Term
| How do you treat a panic attack? |
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Definition
| Give a beta-blocker as you would in a thyroid storm to calm the sympathetic overdrive down |
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Term
| Given for the treatment of generalized anxiety disorder (GAD) |
|
Definition
Venlafaxine
Paroxetine
Escitalopram |
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Term
| Benzodiazepines prescribed for acute relief of a panic attack |
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Definition
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Term
| Which benzodiazepines are not likely to accumulate with repeat doses and indicated for elderly patients? |
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Definition
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Term
| What competitive antagonist can be given for overdoses or to counteract the sedating effects of benzodiazepines? |
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Definition
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Term
| Short term treatment of insomnia |
|
Definition
Zolpidem (Ambien)
Zaleplon |
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Term
| What are the therapeutic uses for morphine? |
|
Definition
| Extreme pain, acute pulmonary edema, palliative measures |
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Term
IV form used as preoperative medication, also used for epidurals
Transdermal form is excellent in chronic patients
Synthetic opioid that’s 80-100x more potent than morphine w/rapid onset |
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Definition
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Term
| Synthetic opioid, similar activity and potency with morphine |
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Definition
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Term
| Used in maintenance program for narcotic dependence treatment |
|
Definition
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Term
1/10th the potency of morphine but excellent antitussive
Good analgesic, low potency for abuse
Usually combined with acetaminophen |
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Definition
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Term
Some mu, kappa, sigma receptor activity
Used as an antitussive in Delsym, Robitussin DM, etc. |
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Definition
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Term
| What moderate opioids are indicated for cough? |
|
Definition
Codeine
Hydrocodone
Hydromorphone |
|
|
Term
| What are the anti-diarrhea opioids? |
|
Definition
Loperamide (Imodium)
Diphenoxylate (Lomotil) combined with atropine |
|
|
Term
| What is the partial opioid agonist used for outpatient opioid detoxification |
|
Definition
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|
Term
An opioid antagonist that binds with high affinity to opioid receptors but does not produce any physiological effect
Completely and dramatically reverses opioid effects |
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Definition
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|
Term
| Oral Naloxone used for outpatient treatment |
|
Definition
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Term
| Which MAO-I is used to treat Parkinsons? |
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Definition
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|
Term
| Which would best treat depression with insomnia? |
|
Definition
| A TCA such as Amitriptyline |
|
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Term
| What is the most commonly prescribed class of antidepressant? First-line choice for depression and can also be given for OCD, bulimia, and anxiety |
|
Definition
| Selective Serotonin Reuptake Inhibitors (SSRIs) |
|
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Term
| How is serotonin syndrome treated? |
|
Definition
Self-limiting syndrome if offending agent is removed
Selegiline (Parkinson’s), and St. John’s wort should be considered |
|
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Term
| Which SSRI is most stimulating? |
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Definition
|
|
Term
| Which SSRI is most sedating? |
|
Definition
|
|
Term
| Which SSRI least stimulating and sedating? |
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Definition
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Term
| Effects on DA levels are thought to be the basis for use in smoking cessation regimens |
|
Definition
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|
Term
Reserved for those failing SSRIs, TCAs, and atypical antidepressants
Low usage (late choice) due to potential toxicity, complex drug interactions |
|
Definition
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|
Term
First line in bipolar depression
Acute mania (valproic acid or carbamazepine may be better)
Adjunct to antidepressant treatment in major depression |
|
Definition
|
|
Term
| What are accepted alternatives to lithium in bipolar depression? |
|
Definition
| Valproic acid and carbamazapine |
|
|
Term
| What are the first line anti-epileptic drugs? |
|
Definition
Valproic acid
Ethosuximide
Phenytoin
Carbamazepine
Oxcarbazepine |
|
|
Term
| Which anti-epileptic drugs are safer for use in pregnancy (Category C)? |
|
Definition
Lamotrigine
Levitiracetam
Zonisamide |
|
|
Term
Drug of choice in adolescents in whom grand mal and petit mal coexist
Infantile epilepsy where its lack of sedative action is an advantage
Useful in absence seizures |
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Definition
|
|
Term
| Approved for montherapy in absence seizures |
|
Definition
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|
Term
All types of partial seizures
Tonic-clonic seizures
Can be used in seizures with known etiology
Reye’s syndrome, after head trauma, seizures that occur during or after neurosurgery |
|
Definition
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|
Term
Febrile seizures in children
Status epilepticus
Long term management of all types of seizures that are difficult to control with other antiepileptics
Used when nothing else is working |
|
Definition
|
|
Term
| Benzodiazepines used for status epilepticus and febrile seizures |
|
Definition
|
|
Term
Absence seizures refractory to ethosuximide or valproic acid
Alone or with other drugs in absence and myoclonic seizures
Lennox-Gastaut syndrome
Infantile spasms and restless legs |
