407 flashcards.txt

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407 flashcards.txt
2011-12-11 01:01:39
407 final flashcards

407 final flashcards
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  1. Acetylcholine
    Cholinergic agonist; ester
  2. Methacholine
    Cholinergic agonist; ester
  3. Carbachol
    Cholinergic agonist; ester
  4. Bethanechol
    Cholinergic agonist; ester
  5. Nicotine
    Cholinergic agonist; alkaloid
  6. Pilocarpine
    Cholinergic agonist; glaucoma
  7. Varenicline tartrate (Chantix)
    Nicotinic PARTIAL agonist; dampens withdrawal sx
  8. Tetraalkylammonium ions
    Reversible AChE inhibitor
  9. Endrophonium
    Reversible AChE inhibitor; Quaternary ammonium; MG dx
  10. Neostigmine
    Reversible covalent AChE inhib; carbamate
  11. Pyridostigmine
    Reversible covalent AChE inhib; carbamate
  12. Physostigmine
    Reversible covalent AChE inhib; carbamate
  13. Isofluorophate
    Irreversible AChE inhib; organophosphate; glaucoma
  14. Echothiophate
    Irreversible AChE inhib; organophosphate; glaucoma
  15. Sarin
    Irreversible AChE inhib; organophosphate; nerve gas
  16. Soman
    Irreversible AChE inhib; organophosphate; nerve gas
  17. Malathion
    Irreversible AChE inhib; organophosphate; insecticide
  18. Diazinon
    Irreversible AChE inhib; organophosphate; insecticide
  19. Pralidoxime Chloride (2-PAM)
    Antidote for AChE poisoning
  20. Tacrine
    Reversible AChE inhib; Alzheimers (DOES NOT SLOW DISEASE PROGRESSION)
  21. Donepezil
    Reversible AchE inhib; alzheimers
  22. Parasympathomimetic drugs� CONTRAINDICATIONS
    1. Asthma 2. COPD 3. ulcer 4. GI/urinary tract obstruction
  23. Cholinergic SE
    SLUD, inc sweating, dec HR, pupil constriction, CNS activation
  24. Tx for cholinergic SE
    Atropine (cholinergic antagonist)
  25. Rivastigmine
    Reversible carbamate AchE inhib; alzheimers (loses effectiveness)
  26. Eptastigmine
    Longer acting than rivastigmine; alzheimers
  27. Reminyl
  28. Memantine (Namenda)
    NMDA antagonist; alzheimers (MAY SLOW PROGRESSION)
  29. Atropine
    VERY LONG HALF LIFE; tachycardia, dec GI motility
  30. Homatropine HBr
    Less toxic and shorter duration than atropine
  31. Homatropine methyl Br
    QUATERNARY (cant cross BBB); GI spasm and ulcer
  32. Clidinium Br
    If lacking quaternary, this would be �BZ� (the chemical warfare agent)
  33. Ipratropium Br
    COPD but no quaternary so would enter CNS
  34. Tropicamide
    VERY SHORT DURATION; mydriasis
  35. Tolterodine (Detrol)
    Dec frequency of urinary bladder contractions
  36. Diphemanil
    Antispasmodic with double bond instead of an ester
  37. Diphenhydramine (Benadryl)
    Antihistamine and strong sedative
  38. Imipramine
    TCA with anticholinergic effects
  39. Solifenacin (Vesicare)
    Muscarinic antagonist for incontinence
  40. Darifenacin (Enablex)
    M3 antagonist for incontinence
  41. Propantheline Br
  42. Benztropine (Cogentin)
    Parkinsons; sedation
  43. Procyclidine
  44. Trimethaphan camphorsulfonate
    MINUTE TO MINUTE CONTROL; controls intracranial bleeding during surgery
  45. Mecamylamine
    Smoking cessation; bad b/c of orthostatic hypotension
  46. d-tubocurarine
    parenteral ONLY, neuromuscular blocker
  47. metocurine
    neuromuscular blocker with WORST CV effects
  48. Succinyl choline
    Only depolarizing neuromuscular blocker used therapeutically; perfect poison
  49. Norepinephrine CV effect
    a1 (inc BP), b1 (dec HR)
  50. Epinephrine CV effect
    a1 and b2 (no BP change), b1 (inc HR)
  51. isoproterenol CV effect
    b2 (dec BP), b1 (inc HR)
  52. l-Norepinephrine (Levophed)
    a, b1, pressor
  53. epinephrine
    a, b1, b2; for anaphylaxis (EPIPENS) and glaucoma
  54. Phenylephrine
