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Neuro IV > Neurology Drug List > Flashcards

Neurology Drug List Flashcards

(60 cards)

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1
Q

Typical D2 Antagonists

A

Chlorpromazine and Haloperidol

Haloperidol and the “azines”

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2
Q

Chlopromazine Side Effects (SE)

A

Dry mouth (antimuscarinic), orthostatic hypotension (a1 antagonist), and sedation (antimuscarinic and antihistamine). Low potency, but also weight gain and increased risk for diabetes.

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3
Q

Halperidol Side Effects (SE)

A

Extrapyramidal side effects (DA blockade), can cause tardive dyskinesias. Used to tx CNS stimulant psychosis.

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4
Q

Atypical D2/5HT Antagonists

A

Clozapine, Quetiapine, Olanpazine, Risperidone, Aripipazole. All cause weight gain.

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5
Q

Clozapine SE

A

Agranulocytosis. Neuroleptic Malignancy. For pts who are refractive to other drugs.

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6
Q

Quetiapine SE

A

Wt gain and Diabetes; decrease EPS

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7
Q

SSRIs

A

Fluoxetine, Paroxetine, Escitralopam, Setraline, and Citalopram. Wide interpatient variations; wt gain, sexual dysfunction, cognitive blunting, and withdrawal sx.

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8
Q

Fluoxetine and Paroxetine

A

blocks serotonin transporter and P450 inhibitor. Withdrawal sx.

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9
Q

Escitralopam

A

SSRI

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10
Q

NDRIs

A

Bupropion

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11
Q

Bupropion

A

Sedation, and potential for seizures at high doses. At high dose causes anxiety.

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12
Q

SNRIs

A

Venlafaxine

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13
Q

Venlafaxine

A

SNRIs. SE: HTN and anxiety, rapid withdrawal.

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14
Q

TCADs (Drugs and Uses)

A

Declining use; 2nd line agaents, antimuscarinic side effects, CV and seizures in overdose.
Amitriptyline.

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15
Q

Amitriptyline

A

TCADs; 2nd line agents for depression, has antimuscarinic SE. CV problems and seizures in overdose. Also has a sedative action.

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16
Q

MAOIs

A

Phenelzine

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17
Q

Phenelzine

A

SE: postural hypotension, seizure, shock, hyperthermia in overdose, hypertensive crisis with foods high in tyramine, +SSRIs –> serotonin syndrome.

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18
Q

Antimanic Agents

A

Lithium Carbonate*, Carpamazepine, Valproate, Olanzapine, Fluoxetine

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19
Q

Lithium Carbonate

A

Interference with PIP recycling. Enhance 5HT action/ decrease NE and DA effect. Use dependent (greatest activity in most active cells); narrow therapeutic index. Diuretics and NSAIDs will increase lithium levels. Can also cuase hypothyroidism, poluuria, and polydipsia.

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20
Q

Sedatives-Hypnotics-Anxiolytics

A

BDZs, Non-BDZ BDZ Agonists, Barbiturates, Melatonin Receptor Antagonist, Other (Diphenhydramine)

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21
Q

BDZs

A

“Lams and Pams”; sedative (a1) and anxiolysis (a2/a5); need much greater dosage increments to achieve CNS depression, increase margin of safety than compared to BARBs.

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22
Q

Flumazenil

A

BDZ receptor antagonists; used in BDZ overdose to relieve CNS depression.

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23
Q

Non-BDZ BDZ Agonists

A

Zolpidem, Eszopiclone, Zalepon, “Zzz drugs”, only acts on a1 GABA receptors.

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24
Q

Zolpidem

A

“Ambien”; mild side effects and no hangover. Decrease sleep latency and nocturnal awakenings.

