Term
| What classes of drugs treat glaucoma? |
|
Definition
alpha agonists
beta blockers
diuretics
Cholinomimetics
Prostaglandins |
|
|
Term
EPINEPHRINE
class
use
mechanism
Side effects |
|
Definition
Alpha agonist
Glaucoma
Decreases aqueous humor synthesis via vasoconstriction
Mydriasis, stinging
CONTRAINDICATED IN CLOSED-ANGLE |
|
|
Term
Brimonidine
class
use
mechanism
Side effects |
|
Definition
Alpha agonist
Glaucoma
Decrease aqueous humor synthesis
None |
|
|
Term
Timolol
class
use
mechanism
Side effects |
|
Definition
Beta blocker
Glaucoma
decrease aqueous humor secretion
none |
|
|
Term
Betaxolol
class
use
mechanism
Side effects |
|
Definition
Beta blocker
glaucoma
decrease aqueous humor secretion
None |
|
|
Term
Acetazolamide
class
use
mechanism
Side effects |
|
Definition
Diuretic
Glaucoma
Inhibition of carbonic anhydrase produces less bicarb and thus less aqueous humor secretion
None |
|
|
Term
Pilocarpine
class
use
mechanism
Side effects |
|
Definition
Direct cholinomimetic
Glaucoma EMERGENCY
Contract ciliary muscle to open trabecular meshwork and increase outflow of aqueous humor
Miosis, Loss of far vision |
|
|
Term
Carbachol
class
use
mechanism
Side effects |
|
Definition
Direct cholinomimetic
Glaucoma
Contract ciliary muscle and open trabecular meshwork increasing aqueous humor outflow
Miosis, Loss of far vision |
|
|
Term
Physostigmine
class
use
mechanism
Side effects |
|
Definition
Indirect cholinomimetic
Glaucoma
Contraction of the ciliary muscle opens trabecular meshwork and increases aqueous humor outflow
Miosis, loss of far vision |
|
|
Term
Echothiophate
class
use
mechanism
Side effects |
|
Definition
Indirect cholinomimetic
Glaucoma
increases contraction of ciliary muscle opening up trabecular meshwork and increasing aqueous humor outflow
Miosis, loss of far vision |
|
|
Term
Latanoprost
class
use
mechanism
Side effects |
|
Definition
Psotaglandin (PFG2a)
Glaucoma
Increase outflow of the aqueous humor
Darkens color of iris |
|
|
Term
Opiod analgesics
mechanism
clinical use
toxicity
antidote |
|
Definition
Agonist at Mu opiod receptors, open K channels, close Ca, decreased release of ACh, NE, 5-HT, glutamate, and Substance P.
Pain, acute pulmonary edema
Addiction, RESPIRATORY DEPRESSION, constipation, MIOSIS, additive CNS DEPRESSION with other drugs, tolerance except for constipation and miosis
Antidote = naloxone or naltrexone |
|
|
Term
Morphine
What class?
Unique features? |
|
Definition
Opiod analgesic
used with other CNS depressants during general anesthesia |
|
|
Term
Fentanyl
what class?
unique features? |
|
Definition
Opiod analgesic
used with other CNS depressants during general anesthesia |
|
|
Term
Codeine
what class?
unique features? |
|
Definition
|
|
Term
Heroin
what class?
unique features? |
|
Definition
|
|
Term
Methadone
what class?
unique features? |
|
Definition
Opiod analgesic
Very long half-life, used to treat addicts |
|
|
Term
Meperidine
what class?
unique features? |
|
Definition
|
|
Term
Dextromethorphan
what class?
unique features? |
|
Definition
Opiod analgesic
Cough suppressant |
|
|
Term
Diphenoxylate
what class?
unique features? |
|
Definition
Opioid analgesic
Anti-diarrhea |
|
|
Term
Loperamide
what class?
unique features? |
|
Definition
Opioid analgesic
Anti-diarrhea |
|
|
Term
Butorphanol
what class?
unique features? |
|
Definition
Partial Mu Opiod agonist
Kappa Opioid agonist
Less respiratory depression
Causes withdrawal if on full opioid agonist |
|
|
Term
Tramadol
what class?
