Usmle Pharmacology- Neurology

Front 1

Alpha agonists treating Glaucoma:

Back 1

- Epinephrine
- Brimonidine

Front 2

What are side effects of epinephrine?

Back 2

- mydriasis
- stinging

Front 3

Beta blockers treating glaucoma:

Back 3

- timolol
- betaxolol
- carteolol

Front 4

Which diuretic treats glaucoma?

Back 4

- Acetazolamide (decreae HCO3)

Front 5

What cholinomimetics treat glaucoma?

Back 5

- Direct: pilocarpine, carbachol
- Indirect: physostigmine, echothiophate

Front 6

What are side effects of cholinomimetics?

Back 6

-miosis
- cyclospasm

Front 7

How does cholinomimetics relieve glaucoma?

Back 7

- increase outflow of aqueous humor
- contract ciliary muscle and open trabecular meshwork

Front 8

What prostaglandin is used for glaucoma?

Back 8

Latanoprost

Front 9

What is side effect of latanoprost?

Back 9

darkens color of iris (browning)

Front 10

How do you know if someone has closed angle glaucoma?

Back 10

- intense pain
- halos around lights

Front 11

Which drugs are used for closed angle glaucoma?

Back 11

- pilocarpine
- acetazolamine
- mannitol

*rapid acting

Front 12

What are opioid analgesics?

Back 12

- morphine
- fentanyl
- codeine
- heroin
- methadone
- meperidine
- dextromethorphan

Front 13

Where are opioid receptors?

Back 13

mu= morphine
delta= enkephalin
kappa= dynorphin

Front 14

Opioid

Back 14

MOA: open Ka+ channels; close Ca+ channels

Inhibit release of Ach, NE, 5HT, glutamate, substance P

Use: pain, cough suppression, diarrhea, pulm edema,

Front 15

What is toxicity of opioid?

Back 15

- addiction
- resp depression
- constipation
- pinpoint pupils

Front 16

Treat cough suppression:

Back 16

dextromethorpahn

Front 17

Treat dirrhea:

Back 17

- loperamide
- diphenoxylate

Front 18

Meperidine + MAOI=

Back 18

serotonin syndrome

Front 19

Butorphanol:

Back 19

MOA: parital agonist at mu receptor and kappa receptor

Use: pain--> less respiratory depression

Front 20

Heroin detox treatment:

Back 20

butorphanol

Front 21

Tramadol:

Back 21

MOA: weak opioid agonist
* inhibit Serotonin and NE reuptake "TRAM IT ALL"

Use: pain

Front 22

Tramadol toxicity?

Back 22

decreases seizure threshold

Front 23

1st line for Tonic-clonic seizure:

Back 23

- phenytoin
- carbamazepine
- valproid acid

(CVP)

Front 24

1st line for Absence Seizure:

Back 24

- eposuximide

Front 25

1st line for Status epilepticus:

Back 25

- phenytoin
- Benzodiazepine

Front 26

Which drugs ahve NO partial seizure activity?

Back 26

- ethosuximide
- benzodiazepine

Front 27

Phenytoin

Back 27

increase Na+ channel inactivation

Front 28

Carbamazepine:

Back 28

Increase Na+ channel inactivation

Front 29

Lamotrigine :

Back 29

blocks voltage-gated Na+ channels

Front 30

Gabapentin:

Back 30

designed as GABA analog
* inhibit HVA calcium channels

Front 31

Topiramate:

Back 31

block Na+ channel
* increase GABA

Front 32

Phenobarbital

Back 32

increase GABAa

Front 33

Valproic acid

Back 33

increase Na+ channel inactivation
* GABA increase

Front 34

Ethosuximide

Back 34

Blocks T-type thalamic Ca+ channels

Front 35

Benzodiazepine

Back 35

increase GABAa

Front 36

Tiagabine

Back 36

Inhibits GABA reuptake

Front 37

Vigabatirin

Back 37

Irreversibly inhibit GABA transaminase-- Increase GABA

Front 38

1st line for trigeminal neuralgia:

Back 38

carbamazepine

Front 39

Gabapentin is also used for:

Back 39

- peripheral neuropathy
- bipolar

Front 40

1st line epilepsy drug for pregnant woman and child:

Back 40

Phenobarbital

P for Pregnancy OKAY

Front 41

Valproic acid is used for _____ seizures also

Back 41

myoclonic

Front 42

Treatment for eclampsia seizures:

Back 42

Benzodiazepine

Front 43

1st line to prevent seizure of eclampsia:

Back 43

MgSO4

Front 44

Benzodiazepine toxicity:

Back 44

- sedation
- tolerance
- dependence

Front 45

Carbamazepine toxicity:

Back 45

- diplopia
- ataxia
- blood dyscrasias
- agranulocytosis
- aplastic anemia
- liver toxicity
- teratogenesis
- induce p-450
- SIADH
- Stevens Johnson

Front 46

Ethosuximide toxicity

Back 46

- GI distress
- Fatigue
- headache
- urticaria
- Steven Johnson Syndrome

Front 47

Phenobarbital

Back 47

- sedation
- tolerance
- dependence
- induce P450

Front 48

Valproic Acid

Back 48

- GI distress
- fatal HEPATOTOXICITY
(measure LFT)
- Neural tube defect in fetus (spina bifida)
- weight gain
** Dont give to pregnancy

Front 49

Lamotrigine

Back 49

Stevens Johnson Syndrome

Front 50

Gabapentine

Back 50

Sedation
Ataxia

Front 51

Topiramate toxicity

Back 51

sedation
kidney stones

Front 52

Ethosuximide toxicity pneumonic:

Back 52

EFGH:
Ethosuximide
Fatigue
GI
Headache

Front 53

What causes Stevens JOhnson syndrome?

