Pharm - Cns

Front 1

Epinephrine

Back 1

MOA: alpha-agonist; vasoconstriction leads to decreased aqueous humor synthesis
tox: mydriasis, stinging
contra: closed-angle glaucoma

Front 2

Brimonidine

Back 2

MOA: decr aqueous humor synthesis

Front 3

Timolol
Betaxolol
Carteolol

Back 3

MOA: decr aqueous humor secretion

Front 4

Acetazolamide

Back 4

MOA: carbonic anhydrase inhibitor (decr aq. humor secretion due to decr bicarb)

Front 5

Pilocarpine
Carbachol
Physostigmine
Echothiophate

Back 5

MOA: increase humor outflow; contract ciliary muscle to open trabecular meshwork, canal of schlemm (stim. sphincter pupillae of iris--constricts)
use: pilocarpine for emergencies
tox: n/v/d, salivation, sweating, miosis, cyclospasm

Front 6

Latanoprost (PGF2alpha)

Back 6

MOA: incr aq. humor outflow
tox: browning of iris

Front 7

Opioid analgesics

Back 7

MOA: opioid receptor agonists; open K+ channels, close Ca channels (hyperpolarization)
tox: respiratory depression, pinpoint pupils (miosis), CNS depression, constipation
reverse: naltrexone (naloxone)

Front 8

Butorphanol

Back 8

MOA: partial mu agonist, kappa agonist
tox: withdrawal if were on full opioid agonist before

Front 9

Tramadol

Back 9

MOA: very weak opioid agonist; inhibits 5HT and NE reuptake
use: chronic pain
tox: decreases seizure threshold

Front 10

Phenytoin

Back 10

MOA: incr. Na channel inactivation
use: 1st line tonic-clonic; 1st line for ppx; also for simple/complex
tox: nystagmus, diplopia, ataxia, sedation, gingival hyperplasia, hirsutism, megaloblastic anemia, teratogen, SLE-like sxs, cyt P-450 inducer

Front 11

Carbamazepine

Back 11

MOA: incr Na channel inactivation
use: first line for tonic-clonic and trigeminal neuralgia; also simple/complex
tox: diplopia, ataxia, agranulocytosis, aplastic anemia, liver tox, teratogen, P450 inducer, SIADH

Front 12

Lamotrigine

Back 12

MOA: blocks voltage-gated Na and Ca channels
use: simple, complex, t-c
tox: Steens-Johnson, HA, dizziness, ataxia

Front 13

Gabapentin

Back 13

MOA: incr. GABA
use: simple, complex, t-c, peripheral neuro
tox: sedation, ataxia

Front 14

Topiramate

Back 14

MOA: blocks Na channels, incr. GABA action
use: simple, complex, t-c
tox: sedation, kidney stones, wt. loss, ataxia, teratogen

Front 15

Phenobarbital

Back 15

MOA: incr. GABA by incr. duration of Cl channel opening
use: 1st line for pregnant, kids; also s, c, t-c
tox: sedation/depr, tol/dep, P450 inducer, vertigo, ataxia, acute psychosis

Front 16

valproic acid

Back 16

MOA: incr Na channel inactivation, incr GABA conc.
use: 1st line t-c, absence, s, c, myoclonic
tox: GI, hepatotox, neural tube defects, tremor, wt. gain, teratogen, check CBCs

Front 17

Ethosuximide

Back 17

MOA: blocks thalamic T-type Ca channels
use: 1st line absence
tox: GI, fatigue, HA, urticaria, Stevens-Johnson, aplastic anemia

Front 18

Benzos

Back 18

MOA: incr GABA action by incr frequency of Cl channel opening; decr. REM sleep
use: 1st line for acute seizure, eclampsia (MgSO4 is first line), sleepwalking, status epilepticus, anxiety, detox
tox: sedation, tolerance, dependence
OD: flumazenil (GABA antagonist)

Front 19

(1) Minimum Alveolar Concentration;
(2) Potency

Back 19

conc. at which 50% of population is anesthetized (decr with age)
potency = 1/MAC

Front 20

Halothane

Back 20

anesthetic
tox: hepatotoxic, malignant hyperthermia

Front 21

Methoxyflurane

Back 21

nephrotoxic

Front 22

Enflurane

Back 22

proconvulsant

Front 23

nitrous oxide

Back 23

expansion of trapped gas

Front 24

Ketamine

Back 24

PCP analog; block NMDA receptors; incr. cerebral flow
use: IV anesthetic

Front 25

Propofol

Back 25

rapid induction; short procedures
potentiates GABA-a

Front 26

local anesthetics
esters (procaine, cocaine, tetracaine)
amides (lidocaine, mepivacaine, bupivacaine)

Back 26

MOA: block Na channels; preferentially bind to activated Na channels
order of blockade: small>large; within small/large, meylinated > non
order of loss: pain, temp, touch, pressure
give with epi
tox: CNS, excitation, CV tox, arrhythmia

Front 27

Succinylcholine

Back 27

MOA: DEPOLARIZING neuromuscular blocking agent; selective for nicotinic receptor
reversal: cholinesterase inhibitors (neostigmine)
tox: hypercalcemia, hyperK

Front 28

Tubocurarine
Atracurium
Vecuronium
Pancuronium, etc

Back 28

MOA: NON depolarizing neuromuscular block; compete with Ach for receptors
Reversal: neostigmine, edrophonium, other cholinesterase inhibitors

Front 29

Dantrolene

Back 29

MOA: prevents Ca release from SR of sk. muscle
use: malignant hyperthermia, neuroleptic malignant syndrome

Front 30

Bromocriptine
Pramipexole
Ropinirole

Back 30

MOA: dopamine agonist

Front 31

Amantadine

Back 31

MOA: increase dopamine

Front 32

Selegiline

Back 32

MOA: prevent dopamine breakdown through inhibition of MAO type B
tox: can enhanced adverse effects of L-Dopa

Front 33

Entacapone
tolcapone

Back 33

MOA: COMT inhibitors
give with L-dopa/carbidopa

Front 34

Benztropine

Back 34

MOA: antimuscarinic; improves tremor and rigidity (no efect on bradykinesia)

Front 35

L-DOPA/carbidopa

Back 35

L-Dopa converted to dopamine in the CNS
Carbidopa is peripheral decarboxylase inhibitor
tox: arrhythmia, can get akinesia btw doses

Front 36

Sumatriptan

Back 36

MOA: 5-HT agonist; causes vasoconstriction; inhibits trigeminal activation and casoactive peptide release
tox: coronary vasospasm

Front 37

memantine

Back 37

MOA: NMDA antagonist to prevent excitotoxicity
tox: dizziness, confusion, hallucination

Front 38

Donepezil

Back 38

MOA: acetylcholinesterase inhibitor (selective for Ach in CNS >>> periphery)
tox: nausea, dizziness, insomnia