CNS depressants pharm 4-20-06
Terms
undefined, object
copy deck
- what is sumatriptan used for
- acute migraine, cluster headache attacks
- what is the mechanism of sumatriptan
- 5-HT1D agonist
- what is the half life of sumatriptan
- less than 2 hours
- what are the side effects of sumatriptan
- chest discomfort, mild tingling
- what are the contraindications for sumatriptan
- patients with CAD or Prinzmetal's angina
- which drugs are used for simple and complex partial seizures
- phenytoin, carbamazapine, lamotrigine, gabapentin, topiramate
- what types of seizures is phenytoin indicated for
- simple and complex partial, tonic-clonic (1st line), status epilepticus (1st line for prophylaxis)
- what types of seizures is carbamazepine indicated for
- simple and complex partial, tonic-clonic, trigeminal neuralgia
- what types of seizures is lamotrigine indicated for
- simple and complex partial, tonic-clonic
- what types of seizures is gabapentin indicated for
- simple and complex partial, tonic-clonic
- what types of seizures is topiramate indicated for
- simple and complex partial, tonic clonic
- what types of seizures is phenobarbital indicated for
- simple and complex partial, tonic clonic
- what drugs can be used for tonic-clonic seizures
- phenytoin (1st line), carbamazapine (1st line), lamotrigine, gabapentin, phenobarbital (first line pregnat women & children), valproate (1st line)
- what drugs can be used for absence seizures
- valproate, ethosuximide
- what drugs can be used for status epilepticus
- phenytoin (prophylaxis), benzodiazapines (acute; diazepam, lorazepam)
- what types of seizure is valproate indicated for
- partial, tonic-clonic, absence
- what types of seizure is ethosuximide inidcated for
- absence
- what type of seizure are benzodiazepines indicated for
- status epilepticus
- other than anti-seizure, what else is phenytoin used for
- class 1B anti-arrhythmic
- how should a patient taking carbamazepine be followed
- monitor LFT's weekly
- which seizure drugs have adjunct use
- gabapentin, topiramate
- which seizure drug is safest in pregnant women
- phenobarbital
- which seizure drug is used in Crigler-Najjar II
- phenobarbital
- what are the advantages of phenobarbital
- can be used in pregnant women, Crigler Najjar II
- what are the side effects of benzodiazepines
- sedation, tolerance, dependence
- what are the side effects of carbamazepine
- diplopia, ataxia, CYP induction, blood dyscrasias, liver toxicity
- what are the side effects of ethosuximide
- GI distress, lethargy, headache, urticaria, Stevens-Johnson syndrome
- what are the side effects of phenobarbital
- sedation, CYP induction, tolerance, dependence
- what are the side effects of phenytoin
- nystagmus, diplopia, ataxia, sedation, ginigival hyperplasia, hirsutism, anemias, teratogenic
- what are the side effects of valproate
- GI distress, rare by fatal hepatotoxicity, neural tube defects (spina bifida)
- what are the side effects of lamotrigine
- life-threatening rash, Stevens-Johnson syndrome
- what are the side effects of gabapentin
- sedation, movement disorders
- what are the side effects of topiramate
- sedation, mental dulling, kidney stones, weight loss
- which anti-epileptic drug is teratogenic
- phenytoin (valproate neural tube defects)
- which anti-epileptic drug can cause dependence
- benzodiazepines, phenobarbital
- which anti-epileptic drug can cause neural tube defects
- valproate
- which anti-epileptic drugs can cause GI distress
- valproate, ethosuximide
- it is necessary to check LFT's with which anti-epileptic drugs
- carbamazepine, valproate
- which anti-epileptic drugs cause CYP induction
- phenobarbital, carbamazepine
- which anti-epileptic drugs can cause blood problems
- carbamazepine (agranulocytosis, aplastic anemia), phenytoin (megaloblastic anemia)
- which anti-epileptic drugs can cause Stevens-Johnson syndrome
- Lamotrigine, ethosuximide
- which anti-epileptic drugs can cause diplopia
- carbamazepine, phenytoin
- what is the mechanism of phenytoin action
- use-dependent blockade of Na+ channels
- what is the clinical application of phenytoin
- first line tonic clonic; partial, prophylaxis for status epilepticus
- what are the toxicities of phenytoin
- nystagmus, ataxia, diplopia, lethargy, SLE like syndrome, induce P450
- what are the chronic toxicities of phenytoin
- gingival hyperplasia in children, peripheral neuropathy, hirsutism, megaloblastic anemia, malignant hyperthermia (rare)
- should pregnant women take phenytoin
- NO -- teratogenic
- why does phenytoin cause megaloblastic anemia
- causes decreased vitamin B-12
- name 4 barbiturates
- phenobarbital, pentobarbital, thiopental, secobarbital
- what is the mechanism of barbiturate action
- increase duration of Cl channel opening --> decreased neuron firing --> facilitate GABA-A action
- how do barbiturates facilitate GABA-A action
- increase duration of Cl channel opening which decreases neuron firing (benzos increase frequency)
- is barbiturate action on the CNS stimulatory or inhibitory
- inhibitory
- what is the clinical application of barbiturates
- sedative for anxiety, seizures, insomnia, anesthesia induction (thiopental)
- which barbiturate is used for anesthesia induction
- thiopental
- what are the side effects of barbiturates
- dependence, additive CNS depression effects with alcohol, respiratory or CV depression (death), drug interactions due to CYP induction
- what should you find out before giving a patient barbiturates
- what other medications they take, because of CYP induction and many drug interactions
- what happens if you give barbiturates to a patient in alcohol-induced coma or DT's
- they might DIE!! Because of additive effect of barbiturates and alcohol --> respiratory depression
- when are barbiturates contra-indicated
- porphyria
- can barbiturates cause dependence
- YES
- My friend Barb was very anxious so her doctor gave her barbiturates to increase the duration of the time she could speak in public without freaking out and having a seizure. She became so dependent on it that she recommended it to her friend Portia who c
- clinical pharmacology made ridiculous. Period
- name a bunch of benzodiazepines
- diazepam, lorazepam, triazolam, temazepam, oxazepam, midazolam, chlordiazepoxide (all have ZZZ in them)
- what is the mechanism of benzodiazepines
- increase frequency of Cl channel opening --> facilitate GABA-A action (Frenzodiazepines increase frequency)
- which GABA receptors are facilitated by barbiturates and bezodiazepines
- GABA-A
- what are the clinical applications of benzodiazepines
- anxiety, spasticity, status epilepticus (diazepam), detoxification (alcohol withdrawal, DT's)
- which benzodiazepine can be used for status epilepticus
- diazepam
- what drugs can be used to treat alcohol withdrawal
- benzodiazepines
- which benzodiazepines are short-acting
- TOM thumb: Triazolam, Oxazepam, Midazolam
- what are the toxic effects of benzos
- dependence, additive CNS depression effects with alcohol
- how are benzos better than barbiturates
- less respiratory depression and coma risk
- how do you treat benzo overdose
- flumazenil
- what is flumzenil used for
- benzo overdose
- how does flumazenil work
- competitive antagonist at GABA receptor
- can a patient become benzodiazepine dependent
- YES
- are barbiturates or benzodiazepines used for alcohol withdrawal
- benzodiazepines