shosh: neuro drugs

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shosh114
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shosh: neuro drugs
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2011-07-19 13:39:34
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  1. Brimonidine
    Alpha agonist, use for glaucoma
  2. Timolol, betaxolol,carteolol
    Betal blockers, use for glaucoma
  3. Latanoprost
    • Prostaglandin, use for glaucoma
    • Causes darkening of iris
  4. Fentanyl
    • Opoid analgesic, opens K+ channels and closes Ca++ channels at mu receptors
    • Causes addiction, respiratory depression, contipation, and miosis
  5. Naloxone
    Mu receptor antagonist, use to treat opiate overdose
  6. Butorphanol
    • Partial agonist at mu receptors, use for analgesia
    • Causes less respiratory depression than opiates, but can cause withdrawal symptoms if the patient is also on an opiate (e.g. morphine, codeine, heroin)
  7. Tramadol
    • Weak opiate agonist, inhibits serotonin and NE reuptake
    • Use to treat chronic pain
    • Major side effect is seizures in epileptic patients
  8. 3 first line drugs for tonic clonic seizures
    Phenytoin, carbamazepine, valproic acid
  9. First line anti-epileptic in children and pregnant women
    Phenobarbital
  10. First line drug for trigeminal neuralgia
    Carbamazepine
  11. First line drug for status epilepticus
    • Benzos in acute cases
    • Phenytoin after patient has been stabilized
  12. Uses and side effects of carbamazepine
    • Tonic clonic seizures, trigeminal neuralgia
    • Cause-
    • Agranulocytosis
    • Aplastic anemia
    • Hepatotoxicity
    • SIADH
    • Steven-Johnson syndrome
  13. Ethosuximide
    • Use for absence seizures
    • Causes GI distress, urticaria, and Steven-Johnson syndrome
  14. Side effects of phenytoin
    • Nystagmus
    • Sedation
    • Gingival hyperplasia
    • Megaloblastic anemia
    • Fetal hydantoin syndrome
    • SLE
  15. Side effects of valproic acid
    • GI distress
    • Hepatotoxicity (can be fatal)
    • Neural tube defects in fetuses
  16. Topiramate
    • Anti-epileptic, blocks Na channels and upregulates GABA action
    • Use for all but absence seizures and status epilepticus
    • Side effects include sedation, weight loss, and kidney stones
  17. What condition contraindicates barbiturate use?
    Porphyrias, because they induce ala synthase
  18. CYP 450 inducers
    • Carbamazepine
    • Phenobarbital
    • Phenytoin
    • Griseofulvin
    • Rifampin
  19. CYP 450 inhibitors
    • Cimetidine
    • Ciprofloxacin
    • Azoles
    • Ritonavir
    • Isoniazid
    • Grapefruit juice
  20. Short acting benzos
    • Midazolam
    • Triazolam
    • Oxazepam
  21. Decreased solubility in blood for an anesthetic indicates
    Rapid induction and recovery
  22. Increased solubility in the blood for an anesthetic indicates
    Long induction and recovery times, but high potency
  23. Inhaled anesthetic with high solubility (so slow onset and high potency)
    -what is the toxicity?
    Halothane, hepatotoxicity
  24. Side effect of enflurane
    Seizures
  25. Cause and treatment of malignant hyperthermia
    • Caused by a mutation in the ryanodine receptor that allows Ca to flood the muscles in response to inhaled anesthetics.
    • Presents with fever, rigidity, and rhabdomyolysis after surgery.
    • Treat with dantrolene
  26. Why does thiopental have a rapid recovery time?
    Redistribution of the drug into fat and skeletal muscle
  27. Mechanism, use, and side effects of ketamine
    • Blocks NMDA receptors and stimulates the CV system.
    • Good dissociative anesthetic for traumatic field injury.
    • Causes disorientation and hallucinations
  28. Propofol
    Rapid anesthetic for short procedures
  29. Side effect of bupivacaine
    CV toxicity
  30. Why is epinephrine given with local anesthetics?
    Causes local vasoconstriction, traps drug in target tissues
  31. 2 uses of dantrolene
    • Neuroleptic malignant syndrome
    • Malignant hyperthermia
    • (blocks release of Ca from SR)
  32. Entacapone, tolcapone
    • COMT inhibitors, prevent dopamine breakdown.
    • Use for Parkinson's
  33. Selegiline
    • Selective MAO B inhibitor, prevents dopamine breakdown.
    • Use for Parkinson's.
  34. Dopamine agonists (4)
    • Bromocriptine
    • Pergoide
    • Pramipexole
    • Ropinirole
  35. Use of benztropine in Parkinson's
    Antimuscarinic drug, can help control tremor and rigidity, but has little effect on bradykinesia
  36. Vitamin that increases dopamine metabolism
    B6 (ask Parkinson's patients if they are taking multivitamins)
  37. Sumatriptan
    • Serotonin agonist, causes vasoconstriction, inhibits activation of the trigeminal nerve
    • Short half life
    • Use to treat acute migraines and cluster headaches
    • Major side effect is coronary vasospasm

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