Neuro Pharm

  1. opioid analgesics- Mechanism of action
    open k+ channels, close ca+2 channels, decrease synaptic transmission.

    Inhibit the release of Ach, NE, 5-HT, glutamate, substance P
  2. Dextromethorphan Clinical use
    Pain and cough suppression
  3. Loperamide
  4. Diphenoxylate
  5. Methadone
    Acute pulmonary edema, maintenance for addicts
  6. Opiod analge toxicity
    • Respiratory depression
    • Constapation
    • Pinpoint pupils
    • CNS depression
  7. Overdose of Opiod Analgesic Treatment
    • Naloxone
    • Naltrexone (opiod receptor antagonist)
  8. Butorphanol Mechanism of action
    Partial agonist at opioid mu receptors, agonist at kappa receptors
  9. Butorphanol Clinical Use
    Pain, Causes less respiratory depression than Full agonists

    Labor and Delivery
  10. Tramadol Mechanism of action
    • Very Weak opiod agonist
    • Inhibits 5-HT, NE reuptake
    • (works on multiple transmitters Tam-it-all)
  11. Tramadol Clinical Use
    • Chronic Pain
    • Migraines
    • (those with addictive personalities)
  12. Tramadol toxicity
    Lowers seizure threshold
  13. Alpha agonist- Epinephrine MOA in glaucoma
    Decrease aqueous humor production due to vasoconstriction
  14. Epinephrine Side effects
    • Mydriasis
    • stiniging
    • not used in closed angle glaucoma
  15. Beta Blockers (Timolol, betaxolol, cartelolol) MOA in glaucoma
    Decrease aquous humor secretion
  16. Diuretics (acetazolamide) MOA n Glaucoma
    Decrease aqueous humor secretion due to decrease bicarb via inhibition of carbonic anhydrase
  17. Cholinomimetics (Direct: carbachol, pilocarpine)

    Indirect( Physostigmine) MOA in Glaucoma
    • increase outflow of aqueous humor
    • contract ciliary muscle
    • open trabecular meshwork
  18. Cholinomeimetics Side effects
    • Miosis
    • Cyclospasm
  19. Prostaglandins (latanoprost) MOA in Glaucoma
    Increase aqueous humor outflow
  20. Latanoprost Side effect
    Darkens color of iris
  21. Can most Epilepsey Drugs be used to treat Simple Partial, ANd Complex Partial seizures
    Yes all except, ethosuximide and Benzo's
  22. Phenytoin MOA & Use
    Increase Na+ channel inactivation

    • 1st Line Tonic Clonic
    • Prophylaxis in Status Epilepticus
  23. Drugs Used to Treat 1st Line tonic Clonic Seizures
    Phenytoin, Carbamazepine, Valproic Acid
  24. Carbamazepine MOA & Use
    Increase Na+ channel inactivation

    First Line for Trigeminal Neuralgia
  25. Lamotragine MOA and Use
    Blocks Voltage Gated Na+ Channels

    Tonic Clonic
  26. Gabapentin MOA & Use
    Gaba Analog

    inhibits HVA Calcium Channels

    Tonic clonic, peripheral neuropathy, bipolar disorder
  27. Topiramate MOA
    • Blocks Sodium Channels
    • increase Gaba action

    "TO mechanisms"
  28. 2 drugs Increase Gaba Action alone
    Phenobarbital and Benzo's
  29. Phenobarb MOA & Use
    Increase Gaba

    1st line Pregnant Woman
  30. Use for Absence Seizures
    • Ethoosuximide ist line
    • Valproic acid
  31. Ethosuximide MOA
    Blocks thalamie T-type Ca+2 Channels
  32. Used for Status Epilepticus
    Benzo's (diazepam, Lorazepam)
  33. Prevents Seizures of Eclampsia second to MgSO4
    Benzo's Diazepam or Lorazepam
  34. Tiagabine MOA
    Inhibits Gaba reuptake
  35. Vigabatrin
    • Irreversibly inhibits Gaba Transaminase
    • Increases Gaba
  36. General Epilepsy Drug Toxicities
    • Diplopia
    • Sedation
    • Ataxia
    • Dizziness
    • Nystagmus
  37. Phenytoin Toxicities
    • Gingival Hypeplasia
    • Hirsutism
    • Megaloblastic anemia (decrease Fol)
    • Teratogenic (fetal hydantoin Syndrome)
  38. BarbiDURATEs (phenobarb, pentobarb, thiopental, secobarb) MOA
    Facilitate Gaba Action by increaseing DURATion of Cl- channel opening-- > decrease neuron firing

