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TN Gériatrie > 6. Common medications > Flashcards

6. Common medications Flashcards

1
Q

Name cognitive enhancers (4)

A
  • donepezil (Aricept)
  • galantamine (Reminyl)
  • rivastigmine (Exelon)
  • memantine (Ebixa®/Namenda® (Can)/(U.S.))
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2
Q

Describe: donepezil (Aricept)

  • Dosing Schedule
  • Indications
  • Contraindications
  • Side Effets
  • Mechanism of Action
A
  • Dosing Schedule: 5-10 mg PO daily
  • Indications: Moderate to severe dementia of Alzheimer’s type
  • Contraindications:
    • Known hypersensitivity
    • caution in untreated obstructive airways disease
    • cardiac conduction abnormalities
    • Active Peptic Ulcer Disease
    • seizure disorder
    • syncope not yet diagnosed (NYD)
  • ​Side Effets: N/V, diarrhea, anorexia, falls, hip fracture, increased need for pacemaker insertion
  • Mechanism of Action: Reversible inhibition of acetylcholinesterase
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3
Q

Describe: galantamine (Reminyl®)

  • Dosing Schedule
  • Indications
  • Contraindications
  • Side Effets
  • Mechanism of Action
A
  • Dosing Schedule: 8-12 mg PO bid
  • Indications: Mild to moderate dementia of Alzheimer’s type
  • Contraindications:
    • Known hypersensitivity
    • caution in untreated obstructive airways disease, cardiac conduction
    • abnormalities
    • Active Peptic Ulcer Disease
    • seizure disorder
    • syncope not yet diagnosed
  • Side Effets: N/V, diarrhea, anorexia, falls, hip fracture, increased need for pacemaker insertion
  • Mechanism of Action: Reversible inhibition of acetylcholinesterase
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4
Q

Describe: rivastigmine (Exelon®)

  • Dosing Schedule
  • Indications
  • Contraindications
  • Side Effets
  • Mechanism of Action
A
  • Dosing Schedule: 1.5 mg PO daily (starting) up to 6 mg PO bid
  • Indications: Mild to moderate dementia of Alzheimer’s type
  • Contraindications:
    • Known hypersensitivity
    • severe hepatic disease
    • caution in untreated obstructive airways disease
    • cardiac conduction abnormalities
    • active peptic ulcer disease
    • seizure disorder
    • syncope not yet diagnosed
  • Side Effets: N/V, diarrhea, anorexia, falls, hip fracture, increased need for pacemaker insertion
  • Mechanism of Action: Acetylcholinesterase inhibition (reversible but very slow)
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5
Q

Describe: memantine Ebixa®/Namenda® (Can)/(U.S.)

  • Dosing Schedule
  • Indications
  • Contraindications
  • Side Effets
  • Mechanism of Action
A
  • Dosing Schedule: 5 mg PO daily (starting) up to 10 mg PO bid
  • Indications: Mild to moderate dementia of Alzheimer’s type
  • Contraindications:
    • Known hypersensitivity
    • conditions that alkalinize urine
    • caution in renal failure
    • seizures
  • Side Effets: Agitation, fatigue, dizziness, headache, hypertension, constipation
  • Mechanism of Action: NMDA-receptor antagonist
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6
Q

Name different laxatives (6)

A
  • bran (All-Bran®)
  • psyllium
    • Metamucil®
    • Prodiem Plain®
  • lactulose
    • Chronulac®
    • Cephulac®
    • Kristalose®(U.S.)
    • Acilac
    • Apo-Lactulose®
    • Laxilose
    • PMS-Lactulose (Can)
  • senna
    • Senokot®/Ex-lax®
    • Glysennid®
  • PEG 3350 (polyethyleneglycol)
    • Lax-A-Day®,RestoraLAX®,Pegalax® (Can)
    • Gavilax®,Healthylax® (U.S.)
  • bisacodyl (Dulcolax®)
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7
Q
A
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8
Q

Describe: bran (All-Bran®)

  • Dosing Schedule
  • Indications
  • Contraindications
  • Side Effets
  • Mechanism of Action
A
  • Dosing Schedule: 1 cup OD
  • Indications: Constipation
  • Contraindications: -
  • Side Effets: Bloating, flatus
  • Mechanism of Action: Bulk-forming laxative
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9
Q

Describe: psyllium

  • Dosing Schedule
  • Indications
  • Contraindications
  • Side Effets
  • Mechanism of Action
A
  • Dosing Schedule: 1 tsp PO tid
  • Indications: Constipation, hypercholesterolemia
  • Contraindications: N/V, abdominal pain, obstruction
  • Side Effets: Bloating, flatus
  • Mechanism of Action: Bulk-forming laxative
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10
Q

Describe: lactulose

  • Dosing Schedule
  • Indications
  • Contraindications
  • Side Effets
  • Mechanism of Action
A
  • Dosing Schedule: 15-30 cc PO OD/bid
  • Indications:
    • Constipation
    • hepatic encephalopathy
    • bowel evacuation following barium exam
  • Contraindications:
    • Patients on low galactose diets
    • Abdominal pain
    • N/V
  • Side Effets: Flatus, cramps, nausea, diarrhea
  • Mechanism of Action: Hyperosmolar agent, lowers pH of colon to decrease blood ammonia levels
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11
Q

Describe: senna

  • Dosing Schedule
  • Indications
  • Contraindications
  • Side Effets
  • Mechanism of Action
A
  • Dosing Schedule: 1-2 tabs PO daily or 10-15 cc syrup PO daily
  • Indications: Constipation
  • Contraindications: Abdominal pain, N/V
  • Side Effets: Cramps, N/V , diarrhea
  • Mechanism of Action: Stimulant laxative
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12
Q

Describe: PEG 3350 (polyethylene glycol)

  • Dosing Schedule
  • Indications
  • Contraindications
  • Side Effets
  • Mechanism of Action
A
  • Dosing Schedule: 17 g (~1 heaping tablespoon) dissolved

in 120 to 240 mL (4 to 8 ounces) of beverage, OD

  • Indications: Constipation, bowel prep (different dosing schedule)
  • Contraindications: Known/suspected bowel

obstruction, known hypersensitivity, renal impairment

  • Side Effets: Abdominal cramps, bloating of the stomach, diarrhea, flatulence, nausea
  • Mechanism of Action: Osmotic laxative
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13
Q

Describe: bisacodyl

  • Dosing Schedule
  • Indications
  • Contraindications
  • Side Effets
  • Mechanism of Action
A
  • Dosing Schedule: 5-15 mg PO (10 mg PR)
  • Indications: Constipation
  • Contraindications: Ileus, obstruction, abdominal pain, N/V, severe dehydration
  • Side Effets: Cramps, pain, diarrhea
  • Mechanism of Action: Stimulant laxative
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14
Q

Describe pharmacologic tx of Parkinson’s Disease (3)

A
  • mainstay of treatment: levodopa/carbidopa (Sinemet®) or levodopa/benserazide (Prolopa®)
    • Levodopa is a dopamine precursor; carbidopa and benserazide decrease peripheral metabolism of levodopa, decreasing side effects and increasing half-life of levodopa
      • levodopa-related fluctuation: delayed onset of response (affected by mealtime), end-of-dose deterioration (“wearing-off ”), random oscillations of on-off symptoms
      • major adverse effect of levodopa is dyskinesia
  • treatment of early PD: dopamine agonists, amantadine, MAOI
  • adjuncts: dopamine agonists, MAOI, anticholinergics (especially if prominent tremors), catechol-O-methyltransferase inhibitors
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TN Gériatrie (6 decks)

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