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25
Eszopiclone
Longer half life than zolpedam; next day psychomotor impairment with higher doses (FDA requires lower dose for initiation); used for sleep maintenance.
26
Zalepon
Dizziness, HA, and somnolence. Decrease time for sleep onset.
27
Barbiturates
Phenobarbital.Anticonvulsant effects without severe sedation or effects on mental or motor activity.
28
Phenobarbital
Anticonvulsant effects without severe sedation or effects on mental or motor activity.
29
Alprazopam
rapid po; acute management of anxiety
30
Flurazepam
long half life --> result in daytime sedation.
31
Diazepam
rapid po; acute management of anxiety
32
Oxazepam
slow oral absorption; no P450 step, so metabolized to inactive glucuronides, short half life.
33
Triazolam
anterograde amnesia; also very rapid --> rebound insomnia because short half life.
34
Lorazepam
same as oxazepam, but rapid via IM
35
Midazolam
status epilepticus
36
Temazepam
intermediate half life; less anterograde amnesia than triazolam.
37
Flumazenil
BDZ receptor antagonist in the case of overdose
38
Melatonin Receptor Agonist
Ramelteon
39
Ramelteon
MT1- induces sleepiness, MT2- regulation of circadian rhythms.
40
Diphenhydramine
antihistamine and antimuscarinic; not recommended but is short term treatment for mild insomnia
41
Buspirone
alternative as anxiolytic, 5HT partial agonist (no sedation); for CNS depressant withdrawal.
42
CNS Stimulants
Cocaine, Amphetamine, Methamphetamine --> interaction with catecholamine NT system; elevation of mood; SE: SNS overactivity. Increase tolerance and dependence; mild withdrawal sx.
43
Tx for Withdrawal Symptoms from CNS stimulants
TCADs and bupropion (NDRI); both better with behavioral therapy. Topiramate (GABA inhibition in alcoholics)
44
CNS Depressants
Alcohol, Barbiturates, and Benzodiazepines; enhance GABA activity; euphoria and sedation --> coma and death. Tx overdose with supportive care or flumazenil (BDZ antagonist). Tolerance and dependence develop rapidly. Withdrawal= high morbidity and mortality.
45
Opiod Analgesics
Heroin: mu agonist; rush and euphoria (highly reinforcing because rapid), overdose (coma, respiratory distress, pinpoint pupils) = tx with naloxone. rapid tolerance and dependence.
46
Cannabinoids
endogenous CR1 receptor in the CNS; enhancement of sensory stimuli; tx with support therapy, little tolerance (if yes, goes away fast), 10% physical dependence
47
Drugs for Tx of Drugs of Abuse
- Methadone: tx opiod withdrawal - Buprenorphine- tx opiod withdrawal - Clonidine: tx opiod withdrawal - Naltrexone: tx opiod withdrawal - Disulfram: blocks aldehyde dehydrogenase --> reduce EtOH consumption.
48
Gaseous Anesthetics
Nitrous Oxide
49
Nitrous Oxide
Common use for dental procedures; less soluble, exhibits more rapid increase in its partial pressure in blood. No surgical anesthesia.
50
Volatile Anesthetics
Halothane: substitute of cyclopropane; for surgical anesthesia. Can cause malignant hyperthermia.
51
Grand Mal (Tonic-Clonic Seizures)
Phenytoin, Carbamazepine, Valproate, Levetiracetam
52
Phenytoin
Phenytoin- for partial and primary generalized tonic clonic, block VSSC (blockage use dependent)
53
Carbamazepine
block VSSC (blockade use dependent)
54
Valproate
potentiation on GABA function; limits activity of T-type Ca2+ channel. hepatotoxicity, contraindicated in pregnancy; 1st line.
55
Levetiracetam
lower rate for fetal malformation, 1st line in tonic clonic. Also used for partial seizure.
56
Broad Spectrum Anti-Epileptics
Phenobarbital, Olazepam, Valproate, Divalproex (similar to valproate)
57
Phenobarbital
enhance GABA inhibition, antagonize glutamate excitation, P450 inducer
58
Absence Seizures Tx
Ethosuximide- supresses brain activity; metabolized by CYP34A; drug of choice. And valproate.
59
Status Epilepticus
Diazepam, Lorazepam, Midazolam.
60
Trazodone
Mixed 5HT Reuptake Blocker/ Receptor Antagonist. . Sedating; used to improve sleep continuity in depression.

Neuro IV (2 decks)

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