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USMLE 1 Pharm Neuro

Terms

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(5) Parkinsons drugs
BALSA:

Bromocriptine,
Amantadine,
Levodopa,
Selegiline,
Antimuscarinics
Parkinson drug:

agonized dopamine receptors
Bromocriptine
Parkinson drug:

Increases Dopamine
(2)
Amantidine,

L-Dopa
Parkinson drug:

selectively inhibits MAO-B, thereby increasing availability of DA
Selegiline
Parkinson drug:

improves cholinergic activity (tremor and rigidity)
Benztropine
(anti-muscarinic)
what coverts L-dopa to dopamine in the brain?

AE to periphreal L-dopa/carbidpoa
Carboxylase


AE:
Arrthymias
serotonin agonist causing vasoconstriction for Tx of migraine or cluster HA

what specific receptor?

AE
Sumatriptan

receptor: 5HT-1D

AE: Coronary vasospasm
AE of Benzodiazepines
Sedation
(3) drugs that are first-line for Tonic-Clonic seizures
PVC:

Phenytoin,

Valproic Acid,

Carbamazepine
(2) drugs that are first-line for Absent seizures
Ethosuximide,

Valproic Acid
MOA of Valproic Acid

(3) AE

Aside from Bipolar d/o, what other psych Dx can it be used for?
MOA:
Na-channel (and Ca-channel) blocker

AE:
Hepatotoxicity,
Neural tube defects in fetus,
Tremor

(also can be used for Schizophrenia)
What are the (4) Tx for Status Epilepticus
Diazepam,

Lorazepam,

Phenytoin,

Phenobarbital
DOC for seizures in pregnant women and children
Phenobarbital
DOC for Trigeminal neuralgia, Tonic-Clonic seizures, schizophrenia and bipolar disorder

(2) AE

what monthly test should be done to patient?
Carbamazepine

AE:
Hepatotoxicity;
Aplastic Anemia

monthly test: LFTs
(2) epilepsy drugs that can cause Stevens-Johnson syndrome
Ethosuximide

Lamotrigine
MOA of Ethosuximide
Blocks T-type Ca-channels
epileptic drug that blocks Na channels and inhibits glutamate release from presynaptic neurons

AE (4)
Phenytoin

AE:
Gingival hyperplasia,
Hirsutism,
SLE-like syndrome,
Nystagmus and ataxia
drug class that facilitates GABA action by increasing the duration of Cl- channel opening

contraindication?
Barbiturates

[barbiDURATes inc DURATion]

CI: Porphyria
Barbiturate that is used in ansthesia induction
Thiopental
drug class that facilitates GABA action by increasing the frequency of Cl- channel opening

use (4)*
Benzodiazepines

use (Dumb ASS):
Detoxification,
Anxiety,
Status epilepticus,
Sleep issues (walking, terrors)
(3) short-acting Benzos
short TOM thumb:

Triazolam,
Oxazepam,
Midazolam
DOC for Huntington's DZ
(3)*
Practice Hunting Trees:

Phenothiazines,
Haloperidol,
Tetrabenazine
DOC for Tourette's
Haloperidol
beta-blocker used to Tx tremor
Propranolol
DOC in Wilson's Dz
Penicillamine
(3)* Neuroleptic Antipsychotics that block the D2 receptors

main use?
THC:

Thioridazine,

Haloperidol,

Chlorpromazine

use: Schizophrenia
AE of Neuroleptics (antipsychotics)

for each receptor blocked:
1. DA
2. Muscarinic
3. Alpha
4. Histamine
DA: Hyperprolactinemia, gynecomastia

Muscarinic: dry mouth, constipation

Alpha: Hypotension,

Histamine: Sedation
Dx:

rigidity, myoglobinuria, autonomic instability, hyperpyrexia, recent Tx for schizophrenia

Tx?
(3 possible)
Neuroleptic Malignant syndrome

Tx:
1. Bromocriptine
2. Amantidine
3. Dantrolene
Dx:

strange oral-facial movements, chorea, recent neuroleptic ingestion
Tardive Dyskinesia
(3) Atypical Antipsychotics
OLanzapine, CLOZapine, RISPERidone

[its not ATYPICAL for OLd CLOZets to RISPER]
MOA of Atypical antipsychotics

which is used to Tx OCD?

which causes Agranulocytosis as an AE?
block Serotonin and Dopamine receptors

OLanzapine - OCD

CLOZapine - Agranulocytosis
(4)* AE of Lithium

Use?
Lithium

LMNOP:
Lithium AE =
Movement (tremor),
Nephrogenic DI,
hypOthyroidism,
Pregnancy problems

