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47 Cards in this Set
- Front
- Back
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Name the five categories of glaucoma drugs
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1. Alpha-Agonists
2. Beta-Blockers 3. Diuretics 4. Cholinomimetics 5. Prostaglandins |
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Alpha-Agonist: Glaucoma
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EPINEPHRINE: Decrease aqueous humor SYNTHSIS (SA:mydriasis, DO NOT USE IN CLOSED-ANGLE)
BRIMONIDINE: Decrease aqueous humor synthesis |
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Beta-Blockers: Glaucoma
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TIMOLOL + BETAXOLOL + CARTELOL
Decrease aqueous humor SECRETION |
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Diuretics: Glaucoma
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ACETAZOLAMIDE
Decrease aqueous humor SECRETION via dec HCO3- (inhibition of carbonic anhydrase) |
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Cholinomimetics (Direct + Indirect): Glaucoma
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Direct: PILOCARPINE + CARBACHOL
Indirect: PHYSOSTIGMINE +ECHOTHIOPHATE Increase OUTFLOW via ciliary muscle contraction and OPENING the TRABECULAR MESHWORK (SA: miosis, cyclospasm) |
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Prostaglandins: Glaucoma
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LATANOPROST
Increase OUTFLOW (SA: darkens iris) |
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Opioid Analgesic: Mechanism
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Act as agonists at opioid receptors (mu/delta/kappa) - open K-channels + close Ca-channels -> Dec synaptic transmission. INHIBIT RELEASE of ACh, NE, 5-HT, Glutamate, Substance P.
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Opioids: Names/Use/Toxicity
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MORPHINE, FENTANYL, CODEINE, HEROIN, METHADONE, MEPERIDINE, DEXTROMETHORPHAN
Use: pain, cough suppression (dextro.), diarrhea, acute pul edema Tox: ADDICTION, resp depression, MIOSIS, CNS depression (Tolerance does not develop to MIOSIS and CONSTIPATION) Treat overdose with NALOXONE or NALTREXONE |
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Butorphanol
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Partial-agonist at mu + agonist at kappa
Use for pain (less resp depression) |
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Tramadol
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Very WEAK opioid agonist + inhibits reuptake of serotonin/NE
Use for chronic pain |
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Phenytoin: Epilepsy
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Use-dependent blockade of Na-channels -> inc refractory period
Use: firist-line for tonic-clonic and status. also covers par-sim and par-comp Tox: Nystagmus (good), ataxia, SLE-like-syndrome, inc CYP450, gingival hyperplasia, hirsutism, megaloblastic anemia, TERATOGEN |
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Carbamazepine: Epilepsy
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Use-dependent blockade of Na-channels -> inc refractory period
Use: first-line for tonic-clonic. also covers par-sim and par-comp. TRIGEMINAL NEURALGIA Tox: Ataxia, BLOOD DYSCRASIA (agranulo, aplastic anemia), liver tox, inc CYP450, SIADH, SJS, TERATOGEN |
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Lamotrigine: Epilepsy
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BLOCKS voltage-gated Na channels
Use: tonic-clonic, par-sim and par-comp Tox: Stevens-Johnson Syndrome |
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Gabapentin: Epilepsy
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GABA analog but namely inhibits HVA Ca channels
Use: Tonic-clonic, par-sim and par-comp. PERIPHERAL NEUROPATHY and BIPOLAR DISORDER |
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Topiramate: Epilepsy
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BLOCKS Na channels and INC GABA activity.
Use: tonic-clonic, par-sim and par-comp. Tox: mental-dulling, KIDNEY STONES |
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Phenobarbital: Epilepsy
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Inc GABA activity by INC DURATION of Cl-channel opening
Use: tonic-clonic, par-sim and par-comp. FIRST-LINE IN PREGNANCY Tox: dependence, INC CPY450 |
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Valproic Acid: Epilepsy
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Na-channel inactivation and inc GABA concentration
Use: first-line tonic-clonic, ABSENCE, myoclonic, par-sim and par-comp. Tox: HEPATOTOX (measure LFTs), NTD (spina bifida) - MAKE SURE PT. IS NOT PREGNANT |
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Ethosuximide
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BLOCKS THALAMIC T-TYPE Ca-CHANNELS
Use: first-line for absence Tox: GI distress, fatigue, headache, SJS |
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Benzodiazepines
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Inc GABA activity by INC FREQUENCY of Cl-channel opening
Use: first-line for acute status-epilepticus and SEIZURES OF ECLAMPSIA (after MgSO4) Tox: sedation, tolerance, dependence |
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Tiagabine: Epilepsy
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Inhibits GABA REUPTAKE
Use; par-sim and par-comp |
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Vigabatrin: Epilepsy
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IRREVERSIBLY INHIBITS GABA TRANSAMINASE -> inc GABA
Use: par-sim and par-comp |
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Barbituates: General
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phenobarbitol, THIOPENTAL
Inc DURATION of Cl-channel opening Use: anxiety, seizures, insomnia, ANESTHESIA INDUCTION (thiopental) Tox: ADDITIVE effect with EtOH, dependence, inc CPY450 DO NOT GIVE BARBITUATES TO A PT WITH PORPHYRIA |
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Benzodiazepines: General
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DIAZEPAM, LORAZEPAM, TRIAZOLAM, MIDAZOLAM
Use: anxiety, spasticity, status epi (loraz and diaz), alcohol-detox DTs, night terrors, sleepwalking, general anesthetic Tox: dependence, less risk of resp depression, DECREASE REM SLEEP TREAT OVERDOSE WITH FLUMAZENIL- works at BZD-R |