unique features? |
|
Definition
Weak opioid agonist
Also inhibits NE and 5-HT reuptake
Decreases seizure threshold
use for chronic pain only |
|
|
Term
Phenytoin
Mechanism
Usage
Toxicity |
|
Definition
Increases Na channel activation
1st line for tonic-clonic seizures and prophylaxis
Also good for all partial seizures, Class 1b anti-arrythmic
Generalized lympadenopathy, P450 induction, gingival hyperplasia, hirsutism, nystagmus, megaloblastic anemia, teratogen, SLE, SJS |
|
|
Term
Carbamazepine
Mechanism
Usage
Toxicity |
|
Definition
Increase Na channel inactivation
1st line for partial seizures, tonic-clonic, and trigeminal neuralgia
bone marrow suppression, hepatotoxic, teratogen, SIADH, p-450 induction, SJS |
|
|
Term
Lamotrigine
Mechanism
Usage
Toxicity |
|
Definition
Blocks voltage gated Na channels
Partial and tonic clonic seizures
SJS |
|
|
Term
Gabapentin
Mechanism
Usage
Toxicity |
|
Definition
Inhibits HVA Ca channels (GABA analog)
Partial and tonic-clonic seizures, peripheral neuropathy, bipolar disorder
Sedation, ataxia |
|
|
Term
Topiramate
Mechanism
Usage
Toxicity |
|
Definition
Blocks NA channels, increases GABA action
Partial and tonic-clonic seizures
Kidney stones, weight loss, mental dulling, sedation |
|
|
Term
Phenobarbital
Mechanism
Usage
Toxicity |
|
Definition
Increases GABAa action
1st line for pregnant women and children with partial or tonic-clonic seizures
P450 induction, SJS, tolerance/dependence, sedation |
|
|
Term
Valproic Acid
Mechanism
Usage
Toxicity |
|
Definition
Increase Na channel inactivation, increase GABA concentration, block NMDA channels
1st line for tonic-clonic
good for partial, absence, mania, and trigeminal neuralgia
Fatal hepatotoxicity, NTDs, Gi distress, weight gain, tremor |
|
|
Term
Ethosuximide
Mechanism
Usage
Toxicity |
|
Definition
Blocks thalamic T-type Ca channels
1st line for absence seizures
Urticaria, SJS, GI distress, headache, fatigue |
|
|
Term
|
Definition
Inhibit GABA reuptake
Good for partial seizures |
|
|
Term
|
Definition
Irreversibly inhibits GABA transaminase increasing GABA
Good for partial seizures |
|
|
Term
Levetiracetam
Mechanism
Usage |
|
Definition
Unknown, may modulate GABA and glutamate release
Good for partial and tonic-clonic seizures |
|
|
Term
Barbituates
Mechanism
Usage
Toxicity |
|
Definition
Increase duration of Cl- channel opening, facilitating GABAa stimulation
Sedative
Dependence, additive CNS depression effects with EtOH, reps/CV depression, induction of p-450
CONTRAINDICATED IN PORPHYRIA |
|
|
Term
Thiopental
what class?
unique features? |
|
Definition
Barbituate
lipid soluble, used for anesthesia induction/short procedures
effects terminated by drug redistribution to muscle and fat
post-op nausea |
|
|
Term
Pentobarbital
what class?
unique features? |
|
Definition
|
|
Term
Secobarbital
what class?
unique features? |
|
Definition
|
|
Term
Benzodiazepines
Mechanism
Usage
Toxicity
Antidote |
|
Definition
Facilitate GABAa action by increasing frequency of Cl- channel opening
Anxiety, spasticity, alcohol detox, night terrors, sleep walking, general anesthetic, hypnotic
Dependence, additive CNS depression with alcohol, low risk of resp depression
Flumazenil for OD |
|
|
Term
Naloxone
what class?
unique features? |
|
Definition
opioid receptor antagonist
none |
|
|
Term
Naltrexone
what class?
unique features? |
|
Definition
opioid receptor antagonist
none |
|
|
Term
Flumazenil
what class?
unique features? |
|
Definition
competitive antagonist for benzo GABA binding site
Also reverses non-benzo hypnotics |
|
|
Term
Diazepam
what class?
unique features? |
|
Definition
Benzo
long acting, good for status epilepticus |
|
|
Term
Lorazepam
what class?