    a1, nasal decongestant
  55. Naphazoline
    Partial a agonist; decongestant; TACHYPHYLAXIS
  56. Tetrahydrozoline (Visine)
    • Partial a agonist; ophthalmic decongestant; TACHYPHYLAXIS
    • Oxymetazoline (Afrin, Visine)
    • Partial a agonist; decongestant; TACHYPHYLAXIS
  57. Clonidine
    a2, for HTN or opiate withdrawal
  58. Guanbenz
    a2; Open ring imidazoline; HTN
  59. guanfacine
    a2; Open ring imidazoline; HTN
  60. methyldopa
    a2; PRODRUG; HTN
  61. Apraclonidine
    a2; glaucoma
  62. tizanidine
    a2, muscle spasticity
  63. a2 agonist SE
    sedation, NA/water retention, dry mouth, withdrawal syndrome
  64. Isoproterenol
    b agonist (nonselective); asthma, COPD, cardiostimulant
  65. metaproterenol
    b2, asthma, COPD; resorcinol
  66. terbutaline
    b2, asthma, COPD, tocolytic; resorcinol
  67. albuterol
    b2, asthma COPD
  68. salmeterol
    b2, asthma, COPD
  69. salmeterol
    b2, slow onset/long duration, long term asthma, COPD
  70. formoterol
    b2, slow onset/long duration, long term asthma, COPD
  71. ritodrine
    b2, tocolytic
  72. b agonist SE
    tachycardia, CNS stimulation at high doses, caution in CAD pts
  73. dobutamine
  74. phenoxybenzamine
    a antagonist (nonselective), IRREVERSIBLE
  75. phentolamine
    a antagonist (nonselective); vasodilator but reflex tachycardia
  76. prazosin
    a1 antagonist, smooth muscle relaxation in BPH, 1st dose effect
  77. terazosin
    a1 antagonist, smooth muscle relaxation in BPH, 1st dose effect
  78. doxazosin
    a1 antagonist, smooth muscle relaxation in BPH, 1st dose effect
  79. yohimbine
    a2 antagonist; inc sympathetic discharge
  80. propranolol
    b blocker (nonselective); dec renin release
  81. therapeutic uses for b blockers
    HTN, angina, arrhythmias, migraine, stage fright, thyrotoxicosis, CHF
  82. Nadolol
    B blocker (nonselective); less lipophilic than propranolol
  83. Timolol (timoptic)
    B blocker (nonselective); glaucoma
  84. Pindolol
    B blocker (nonselective); PARTIAL � ISA
  85. Carteolol
    B blocker (nonselective); PARTIAL � ISA
  86. Metoprolol
    b1, for almost all cardiac conditions
  87. bisoprolol
    b1, for almost all cardiac conditions
  88. atenolol
    b1, PERFECT B BLOCKER (cardioselective, low lipophilicity, long duration); HTN and angina
  89. esmolol
    b1, cleared quickly b/c of ester group
  90. B blocker SE
    1. bradycardia 2. AV block 3. Sedation 4. Masked hypoglycemia sx 5. Withdrawal
  91. B blocker (nonselective) contraindications
    Asthma, COPD, late stage CHF
  92. Labetalol
    B blocker (nonselective), a1 antagonist; racemic mix prevents reflex tachy (BETTER THAN PRAZOSIN)
  93. Carvedilol
    B blocker (nonselective), a1 antagonist; racemic (no reflex tachy)
  94. Metyrosine
    Blocks tyrosine hydroxylase; no NE, DA, Epi produced
  95. Reserpine
    Blocks vesicular monoamine transporter; deplete monoamines
  96. Bretylium
    Blocks NE release; antiarrhythmic
  97. Renin
    Angiotensin � ang I � ang II � vasoconstriction/aldosterone (inc Na and water reabsorp)
  98. Hindbrain
    Medulla and pons (cerebellum)
  99. Medulla
    Respiration, cardiac, vasomotor
  100. Cerebellum
  101. Forebrain
    Higher struc (thalamus, hypothalamus, basal ganglia, limbic)
  102. Thalamus
    Relay station to and from cortex
  103. Hypothalamus
  104. Basal ganglia
    Voluntary motor
  105. Limbic
    Hippocampus, amygdala (Emotions, memory)
  106. EPS sx
    Dystonia, pseudoparkinsonism, tremor, akathisia
  107. EPS tx
    Benztropine, artane, anticholinergics, antihistamines, DA releasing agents
  108. Tardive dyskinesia sx
    IRREVERSIBLE; mouth movements, choreiform, athetoid, to and fro movements
  109. Neuroleptic malignant syndrome
    Serious. Rapid. Fatal.