Use: Mood stabilizer for Bipolar disorder to block manic events
(4)* SSRIs


AE? (2)
"the CITy PAROt FLU down SERTRAIL":

CITalopram,

PAROxetine,

FLUoxetine,

SERTRALine

AE: Sexual dysfunction and N/V
(3) TCAs

MOA

Basic (not toxic) AE (2)
CIA:
Clomipramine,
Imipramine,
Amitriptyline

MOA: block reuptake of NE and Serotonin

AE:
Sedation,
anticholinergic side effects
TCA used for bedwetting
Imipramine
TCA used for OCD
Clomipramine
Toxicity of TCA
(3)
("Tri-C"):

Convulsions,

Coma,

Cardiotoxicity
(5)* Heterocyclic Antidepressants
"you need BUtane in your VEINs to MURder for a MAP of alcaTRAZ"

BUproprion,
VENlafaxine,
MIRtazapine,
MAProtiline,
TRAZodone
heterocyclic that also Tx smoking
Bupropion
heterocyclic that inhibits Serotonin, NE and DA reuptake
Venlafaxine
heterocyclic that is an alpha2-blocker
Mirtazapine
what (3) drugs can MAO-inhibitors not combine with?

why?
Tyramine - HTN crisis

SSRI - Serotonin syndrome

B-agonist - Serotonin syndrome
what does it mean if an anesthetic has a high solubility in blood?
(2)
slower induction and slower recovery time

(Low blood solubility = rapid induction and recovery time)
what does it mean if an anesthetic has a high solubility in lipids?
Increased Potency

High lipid solubility = 1/MAC
AE of Halothane
Hepatotoxicity
(5)* types of IV anesthetics
B.B.King on OPIATES PROPOses FOOLishly:

Barbs,
Benzos,
Ketamine,
Opiates,
Propofol
common Benzo used for endoscopy
Midazolam
how can you tell Amide local anesthetics versus esters?

MOA of locals
AmIdes have 2 "I's" in the name

ex: LIdocaIne

MOA: Na-channel blockers
which local anesthetic has cardiovascular toxicity?
Bupivacaine
used to Tx hyperthermia caused by inhalation anesthetics and neuroleptic malignant syndrome

MOA
Dantrolene


MOA:
prevents release of Ca from SR of skeletal muscles
what mixed agonist/antagonist of opioid receptors can place a person on Methadone back into withdrawal?
Pentazocine
what is the only opioid delivered parenterally?
Fentanyl
what is the only local anesthetic used topically?
Benzocaine
(2) MAO inhibitors
Phenelzine,


Tranylcypromine
what NT does it block:

Neuroleptics
Dompamine (D2)
what NT does it block:

Atypical antipsychotics
Serotonin

Dopamine
what (2) NT does it block:

TCAs
Serotonin

NE
what NT does it block:

Heterocyclics
Vary...
which SSRI also inhibits NE?
Fluoxetine
which opiate receptor has the majority of the AE and Euphoria?

which has Dysphoria?
U - Euphoria (and AE)


K - Dysphoria
in addition to Tx schizo, what abdominal Sx does Chlorpromazine Tx?
Nausea and Vomiting
what class of Antipsychotics have AE associated w/ blocking Dopamine, Muscarinic, alpha and Histamine receptors?
Neuroleptics

Chlorpromazine ("-AZINES") and Haloperidol
Which Schizophrenic drug is also effective in minimizing the emotional bluntness and social withdrawal Sx?
Olanzapine
what "NSAID" does not inhibit prostaglandin synthesis?
Acetaminophen
general anesthetic that causes AE of Hyperthermia, HTN, HyperK, tachycardia, muscle rigidity and Metabolic Acidosis?
Halothane
which Benzo is good for alcohol withdrawal?
Diazepam
which anti-alcohol med causes nausea and vomiting w/ alcohol consumption?
Disulfiram
what Benzo is good versus Agoraphobia and Panic disorders?
Alprazolam
what anti-epileptic / anti-psychotic can induce seizures?
Clozapine
AE of Propofol
Metabolic Acidosis
list the progressive depression of the CNS
(5)
Sedation -> Hypnosis -> Anesthesia ->
Coma -> death
what is the effect a local anesthetic has on nerve fibers?
Pain -> Sensory -> Motor

Deck Info

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