unique features? |
|
Definition
Benzo
medium acting, good for status epilepticus |
|
|
Term
Triazolam
what class?
unique features? |
|
Definition
|
|
Term
Temazepam
what class?
unique features? |
|
Definition
|
|
Term
Oxazepam
what class?
unique features? |
|
Definition
|
|
Term
Midazolam
what class?
unique features? |
|
Definition
Benzo
short acting, used with anesthetics
may cause severe post-op respiratory depression, low BP, and amnesia |
|
|
Term
Chlordiazepoxide
what class?
unique features? |
|
Definition
|
|
Term
Alprazolam
what class?
unique features? |
|
Definition
|
|
Term
Non-benzo hypnotics
Mechanism
Use
Toxicity |
|
Definition
bind to BZ1 GABA subtype
Insomnia
Lower dependence and hangover risk, rapid liver metabolism
Ataxia, headaches, confusion |
|
|
Term
Zolpidem
what class?
unique features? |
|
Definition
|
|
Term
Zaleplon
what class?
unique features? |
|
Definition
|
|
Term
Eszopiclone
what class?
unique features? |
|
Definition
|
|
Term
| General effects of inhaled anesthetics |
|
Definition
| Myocardial depression, respiratory depression, nausea/emesis, increased cerebral blood flow despite decreased cerebral metabolic demand |
|
|
Term
Halothane
what class?
unique features? |
|
Definition
Inhaled anesthetic
Hepatotoxic (H&H) |
|
|
Term
Enflurane
what class?
unique features? |
|
Definition
inhaled anesthetic
proconvulsant |
|
|
Term
Isoflurane
what class?
unique features? |
|
Definition
|
|
Term
Sevoflurane
what class?
unique features? |
|
Definition
|
|
Term
Methoxyflurane
what class?
unique features? |
|
Definition
inhaled anesthetic
nephrotoxic |
|
|
Term
Nitrous Oxide
what class?
unique features? |
|
Definition
inhaled anesthetic
expansion of trapped gas |
|
|
Term
Arylcyclohexylamine
mechanism
use
toxicity |
|
Definition
PCP analog, blocks NMDA receptors
Dissociative IV anesthetic
Cardiovascular stimulant, increased cerebral blood flow, hallucinations, disorientation |
|
|
Term
Ketamine
what class?
unique features? |
|
Definition
|
|
Term
Propofol
what class?
unique features? |
|
Definition
IV anesthetic that potentiates GABAa
rapid induction and short procedures with less post-op nausea than thiopental |
|
|
Term
Local anesthetics
mechanism
use
toxicity
esters vs. amides |
|
Definition
Block activated Na channels
minor surgery, spinal anesthesia. must give with vasoconstrictor like epinephrine to decrease bleeding and enhance local activity
CNS excitation, hyper or hypotension
esters can cause allergic reaction |
|
|
Term
Procaine
what class?
unique features? |
|
Definition
Ester local anesthetic
none |
|
|
Term
Cocaine
what class?
unique features? |
|
Definition
Ester local anesthetic
risk of arrhythmia, don't need to give vasoconstrictors with it |
|
|
Term
Tetracaine
what class?
unique features? |
|
Definition
Ester local anesthetic
none |
|
|
Term
Lidocaine
what class?
unique features? |
|
Definition
Amide local anesthetic (2 "I"s in name)
none |
|
|
Term
Mepivacaine
what class?
unique features? |
|
Definition
Amide anesthetic (2 "I"s in name)
none |
|
|
Term
Bupivicaine
what class?
unique features? |
|
Definition
Amide local anesthetic (2 "I"s in name)
Severe cardiovascular toxicity |
|
|
Term
| 3 Principles of local anesthetic use? |
|
Definition
1. Infected (acidic) tissue causes amides to be charged and thus unable to penetrate membrane. Need to use more.
2. Order of nerve blockade:
Small myelinated fibers --> small unmyelinated fibers --> large mymyelinated fibers --> large unmyelinated fibers
Therefore
Pain --> temperature --> touch -->pressure
3. Except for cocaine, must give vasoconstrictor to reduce bleeding and prevent anesthetic from diffusing away |
|
|
Term
Succinylcholine
what class?