  110. Chlorpromazine
    FIRST 1st gen antipsychotic; phenothiazine
  111. Promethazine
    1st gen antipsychotic; antiemetic
  112. Thioridazine
    1st gen antipsychotic; MANY MANY SE
  113. Fluphenazine
    1st gen antipsychotic; EPS
  114. Proclorperazine
    1st gen antipsychotic; antiemetic
  115. Perphenazine
    1st gen antipsychotic; CATIE equal efficacy but tardive dyskinesia
  116. Thiothixene
    1st gen antipsychotic; modest EPS
  117. Haloperidol
    1st gen antipsychotic; EPS
  118. Molindone
    1st gen antipsychotic; moderate EPS
  119. Pimozide
    1st gen antipsychotic; tourette�s
  120. Clozapine
    2nd gen antipsychotic; agranulocytosis
  121. Olanzapine
    2nd gen antipsychotic; wt gain and diabetes
  122. Quetiapine (Seroquel)
    2nd gen antipsychotic; metabolite w/antidepressant property
  123. Risperidone
    2nd gen antipsychotic; designed to be 5HT2 AND D2 antagonist
  124. Ziprasidone
    2nd gen antipsychotic; prolongs QT interval
  125. Lurasidone
    2nd gen antipsychotic; low doses similar effectiveness as high (fast onset; days without titration)
  126. Aripiprazole (abilify)
    2nd gen antipsychotic; dopaminergic-state dependent actions and partial 5HT1a agonist
  127. Phenelzine
    Nonselective MAO inhibitor; depression
  128. Selegiline
    MAO-B; antidepressant and parkinsons
  129. Moclobemide
    MAO-A; antidepressant; reversible
  130. MAO inhibitors SE
    Hypertensive crisis, avoid tyramine, lots of interactions an SE
  131. TCA indications
    Depression, panic, chronic pain, enuresis BUT CAUTION SUICIDE
  132. Imipramine
    TCA (enuresis and ADHD)
  133. Amitriptyline
  134. Clomipramine
    TCA, OCD
  135. Desipramine
    TCA secondary amine from imipramine
  136. Nortriptyline
    TCA secondary amine from amitriptyline
  137. TCA SE
    LESS everything but pts may be suicidal
  138. SSRI uses
    MANY b/c of modest SE
  139. SSRI SE
    Sexual dysfunct; SSRI discont syndrome; serotonin syndrome
  140. Vilazodone
    (antidepressants) SSRI and 5ht1a partial agonist (REDUCED SEXUAL SE)
  141. Maprotiline
    Tetracyclic NET inhibitor (antidepressants)
  142. Amoxapine
    (antidepressants) tetracyclic NET inhibitor; D2 antagonist
  143. Mirtazapine
    (antidepressants) targets a bunch of RECEPTORS; tetracyclic
  144. Bupropion
    (antidepressants) unicyclic; GAD
  145. Trazodone
    (antidepressants) 5ht2 antagonist
  146. Venlafaxine
    (antidepressants) SNRI; GAD and panic
  147. Desvenlafaxine
    (antidepressants) SNRI
  148. Duloxetine (Cymbalta)
    (antidepressants) SNRI; GAD and peripheral neuropathy
  149. Milnacipran
    (antidepressants) SNRI; fibromyalgia
  150. Atomoxetine
    (antidepressants) NSRI; ADHD; NOT APPROVED for depression
  151. Lithium
    MANIA; Gq; small TI with dose related SE and toxicity; lag time
  152. Psychostimulant uses
    Appetite suppressant; narcolepsy; ADHD
  153. Psychostimulant pharmacophore
    • Adderall
    • [psychostimulants] Mixture of + salts and racemic amphetamine; ADHD; longacting
  154. Amphetamine MOA
    Monoamine releasing agent
  155. Cocaine
    [psychostimulants] Esterases cleave so not given orally; block reuptake of DA, 5HT, NE
  156. Methylphenidate (Ritalin, concerta)
    [psychostimulants] narcolepsy, ADHD; DAT and NET
  157. Straterra (Atomoxetine)
    [psychostimulants] but NOT a stimulant; ADHD; NET
  158. Modafinil
    [psychostimulants] narcolepsy, little euphoria low addiction but $$$
  159. R-modfainil (Nuvigil)
    [psychostimulants] narcolepsy; cheaper
  160. Vyvanse (lisdexamfetamine)
    [psychostimulants] PRODRUG; only orally active
  161. Intuniv
    [psychostimulants] a2 agonist for pts who cant tolerate psychostimulant; long acting form of ganfacine
  162. Phentermine
    [psychostimulants] appetite control
  163. Phenmetrazine
    [psychostimulants] appetite control
  164. Benzphetamine
