shosh: neuro drugs
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Alpha agonist, use for glaucoma
Betal blockers, use for glaucoma
- Prostaglandin, use for glaucoma
- Causes darkening of iris
- Opoid analgesic, opens K+ channels and closes Ca++ channels at mu receptors
- Causes addiction, respiratory depression, contipation, and miosis
Mu receptor antagonist, use to treat opiate overdose
- 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)
- Weak opiate agonist, inhibits serotonin and NE reuptake
- Use to treat chronic pain
- Major side effect is seizures in epileptic patients
3 first line drugs for tonic clonic seizures
Phenytoin, carbamazepine, valproic acid
First line anti-epileptic in children and pregnant women
First line drug for trigeminal neuralgia
First line drug for status epilepticus
- Benzos in acute cases
- Phenytoin after patient has been stabilized
Uses and side effects of carbamazepine
- Tonic clonic seizures, trigeminal neuralgia
- Aplastic anemia
- Steven-Johnson syndrome
- Use for absence seizures
- Causes GI distress, urticaria, and Steven-Johnson syndrome
Side effects of phenytoin
- Gingival hyperplasia
- Megaloblastic anemia
- Fetal hydantoin syndrome
Side effects of valproic acid
- GI distress
- Hepatotoxicity (can be fatal)
- Neural tube defects in fetuses
- 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
What condition contraindicates barbiturate use?
Porphyrias, because they induce ala synthase
CYP 450 inducers
CYP 450 inhibitors
- Grapefruit juice
Short acting benzos
Decreased solubility in blood for an anesthetic indicates
Rapid induction and recovery
Increased solubility in the blood for an anesthetic indicates
Long induction and recovery times, but high potency
Inhaled anesthetic with high solubility (so slow onset and high potency)
-what is the toxicity?
Side effect of enflurane
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
Why does thiopental have a rapid recovery time?
Redistribution of the drug into fat and skeletal muscle
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
Rapid anesthetic for short procedures
Side effect of bupivacaine
Why is epinephrine given with local anesthetics?
Causes local vasoconstriction, traps drug in target tissues
2 uses of dantrolene
- Neuroleptic malignant syndrome
- Malignant hyperthermia
- (blocks release of Ca from SR)
- COMT inhibitors, prevent dopamine breakdown.
- Use for Parkinson's
- Selective MAO B inhibitor, prevents dopamine breakdown.
- Use for Parkinson's.
Dopamine agonists (4)
Use of benztropine in Parkinson's
Antimuscarinic drug, can help control tremor and rigidity, but has little effect on bradykinesia
Vitamin that increases dopamine metabolism
B6 (ask Parkinson's patients if they are taking multivitamins)
- 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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