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Pharm -- Neuro
First Aid 2012 471-479
80
Medical
Graduate
02/07/2013

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Cards

Term
memantine
Definition
NMDA receptor antagonist --> prevents excitotoxicity (cell death!!) from too much glutamate in Alzheimer's
Term
donepezil
Definition
achetylcholinesterase inhibitor
Alzheimer's
Term
galantamine
Definition
achetylcholinesterase inhibitor
Alzheimer's
Term
rivastigmine
Definition
achetylcholinesterase inhibitor
Alzheimer's
Term
reserpine
Definition
inhibits ability to store NE, A, 5-HT --> amine depletion
Huntington's
Term
tetrabenazine
Definition
promotes early degradation of DA --> amine depletion
Huntington's
Term
sumatriptan
Definition
5-HT1B/1D agnoist
coronary vasospasm -- not for CAD or Prinzmetal's angina
Term
pregabalin
Definition
binds Ca2+ channels --> decreased glutamate/NE release
neuropathic pain, fibromyalgia, partial seizures
Term
bromocriptine
Definition
ergot, dopamine receptor agonist
Term
pramipexole
Definition
non-ergot, dopamine receptor agonist
Term
ropinirole
Definition
non-ergot, dopamine receptor agonist
Term
amantadine
Definition
increase DA release (increase endogenous DA effect)
Term
entacapone
Definition
COMT inhibitor -- inhibit peripheral methylation --> more DA available centrally
Term
tolcapone
Definition
COMT inhibitor -- inhibit peripheral AND central methylation --> more DA available centrally
Term
benztropine
Definition
antimuscarinic
helps tremor/rigidity
Term
epinephrine
Definition
alpha-agonist
decrease aqueous humor secretion (2/2 vasoconstriction)
mydriasis (NOT for closed-angle glaucoma!!), stinging
Term
brimonidine
Definition
alpha-agonist
decrease aqueous humor secretion
no eye changes
Term
timolol, betaxolol, carteolol
Definition
beta-blockers
carteolol is non-selective (breaks A-->M rule!!)
decrease aqueous humor secretion
no eye changes
Term
acetazolamide
Definition
alpha-agonist
decrease aqueous humor secretion (2/2 decreased HCO3)
no eye changes
Term
pilocarpine
Definition
direct cholinomimetic
increase outflow of aqueous humor, contract ciliary muscle and open traecular meshwork; use in emergencies!!
miosis, cyclospasm
Term
carbachol
Definition
direct cholinomimetic
increase outflow of aqueous humor, contract ciliary muscle and open trabecular meshwork
miosis, cyclospasm
Term
physostigmine
Definition
indirect cholinomimetic
increase outflow of aqueous humor, contract ciliary muscle and open trabecular meshwork
miosis, cyclospasm
Term
echothiphate
Definition
indirect cholinomimetic
increase outflow of aqueous humor, contract ciliary muscle and open trabecular meshwork
miosis, cyclospasm
Term
latanoprost
Definition
PGF2alpha
indirect cholinomimetic
increase outflow of aqueous humor
darkens color of iris!!
Term
fentanyl
Definition
opioid receptor agonists -- open K+ channels, close Ca2+ channels --> decrease synaptic transmission
Term
meperidine
Definition
opioid receptor agonists -- open K+ channels, close Ca2+ channels --> decrease synaptic transmission
Term
dextromethorphan
Definition
opioid receptor agonists -- open K+ channels, close Ca2+ channels --> decrease synaptic transmission
for cough
Term
diphenoxylate
Definition
opioid receptor agonists -- open K+ channels, close Ca2+ channels --> decrease synaptic transmission
for diarrhea
Term
levorphanol
Definition
opioid receptor agonists -- open K+ channels, close Ca2+ channels --> decrease synaptic transmission
Term
loperamide
Definition
opioid receptor agonists -- open K+ channels, close Ca2+ channels --> decrease synaptic transmission
for diarrhea
Term
codeine
Definition
opioid receptor agonists -- open K+ channels, close Ca2+ channels --> decrease synaptic transmission
Term
random use for opioids
Definition
acute pulm edema (decrease anxiety and preload)
Term
butorphanol
Definition
partial agonist --> can cause withdrawal
Term
tramadol
Definition
very weak opioid agonist
inhibits 5-HT and NE reuptake
decreases seizure threshold
Term
pentazocine
Definition
mixed agonist-antagonist --> can cause withdrawal
Term
opioid receptors
Definition
mu -- endorphins
delta -- enkephalin
kappa -- dynorphin
Term
phenytoin
Definition
increase Na+ channel inactivation, inhibit glutamate release
nystagmus/ataxia, SLE-like syndrome, gingival hyperplasia in kids, peripheral neuropathy, hirsutism, megaloblastic anemia, fetal hydantoin syndrome, generalized LAD (pseudolymphoma!!)
first line for status prophylaxis
Term
carbamazepine
Definition
increase Na+ channel inactivation
for trigeminal neuralgia
blood stuff (agranulocytosiss, aplastic anemia), liver toxicity, Stevens-Johnson, SIADH
Term
lamotrigine
Definition
blocks voltage-gated Na+ channels
Steven-Johnson
Term
gabapentin
Definition
GABA analog, but really inhibits HVA Ca2+ channels
for peripheral neuropathy, postherpetic neuralgia
Term
topiramate
Definition
blocks Na+ channels, increase GABA action
Term
phenobarbital
Definition
increase duration of Cl channel opening (GABA-A)
for pregnant women, children
contraindicated in porphyria
Term
valproic acid
Definition
increase Na+ channel inactivation, increase GABA concentration
for myoclonic seizures
hepatotoxicity, neural tube defects
Term
ethosuximide
Definition
blocks thalamic T-type Ca2+ channels
EFGH -- Ethosuximide, Fatigue, GI, Headache + Stevens-Johnson
Term
benzodiazepines
Definition
increase frequency of Cl- channel opening (GABA-A)

