UTMB pharm – exam Questions With 100% Correct Answers

Acetylcholine - Decrease causing depression & Alzheimer's Increase causing PD Analgesics vs opioid - Analgesic relieve pain without causing the loss of consciousness Opioids are the most effective pain relievers available Benzo use: - Anxiety Insomnia Seizures Muscle spasm Alcohol withdraw Preop Benzo-like drug: Zolpidem (Ambien) - Sedative-hypnotic, most widely used hypnotic. Short term management for insomnia (hopefully patient not on long term) Side effects of dizziness and daytime drowsiness Carbamazepine (Tegretol) is for - Epilepsy Bipolar disorder Trigeminal and glossopharyngeal neuralgias Adverse effects: Nystagmus Axtaxia Leukopenia Anemia ThrombocytopeniaCOMT Inhibitor - Entacapone (Comtan) is for - COMT is an enzyme to decrease the production of levodopa metabolizer so it stays in the system longer. (PD) Adverse effects: dyskinesias, orthostatic hypotension, n/v, diarrhea, constipation, discoloration in urine Dopamine receptor agonists MOA and what for? - MOA: mimic dopamine in brain for PD Drug for Alzheimer's? How do they work? - Reversible Cholinesterase Inhibitor: Donepezil (Aricept, Aricept ODT) keeps more acetylcholine in system.. check ALT/AST before giving b/c metabolized by liver lots of side effects such as bradycardia, bronchoconstriction Receptor antagonists (better than cholinesterase inhibitors): Memantine (Namenda, Namenda XR) regulates glutamate to help improve memory Adverse effect besides dizziness, confusion, and HA is constipation Drug interactions w morphine - CNS depessants Anticholinergic drugs (low acetylcholine = depression) Hypotensive drugs MAOIs Agonist-antagonist opioids Opoid antagonists Others Ergot alkaloids (Ergotamine) is for - Agonist of serotonin receptors to help w. migraines (second line drug for migraine) GABA - reduces anxietyif GABA decreased, may cause schizophrenia Gabapentin: - Adjunctive therapy of partial seizures Neuropathic pain, etc. Fewer drug interactions Glutamate (NMDA) - Prolonged increase can kill neurons and cause Alzheimer's decreased NMDA can cause psychosis How do local anesthetics work? - Suppress pain by blocking sodium channels and by blocking impulse conduction along axons only in neurons near site of administration. *Use with vasoconstriction: epinephrine decreases blood flow and prolongs the anesthetic effects* Adverse effects: hypertension, palpitation, nervousness, tachycardia Increased amyloid beta chains and decreased acetylcholine production usually means - Alzheimer's disease Lidocaine (or xylocaine): - Most widely used local anesthetic Also used for cardiac dysrhythmia Topical or injection MAO-B inhibitor - Selegiline (Eldepryl, Zelapor) - Inhibits the dopamine metabolizer Used w/ levodopa to prolong it staying in the body, improves motor function Stops working for the most part after 12-24 mo. Give last dose by 12 noon Adverse effects: Mainly insomnia, drug interactions w meperidine or SSRIsMethylnaltrexone is for - constipation induced by opioids Migraine: - Throbbing, n/v, photosensitivity, highly debilitaing Vasodilation causing pain Calcitonin gene related peptide Serotonin Morphine sulfate is from which plant? - The seedpod of the poppy plant Morphine does not cross BBB Most widely prescribed drug in the US that can be combined with aspirin, tylenol, ibuprofen - Hydrocodone Narcan is: - Pure opioid antagonist (antidote) Antagonists at mu and kappa receptors No analgesia Phenobarbital: - Reduce seizures without causing sedation A barbiturate GABA Sedation Phenytoin (Dilantin) is for - Gold standard drug for tonic-clonic or partial seizures and some CV problems Binds to albumin Adverse effects: Nystagmus Ataxia SedationGingival hyperplasia Effects on pregnancy and CV system Diplopia (double vision) Cognitive impairment Many drug interactions