-
Glaucoma drugs which decrease aqueous humor synthesis
- a-agonists
- Epinephrine (don't use in closed-angle), brimonidine
-
Glaucoma drugs which decrease aqueous secretion
- B-blockers
- Timolol, betaxolol, carteolol
- Acetazolamide: decrease bicarb via inhibition of carbonic anhydrase
-
Glaucoma drugs which increase outflow of aqueous humor
- Direct cholinomimetics: pilocarpine (emergencies), carbachol
- Indirect cholinomimetics: physostigmine, echothiophate
- PGF2a: latanoprost (darkens iris)
-
Opioid effects on membrane channels
- Open K channels
- Close Ca channels
- Decreases synaptic transmission, inhibits NT release
-
Butorphanol: MOA
- Partial agonist at mu receptor, agonist at kappa
- For pain
- precipitates withdrawal
-
Tramadol: MOA
- Weak opioid, inhibits 5HT and NE reuptake
- for chronic pain
-
Tramadol: tox
- like opioids
- Decreases seizuer threshold
-
Seizure drugs increasing Na channel inactivation
- Phenytoin
- carbamazepine
- Valproate
-
Seizure drugs blocking Na channels
-
Gabapentin: MOA
inhibits calcium channels
-
Increase GABA action (seizure drugs)
- Topiramate
- Phenobarbital (duration of opening)
- Valproate (increase GABA concentration)
- Benzodiazepines (frequency of opening)
- Tiagabine (inhibits reuptake)
- Vigabatrin (inhibits GABA transaminase irreversibly)
-
Ethosuxamide: MOA
Blocks thalamic T-type Ca channels
-
Seizure drugs that induce P450
- Carbamazepine
- Phenobarb
- Phenytoin
-
Seizure drugs causing Stevens-Johnson syndrome
- Ethosuximide
- Carbamazepine
- Lamotrigine
-
Carbamazepine: tox
- Diplopia, ataxia
- Blood issues
- Liver
- SIADH
- teratogenesis
- P450 induction, SJ
-
Phenytoin: tox
- Nystagmus, diplopia, ataxia, peripheral neuropathy
- Sedation, hirsutism
- SLE-like
- megaloblastic anemia, gingival hyperplasia (kids)
- Induction
-
Valproate: tox
- GI, fatal hepatotox
- Spina bifida in fetus
- Tremor, weight gain
-
Topiramate: tox
sedation, mental dulling, kidney stones, weight loss
-
Phenytoin: specific MOA
- Use-dependent Na block increases refractory period
- Inhibits glutamate release from neuron
-
Barbiturates contraindicated in
porphyria
-
Short-acting benzodiazepines
- Are Triazolam, Oxazepam, Midazolam
- have highest addictive potential
-
Low blood solubility in anesthetics means:
rapid induction and recovery
-
High solubility in lipids for anesthetics means
higher potency which = 1/MAC
-
High blood/gas ratio means...
- high solubility in blood
- means slow induction and recovery
-
Anesthetics effect on lungs
increase rate and depth of ventilation increases gas tension
-
Inhaled anesthetics effect on cerebral blood flow
increase
-
-
Methoxyflurane: tox
nephro
-
Enflurane: tox
proconvulsant
-
Barbiturate effect on cerebral blood flow
Decreases
-
Benzo effect on BP
decrease
-
Ketamine/arylcyclohexylamines: MOA and heart/brain effects
- PCP analogs block NMDA receptors
- Stimulate cardio
- Increase cerebral blood flow
-
Propofol: MOA
potentiates GABA
-
Local anesthetics: MAO
- Preferentially bind active Na channels
- Need more in infected/acidic tissue
-
Order of nerve blockade with local anesthetics
- small myelinated > small unmyelinated > large myelinated > large unmyelinated
- pain temp touch pressure
-
Bupivacaine: tox
cardiovascular
-
NM blocking drugs are selective for
motor nicotinic receptors
-
Nondepolarizing NM blockers are competitve with ACh. Name suffix and how to reverse
- -curium
- Reverse with cholinesterase inhibitors
-
Dantrolne treats
- malignant hyperthermia (from succ + inhalational anesthetic)
- NMS (antipsychotic tox)
-
Dantrolene: MOA
prevents release of Ca from the SR of skeletal muscle
-
Dopamin receptor agonists for PD
- bromocriptine, pergolide (ergot)
- Pramipexole, ropinirole (non-ergot)
-
Amantadine: MOA in PD
Increase dopamine release
-
Selegiline: MOA
MAO-B inhibitor prevents DA breakdown
-
Entacapone, tolcapone: MOA
- COMT inhibitors prevent L-dopa degradation
- entacapone works peripherally
- tolcapone works centrally
-
Cenztropine: MOA for PD
- antimuscarinic to curb cholinergic activity
- improves tremor/rigidity only
-
Carbidopa: MOA
peripheral decarboxylase inhibitor
-
Memantine: MOA and use
- Alzheimer's
- NMDA receptor antagonist
- Prevents excitotixicty mediated by Ca
-
Acetylcholinesterase inhibitors for AD
donepezil, galantamine, rivastigmine
-
How to treat Huntington's
- Reserpine (blocks NE transport)
- tetrabenazine (blocks dopamine)
- Haldol (antagonize dopamine receptor)
-
Sumatriptan: MOA and tox
- serotonin 1b/1d agonist cuasing vasoconstriction and CNV inhibition
- tox: coronary vasospasm, tingling
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