    [psychostimulants] appetite control
  165. Diethylpropion
    [psychostimulants] appetite control drug of choice
  166. Trimethylxantine
    [psychostimulants] Caffeine
  167. Dimethylxanthines
    [psychostimulants] Theophylline and thebromine
  168. Cathinone
    [psychostimulants] bath salts
  169. L-dopa (levodopa)
    [parkinsons] gold standard
  170. Carbidopa
    [parkinsons] peripheral acting decarboxylase inhibitor
  171. Sinemet
    [parkinsons] Carbidopa and L-DOPA; requires functional dopamine synthesis
  172. Entacapone (comtan)
    [parkinsons] only COMT inhibitor avail; given when pt begins experiencing end-of-dose wearing off
  173. Stalevo
    [parkinsons] levodopa + sinemet + comtan; inc �on time�
  174. Apomorphine
    [parkinsons] mixed D1 D2 partial agonist, N/V and kidney problems
  175. Pramipexole
    [parkinsons] D2/D3 agonist, N/V
  176. Ropinirole
    [parkinsons] D2/D3 agonist, N/V; also for restless legs
  177. Rotigotine NeuroPro
    [parkinsons] D2/D3 agonist, N/V; transdermal
  178. Bromocriptine
    [parkinson] ergoline
  179. Pergolide
    [parkinsons] d/c because of valvulopathy
  180. Dihydrexidine
    [parkinsons] d1 agonist; NICHOLS DRUG
  181. MPTP
    Activated by MAO-B to MPP and induces parkinsonism
  182. Deprenyl (selegiline)
    [parkinsons] MAO B inhibitor; has triple bond
  183. Rasagiline mesylate
    [parkinsons] MAO B inhibitor; has triple bond
  184. Psilocin
    [psychadelics] tryptamine; mushroom
  185. Psilocybin
    [psychadelics] tryptamine; mushroom
  186. DMT
    [psychadelics] tryptamine; natural plant alkaloid smoked or injected
  187. LSD
    [psychadelics] Lysergic acid diethylamide; most potent hallucinogen
  188. Phenethylamine psychadelics
    Substituted amphetamines developed from mescaline
  189. Phenethylamine psychedelic pharmacology
    Activate 5ht2a; low toxicity; nonaddicting; rapid tolerance
  190. Ecstasy (MDMA)
    [psychadelics] not a hallucinogen; serotonin and dopamine release; NEUROTOXICITY; several deaths
  191. THC
    [psychadelics] low toxicity; not an alkaloid; GPCR
  192. THC medical uses
    AIDS wasting, glaucoma, nausea from chemo, multiple sclerosis
  193. THC SE
    Impaired short term memory, panic or anxiety from potent marijuana, cannabis dependence in 1/9, bronchitis, psychosis
  194. PCP (phencyclidine)
    [psychadelics] toxic psycotomimetic that causes schizo-like effects
  195. Ketamine
    [psychadelics] less dangerous than PCP but still dissociative; dependence and addiction
  196. �Spice�
    Synthetic cannabinoids
  197. Fomepizole
    [alcohol] inhibits ADH and used for ethylene glycol/methanol poison
  198. Disulfuram
    [alcohol] inhibits ALDH; makes you sick if you use alcohol
  199. Naltrexone
    [alcohol] alcoholism tx; opioid antagonist that dec cravings
  200. Acomprosate
    [alcohol] alcoholism tx; NMDA antagonist that reduces withdrawal sx
  201. Sedative defn
    Calms anxiety; dec excitement and activity; does NOT produce drowsiness or impair performance
  202. Hypnotic defn
    Induces natural SLEEP
  203. Anxiolytic defn
    Relieves anxiety WITHOUT sleep or sedations; not all anxiolytics are sedatives
  204. Narcotic defn
    Literally SLEEP PRODUCING; opioids/illegal drugs
  205. Factors that regulate sleep
    Age, sleep hx, drug ingestion, circadian rhythm
  206. GABA-a/BZD ligands at BZD site
    BZDs (PAM), non-BZDs like zolpidem, BZD antagoniss, inverse agonists (NAM)
  207. GABA-a/BZD ligands at other sites
    Bbts, alcohol, GABA antagonists, GABA agonists, etomidate and propofol
  208. BZD 1 position
    Active source of metabolits
  209. BZD 5 position
    Decreased activity if substituted
  210. BZD 7 position
    Inc affinity if group is electronegative
  211. BZD 1-2 position
    Electron rich ring = high affinity but dec half life
  212. Slow elimating BZDs
    Chlordiazepoxide, Diazepam, Flurazepam, Clorazepate, Quazepam, Prazepam