    (gaba is inhibitory)
  39. Barbiturates Use
    Sedative for anxiety, seizures, insomnia, induction of anesthesia (thiopental)
  40. Inducers of p450
    • "BCGPQRS"
    • Barbiturates Carbamazepine Griseofolvin Phenytoin Quinidine
    • Rifampine St. Johns Wart Alchohol
  41. Benzo'a (FREnzo's) MOA
    Facilitate Gaba action by increaseing FREquency of Cl- channel opening

    decrease REM sleep
  42. Short Acting Benzo's

    • Triazolam
    • Oxazepam
    • Midazolam

    Highest Addictive potential
  43. Used Primarily for Alcohol withdrawl
    Chlordiazepoxide, Diazepam
  44. Benzo Overdose Treatment
    Flumazenil- competitive antagonist at GABA Benzo receptors
  45. Halothane (inhaled Anesthetic)
    • Low MAC, More potent
    • High blood solubility longer induction
    • More Lipid Soluble-More Potent, longer
    • induction & recovery time
  46. Nitric Oxide (inhaled Anesthetic)
    • High Mac Low Potency
    • Low Blood Solubility, Rapid Induction
    • Low Lipid Solubility less potent
  47. Thiopental (Barbiturate/IV Anesthetics)
    High Potency, High Lipid Slouble, RAPID entry to brain
  48. Midazolam (benzo/IV anesthetic)
    MC Drug used for endoscopy

    Can cause: Amnesia, with post-op Cardio/resp depression
  49. Ketamine (PCP analog)
    Block NMDA receptor

    (NMDA receptors For learning and Memory)

    Less respiratory/cardio depression Good for kids!
  50. Morphine/Fentanyl Use As IV anesthetic
    Concious Sedation/general anesthesia

    • (morphine histamine release itchy nose
    • fenttanyl no histamine release)
  51. Propofol
    Potentiates Gaba (inhibitory)

    Rapid Anesthesia induction and short procedures

    "milk of amnesia"/ high TG content/< N/V post op than thiopental
  52. Local Anesthetics
    Esters: Procaine, Cocaine, Tetracaine

    AmIdes: LIdocaIne, MepIvacaIne, BupIvacaIne
  53. Local Anesthetic MOA
    Block Na+ channels, most effective in rapidly firing neurons
  54. Order of Nerve Blockade (local anesthetics)
    Small myelinated> small Umylenated>large myelinated> large unmyelinated
  55. Order of Loss (local Anesthetics)
  56. Local Anesthetics excep cocaine should be given with?
    Vasoconstrictors (Epinephrine) to enhance local action

    decrease bleeding, increase anesthesia
  57. Neuromuscular Blocking Drugs Use
    (Depolarizing and Nondepolarinzing)
    Muscle Paralysis in surgery or mechanical ventilation

    Selective for motor nicotinic receptor
  58. Succinylcholine (Depolarizing) MOA
    imitates Ach at Nicotinic M receptors acting non-competitively, but then blocks the receptor
  59. Succinylcholine Reversal blockade
    Phase I: Prolonged depolarization (block made worse/potentiated by cholinesterase inhibitors)

    Phase 2: Repolarized but blocked- antidote is chonesterase inhibitors ie Neostigmine
  60. Nondepolarizing Neuromuscular Blockers
    (Tubocurarine, atracurine,
    Competitive Ach receptor blocker
  61. Reversal Of Non-depolarizing blockers
    Neostigmine, edrophonium, other cholinesterase inhibitors
  62. Dantroline MOA & Use
    Preents the realeas of Ca+2 from SR of skeletal muscle

    Malignant Hyperthermia-caused by use of inhaled anesthetics and succinylcholine together

    Neuroleptic Malignant Syndrome- caused by toxicity of antipsychotic drugs
  63. Neuroleptic Malignant Syndrome
    Muscle rigidity Fever, delirium, autonomic instability
  64. Malignant hyperthermia:
    Myoglobinuria, excessmuscle contraction, hyperthermia, body decreases O2 supply, can't remove CO2 & regulate body temp
  65. Parkinsons Drugs
    • "BALSA"
    • Bromocriptine
    • AMantadine
    • Levodopa + Carbidopa
    • Slegiline (COMT inhibitors)
    • Antimuscarinics (Benztropine)
  66. Selegiline
    • Inhibits MAO-B
    • Prevents Breakdown of Dopamine in brain
  67. Entacapan, Tolcapan
    inhibit COMT which usually converts levodopa to 3-O methyldopa.

    SO it Increase [ Levodopa] in CNS which is then converted to dopamine by DDC (Dopamine DeCarboxylase)
  68. Alzheimers Drugs
    Memantine- NMDA receptor antagonist prevents excitotoxicity mediated by Ca+2

    Donepezil/Rivastigmine/Galantamine- Ach cholinesterase inhibitor therfore increase Ach

    • Remember Alzheimers decrease Ach
    • NMDA involved in learning and memory
  69. Huntigtons Disease & Treatment
    Increase Dopamine, decrease GABA + Ach

    Haloperidol Dopamine Receptor Antagaonist (decrease dopamine

    Respirine + Tetrabenazine
  70. Sumatriptan
    5-HT 1B/1D Agonist causes vasoconstriction

    Migraines, Cluster headaches
Card Set
Neuro Pharm
Glaucoma, Opiod analgesics, epilepsy drugs, Barbiturates, Benzo's, Anesthetics,Neuromuscular blocking drugs, Parkinson's Drugs, Alzheimer's Drugs,Huntigton's Drugs, Sumatriptan