Review 2.1

• what are the first line of meds for focal seizures?

  Carbamazepine and Lamotrigine
• what are the second line of meds for focal seizures?

  Oxcarbazepine, Levetiracetam, and Valporic acid
• Valporic acid is the first line in what seizures

  generalized tonic-clonic

  absence

  myoclonic

  tonic and atonic seizures

  idopathic generalized epilepsy
• what two meds are first line for absence seizures?

  Ethosuximide and valporic acid
• second line meds for generalized tonic-clonic seizures

  Lamotirgine, Carbmazepine, and Oxcarbazepine
• second line for absence and tonic/atonic seizures

  Lamotrigine
• second line for myoclonic seizures

  Levetiracetam and Topiramate
• second line of meds for idiopathic generalized epilepsy

  Lamotrigine and topiramate
• what seizure meds cause hyperplasia of gums?

  Carbamazepine and Phenytoin
• functions of PNS

  decrease HR, increase gastric secretions, emptying bladder and bowel, focus eye for near vision, constrict pupil, contract bronchial smooth muscle
• function of CNS

  CV,

  regulation of body temp (dilate blood flow to surface, secretion of sweat, and piloerction)

  fight or flight
• what is a neurotransmitter of the PNS

  acetylcholine
• what are the receptor of acetylcholine?

  Cholinergic: Nicotinic N, Nicotinic M, and Muscarnic
• what are andrenic neurotransmitters and their receptors?

  Epi and Norepi

  receptors: Alpha1 1, alpha 2, beta 1, beta 2, and dopamine
• what is the function of nicotinic receptors?


  promotes neurotransmission of all ganglia of SNS and PNS

  promotes ep from adrenal medulla
• what is the function of Muscarnic receptors

  increase glandular secretions (pulmonary, gastric, intestinal, and sweat)

  contraction of smooth bronchi and GI

  decrease HR

  contraction of sphincter muscle of iris (miosis) and ciliary muscle of eye (near vision)

  dilation of BV

  voiding of bladder
• what is alpha 1 function

  vasoconstriction, ejaculation, and contraction of bladder and prostate
• alpha 2 function

  not much clinical significance in the PNS

  CNS: reduces sympathetic outflow to heart and BV, relief of pain
• beta 1 functions in the heart

  increases HR, force of contraction, and velocity of conduction in AV node
• beta 1 functions in the kidney

  releases renin
• beta 2 function

  bronchial dilation

  relax of uterine muscle - delays labor

  vasodilation

  glycogenolysis
• dopamine function

  dilates renal blood vessels
• what receptors can epi activate?

  all alpha and beta
• what receptors can norepi activate?

  all alpha receptors and beta 1
• what receptors can dopamine activate?

  alpha 1, beta 1, and dopamine
• when you activate muscarinic or cholinergic agonist you get what?

  SLUDGE (Salivation, lacrimination, urination, diarrhea, GI, emesis)
• when you block a muscarinic with an anticholinergic or antimucarinic you get


  cant pee, see, spit, or shit
• drugs that are cholinergic or muscarinic agonist

  Bethanechol, Cevimeline, Pilocarpine, Acetylcholine
• Bethanchol is given for what and do not give to what pt with this disease


  use: urinary retention, GI uses, Gi reflux

  do not give to hyperthyroidism and PUD pts
• what do you treat muscarnic poisoning with? think SLUDGE

  atropine
• Cevimeline treats what 


  SJS - helps turn on salivary glands
• Pilocarpine treats what

  SJS and topical therapy for glaucoma
• acetylcholine is used for what after cataract surgery?

  pupil constriction
• meds that are muscarinic antagonist or anticholinergic and function

  atropine, Oxybutynin, Darifenacin, Solifenacin, Tolterodine, Fesoterodine, Tropisum

  function: cant see, shit, pee, or spit
• Atropine uses

  preanesthetic, eye disorders, bradycardia, intestinal hypermotility, asthma (can worsen in high doses)
• oxybutynin used to treat overactive bladder but can cause what in older adults and peds?

  hallucinations and agitation
• Darifenacin has the greatest selectivity what muscarnic receptor for OAB?

  M3 selectivity

  has not effect of M1 in the brain or M2 in the heart
• All anticholinergic or antimuscarnic cause what ECG problems

  prolonged QT
• what 3 meds are nonselective M receptors?

  Tolterodine, Fesoteroidine, and Trospium
• What meds are better for elderly for OAB?

  Beta 3 adrenoreceptor agonist - do not effect muscarninic receptors

  mirabegron and Vibegron