unique features? |
|
Definition
Depolarizing neuromuscular blocker
none |
|
|
Term
Depolarizing neuromuscular blockers
toxicity
reversal |
|
Definition
hypercalcemia and hyperkalemia
Cannot reverse phase 1 (the prolonged depolarization)
Phase 2 (repolarized but blocked) reversed by cholinesterase inhibitors
Cholinesterase inhibitors increase phase 1 blockade |
|
|
Term
Non-depolarizing neuromuscular blockers
mechanism
reversal |
|
Definition
compete with ACh for motor nicotinic receptors
reverse with acetyl cholinesterase inhibitors |
|
|
Term
Tubocurarine
what class?
unique features? |
|
Definition
Non-depolarizing neuromuscular blocker
none |
|
|
Term
Atracurium
what class?
unique features? |
|
Definition
non-depolarizing neuromuscular blocker
none |
|
|
Term
Mivacurium
what class?
unique features? |
|
Definition
Non-depolarizing neuromuscular blocker
none |
|
|
Term
Pancuronium
what class?
unique features? |
|
Definition
Non-depolarizing neuromuscular blocker
none |
|
|
Term
Vecuronium
what class?
unique features? |
|
Definition
Non-depolarizing neuromuscular blocker
none |
|
|
Term
Rocuronium
what class?
unique features? |
|
Definition
non-depolarizing neuromuscular blocker
none |
|
|
Term
|
Definition
Prevents release of Ca from sarcoplasmic reticulum of skeletal muscle
Malignant hyperthermia and neuroleptic malignant syndrome |
|
|
Term
Bromocriptine
mechanism
usage |
|
Definition
Ergot dopamine agonist
Parkinson's, least preferred dopamine agonist |
|
|
Term
Pramipexole
mechanism
usage |
|
Definition
Non-ergot dopamine agonist
Parkinson's |
|
|
Term
|
Definition
Non-ergot dopamine agonist
Parkinson's |
|
|
Term
Amantadine
mechanism
usage
toxicity |
|
Definition
Antiviral which may increase dopamine release
Parkinsons, Influenza A, rubella
Ataxia |
|
|
Term
l-dopa/carbidopa
mechanism
use
toxicity |
|
Definition
increase level of dopamine in the brain by giving dopamine precursor and inhibitor of its peripheral metabolism
Parkinson's
Arrythmias
Long-term: dyskinesias, akinesia between dose |
|
|
Term
Selegiline
mechanism
use
toxicity |
|
Definition
Inhibits MAO-B which normally metabolizes dopamine over NE/5-HT
Use as an adjunct to l-dopa in parkinson's
may enhance adverse effects of L-dopa |
|
|
Term
|
Definition
COMT inhibitor thus preventing dopamine breakdown
Parkinson's |
|
|
Term
|
Definition
COMT inhibitor thereby preventing dopamine breakdown
Parkinson's |
|
|
Term
|
Definition
Antimuscarinic
improves tremor and maybe rigidity, but not bradykinesia of parkinson's |
|
|
Term
Memantine
mechanism
use
toxicity |
|
Definition
NMDA receptor antagonist thus preventing glutamate toxicity
Alzheimer's
Dizziness, confusion, hallucinations |
|
|
Term
Donepezil
mechanism
usage
toxicity |
|
Definition
Acetylcholinesterase inhibitor
Alzheimer's
Nausea, dizziness, insomnia |
|
|
Term
Galantamine
mechanism
use
toxicity |
|
Definition
Acetylcholinesterase inhibitor
Alzheimer's
Nausea, dizziness, insomnia |
|
|
Term
Rivastigmine
Mechanism
Usage
Toxicity |
|
Definition
Acetylcholinesterase inhibitor
Alzheimer's
Nausea, Dizziness, Insomnia |
|
|
Term
|
Definition
Reserpine + tetrabenzine to deplete amines
Haloperidol to block dopamine receptors |
|
|
Term
Sumatriptan
mechanism
use
toxicity |
|
Definition
5-HT1 agonist causing vasoconstriction and inhibition of trigeminal activation
Migraines, cluster headaches
half-life less than 2 hours
Coronary vasospasm (contraindicated in CAD or Prinmetal angina), mild tingling |
|
|
Term
Treatment for
Alcohol Withdrawal |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
Methylphenidate
Amphetamines |
|
|
Term
Treatment for
Atypical Depression |
|
Definition
|
|
Term
Treatment for
Bipolar Disorder |
|
Definition
Lithium
Valproate
Carbamazepine
Atypical Antipsychotics |
|
|
Term
|
Definition
|
|
Term
Treatment for
Depression with insomnia |
|
Definition
|
|
Term
|
Definition
|
|
Term
Treatment for
Panic Disorder |
|
Definition
|
|
Term
|
Definition
|
|
Term
Treatment for
Schizophrenia |
|
Definition
|
|
Term
Treatment for
Tourette's Syndrome |
|
Definition
|
|
Term
Treatment for
Social phobias |
|
Definition
|
|
Term
CNS STIMULANTS
Mechanism
Use |
|
Definition
Increase catecholamines in the synaptic cleft (NE and Dopamine)
ADHD, Narcolepsy, Appetite control |
|
|
Term
Methylphenidate
what class?