  213. Chlordiazepoxide
    [sedative-hypnotics] slow; anxiolytic and alcohol withdrawal
  214. Diazepam (Valium)
    [sedative-hypnotics] slow; anxiolytic, alcohol withdrawal (DOC), convulsive disorders
  215. Flurazepam
    [sedative-hypnotics] slow; hypnotic
  216. Clorazepate
    [sedative-hypnotics] slow; anxiolytic, alcohol withdrawal;, convulsive disorders
  217. Quazepam
    [sedative-hypnotics] slow; hypnotic
  218. Prazepam
    [sedative-hypnotics] slow; anxiolytic
  219. Intermediate eliminating BZDs
    Alprazolam, Lorazepam, Clonazepam, Oxazepam, Temazepam, Estrazolam
  220. Alprazolam
    [sedative-hypnotics] intermediate; anxiolytic and anesthetic
  221. Lorazepam
    [sedative-hypnotics] intermediate anxiolytic, hypnotic
  222. Clonazepam
    [sedative-hypnotics]; intermediate; anticonvulsant
  223. Oxazepam
    [sedative-hypnotics] intermediate; anxiolytic and alcohol withdrawal
  224. Temazepam
    [sedative-hypnotics] intermediate; hypnotic
  225. Estrazolam
    [sedative-hypnotics] intermediate; DC�ed
  226. Rapid eliminating BZDs
    Midazolam, triazolam
  227. Midazolam
    [sedative-hypnotics]; rapid; anesthesia
  228. Triazolam
    [sedative-hypnotics]; rapid; hypnotic
  229. Slow eliminating BZD characteristics
    Accumulation, active metabolites, sedation, useful in pts who wake up in the middle of the night
  230. Intermediate to rapid eliminating BZDs characteristics
    Preferred in hepatic problems and elderly, alter liver enzymes, rapid tolerance, rebound insomnia
  231. BZD indications
    Anxiolytic, hypnotic, epilepsy, alcohol withdrawal, muscle relaxant, anesthetic
  232. BZD SE
    Sedation, weakness, HA, nausea, vertigo, paradoxical effects, but LOW abuse potential
  233. Flumazenil
    [sedative-hypnotics] BZD and Z hypnotic overdose; neutral antagonist (Safe)
  234. Flumazenil SE
    [sedative-hypnotics] induce convulsions and panic attacks
  235. Zolpidem
    [sedative-hypnotics] non BZD Z-hynpnotic; short term insomnia tx; sometimes abused
  236. Zaleplon
    [sedative-hypnotics] non BZD Z hypnotic; BZ1; short term insomnia tx; rapid acting
  237. Eszopiclone (Lunesta)
    [sedative-hypnotics] nonBZD Z hypnotic; LONG TERM insomnia tx; allows you to sleep through the night
  238. Z hypnotics
    [sedative-hypnotics] PAMS, more selective than BZDs; cause less neg effects on sleep than BZDs
  239. Z hypnotics SE
    Daytime drowsiness, sleep-activities
  240. Flunitrazepam
    [sedative-hypnotics] BZD; ROOFIES; anterograde amnesia
  241. Phenobarbital
    [sedative-hypnotics] barbiturate, anticonvulsant, long acting
  242. Barbiturate pharmacology
    [sedative-hypnotics] More dangerous (CV and resp depression) but sleep effects similar to BZDs
  243. GABA-B receptor
    Metabotropic; Gi/o; heterodimer
  244. Baclofen
    [sedative-hypnotics] GABA-b agonist; muscle relaxant; alcoholism tx
  245. GABA-B antagonists
    Phaclogen, saclofen, 2-hydroxysaclofen
  246. Xyrem (GHB)
    [sedative-hypnotics] DATE RAPE DRUG; dual classified; special administration procedures; used for sleep disorders
  247. Gamma-hydroxybutyric acid (GHB)
    [sedative-hypnotics] illicit drug; loss of consciousness
  248. Ramelteon (Rozerem)
    [sedative-hypnotics] Melatonin agonist; faster sleep onset (insomnia); NO ABUSE, WITHDRAWAL, DEPENDENCY
  249. Antihistamines used as sleep aids
    [sedative-hypnotics] Diphenhydramine, doxylamine, pyrilamine
  250. Sedative hypnotic abuse
    Similar effects to etOH; euphoria; dependence (except rozerem)
  251. Types of anxiety
    GAD, panic, OCD, social, PTSD, anxiety from medical issues
  252. Anxiolytic BZDs
    Alprazolam, chlordiazepoxide, clonazepam, clorazepate, diazepam, lorazepam, oxazepam
  253. Buspirone
    [anxiolytics] partial 5HT1A agonist; longer onset than BZD but less abuse; NOT GOOD FOR PANIC
  254. Buspirone advantages
