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Pharmacology > Antidementia/Sedatives And Hypnotics/Antiparkinson/Antiepileptics/Skeletal Muscle Bone And Joint Disorder Drugs > Flashcards

Antidementia/Sedatives And Hypnotics/Antiparkinson/Antiepileptics/Skeletal Muscle Bone And Joint Disorder Drugs Flashcards

1
Q

Alzheimeis vs dementia

A

Alzheimer is a type of dementia

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2
Q

What can you see all the changes of dementia in?

A

MRI and biomarkers

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3
Q

What is cholinesterase?

A

An enzyme that destroys acetylcholine

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4
Q

What do cholinesterase inhibitors do?

A

Increase level of acetylcholine in CNS by inhibiting its breakdown and slowing neural destruction

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5
Q

Can dementia be cured?

A

No, meds can only slow down the progress

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6
Q

Cholinesterase inhibitors ex?

A

Donepezil and rivastigmine (Exelon)

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7
Q

Donepezil class

A

Cholinesterase inhibitors

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8
Q

Rivastigmine (Exelon) class

A

Cholinesterase inhibitors

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9
Q

What can donepezil do other than inhibit cholinesterase?

A

Slow down hr

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10
Q

NMDA receptor antagonists action?

A

Blocks excessive amino acid glutamate in the CNS, calms neurotransmitters
They attach to nerve cell receptors and prevent cell damage

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11
Q

NMDA blockers ex?

A

Memantine (Namenda)

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12
Q

Memantine (Namenda) class

A

NMDA blockers

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13
Q

Galantamine class?

A

Cholinesterase inhibitors

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14
Q

What can galantamine cause?

A

Bronchoconstriction

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15
Q

Adverse reactions of antidementia drugs?

A

NVD, anorexia, dizziness, headache

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16
Q

Contraindications of antidementia drugs?

A

Pregnancy and lactation
Delirium (b/c not made to treat this)

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17
Q

Are sedatives and hypnotics long term or short term drugs?

A

Short term

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18
Q

What are 2 drug classes under sedatives and hypnotics?

A

Barbiturates and nonbarbiturates

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19
Q

What are barbiturates used for?

A

Only for deep, nonwaking sleep (ex: suicide) b/c has harsh side effects

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20
Q

What class of drugs does nonbarbiturates include?

A

Benzodiazepines and nonbenzodiazepines
(These meds are used for rest not for anxiety)

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21
Q

Benzo used for rest ex?

A

Temazepam, triazolam

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22
Q

Nonbenzo used for rest ex?

A

Eszopiclone, zolpidem (Ambian)

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23
Q

Barbiturates actions

A

CNS depression and mood alterations, resp depression

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24
Q

Benzo actions

A

CNS depression, lesser effect on resp rate

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25
Q

What do you need to keep in mind when pt is taking benzo?

A

They can be addicting and pt can build up tolerance

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26
Q

Nonbenzo action

A

CNS depression, but effects will diminish after ~2 weeks!

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27
Q

What do you need to keep in m8nd when pt is taking nonbenzo?

A

They can build up a tolerance, and may experience withdrawal once the effects diminish

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28
Q

Adverse reaction of sedatives and hypnotics?

A

Dizziness, drowsiness, headache, nausea

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29
Q

Contraindications of sedatives and hypnotics?

A

Pregnancy and lactation
Coma
Severe resp problems
Hx of habitual drug and alcohol use

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30
Q

What are Parkinson pt at risk for?

A

Falling

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31
Q

How do doctors diagnose Parkinsons?

A

With assessment
Assess symptoms
And handwriting test b/c writing will get smaller overtime with Parkinsons

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32
Q

What is Parkinson caused by?

A

Imbalance of dopamine and acetylcholine in the CNS

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33
Q

What is dopaminergic drugs?

A

Go through the blood-brain barrier when dopamine cannot pass

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34
Q

Dopaminergic drugs ex?

A

Levodopa and carbidopa

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35
Q

How are levodopa and carbidopa used?

A

Always used together!
Called duodopa, have less side effects

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36
Q

Dopaminergic drugs ex other than duodopa?

A

Bromocriptine (stimulate dopamine receptors)
Rasagiline, selegiline (increase availability of dopamine)

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37
Q

What do dopaminergic drugs treat other than Parkinsons?

A

Restless legs syndrome

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38
Q

Adverse reactions of dopaminergic drugs?

A

Dry mouth
Constipation
Headache, dizziness
Abd pain
NVD, anorexia
Suicidal thoughts

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39
Q

Actions of dopamine receptor agonists

A

Mimicking effects of dopamine in the brain

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40
Q

Dopamine receptor agonist ex?

A

Pramipexole, ropinirole

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41
Q

Pramipexole class?

A

Dopamine receptor agonist

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42
Q

Ropinirole class?

