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Summer 2024 > 725 Quiz 3 > Flashcards

725 Quiz 3 Flashcards

1
Q

Dementia includes symptoms such as ___________ dysfunction, ________ loss, ___________ impairment, language and ___________ issues, and _____________ symptoms.

A

cognitive dysfunction
memory loss
reasoning impairment
language and communication issues, and
behavior symptoms

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2
Q

What are two behavior symptoms associated with dementia?

A

psychosis and agitation

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3
Q

According to Amyloid Cascade Hypothesis, AD is caused by the accumulation of toxic ____________ plaques, hyperphosphorylation of ______, ___________ _____________ formation, ____________ dysfunction, and ultimately _________ loss.

A

toxic amyloid-beta plaques
hyperphosphorylation of tau
neurofibrillary tangle formation
synaptic dysfunction
neuronal loss (w/memory loss)

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4
Q

The most successful tx of cognitive and memory s/s associated with AD is associated with boosting _________ functioning and stopping the destruction of ______ .

A

cholinergic; AcH

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5
Q

What is the target when attempting to boost cholinergic functioning and preserving AcH?

A

AcHE

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6
Q

What three medications target AcHE? DR. G

A

donepezil, rivastigmine, galantamine

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7
Q

Class of medication: atomoxetine

A

selective NE reuptake inhibitor (NRI)

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8
Q

Mechanism of action: atomoxetine

A

selectively blocks presynaptic NETs in PFC -> increases DA/NE in PFC

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9
Q

Class medication: bupropion

A

NDRI

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10
Q

Bupropion is a _______ NRI and DAT inhibitor.

A

weak

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11
Q

How does bupropion block reuptake DA?

A

as a DAT inhibitor

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12
Q

Class medication: guanfacine?

A

alpha 2A adrenergic agonist

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13
Q

Class medication: clonidine?

A

alpha 2A adrenergic agonist

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14
Q

Stimulants mechanism of action, where?

A

DA NE Reuptake Inhibitor (DNRI); presynaptic cleft

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15
Q

Black box warning for stimulants?

A

Abuse and dependence (schedule II)

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16
Q

Stimulants can cause this SE in males that is an emergency.

A

priapism

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17
Q

What are the two classes of stimulants?

A

methylphenidate and amphetamine

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18
Q

What does amphetamine do different from methylphenidate

A

enhances presynaptic DA release

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19
Q

Children, especially pre-school children, present with these common SEs (4) of stimulant tx

A

emotional outbursts
irritability
trouble falling asleep
repetitive thoughts/behaviors

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20
Q

Cholinesterase inhibitors improve _________ and the ___________ but does __________ the disease; a dramatic effect is NOT typical.

A

symptoms and course; reverse

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21
Q

Cholinesterase inhibitors have common _______ SEs and also can cause a safety concern of ______________.

A

GI

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22
Q

Guanfacine ER can cause a safety issue of ____________ and _____________ and can cause an emergency SE in males of ____________ .

A

dizziness, drowsiness, priapism

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23
Q

When stopping clonidine ER what must you do and why?

A

taper or rebound HTN

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24
Q

Common SEs of clonidine ER which can cause a safety issue?

A

Dizziness, drowsiness

25
Q

Black box warning of atomoxetine?

A

children/young adults: worsening depression/SI

26
Q

Although atomoxetine is not a stimulant, it can cause this SE

A

decreased appetite

27
Q

Cognition includes me____, lan____, o__________, j__________, conducting i_________ ____________, performing a_________, and p_______-________.

A

memory, language, orientation, judgement, conducting IPRs, performing actions (praxis), and problem-solving.

28
Q

Hallmark symptom of delirium? Typical presents with global impairments of what?

A

impairment in consciousness (usually decreased); cognitive functions

29
Q

The primary neurotransmitter, which is reduced, in delirium is what? And speaking on this what is one of the most common causes of delirium?

A

AcH; too many rx’d medications with anticholinergic activity

30
Q

Major differential points between delirium and dementia when dx’ing? delirium w/hallucinations/delusions vs schizophrenia? vs depression?

A

time to develop and fluctuation of s/s; hallucinations/delusions more constant and better organized, no change in consciousness in schizophrenia; confusion not seen in depression

31
Q

Atomoxetine can cause ______ toxicity, ____ prolongation, and although not a stimulant these CV effects: ____ , increased _____, and cardiovascular ___________ .