    little/no sedation, no CNS depression, no muscle relaxation, little abuse tolerance or withdrawal
  255. Buspirone disadvatanges
    Slow onset, not for severe or panic, best in BZD-naive pts
  256. SSRI anxiolytic use
    OCD and panic 1st line
  257. SSRI anxiolytics
    Fluoxetine, paroxetine, sertraline, fluvoxamine, citalopram, escitalopram
  258. Clomipramine [anxiolytics]
    TCA; 2nd line for OCD
  259. Venlafaxine [anxiolytics]
    SNRI for GAD, social, panic
  260. Duloxetine [anxiolytics]
    SNRI for GAD
  261. Propranolol [anxiolytics]
    Social and PTSD (nightmares)
  262. Hydroxyzine [anxiolytics]
    Histamine h1 antagonist
  263. Clonidine [anxiolytics]
    a2 agonist; panic and anxiety from withdrawal
  264. factors triggering seizure
    stress/fatigue, blood gas and ph, hypoglycemia, light/sound/touch, alcohol withdrawal
  265. Maximal electricshock (MES) model
    [anticonvulsant] tonic-clonic (TC), complex partial
  266. Metazole model
    [anticonvulsant] GABA-A NAM; drug-induced and absence
  267. Kindled-limbic
    [anticonvulsant] repeated electrical stimulation; complex and tests effectiveness
  268. Phenytoin
    [anticonvulsant] Na channels; partial, TC
  269. Phenytoin SE
    [anticonvulsant] nystagmus, chronic stuff like hirsutism, SJS
  270. Phenytoin interactions
    [anticonvulsant] Induces p450, CBZ enhances and gets enhanced
  271. Fosphenytoin
    [anticonvulsant] prodrug, metabolized by phosphatases
  272. Ethotoin
    [anticonvulsant] TC, psychomotor seizures
  273. x-mephenytoin
    [anticonvulsant] d/c
  274. carbamazepine (CBZ)
    [anticonvulsant] Na channel, all except absence, neuralgias, DOC for partial
  275. CBZ SE
    [anticonvulsant] HEPATIC and blood
  276. CBZ interactions
    [anticonvulsant] autoinducer; clearance inhibited by valproic acid
  277. Oxcarbamazepine
    [anticonvulsant] Na channel; partial
  278. Phenobarbital [anticonvulsant]
    Partial and TC (infants)
  279. Phenobarbital SE
    [anticonvulsant] sedation, dependence, and paradoxical in kids
  280. Phenobarb interactions
    [anticonvulsant] CBZ, valproate, lamotrigine, tiagabine, zonisamide
  281. Primidone
    [anticonvulsant] TC, simple, complex, adjunct
  282. Mephobarbital
    [anticonvulsant] not really used
  283. BZDs as anticonvulsants
    Diazepam, lorazepam, midazolam, chlorazapate, clonazepam
  284. BZDs as anticonvulsants indication
    Status epilepticus
  285. Gabapentin
    [anticonvulsant] partial, neuropathic pain, migraine
  286. Gabapentin MOA
    [anticonvulsant] inc GABA, modulates Ca
  287. Pregabalin
    [anticonvulsant] neuropathy (diabetic and post herpetic), anxiety
  288. Vigabatrin
    [anticonvulsant] irreversible GABA transaminase inhib; use in refractory
  289. Tiagabine
    [anticonvulsant] GAT inhibitor; partial; TC
  290. Lacosamide
    [anticonvulsant] Na channels; CRMP-2
  291. Rufinamide
    [anticonvulsant] triazole deriv w/little similarity to others; partial and Lennox Gastaut
  292. Lamotrigine
    [anticonvulsant] Na channel; partial and absence adjunct
  293. Zonisamide
    [anticonvulsant] partial in pts >12
  294. Levetiracetam
    [anticonvulsant] GABA, Ca channel; partial adjunct
  295. Ionotropic excitatory amino acid receptors [anticonvulsant]
    NMDA, AMPA, kainite
  296. NMDA activation
    [anticonvulsant] Glu binding, Glycine, Mg removal from cell depolarization
  297. Felbamate
    [anticonvulsant] NMDA antagonist; 3rd line bc of APLASTIC ANEMIA and HEPATOTOXIC
  298. Topiramate receptor effects
    [anticonvulsant] kainite/AMPA antagonist; Na channels; GABA-a
  299. Topiramate use
    [anticonvulsant] partial onset, TC, has CNS SE
  300. Ethosuximide
    [anticonvulsant] Ca channels; ABSENCE ONLY
  301. Phensuximide
    [anticonvulsant] ethosuximide deriv
  302. Methsuximide
    [anticonvulsant] ethosuximide deriv
  303. Valproic acid
