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What do you develop w/ benzodiazepines use? What receptors?
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Tolerance
down-regulation of B2 receptors
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Initial Tx for Status Epilepticus?
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1) Diazepam
2) Lorazepam
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What drug causes sedation, ataxia and diplopia?
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Phenytoin
SAD Sx.
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What is SAD Sx and who produces it?
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sedation, ataxia and diplopia
Phenytoin
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What drugs causes gingival hyperplasia?
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1) Phenytoin
2) Nifedipine
3) Cyclosporin
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CNS drugs
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CNS drugs...
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Name the anticonvulsant that is degraded in zero-order?
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Phenytoin
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What drug is used for tx of abscence seizure?
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Ethosuximide
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What is the mechanism of action of ethosuximide?
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blocks Ca+ in thalamic neurons
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What drug do you use for preop sedation i.v.? It causes amnesia...
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Midazolam
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Name the drug that causes megaloblastic anemia and decreases folic acid?
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Phenytoin
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What anticovulsant causes SIADH?
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Carbamazepine
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What effect does carbamazepine have on the liver?
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it induces cyt P450 (+)
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What is the formula for minimal alveolar anesthetic concentration?
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MAC= 1/(potency[lipid solubility])
Lipid = potency = 1/MAC
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What anticonvulsant causes drug induced Ricketts or ostemalacia?
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Phenytoin
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DOC for trigeminal neuralgia?
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Carbamazepine
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What are 3 Side/Effects (S/E)of Carbamazepine?
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1) Cyt. P450 inducer (+)
2) Hematotoxicity
3) increase ADH (retains water)
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What is the effect of carbamazepine and Oral Contraceptives?
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inactivates sex steroids and O.C.
lowers estriol
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What is carbamazepine the DOC for?
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Trigeminal Neuralgia
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What effect does carbamazepine have on P450?
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induces it
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Name two important Side/Effects (S/E) of Carbamazepine?
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1) hematotoxicity
2) SIADH
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Drug used for Anxiety/Panic?
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A/P AlPrazolam
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Patien w/ depression needs to be treated but has liver failure? Tx pt. w/ which benzos...
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1) Oxazepam
2) Temazepam
3) Lorazepam
Out The Liver
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What are the three OUT THE LIVER Benzodiazepines?
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Oxazepam
Temazepam
Lorazepam
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Tx for Status Epilepticus (I.V.)?
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Lorazepam
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What drug is used for relaxation and detoxification for withdrawal states?
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diazepam
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Antidote for Zolpidem overdose?
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Flumazenil
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Where do benzodiazepines work?
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GABAa receptor
gama binding site
BZ1 hypnotic (sleep)
increases frecuency of Cl- channel
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What site do benzodiazepines act in?
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gama binding site
BZ 1
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What drug is antagonist at the BZ receptor?
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flumazenil
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What drug acts in the BZ1 receptor but it's not a benzodiazepine?
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Zolpidem
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What is the action of barbiturates [high dose]?
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increase duration Cl-
opens Cl- channels
blocks Na+ channels
barbiDURATES
increases duration of Cl- open
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What is the mechanism of Buspirone?
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- no gaba
- partial agonist at 5HT1a
-nonsedating
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What is the action of disulfiram? Whic cell compartment does it work on?
Increase what?
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inhibits acetaldehyde dehydrogenase
- mitochondria
- increases NADH
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What is Methanol used for? (Tx)
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- Ehtanol intoxication
- fomepizole
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What is the definite Tx for ethanol/fomepizole intoxication?
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Dialysis
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What is methanol degraded to?
Enzyme?
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formaldehyde
- alcohol dehydrogenase
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What is the lethal dose of methanol?
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5 ounces
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What is the toxic retinal dose of methanol?
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5cc
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What does the Disulfiram Reaction consists of?
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1) Nausea
2) Vomiting
3) Vertigo
4) Hypotension/Shock
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What causes a 3/sec spike pattern on EEG?
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Abscence seizure
Petite Mal
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What is indicated in neuropathic pain?
|
1) Felbamate
2) Lamotrigine
3) Gabapentin
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What are the S/E of Felbamate?
|
Aplastic Anemia
Acute Liver Failure
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What are the S/E of Lamotrigine?
|
Steven-Jonhson Sx
Rash
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What are felbamate, lamotrigine and gabapentin used for?
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Neuropathic pain
|
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Name the 3 new Anticovulsants?
|
Felbamate
Lamotrigine
Gabapentin
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Name 3 drugs used in complex seizure tx?
|
Valproic Acid
Phenytoin
Carbamazepine
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Tx for Generalized Anxiety States (GAS)?
|
Buspirone
|
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How long do you wait for buspirone to take effect?
|
1-2 weeks
|
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What is divalproex used for?
|
Bipolar Disorder (backup)
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