Pharmacology

Question 1

What class is carbamazepine

Answer 1

Na channel blocker

Question 2

what is the indication of carbamazepine

Answer 2

Focal epileptic seizures

Trigeminal neuralgia

Question 3

What are the side effects of carbamazepine

Answer 3

diplopia
ataxia
blood dycrasias
tertogenic 
hyponatraemia

Question 4

What drug class is phenytoin

Answer 4

Na channel blocker

Question 5

What is the indication of phenytoin

Answer 5

Status epilepticus

Question 6

What are the side effects of phenytoin

Answer 6

Gingival hyperplasia
peripheral neuropathy 
nystagmus
ataxia, sedation 
teratogenic
enzyme inducer 
double vision 
hirsutism

Question 7

what class is Lamotrigine

Answer 7

Na channel blocker

Question 8

What is the indication of lamotrigine

Answer 8

Generalised and focal seizures

Question 9

What are the side effects of lamotrigine

Answer 9

rash and steven johnson syndrome - therefore takes a long time to build up dose
NOT teratogenic
double vision

Question 10

Drug class of Na valproate

Answer 10

Na channel blocker with increased GABA concentration

Question 11

Indications of Na valproate

Answer 11

General epileptic seizures

Question 12

Side effects of Na valproate

VALPROATE

Answer 12

Teratogenic 
Balding 
Fattening
tremor 
ataxia 
liver dysfunction/toxicity
oedema 
thrombocytopaenia
enchephalopathy

Question 13

what are the 5 mechanisms of action of analgesia

Answer 13

reduce inflammation at site of injury
suppressing nerve conduction
suppressing synaptic transmission
activating descending inhibitory controls
targeting ion channels upregulated (GABA) in nerve damage

Question 14

what is the difference between opiates and opioids

Answer 14

opiates = plant based drug eg morphine
opioid = any agent that acts upon opioid receptors eg morphine, endogenous substances like endorphins and enkephalins

Question 15

where is periaqueductal grey found

Answer 15

midbrain

Question 16

where is locus ceruleus found

Answer 16

pons

Question 17

where is nucleus raphe magnus found

Answer 17

medulla

Question 18

excitation of PAG causes profound analgesia/pain

Answer 18

analgesia

Question 19

what substances are released from NRM

Answer 19

5HT and enkephalins

Question 20

what substance is released from LC

Answer 20

NA

Question 21

what happens when endogenous chemicals are released from the NRM and LC

Answer 21

they act on the dorsal horn of the spinal cord and inhibit nociceptive transmission

Question 22

what type of receptor mediates opioid action

Answer 22

GPCR

Question 23

what does GPCR signalling produce and what subunits are responsible

Answer 23

inhibition of voltage gated Ca channels to prevent release of neurotransmitter - Gi/o Bgamma subunit pre synaptically
opening of K channels to suppress excitation of post synaptic neuron - Gi/o Bgamma subunit
inhibition of adenylyl cyclase - Gi/o alpha subunit

Question 24

what are the opioid receptos

Answer 24

mu
delta
kappa

Question 25

adverse effects of opioids

Answer 25

``` addiction N+V respiratory depression postural hypotension constipation confusion, euphoria, dysphoria, hallucinations, myoclonus ```

Question 26

what receptor do opioid agonists mostly work on

Answer 26

mu receptors

Question 27

how is morphine metabolised

Answer 27

liver

Question 28

methods of morphine administration

Answer 28

PO, SC, IM, IV, epidural, intrathecal

Question 29

what is heroin

Answer 29

diamorphine

Question 30

diamorphine has a rapid/slow onset of action when administered IV

Answer 30

rapid

Question 31

codeine can be given IV, true or false

Answer 31

FALSE | only given orally

Question 32

when is pethidine used

Answer 32

in acute pain eg labour

Question 33

pethidine is suitable for chronic pain, true or false

Answer 33

false | it has a short duration

Question 34

buprenorphine is a partial/full agonist

Answer 34

partial

Question 35

tramadol is a weak/strong mu agonist

Answer 35

weak

Question 36

how is tramadol administered

Answer 36

PO

Question 37

in which neurological condition is tramadol contraindicated

Answer 37

epilepsy

Question 38

methadone has a long/short half life making it effective as in drug withdrawal

Answer 38

long half life

Question 39

how strong is etorphine

Answer 39

VERY | only used in large animals

Question 40

fentanyl is used in chronic/acute pain states

Answer 40

chronic

Question 41

pethidine should not be used in conjunction with MAO inhibitors, true or false

Answer 41

true

Question 42

what is a neurotoxic metabolite of pethidine

Answer 42

norpethidine

Question 43

what is naloxone

Answer 43

complete opioid mu receptor antagonist

Question 44

how is naloxone administered

Answer 44

IM, IV, SC

Question 45

what is naltrexone

Answer 45

opioid receptor antagonist

Question 46

how is naltrexone administered

Answer 46

PO

Question 47

naltrexone has a shorter half life than naloxone, true or false

Answer 47

false | half life of naltrexone is longer than that of naloxone

Question 48

NSAIDs act centrally/peripherally

Answer 48

both!

Question 49

what adverse effects arise from COX 1 inhibition COX 2 inhibition

Answer 49

COX 1 - Peptic ulcer disease | COX 2 - nephrotoxicity

Question 50

selective COX 2 inhibitors are anti/pro thrombotic

Answer 50

PRO thrombotic - lead to heart disease

Question 51

subtypes of ACh receptors

Answer 51

nicotinic | muscarinic

Question 52

where are nicotinic receptors found

Answer 52

``` skeletal muscle parasympathetics sympathetics spinal cord NMJ ```

Question 53

where are muscarinic receptors found

Answer 53

target organ | peripheral tissues

Question 54

nicotinic receptors are ionotropic/metabotropic and are slow/fast

Answer 54

ionotropic | fast

Question 55

muscarinic receptors are ionotropic/metabotropic and are slow/fast

Answer 55

metabotropic | slow

Question 56

GABA a mediates

Answer 56

Cl-

Question 57

GABA b mediates

Answer 57

K+

Question 58

side effects of topiramate

Answer 58

cognitive problems | weight loss

Question 59

what is the difference between nociceptive and neuropathic pain

Answer 59

nociceptive - response to painful stimulus with an intact nervous system neuropathic - inappropriate response caused by dysfunctional nervous system