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Anesthetic Solubility Principles
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Dec solubility in blood -> RAPID INDUCTION and recovery times
Inc solubility in lipids -> MORE POTENT -> lower MAC |
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Inhaled Anesthetics
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halothane, enflurane, isoflurane, sevoflurane, methoxyflurane, nitrous oxide
Effects: myocardial/resp depression. INC CEREBRAL BLOOD FLOW Tox: hepatotox (halothane), nephrotox (methoxyflurane), proconvulsant (enflurane), expansion of trapped gas (nitrous oxide) |
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IV Anesthetics (5)
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1. Barbituates
2. Benzodiazepines 3. Ketamine (Arylcyclohexylamines) 4. Opiates 5. Propofol |
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Barbituates: IV Anesthetics
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THIOPENTAL - high potency/rapid onset
Use: induction of anesthesia Effect is terminated by rapid redistribution into tissue and fat DEC CEREBRAL BLOOD FLOW |
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Benzodiazepines: IV Anesthetics
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MIDAZOLAM - use with gaseous anesthetics and narcotics
RESP DEP + DEC BP (overdose) -> TREAT WITH FLUMAZENIL |
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Ketamine: IV Anesthetics
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PCP analog -> BLOCKS NMDA RECEPTOR.
CV stimulant, HALLUCINATION, INC CEREBRAL BLOOD FLOW |
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Opiates: IV Anesthetics
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MORPHINE, FENTANYL -> CNS depressant, use during general anesthesia
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Propofol: IV Anesthetics
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Used for RAPID INDUCTION (potentiates GABAa). Less post-operative nausea than thiopental
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Local Anesthetics: General
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Two groups of LA's: ester's and amides (AMIDES HAVE TWO I's IN THEIR NAME)
Block Na-channels by binding to SPECIFIC RECEPTORS on channel. Prefer activated Na-channels -> most effective at RAPIDLY FIRING NEURONS. Tertiary amine LA's penetrate membrane as nonpolar molecules then bind to ion channels in a charged form. |
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Local Anesthetics: Principles/Toxicity
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1. In infected (ACIDIC) tissues, alkaline LA's are charged and cannot penetrate membrane well -> inc LA's needed
2. Sensitivty: small>large. myelinated>unmeylinated, size>myelination 3. First lose pain>temp>touch>pres 4. Vasoconstrictors (epinephrine): Enhance local action, dec bleeding, and dec systemic concentration Tox: CNS EXCITATION, CV tox (bupivacaine) |
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Neuromuscular Block: Depolarizing
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SUCCINYLCHOLINE
Phase I: prolonged depol. (NO ANTIDOTE) - exacerbated by cholinesterase-inhibitors Phase II: repolarized but blocked (TREAT WITH CHOLINESTERASE INHIBITORS: NEOSTIGMINE) |
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an enthusiast
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aficionado
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Dantrolene
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Treatment of MALIGNANT HYPERTHERMIA caused by inhalation anesthetic + succinylcholine combo.
Also used to treat Neuroleptic Malignant Syndrome (Prevents Ca release) |
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Parkinson's Disease Drugs: General (5)
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1. DA-R Agonists
2. Inc DA release 3. Prevent DA breakdown 4. ACh inhibitors 5. Exogenous DA |
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DA-R Agonists: PD
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BROMOCRIPTINE (ergot)
PRAMIPEXOLE (non-ergot) |
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Inc DA release: PD
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AMANTIDINE (may inc DA), also used against influenza A and rubella
Tox: ataxia |
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Prevent DA breakdown: PD
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Selegiline (MAOI Type B)
Entacapone, tolcapone (COMT Inhibitor - prevent L-Dopa degradation: peripheral) |
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ACh inhibitors: PD
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Benztropine (antimuscarinic: used to reduce TREMOR)
(for essential or familial tremors use beta-blockers: propranolol) |
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Exogenous DA: PD
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L-Dopa, Levodopa/Carbidopa
L-Dopa can cross the BBB and is converted to DA via DA decarboxylase Tox: arrhythmias (peripheral conversion to DA), DYSKINESIA after dose, AKINESIA between doses. |
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Selegiline
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Selective MAO type-B inhibitor
adjunct therapy |
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Alzheimer's Drugs
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MEMANTINE
NMDA receptor antagonist -> helps prevent excitotoxicity (mediated by Ca) (may cause hallucinations/confusion) |
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Alzheimer's Drugs
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DONEPEZIL, galantamine, rivastigmine
Acetylcholineesterase Inhibitors |
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Huntington's Drugs
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HD has too much DA and too little GABA + ACh
HALOPERIDOL: DA-R antagonist RESERPINE + TETRABENAZINE: amine depleting |
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Sumatriptan
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5-HT1b/1d AGONIST -> vasoconstriction, trigeminal inhibition, and vasoactive peptide release
Use: MIGRAINES/CLUSTER HEADACHES Tox: CORONARY VASOSPASM |