unique features? |
|
Definition
|
|
Term
Dextroamphetamine
what class?
special features? |
|
Definition
|
|
Term
Mixed amphetamine salts
what class?
special features? |
|
Definition
|
|
Term
TYPICAL ANTIPSYCHOTICS
mechanism
use
toxicity |
|
Definition
Block D2 receptors increasing cAMP
Positive symptoms of schizophrenia, psychosis, mania, Tourette's
Stored in body fat, EPS, galactorrhea, anti-muscarinic, anti-alpha adrenergic, and anti-histamine effects
Neuroleptic malignant syndrome
Tardive dyskinesia |
|
|
Term
Trifluoperazine
what class?
unique features? |
|
Definition
High potency typical antipsychotic
higher chance of EPS, lower chance of other side effects |
|
|
Term
Fluphenazine
what class?
unique features? |
|
Definition
High potency typical antipsychotic
higher chance of EPS, lower chance of other side effects |
|
|
Term
Haloperidol
what class?
unique features? |
|
Definition
High potency typical antipsychotic
higher chance of EPS, lower chance of other side effects |
|
|
Term
Chlorpromazine
what class?
unique features? |
|
Definition
Low potency typical anti-psychotic
lower chance of EPS, higher chance of other side effects
Corneal deposits |
|
|
Term
Thioridazine
what class?
unique features? |
|
Definition
Low potency typical antipsychotic
lower chance of EPS, higher chance of other side effects
reTinal deposits |
|
|
Term
ATYPICAL ANTISPYCHOTICS
Mechanism
use
toxicity |
|
Definition
varied effects on 5-HT2, dopamine, alpha adrenergic and H1 receptors
Positive and negative symptoms of schizophrenia
fewer EPS and anti-cholinergic effects than typicals |
|
|
Term
Olanzapine
what class?
unique features? |
|
Definition
Atypical antipsychotic
also used for OCD, anxiety, depression, mania, Tourette's
Weight gain |
|
|
Term
Clozapine
what class?
unique features? |
|
Definition
Atypical antipsychotic
weight gain, agranulocytosis, must monitor CBC weekly |
|
|
Term
Quetiapine
what class?
unique features? |
|
Definition
Atypical antipsychotic
none |
|
|
Term
Risperidone
what class?
unique features? |
|
Definition
Atypical antipsychotic
none |
|
|
Term
Aripiprazole
what class?
unique features? |
|
Definition
atypical antipsychotic
none |
|
|
Term
Ziprasidone
what class?
unique features? |
|
Definition
Atypical antipsychotic
long QT interval |
|
|
Term
Lithium
mechanism
use
toxicity |
|
Definition
not known, maybe it inhibits phosphoinositol
Bipolar, SIADH
LMNOP
Movement (tremor, Nephrogenic di, hypOthyroidism, Pregnancy problems (ebstein's anomaly)
must be careful when prescribing thiazides due to pure renal clearance dependent on Na PCT reabsorption |
|
|
Term
|
Definition
5-HT1 agonist
Anxiety disorder |
|
|
Term
TRICYCLIC ANTIDEPRESSANTS
Mechanism
use
side effects
toxicity |
|
Definition
Block reuptake of NE and serotonin
depression, fibromyalgia
sedation, orthostatics, anticholinergic effects (3rd gen worse than 2nd)
Tri-Cs: Convulsions, Coma, Cardiotoxicity, respiratory depression, fever, (confusion and hallucination in elderly) |
|
|
Term
| How do you treat cardiotoxicity from TCAs? |
|
Definition
| Hypertonic sodium bicarb infusion |
|
|
Term
Amitryptiline
what class?