    [anticonvulsant] generalized and absence
  304. Dilvaproex sodium
    [anticonvulsant] valproic acid deriv; ABSENCE and generalized; monitor liver fct
  305. Grand mal/TC drugs of choice
    CBZ, phenytoin, valproate
  306. General absence DOC
  307. Partial DOC
    CBZ/oxCBZ, phenytoin, valproate
  308. Atypical DOC
  309. Myoclonic DOC
  310. Atonic DOC
  311. Status epilepticus DOC
    Diazepam, lorazepam
  312. Diazepam [muscle relaxants]
    SPASMOLYTIC; GABA A, CNS and spinal cord, sedation
  313. Baclofen [muscle relaxants]
    SPASMOLYTIC; GABA B, CNS and spinal cord, less sedation than BZDs, WARNING for withdrawal syndrome from intrathecal use
  314. Tizanidine [muscle relaxants]
    SPASMOLYTIC; a2 agonist; clonidine congener
  315. cyclobenzaprine (flexeril)
    [muscle relaxants] SPASMOLYTIC; tricyclic; sedation; ACUTE
  316. Chlorzoxazone
    [muscle relaxants] SPASMOLYTIC; similar to flexeril
  317. Orphenadrine
    [muscle relaxants] SPASMOLYTIC; similar to flexeril
  318. Carisprodol
    [muscle relaxants] SPASMOLYTIC; similar to flexeril; drug seekers
  319. Dantrolene sodium
    [muscle relaxants] SPASMOLYTIC; ONLY ONE TO WORK AT MUSCLE; blocks contractions
  320. Dantrolene sodium indications
    [muscle relaxants] cerebral palsy, MS, MALIGNANT HYPERTHERMIA
  321. Spasmolytic indications
    CHRONIC neurological diseases and ACUTE injury
  322. Short acting neuromuscular blockers
    [muscle relaxants] succinylcholine, mivacurium
  323. Intermediate acting neuromusc blocker
    [muscle relaxants] atracurium, vecuronium, rocuronium
  324. Long acting neuromusc blocker
    [muscle relaxants] pancuronium
  325. Neuromusc blocker indications
    Musc relaxation during surgery, endotracheal intub, controlled ventilation
  326. Ether
    [anesthetics] inhaled; EXPLOSIVE, irritant, N/V
  327. Nitrous oxide
    [anesthetics] inhaled; good analgesia and good for short procedures (rapid)
  328. Halothane (Fluothane)
    [anesthetics] inhaled; less analgesia and musc relaxation, hepatoxic, INC MYOCARDIUM SENSITIVITY
  329. Enflurane
    [anesthetics] inhaled; similar to but less toxicity than halothane
  330. Isoflurane
    [anesthetics] inhaled; dec mean arterial pressure
  335. LOW solubility effect on induction
    FAST induction
  336. HIGH solubility effect on induction
    SLOW induction
  337. MAC
    Minimum conc in alveoli to eliminate pain response in 50% of pts
  338. Inhalation anesthetics SE
    Dec brain metabolic rate and inc intracranial pressure; MALIGNANT HYPERTHERMIA
  339. Malignant hyperthermia
    Massive Ca release; tachy, HTN, hyperkalemia, muscle rigidity, hyperthermia; genetics
  340. Ketamine [anesthetics]
    IV; dissociative; blocks Glu receptors
  341. Etomidate
    [anesthetics] IV; non-bbt, high N/V
  342. Propofol
    [anesthetics] IV; similar to etOH; antiemetic; rapid onset and recovery
  343. Thiopental
    [anesthetics] IV; short acting Bbt
  344. Midazolam [anesthetics]
    IV, BZD, very short acting
  345. IV Anesthetics
    Most do not have good analgesia
  346. Local anesthetics MOA
    Block sensory transmission to brain; block Na channels (CAINES)
  347. Local anesthetics SAR
    Esters or amides; weak bases; lipid sol = potency = onset rate
  348. Cocaine [anesthetics]
    Local ester; medium duration
  349. Procaine
    [anesthetics] local ester; short duration
  350. Tetracaine
    [anesthetics] local ester; long duration
  351. Benzocaine
    [anesthetics] local ester; topical only
  352. Lidocaine
    [anesthetics] local amide; medium duration
  353. Mepivacaine
    [anesthetics] local amide; medium dur
  354. Bupivacaine
    [anesthetics] local amide; long dur
  355. Local anesthetic toxicities
    CNS (sedation, restlessness, nystagmus, convulsions), CV (arrhythmias, vasodilation, block), Allergic
  356. m (Mu) opioid receptor
    analgesia; euphoria; resp depression, miosis, constipation, tolerance, withdrawal