A

Dopamine receptor agonist

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43
Q

What does ropinirole also treat other than parkinsons?

A

Restless leg syndrome

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44
Q

Adverse reactions of dopamine receptor agonists

A

NVD
Dizziness
Confusion
Postural hypotension
Headache

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45
Q

What is COMT?

A

An enzyme that eliminates dopamine

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46
Q

What do COMT inhibitors do?

A

Prolong the effect of levodopa

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47
Q

COMT inhibitors ex?

A

Entacapone

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48
Q

Entacapone class?

A

COMT inhibitors

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49
Q

Adverse reactions of COMT inhibitors?

A

Dizziness
orthostatic hypotension
sleep disorders
muscle cramps
Dyskinesia（运动障碍）
Hyperkinesia（运动机能亢进）
Akathisia（静坐不能）

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50
Q

Contraindications of COMT inhibitors?

A

Pregnancy and lactation
Liver dysfunction

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51
Q

What do cholinergic-blocking drugs do?

A

Cholinergic (rest & digest) blocking = fight or flight
Increase hr and GI movement
Block acetylcholine in the CNS, enhance dopamine transmission

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52
Q

What is the antidote of cholinergic overdose?

A

Benztropine (Cogentin)

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53
Q

Cholinergic blocking drugs ex?

A

Benztropine (Cogentin)
Diphenhydramine (Benadryl)

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54
Q

Diphenhydramine (Benadryl) class

A

Cholinergic blocking

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55
Q

Benztropine (Cogentin) class

A

Cholinergic blocking

56
Q

How are cholinergic blockers used in parkinsons?

A

Adjunctive therapy in all forms of parkinsonism

57
Q

Cholinergic blockers adverse reactions

A

Dry mouth
Blurred vision
Nausea
Dizziness
Confusion
Urinary retention
Skin rash
Tachycardia
Constipation

58
Q

What is the tx goal for seizure?

A

Treat the underlying cause

59
Q

Absent seizure definition

A

Vacant stare, loss of consciousness

60
Q

Myoclonic seizure definition

A

Sudden, forceful contraction of single/multiple muscles

61
Q

Clonic seizure definition

A

Longer jerking activity

62
Q

Tonic-clonic seizure definition

A

Also called the grand mal seizure
Alternate contraction (tonic) and relaxation (clonic) of muscle, loss of consciousness and abnormal behavior

63
Q

Atonic seizure definition

A

Loss of muscle tone

64
Q

Simple seizure definition

A

Consciousness not impaired, can involve senses (flashing light, change in taste, speech), and motor ability affected

65
Q

Complex seizure definition

A

Consciousness impaired, staring gaze, hallucination/delusion, begins focal and becomes generalized

66
Q

Another name for antiepileptics?

A

Anticonvulsants

67
Q

What are antiepileptics or anticonvulsants used for?

A

Manage seizure disorders

68
Q

Hydantoins are drugs used for?

A

Seizures

69
Q

Hydantoins actions

A

Stabilize hyperexcitability in the motor cortex of the brain

70
Q

Carboxylic acid derivatives are drugs that used for?

A

Seizures

71
Q

Carboxylic acid derivatives action?

A

Increase levels of GABA which stabilizes cell membranes

72
Q

Succinimides are drugs used for?

A

Seizures

73
Q

Succinimides action?

A

Depress motor cortex, creating a higher threshold before nerves react to the convulsive stimuli

74
Q

Benzoes can be used for anxiety, rest, and?

A

Seizures

75
Q

Benzoes action when used for seizures?

A

Elevate seizure threshold by decreasing postsynaptic excitation

76
Q

What does gabapentin do?

A

GABA agonist

77
Q

Topiramate action?

A

Blocks seizure activity rather than raising the threshold

78
Q

Can antiepileptics be used prophylactically?

A

Yes

79
Q

What is phenytoin used for?

A

Ongoing seizure control

80
Q

What will pt be on if they newly diagnosed with epilepsy?

A

Long term antiepileptic meds

81
Q

What will antiepileptics decrease the effects of?

A

Oral contraceptives

82
Q

Felbamate class?

A

Antiepileptics

83
Q

Carbamazepine class?

A

Antiepileptics

84
Q

Lamotrigine class

A

Antiepileptics

85
Q

Clobazam class

A

Antiepileptics

86
Q

General adverse reactions of antiepileptics

A

Dizziness
Weakness
Headache
NVD
Anorexia
Constipation
Gingivitis
Slurred speech
Skin rashes

87
Q

Severe adverse reactions of antiepileptics

A

SJS (lamotrigine)
Pancytopenia (felbamate, carbamazepine)

88
Q

If pt develop pancytopenia with antiepileptics, what precautions will they be on?

A

Bleeding and infection

89
Q

Phenytoin contraindicated in?

