Al-Mehdi NM Pharmacotherapeutics Flashcards
Autoimmune disorder resulting in loss of presynaptic neuronal VGCCs and impaired ACh release
Lambert-Eaton Syndrome
patient presents with weakness what do you automatically think
muscle weakness
fluctuating muscle weakness sign of
neuromuscular junction problems
AchE in synapse of NMJ allows for what to be recycled
choline
in the spinal cord, NOT NMJ, what prevents GABA release by degrading synaptobrevin
Tetanus toxin
at the NMJ level, what degrades SNAP-25 and syntaxin causing no release of Ach
Botulinum toxin
Nm receptor blockers end in
“curonium”
Nm receptor agonists
succinylcholine
acetylcholine
nicotine
Nm only location in the body
NMJ
autoimmune disease targeting VGKC and increase in Ach release
neuromyotonia
condition where your muscles are unable to relax after contraction
myotonia
NMJ disorders highest prevelance in what populations
younger women and older men
this can lead to myasthenia gravis and targets Nm
Thymoma
this is associated w/ Lambert-Eaton syndrome and targets p/q type VGCC
small cell lung cancer
features include: painless, fluctuating muscle weakness and Ptosis; weakness increases with continued activity
Myasthenia Gravis
other main clinical features include dysarthria and myasthenic sneer
Myasthenia Gravis
defined as the need for ventilator support for respiratory muscle weakness
myasthenic crisis
ocular findings of this include shifting ptosis (from one eye to the other)
Myasthenia Gravis
To diagnose MG:
AChE inhibitors
AChE inhibitors used to diagnose MG:
Neostigmine and Edrophonium
everything slows down on EMG
MG
amplitude increases on EMG for this
Lambert-Eaton syndrome
drug used to manage MG
Pyridostigmine bromide
surgery to perform for MG
thymectomy
type of drugs used to treat MG
immunosuppressants
Cyclosporine and Tacrolimus inhibit what
calcineurin (decrease in IL-2)
monoclonal Ab against CD20 (inhibits B cells)
Rituximab
Eculizumab is monoclonal antibody against what
C5 (MAC)
glucocorticoid that inhibits B cells
Prednisone
Azathioprine and Mycophenolate Mofetil MoA
inhibit B cell and have cytotoxic effects
1st line immunosuppressant drugs for MG:
Azathioprine and Prednisone
lower extremity weakness and dry mouth features of
Lambert-Eaton syndrome
small cell lung carcinoma (SCLC) has antibodies against what transcription factor
SOX1
test for LEMS
triple timed up and go test
Lambert-Eaton Syndrome isassociated w/ what carcinoma
small cell lung carcinoma
MoA for Amifampridine (3,4-Diaminopyridine) and used to treat…
opens VGCC and increases Ach release; used to treat LEMS
cause of denervation atrophy (important for trophic function of muscle)
non-vesicular Ach release
Nm blockers that are used for general anesthetics end in
-curium
after surgery, paralysis is reversed by IV what
Neostigmine
neuromuscular blockade drug that can lead to malignant hyperthermia
succinylcholine
caused by mutation in RyR and use of succinylcholine and halothane
malignant hyperthermia
increase in end-tidal CO2 during ventilation is a sign of what
malignant hyperthermia
to treat malignant hyperthermia
Dantrolene
velocity-dependent increase in resistance to passive movement
spasticity
chronic spasticity
contracture
sign of UMN lesion
spasticity
Tizanidine and Baclofen are what
antispastic drugs
alpha2 agonist used as antispastic drug; inhibits release of Ach
Tizanidine
GABAb agonist used as antispastic drug
Baclofen
GABA a agonist used as antispastic drug
benzodiazepines
adverse effects of antispastic drugs
sedation
one of the most prescribed drugs in the ED used to treat muscle spasm caused by local tissue trauma or muscle strains
Cyclobenzaprine