  357. K (kappa) opioid receptor
    Analgesia, SEDATION, DYSPHORIA but less miosis, resp depression and dependence
  358. d (delta) opioid receptor
  359. orphanin opioid receptor like subtype 1 (ORL1)
    ANTAGONIZE for analgesia, Gi/o
  360. Phenanthrene SAR 3 position
    [Opioids] substitution = dec potency - codeine
  361. Phenanthrene SAR 6 position
    [Opioid] inc activity � hydromorphone, oxycodone
  362. Phenanthrene SAR 14 position
    [Opioid] inc acitivity � oxycodone
  363. Phenanthrene SAR N-allyl
    Antagonist � naloxone/ naltrexone
  364. Codeine
    [Opioid] weak analgesia, good antitussive, CYP2d6 converts to morphine
  365. Morphine
    [Opioid] severe, acute, chronic pain
  366. Hydromorphone (Dilaudid)
    [Opioid] severe
  367. Oxymorphone
    [Opioid] severe
  368. Levorphanol
    [Opioid] severe
  369. Apomorphine
    [Opioid] emetic; parkinsons
  370. Hydrocodone (Vicondin, Lortab)
    [Opioid] moderate
  371. Oxycodone/aspirin
    [Opioid] mod to severe
  372. Oxycontin
    [Opioid] controlled release oxycodone. Hillbilly heroin abuse
  373. Dextromethorphan (DXM)
    [Opioid] antitussive only
  374. Heroin (diacetylmorphine)
    [Opioid] low m affinity, high lipophilicity, metabolized to 6acetylmorphine
  375. Meperidine (Demerol)
    [Opioid] M agonist, no antitussive, less SE than phenanthrenes
  376. Methadone
    [Opioid] M agonist, treats pain and ADDICTION (long duration)
  377. Tramadol (Ultram)
    [Opioid] Weak m, inhibits 5HT and NE reuptake; non addicting, no resp depression, no constipation
  378. Ketorolac
    [Opioid] NSAID for severe; short term use only
  379. Tapentadol
    [Opioid] weak m agonist and inhibit NET; lower SE profile
  380. Methotrimeprazine
  381. Fentanyl injection
    [Opioid] anesthetics; m agonist, MORE POTENT THAN MORPHINE
  382. Sufentanil
    [Opioid] anesthetics, m agonist, fentanyl bioisostere; SUPER POTENT
  383. Alfentanil
    [Opioid] anesthetics, m agonist, MORE POTENT THAN MORPHINE. Ultra short acting
  384. Remifentanil
    [Opioid] anesthetic. Selective m; similar to alfentanil
  385. Diphenoxylate with atrophine (Lomotil)
    [Opioid] antidiarrheal
  386. Difenoxin with atropine (Motofen)
    [Opioid] antidiarrheal; active metabolite of diphenoxylate
  387. Loperamide (Imodium)
    [Opioid] OTC antidiarrheal; travelers diarrheal; caplet or liquid
  388. Buprenorphine
    [Opioid] mixed activity; treats opioid withdrawal and addiction
  389. Butorphanol
    [Opioid] mixed; morphinan struc;
  390. Nalbuphine
    [Opioid] mixed; phenanthrene; k agonist, m antagonist (produces withdrawal)
  391. Pentazocine
    [Opioid] benzomorphan struc; k agonist, m antagonist
  392. Dezocine
    [Opioid] partial m, postop and cancer pain
  393. Pentazocine and naloxone combination (Talwin)
    [Opioid] orally = naloxone not bioavail. Injected = naloxone blocks opioid action of pentazocine
  394. Naloxone
    [Opioid] m antagonist; IV; no antitussive; for opioid overdose
  395. Naltrexone
    [Opioid] oral; blocks heroin effects, etOH dependence
  396. Nalmefene
    [Opioid] longer acting version of naloxone
  397. Drugs for mild pain
    Aspirin, APAP, Ibu, NSAIDs, Cox2
  398. Drugs for moderate pain
    Codeine, Darvocet, tylox, Percocet
  399. Drugs for severe pain
    Morphine, hydromorphone, meperidine, pentazocine
  400. Therapeutic use of opioids
    Cough, constipating effect, pulm edema, sedative, anesthesia, addiction
  401. Agonist maintenance for long term tx of opioid addiction
    Methadone maintenance � stabilize, cross tolerance to heroin, tolerance to sedation
  402. Partial agonist therapy for long term tx of opioid addiction
    Buprenorphine � cross tolerance, blocks effect, long acting and low tol
  403. Antagonist maintenance for long term tx of opioid addiction
    Naltrexone � does not alleviate cravings