A

Bradycardia, SA block, AV block, pregnancy and lactation

90
Q

Ethotoin contraindicated in?

A

Hepatic abnormalities

91
Q

Succinamides contraindicated in?

A

Bone marrow depression (pancytopenia), hepatic/renal impairment

92
Q

Oxcarbazepine contraindicated in?

A

Dementia

93
Q

Carbamazepine contraindicated in?

A

MAOIs within 2 weeks/14 days
Bone marrow suppression
Hepatic/renal impairment
Pregnancy

94
Q

What can oxcarbazepine and carbamazepine cause?

A

Hyponatremia

95
Q

Valproic acid contraindicated in?

A

Renal impairment
Pregnancy

96
Q

Skeletal muscle relaxants ex?

A

Baclofen, chlorzoxazone, carisoprodol

97
Q

Baclofen class

A

Skeletal muscle relaxants

98
Q

Chlorzoxazone class

A

Skeletal muscle relaxants

99
Q

Carisoprodol class

A

Skeletal muscle relaxants

100
Q

Skeletal muscle relaxants action

A

Relieves pain, reduce muscle spasms

101
Q

What are skeletal muscle relaxants used for?

A

Strains and back pain, pre-op use to relax muscle tone

102
Q

Skeletal muscle relaxants adverse reactions

A

Sedation, drowsiness, constipation/diarrhea, bradycardia/tachycardia, rash

103
Q

Baclofen contraindications

A

Muscle spasms caused by rheumatic disorders (ex: rheumatoid arthritis)

104
Q

Carisoprodol contraindications

A

Hypersensitivity to meprobamate

105
Q

Cyclobenzaprine contraindications

A

Recent MI, cardiac disorders, hyperthyroidism

106
Q

Oral dantrolene contraindications

A

Lactation, active hepatic disease, muscle spasm caused by rheumatic disorders

107
Q

What is DMARDs action?

A

Immunosuppressant

108
Q

DMARDs uses

A

Chronic musculoskeletal conditions (autoimmune disorders)
(Rheumatoid arthritis, cancer therapy, fibromyalgia)

109
Q

Methotrexate class

A

DMARDs

110
Q

Adverse reactions of DMARDs

A

Alopecia (hair loss), nausea, flu-like symptoms, skin rash, GI upset and pancytopenia (Sulfasalazine)

111
Q

DMARDs contraindications

A

Methotrexate: renal insufficiency, liver disease, alcohol abuse, pancytopenia, folate deficiency
Biological DMARDs: CHF, neurological demyelinating diseases

112
Q

What are bone resorption inhibitors called?

A

Bisphosphonates

113
Q

What do bisphosphonates do?

A

Increase bone marrow density

114
Q

What are bisphosphonates used for?

A

Postmenopausal osteoporosis
Hypercalcemia
Paget disease of bone

115
Q

Adverse reactions of bisphosphonates

A

NVD, increased/recurrent bone pain, headache, dyspepsia, abd pain

116
Q

How should pt take bisphosphonates to prevent GI issues?

A

Take in the morning, 30 min before food and do distraction activities (shower, reading, watch TV), remain in upright position

117
Q

Bisphosphonates ex?

A

Alendronate, risedronate

118
Q

Risedronate class

A

Bisphosphonates

119
Q

Alendronate class

A

Bisphosphonates

120
Q

Bisphosphonates contraindications

A

Hypocalcemia, pregnancy, renal impairment

121
Q

Allopurinol class?

A

Uric acid inhibitors (antigout)

122
Q

Febuxostat class

A

Uric acid inhibitors

123
Q

Colchicine class

A

Uric acid inhibitors

124
Q

Pegloticase class

A

Uric acid inhibitors

125
Q

Probenecid class

A

Uric acid inhibitors

126
Q

What do allopurinol do?

A

Reduce uric acid levels and urate crystals in joints

127
Q

What do febuxostat do?

A

Reduce uric acid levels

128
Q

What do colchicine do?

A

Reduce inflammation caused by urate crystal deposit in joints

129
Q

What do pegloticase do?

A

Reduce uric acid levels

130
Q

What do probenecid do?

A

Reduce uric acid levels

131
Q

Uric acid inhibitors adverse reactions

A

NVD, headache, skin rash (allopurinol), SJS, bone marrow depression (colchicine)

132
Q

Colchicine contrindicstions

A

Serious GI/renal/hepatic/cardiac disorders

133
Q

Probenecid contraindications

A

Uric acid kidney stones, <2 y.o.

134
Q

How are pegloticase usually given?

A

IV

135
Q

Pegloticase infusion often has what adverse reaction?

A

Anaphylatic reaction

136
Q

What should you do before pt start IV pegloticase?

A

Premedicate with antihistamines and corticosteroids due to possible anaphylatic reactions

Pharmacology (27 decks)

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