don't take with barbituates, alcohol, neuroleptics, 1st gen antihistamines

short -- TOM = Triazolam, Oxazepam, Midazolam, + alprazolam
intermediate -- chlordiazepoxide, prazepam, clonazepam, flurazepam, diazepam
long -- LET = lorazepam, estazolam, temazepam
Term
tiagabine
Definition
inhibits GABA reuptake
partial seizures ONLY
Term
vigabatrin
Definition
irreversibly inhibits GABA transaminase
partial seizures ONLY
Term
levetiracetam
Definition
Term
primidone
Definition
becomes phenobarbital
Term
pentobarbital
Definition
increase duration of Cl channel opening (GABA-A)
contraindicated in porphyria
Term
thiopental
Definition
increase duration of Cl channel opening (GABA-A)
high lipid solubility, rapid entry into brain, rapid redistribution into skeletal muscles and fat --> rapid recovery
Term
secobarbital
Definition
increase duration of Cl channel opening (GABA-A)
contraindicated in porphyria
Term
zolpidem
Definition
non-benzo hypnotics, less dependence
act at BZ1 receptor
Term
zaleplon
Definition
non-benzo hypnotics, less dependence
act at BZ1 receptor
Term
eszopiclone
Definition
non-benzo hypnotics, less dependence
act at BZ1 receptor
Term
anesthetics
-- solubility in blood
-- solubility in lipids
-- gas tension
-- AV concentration gradient
Definition
-- high blood solubility, slower onset and recovery
-- high lipid solubility, high potency, low MAC
-- high gas tension, high RR, deep ventilation
-- high AV concentration gradient, slower onset of action
Term
halothane
Definition
inhaled anesthetic
high lipid and blood solubility
myocardial depression (hypotension, decreased renal perfusion), resp depression, increased cerebral blood flow (can cause cerebral edema!!)
hepatic necrosis (rapid death, high AST/ALT, PT, WBC, eosinophils, normal albumin -- t1/2 = 20d), arrhythmias
Term
enflurane
Definition
inhaled anesthetic
seizures
Term
isolurane
Definition
inhaled anesthetic
Term
sevoflurane
Definition
inhaled anesthetic
Term
methoxyflurane
Definition
inhaled anesthetic
nephrotoxic
Term
nitrous oxide
Definition
inhaled anesthetic
low lipid and blood solubility
Term
ketamine
Definition
arylcyclohexylamine (PCP analogs)
block NMDA (glutamate) receptors
cardiovascular stimulants!!
Term
propofol
Definition
potentiates GABA-A
Term
etomidate
Definition
prolongs GABA-A activity
Term
esters vs. amides
Definition
esters -- allergic reactions, shorter duration of action
amides -- 2 I's!!
Term
local anesthetics (-caine)
Definition
-- block inside of activated Na+ channels
-- acidic tissue (infection), alkaline anesthetics are changed and cannot penetrate membrane --> need higher dose
-- small myelinated, then small unmyelinated, large myelinated, finally large unmyelinated
-- lose pain, then temp, touch, finally pressure
-- except for cocaine, given with epi (NOT nose, digits, penis, pinna)
Term
succinylcholine
Definition
depolarizing neuromuscular blocking agent
Phase I -- prolonged depolarization (fasciculations), no antidote
Phase II -- repolarized but blocked, antidote is cholinesterase inhibitors
Term
tubocurarine
Definition
non-depolarizing neuromuscular blocking drugs
competitively blocks ACh receptors
Term
atracurium
Definition
non-depolarizing neuromuscular blocking drugs
competitively blocks ACh receptors
Term
mivacurium
Definition
non-depolarizing neuromuscular blocking drugs
competitively blocks ACh receptors
Term
pancuronium
Definition
non-depolarizing neuromuscular blocking drugs
competitively blocks ACh receptors
Term
vecuronium
Definition
non-depolarizing neuromuscular blocking drugs
competitively blocks ACh receptors
Term
rocuronium
Definition
non-depolarizing neuromuscular blocking drugs
competitively blocks ACh receptors
Term
dantrolene
Definition
prevents Ca2+ release from sarcoplasmic reticulum
for malignnt hyperthermia and meuroleptic malignant syndrome
Term
selegiline
Definition
inhibits MAO-B centrally
Term
random thing about levodopa
Definition
B6 increases peripheral metabolism of levodopa --> decreased effectiveness!!
Term
[image]
Definition

Train of Four

non-depolarizing neuromuscular blocking drugs

Term
[image]
Definition

Train of Four

depolarizing neuromuscular blocking drugs

Note: usually succinylcholine lasts ~10min, but some people have atypicalcholinesterase and it takes hours!! (give antidote during Phase II!!)

Term
random opioid side effect
Definition
biliary colic -- SM contraction of sphincter of Oddi --> increased GB pressure
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