|
Definition
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|
Term
| Anti-epileptic drugs used for the treatment of status epilepticus |
|
Definition
Start IV Diazepam or lorazepam
Since seizure recurrence is high, add a longer acting antiepileptic such as phenytoin
If SE continues, proceed to phenobarbital
If SE has not resolved, general anesthesia, intubation & respiratory support |
|
|
Term
|
Definition
Diazepam rectally
Phenobarbital in children if recurrent
Patients usually recover completely |
|
|
Term
Monotherapy for partial seizures
Add on therapy for generalized including petit mal & also partial seizures
For Lennox-Gastaut syndrome in both children and adults
Bipolar disorder |
|
Definition
|
|
Term
| Generalized tonic-clonic seizures in adults, partial and myoclonic seizures in children ages 6 years and older |
|
Definition
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|
Term
| Most effective symptomatic treatment for PD |
|
Definition
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|
Term
| Given alongside Levodopa to help mediate side effects and allow for better absorption into the CNS |
|
Definition
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|
Term
| Preferred in younger patients with Parkinsons either alone or as an adjunct |
|
Definition
|
|
Term
| Preferred in older Parkinsons patients who may be more vulnerable to adverse cognitive defects |
|
Definition
|
|
Term
| Approved for use as a "rescue therapy" for the treatment of "off" episodes in patients with a fluctuating response to DA therapy |
|
Definition
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|
Term
| What should be given alongside Apomorphine |
|
Definition
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|
Term
| Reduces the clinical symptoms of "wearing off" in patients treated with SINEMET |
|
Definition
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|
Term
| Used only in patients who have not responded to other therapies for Parkinsons and with appropriate monitoring for hepatotoxicity |
|
Definition
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|
Term
Shorter duration of action (2 hrs)
Administered simultaneously with Sinemet
Peripheral inhibition of COMT only
No incidence of hepatotoxicity and requires no special monitoring |
|
Definition
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|
Term
MAO-B selective inhibitor used for the symptomatic treatment of Parkinsons
Benefits are modest, may have neuroprotective effects |
|
Definition
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|
Term
Used widely prior to L-DOPA discovery
Modest antiparkinsonian activity that is useful in the treatment of early PD or as an adjunct to dopamimetic therapy. Reduces tremor more than bradykinesia |
|
Definition
Muscarinic receptor antagonists:
Trihexyphenidyl
Benztropine mesylate
Biperiden
Diphenhydramine hydrochloride |
|
|
Term
| Treatment with what is standard in long-term treatment of schizophrenia |
|
Definition
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Term
| How do you treat acute extra-pyramidal symptoms such as those seen with first gen typical anti-psychotics? |
|
Definition
Anticholinergics:
Procyclidine, orphenadrine
Benzatropine
Diphenhydramine (Benadril) |
|
|
Term
| How do you treat chronic extra-pyramidal symptoms (tardive dyskinesia) seen with first gen typical anti-psychotics? |
|
Definition
Symptoms persist even after the drugs have been stopped
Cessation will slowly reverse the adapative changes in the nigrostriatal dopaminergic pathways
Switching to atypical antipsychotic, Clozapine ameliorates these side effects |
|
|
Term
| What do you give for Neuroleptic malignant syndrome (NMS)? |
|
Definition
A rare complication of anti-psychotic use that resembles a severe form of Parkinsonism
Stop the drug, lower body temp, give hemodynamic stabilization, Dantrolene & Bromocriptine |
|
|
Term
Often used to treat acute schizophrenia
MoA: Potent D2 blocker
Very little sedation, low anti-muscarinic effects, little orthostatic hypotension |
|
Definition
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|
Term
Used only if a patient is unresponsive to two other neuroleptics and has tardive dyskinesia or severe EPS
Careful monitoring, CBC is mandatory and must be at normal levels |
|
Definition
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|
Term
| The most commonly used anti-psychotic during an acute psychotic break |
|
Definition
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|
Term
Used to treat psychoses in Parkinson’s disease
Less potential for exacerbating Parkinson's because it blocks D1, D4 & 5HT2A receptors not D2 receptors |
|
Definition
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|
Term
| Recently approved as an adjunct in the treatment of depression |
|
Definition
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|
Term
| Which of the following antipsychotic has minimal sedation? |
|
Definition
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|
Term
Acts very rapidly, producing unconsciousness in 20 sec since the drug reaches the brain from its injection site
Used for induction of anesthesia
Not preferred for maintenance anesthesia due to slow elimination |
|
Definition
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|
Term
| What anesthetic drug can uniquely be used in its IV form for maintaining anesthesia? |
|
Definition
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|
Term
The only barbituate that is used as an anesthetic
High lipid solubility, rapid action ~20s
Short duration-5 min due to redistribution to muscle |
|
Definition
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|
Term
Onset of activity is slower (1-2 min)
Good analgesic effect
Causes “Dissociative” anesthesia: patient may be conscious but has amnesia and is insensitive to pain |
|
Definition
|
|
Term
| Preferred for induction and maintenance anesthesia |
|
Definition
Inhalation/volatile anesthetics, most often N2O
Always given with oxygen |
|
|
Term
| What is used alongside volatile anesthetics to cause sympathetic stimulation, minimizing cardiac depressant effects |
|
Definition
|
|
Term
| How is malignant hyperthermia due to inhaled anesthetics treated? |
|
Definition
| Dantrolene prevents calcium release |
|
|
Term
| How is methemoglobinemia (caused by prilocaine) treated? |
|
Definition
|
|
Term
| Which anti-spasmodic would you use if you wanted to avoid sedation? |
|
Definition
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