Neurology, Special Senses, and Psychiatry Lecture Review

Flashcards covering anticonvulsant pharmacology, anesthetic mechanisms, neurodegenerative therapy, and core psychiatric definitions and defense mechanisms.

Phenytoin

A narrow spectrum anticonvulsant that blocks $Na^+$ channels; side effects include gingival hypertrophy, hirsutism, and Stevens-Johnson syndrome (SJS).

Ethosuximide

A narrow spectrum anticonvulsant used for absence seizures only that works by blocking $Ca^{2+}$ channels.

Valproate

A broad spectrum anticonvulsant that blocks $Na^+$ channels, $Ca^{2+}$ channels, and GABA transaminase; it has the highest risk of teratogenicity among all anticonvulsants.

Levetiracetam

An anticonvulsant that blocks Synaptic Vesicle protein 2A (SV2A).

Barbiturates

Agents such as phenobarbital and pentobarbital that facilitate $GABA_A$ action by increasing the duration of $Cl^-$ channel opening.

Benzodiazepines

Agents that facilitate $GABA_A$ action by increasing the frequency of $Cl^-$ channel opening.

ATOM mnemonic

Refers to Alprazolam, Triazolam, Oxazepam, and Midazolam, which are short-acting benzodiazepines with higher addictive potential.

Flumazenil

A competitive antagonist at the GABA benzodiazepine receptor used to treat benzodiazepine overdose.

Suvorexant

An orexin (hypocretin) receptor antagonist used for insomnia; it is contraindicated in patients with narcolepsy.

Sumatriptan

A $5-HT_{1B/1D}$ agonist used for acute migraine and cluster headaches; contraindicated in patients with coronary artery disease (CAD).

Carbidopa

An agent that blocks peripheral conversion of L-DOPA to dopamine by inhibiting DOPA decarboxylase, increasing central bioavailability.

Selegiline and Rasagiline

Selective inhibitors of MAO-B used in Parkinson disease to block the conversion of dopamine to 3,4-dihydroxyphenylacetic acid (DOPAC).

Riluzole

A treatment for Amyotrophic lateral sclerosis (ALS) that works by decreasing neuron glutamate excitotoxicity.

Memantine

An NMDA receptor antagonist used for moderate to advanced Alzheimer disease to prevent $Ca^{2+}$ mediated excitotoxicity.

MAC (Minimum Alveolar Concentration)

The concentration of inhaled anesthetic required to prevent 50% of subjects from moving in response to a noxious stimulus.

Dantrolene

A ryanodine receptor antagonist used to treat malignant hyperthermia and neuroleptic malignant syndrome.

Succinylcholine

A depolarizing neuromuscular blocking drug that acts as a strong $N_m$ nicotinic receptor agonist.

Baclofen

A $GABA_B$ receptor agonist in the spinal cord used to treat muscle spasticity and multiple sclerosis.

Latanoprost

A prostaglandin (PGF2$\alpha$) used in glaucoma that increases aqueous humor outflow; it can cause browning of the iris.

Classical conditioning

Learning in which a natural response is elicited by a learned stimulus that was previously presented with an unconditioned stimulus.

Transference

A phenomenon where a patient projects feelings about formative or important persons onto the physician.

Displacement

An immature ego defense involving the redirection of emotions or impulses to a neutral person or object.

Reaction formation

Replacing a warded-off idea or feeling with an emphasis on its opposite, such as treating a resented person with excessive nurturing.

Sublimation

A mature ego defense where an unacceptable wish is replaced with a similar but socially acceptable course of action.

Korsakoff syndrome

Amnesia and disorientation caused by vitamin $B_1$ deficiency, typically involving destruction of the mammillary bodies.

Delirium

A reversible, acute state of waxing and waning consciousness characterized by disorganized thinking and decreased attention span.

Hypnagogic hallucination

A perception occurring while going to sleep; sometimes seen in narcolepsy.

Schizoaffective disorder

A disorder requiring $\ge 2$ weeks of psychotic symptoms in the absence of a manic or depressive episode, combined with mood symptoms.

DIG FAST

Mnemonic for manic episode symptoms: Distractibility, Impulsivity, Grandiosity, Flight of ideas, Activity increase, Sleep need decrease, Talkativeness.

SIG: E CAPS

Mnemonic for Major Depressive Disorder symptoms: Sleep, Interest, Guilt, Energy, Concentration, Appetite, Psychomotor, Suicidal ideation.

Tourette syndrome

Onset before age 18, characterized by motor and vocal tics persisting for over 1 year; associated with OCD and ADHD.

SAD PERSONS

Mnemonic for suicide risk factors: Sex (male), Age, Depression, Previous attempt, Ethanol, Rational thinking loss, Sickness, Organized plan, No spouse, Stated intent.