry mouth
mechanism of maprotiline
blocks NE reuptake
major side effect of maproptiline
orthostatic hypotension
2 major side effects of trazadone
priapism, orthostatic hypotension
primary mechanism of trazadone
inhibits seratonin reuptake
name the 5 heterocyclics
buproprion, venlafaxine, mirtazapine, maprotiline, trazadone
name 2 MAO inhibitors
phenelzine, tranylcypromine
3 uses for mao inhibitors
atypical depression (w/ psychosis or phobia), anxiety, hypochondriacs
what drug is used for hypochondriacs?
mao inhibitors
what 2 substances causes hypertensive crises in mao inhibitors
tyramine ingestion, meperidine (opioid)
what characteristic is required in anesthetics for rapid induction and recovery
decreased solbulity in blood
what characteristic in necssary for anesthetics to be potent
incresaed solbulity in lipids
what does MAC stand for
minimal anesthetic concentratoin
what is a mathematical expression for anesthetic potency
name 6 inhaled anesthetics?
halothane, enflurane, isoflurane, sevoflurane, methoxyflurane, nitrous oxide
4 major side effects of inhaled anesthetics
myocardial depression, respiratory deprssion, nausea/emsis, incresaed cerebral blood flow
anesthetic that causes hepatotoxicity
anesthetic that causes nephrotoxicity
proconvulsant anesthetic
what is the main purpose of using inhaled anesthetics?
maintenance after induction w/ IV anesthetics
what is the major barbituate anesthetic
which anesthetic leads to decreased cerebral blood flow
is thiopental potent or not potent?
what is the major use of IV anesthetics?
rapid induction of anesthesia, maintained though with inhalation agents
what is the most common anesthetic used for endoscopy
what is a dissociative anesthetic (appear to be awake but unconscious and feel no pain)
side effects: disorientaiton, hallucination, nightmares
which anesthetic is a cardiovascular stimulant and cannot be used in those w/ hypertension/ stroke
what anesthetic is best for those who are hypovolemic or in shock
name 2 opiates used for anesthesia
moprhine, fentanyl
what is the major benefit of using propofol?
less postoperative nausea than tiopental
name 3 ester anesthetics
procaine, cocaine, tetracaine
name 3 amide anesthetics
lidocaine, bupivacaine, mepivacaine
how do local anesthetics work?
blocks sodium channel by bidning to specific receptors in inner portion of channel
in what form (charged or uncharged) do local anesthetics bind to ion channels?
why do you need to use more anesthetic in infected tissue?
it's acidic so anesthetics become charged and can't penetrate as well
what is the general order of nerve blockade for local anesthetics?
small>large, myelinated>unmyelinated
what is the order of sensation loss for local anesthetics
pain first then temprature then touch then pressure
what do you give with local anesthetics to enhance local actoin?
vasoconstrictors (epinephrine)
how do vasoconstrictors + local anesthetics work?
decrease bleeding and systemic concentratoin so increase local action
what do you use for spinal anesthesia?
local anesthetics
if you are allergic to ester anesthetics, what do you do?
give amide anesthetics
anesthetic that causes severe cardiovascular toxicity
anesthetic that causes arryhtmias
what is the use for neuromuscular blockade drugs (2)
muscle paralyis in surgery or mechanical venitilatoin
what is the selectivity of neuromusclar blocking drugs?
selective for motor vs autonomic nicotinic receptor
what is a depolarizing neuromusclar blocking drug
what are the 2 phases in succinylcholine action?
phase I (prolonged depolarizatoin), phase II (repolarized but blocked)
which phase of succinylcholine is potentiated by cholinesterase inhibitors
phase I
what phase of succinylcholine can you use neostigmine as an antidote?
phase II
name 2 nondepolarizing neuromusuclar blockers
atracurium, mivacurium
what is the mechanism of nondepolarizing neuromuscular blocing drugs
competitive inhibitor with ACh for ACh receptors
how do you reverse atracurium blockade?
give neostigmine or edrophonium
drug used to treat malignant hyperthemia
what 2 anesthetic drugs in combination cause malignant hyperthemia
inhalation anesthetics (Except nitric oxide) + succinylcholine
what is the drug used to treat neuroleptic malignant syndrome
what is the mechanism of dantrolene
prevents release of caclium fromsarcoplasmic reticulum of skeletal muscle
what drugs are good for OCD?
olanzapine, SSRIs, clomipramine
what drugs are good for generalized anxiety disorder? (5)
barbituates, benzodiazepens, olanzapine, venlafaxine, MAO inhibitors