Back 53

- Carbamazepine
- Ethosuximide
Lamotrigine
CEL

Front 54

Phenytoin toxicity

Back 54

- nystagmus
- diplopia
- ataxia
-sedation
- gingival hyperplasia
- hirsutism
- megaloblastic anemia
- teratogenesis
- SLE like syndrome

Front 55

Phenytoin:

Back 55

MOA: block NA+ channel
* Increase refractory period
* inhibit glutamate release from excitatory presynaptic neuron

Use: TOnic-clonic seizures; class IB

Front 56

Barbiturate:

Back 56

MOA: faciliatate GABAa by increase duration of Cl- channel opening

USE: sedative for anxiety, seizures, insomnia, induction of anesthesia

Toxic: additive CNS depression with alcohol

Front 57

Barbituate is contraindicated in:

Back 57

Porphyria

Front 58

Benzodiazepine:

Back 58

MOA: Facilitate GABAa by increase frequency of Cl- channel opening
* decrease REM sleep

Use: anxiety; spasticity; status epilepticus; detox (DT); night terror; sleep walking; hypnotic

Toxic: additive CNS depression with alcohol

Front 59

Treat benzo overdose with:

Back 59

Flumazenil

Front 60

Short acting Benzo:

Back 60

TOM
Triazolam
Oxazepam
Midazolam

Front 61

Anesthestics are:

Back 61

lipid soluble to cross BBB

Front 62

For Rapid, high potent drug:

Back 62

Low solublility in blood
High solubility in lipid

Front 63

Inhaled anesthetics:

Back 63

- halothane
- enflurane
- NO

USE: myocardial depression, respiratory depression, nausea, increased cerebral blood flow

Front 64

Toxicity of inhaled anesthetics

Back 64

hepatotoxicity (halothane)
nephrotoxicity (methoxyflurane)
proconvulsant (enflurane)
Malignant hyperthermia

Front 65

IV anesthetics

Back 65

B.B. King on Opiates Proposes Foolishly:
Barbituate
Benzo
Ketamine
Opiate
Propofol

Front 66

Barbituate (Thiopental)

Back 66

high potent
highl lipid

*DECREASE CEREBRAL BLOOD FLOW

Front 67

Benzodiazepine

Back 67

side effect: post-op respiratory depression; decreased BP; amnesia

Front 68

Ketamine

Back 68

PCP analog
* block NMDA receptors

* INCREASE CEREBRAL BLOOD FLOW

Front 69

Propofol

Back 69

potentiate GABAa

Front 70

Local Anesthetics

Back 70

- Ester (procaine, cocaine, tetracaine)

- Amides (lidocaine, mepivacaine, bupivacaine) 2 I's

Front 71

NM blockers

Back 71

muscle paralysis

*Depolarizing: Succinylcholine

* Non-depolarizing: -curarine

Front 72

Side effect of succinylcholine:

Back 72

- hypercalcemia
- hyperkalemia

Front 73

Reversal of block of Succinylcholine:

Back 73

phase i: no antidote (block potentiated by cholinesterase inhibitors)

phase ii: antidoe

Front 74

Dantrolene

Back 74

- treat malignant hyperthermia
- treat NMS

MOA: prevent Ca+ release from SR of skeletal muscle

Front 75

Parkinson:

Back 75

high cholinergic

low dopamine

Front 76

Parkinson Drugs:

Back 76

BALSA

Bromocriptine
Amantadine
Levodopa (carbidopa)
Selegiline
Antimuscarinics

Front 77

Bromocriptine:

Back 77

agonize dopamine receptor

Front 78

Amantadine

Back 78

increase dopamine

(also antiviral vs influenza A and rubella)

Front 79

selegiline:

Back 79

MAO-I B

* prevent dopamine breakdown

Front 80

Benztropine (antimuscarinic):

Back 80

curb excess cholinergic activity

Front 81

L-dopa/carbidopa is unlike dopamine because:

Back 81

- crosses BBB and converted to dopa decarboxylase in CNS to dopamine

Front 82

Carbidopa

Back 82

peipheral decarboxylase inhibitor

Front 83

Selegiline preferentially metabolizes:

Back 83

Dopamine over NE and 5HT

Front 84

What are alzheimer drugs:

Back 84

- memantine
- donepezil; galantamine; rivastigmine

Front 85

Memantine:

Back 85

NMDA receptor antagonist

* prevent excitotoxicity

Front 86

Donepezil; glantamine;rivastigmine

Back 86

ACHe inhibitors

Front 87

Huntington effect:

Back 87

high dopamine
low GABA
low ACh

Front 88

Huntington drugs:

Back 88

- Reserpine + tetrabenazine

- Haloperidol

Front 89

Sumatriptan:

Back 89

5HT 1b/1d agonist

USE: acute migraine, cluster headache

TOXIC: coronary vasospasm

"SUMo wrestler TRIPS AND falls on your head"

Front 90

Sumatriptan is contraindicated in:

Back 90

= CAD
= Prinzmetal angina

Front 91

riluzole

Back 91

NMDA receptor antagonist

* treat ALS