unique features? |
|
Definition
3rd gen TCA
3rd gens have worse anticholinergic effects |
|
|
Term
Nortriptyline
what class?
unique features? |
|
Definition
2nd gen TCA
2nd gens have less anti-cholinergic effects |
|
|
Term
Imipramine
what class?
unique features? |
|
Definition
TCA
used to treat bed wetting |
|
|
Term
Desipramine
what class?
unique features? |
|
Definition
|
|
Term
Clomipramine
what class?
unique features? |
|
Definition
|
|
Term
Doxepin
what class?
unique features? |
|
Definition
|
|
Term
Amoxapine
what class?
unique features? |
|
Definition
|
|
Term
SSRIs
mechanism
use
toxicity |
|
Definition
Serotonin specific reuptake inhibitors, take 4-8 weeks to see effect
Depression, OCD, bulimia, social phobias, PTSD
GI distress, sexual dysfunction, risk of serotonin syndrome |
|
|
Term
How do you treat serotonin syndrome?
how does it work? |
|
Definition
Cyproheptadine
5-HT2, 5-HT1 and histamine receptor antagonist |
|
|
Term
Fluoxetine
what class?
unique features? |
|
Definition
|
|
Term
Paroxetine
what class?
unique features? |
|
Definition
|
|
Term
Sertaline
what class?
unique features? |
|
Definition
|
|
Term
Citalopram
what class?
unique features? |
|
Definition
|
|
Term
| Symptoms of Neuroleptic Malignant Syndrome |
|
Definition
| rigidity, myoglobinuria, autonomic instability, fever |
|
|
Term
| Symptoms of Tardive dyskinesia |
|
Definition
| sterotypic oral-facial movements |
|
|
Term
| Symptoms of serotonin syndrome |
|
Definition
| hyperthermia, myoclonus, cardiovascular collapse, flushing, diarrhea, seizures |
|
|
Term
SNRIs
mechanism
use
toxicity |
|
Definition
Inhibit serotonin and NE reuptake
Depression
increased BP, stimulant, sedative, nausea |
|
|
Term
Venlafaxine
what class?
unique features? |
|
Definition
SNRI
also used for generalized anxiety disorder |
|
|
Term
Duloxetine
what class?
unique features? |
|
Definition
SNRI
has greater effect on NE, also used for diabetic neuropathy |
|
|
Term
MAOIs
mechanism
use
toxicity |
|
Definition
Nonselective MAO inhibiton causing increased levels of amines (NE, serotonin, dopamine)
Atypical depression, anxiety, hypochondriasis
Hypertensive crisis with tyramine ingestion (wine/cheese) or beta agonists, CNS stimulation
Risk of serotonin syndrome |
|
|
Term
Tranylcypromine
what class?
unique features? |
|
Definition
|
|
Term
Phenelzine
what class?
unique features? |
|
Definition
|
|
Term
Isocarboxazid
what class?
unique features? |
|
Definition
|
|
Term
Bupropion
mechanism
use
toxicity |
|
Definition
increased NE and dopamine
depression, smoking cessation
stimulant, seizure in bulimics, headache |
|
|
Term
Mirtazapine
mechanism
use
toxicity |
|
Definition
alpha 2 antagonist leading to increased NE and 5-HT release and 5-HT2/3 receptor antagonist
Depression with insomnia
Sedation, increased appetite and weight gain, dry mouth |
|
|
Term
Maprotiline
mechanism
use
toxicity |
|
Definition
Blocks NE reuptake
Depression
orthostatic hypotension, sedation |
|
|
Term
Trazodone
mechanism
use
toxicity |
|
Definition
Inhibits serotonin reuptake
Insomnia, antidepressant at high doses
Priapism, postural hypotension, nausea, sedation |
|
|