A

HTN, QT, HTN, HR, collapse

32
Q

Which two ADHD medication causes xerostomia?

A

atomoxetine and clonidine

33
Q

What ADHD medication can cause sinus node dysfunction?

A

guanfacine

34
Q

Which of the non-stimulant medications for ADHD cause fatigue/drowsiness?

A

ALL

35
Q

Which ADHD tx can cause rebound HTN if suddenly stopped?

A

clonidine

36
Q

Which ADHD med can cause a skin rash?

A

guanfacine

37
Q

Which type of ADHD medication can cause peripheral vasculopathy?

A

stimulants

38
Q

Methylphenidate blocks the transports for both what?

A

NE and DA

39
Q

Amphetamines are similar to methylphenidates but blocks transporters in a different manner… by being a _________ __________ and pseudosubstrate for ________ and _________ which means it binds to the same site that NE and DA binds to thus __________ their uptake.

A

competitive inhibitor, NET and DAT, inhibits

40
Q

Tics from stimulants are caused by?

A

excess DA

41
Q

Stimulants can increase ____________ .

A

anxiety

42
Q

Taking lower doses of atomoxetine increases the activity of ____ post synaptic neurons, and at higher doses causes ______________.

A

A2; sedation

43
Q
A
44
Q

Vortioxetine (Trintellix) is an SSRI and modulates ______ 5HT receptors- in AD it can help ________ and ________ by modulating glutamate, AcH, histamine, and NE in the ________ by 5HT__ blockade.

A

all; cognition and depression, hippocampus, 5HT3

45
Q

Donepezil is a ______ acting ______ inhibitor of ______ in the _____ & _____ synapse and is _________ . It also works in and outside of the ______ and is ________ .

A

long; selective; AcHE; pre/post; reversible; CNS; reversible

46
Q

Donezepil targets memory, behavior, & cognition, especially these 6 things in AD; it can ______ nursing home admission w/ _________ of functioning.

A
47
Q

Memantine is a __________ antagonist which _____ abnormal activation of ________ transmission.

A

NMDA; decreases; glutamate

48
Q

Brexiprazole is a _______ agonist at the 5HT__ __ and __ __ receptors and is a potent antagonist at the 5HT __ ___ receptor; it is FDA approved to treat what in dementia? … which is contradictory to the black box warning of what?

A

partial; 5HT1A and D2; 5HT2A; agitation; increased risk of death in the elderly with dementia related psychosis

49
Q

Rivastigmine inhibits _______ in the cortex and hippocampus and periphery, and _______ in the _____ but is selective more for ______ (>65%); it is ___________ acting and is _______________.

A

AcHE; BucHE; glia; AcHE; intermediate; pseudoirreversible

50
Q

What is a potential advantage of rivastigmine in treating AD?

A

may help in the later stages and/or rapidly advancing AD

51
Q

Gabapentin is sometimes used with AD patients for behavioral issues and is a voltage-gated _____ channel _______ - which decreases firing and increases _______ .

A

Ca; inhibitor; GABA

52
Q

Carbamazepine (Tegretol) is sometimes used for behavioral in AD patients, 2nd line in tx’ing __________ ; it __________ _____ channels, preventing firing thereby increasing __________ .

A

aggression; inhibits Na; GABA

53
Q

Methylphenidate blocks ____ and ____ transporters which blocks their reuptake.

A

DA; NE

54
Q

The difference in IR and ER is the ______ ______ with IR lasting _____ hours and ER lasting _______ hours; Vyvanse lasts _______ and is a ____ drug which is preferred for someone with a hx of ______.

A

half life; 4-6 hours; 8-10 hours; 12 hours; pro; SUD

55
Q

If a stimulant is not working long enough, what two options do you have in rx’ing?

A

increase dose or change to long acting

56
Q

In ADHD DA and NE are decreased which results in a decreased _______ of ________ output in the _____ of the brain which increases ________.

A
57
Q

Children with ADHD should be evaluated by using the __________ children’s scale and this should be used by __________ and _________ how long after start of tx?

A

Vanderbilt; parents and teachers; 2 wks

58
Q

Viloxazine (Qelbee) inhibits _____ and also has actions at what two receptors that may (though not FDA approved) help mood?

A

NET; 5HT2B and 5HT2C

59
Q
A

Summer 2024 (12 decks)

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