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
2
Q
What can you see all the changes of dementia in?
A
MRI and biomarkers
3
Q
What is cholinesterase?
A
An enzyme that destroys acetylcholine
4
Q
What do cholinesterase inhibitors do?
A
Increase level of acetylcholine in CNS by inhibiting its breakdown and slowing neural destruction
5
Q
Can dementia be cured?
A
No, meds can only slow down the progress
6
Q
Cholinesterase inhibitors ex?
A
Donepezil and rivastigmine (Exelon)
7
Q
Donepezil class
A
Cholinesterase inhibitors
8
Q
Rivastigmine (Exelon) class
A
Cholinesterase inhibitors
9
Q
What can donepezil do other than inhibit cholinesterase?
A
Slow down hr
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
11
Q
NMDA blockers ex?
A
Memantine (Namenda)
12
Q
Memantine (Namenda) class
A
NMDA blockers
13
Q
Galantamine class?
A
Cholinesterase inhibitors
14
Q
What can galantamine cause?
A
Bronchoconstriction
15
Q
Adverse reactions of antidementia drugs?
A
NVD, anorexia, dizziness, headache
16
Q
Contraindications of antidementia drugs?
A
Pregnancy and lactation
Delirium (b/c not made to treat this)
17
Q
Are sedatives and hypnotics long term or short term drugs?
A
Short term
18
Q
What are 2 drug classes under sedatives and hypnotics?
A
Barbiturates and nonbarbiturates
19
Q
What are barbiturates used for?
A
Only for deep, nonwaking sleep (ex: suicide) b/c has harsh side effects
20
Q
What class of drugs does nonbarbiturates include?
A
Benzodiazepines and nonbenzodiazepines
(These meds are used for rest not for anxiety)
21
Q
Benzo used for rest ex?
A
Temazepam, triazolam
22
Q
Nonbenzo used for rest ex?
A
Eszopiclone, zolpidem (Ambian)
23
Q
Barbiturates actions
A
CNS depression and mood alterations, resp depression
24
Q
Benzo actions
A
CNS depression, lesser effect on resp rate
25
What do you need to keep in mind when pt is taking benzo?
They can be addicting and pt can build up tolerance
26
Nonbenzo action
CNS depression, but effects will diminish after ~2 weeks!
27
What do you need to keep in m8nd when pt is taking nonbenzo?
They can build up a tolerance, and may experience withdrawal once the effects diminish
28
Adverse reaction of sedatives and hypnotics?
Dizziness, drowsiness, headache, nausea
29
Contraindications of sedatives and hypnotics?
Pregnancy and lactation
Coma
Severe resp problems
Hx of habitual drug and alcohol use
30
What are Parkinson pt at risk for?
Falling
31
How do doctors diagnose Parkinsons?
With assessment
Assess symptoms
And handwriting test b/c writing will get smaller overtime with Parkinsons
32
What is Parkinson caused by?
Imbalance of dopamine and acetylcholine in the CNS
33
What is dopaminergic drugs?
Go through the blood-brain barrier when dopamine cannot pass
34
Dopaminergic drugs ex?
Levodopa and carbidopa
35
How are levodopa and carbidopa used?
Always used together!
Called duodopa, have less side effects
36
Dopaminergic drugs ex other than duodopa?
Bromocriptine (stimulate dopamine receptors)
Rasagiline, selegiline (increase availability of dopamine)
37
What do dopaminergic drugs treat other than Parkinsons?
Restless legs syndrome
38
Adverse reactions of dopaminergic drugs?
Dry mouth
Constipation
Headache, dizziness
Abd pain
NVD, anorexia
Suicidal thoughts
39
Actions of dopamine receptor agonists
Mimicking effects of dopamine in the brain
40
Dopamine receptor agonist ex?
Pramipexole, ropinirole
41
Pramipexole class?
Dopamine receptor agonist
42
Ropinirole class?
Dopamine receptor agonist
43
What does ropinirole also treat other than parkinsons?
Restless leg syndrome
44
Adverse reactions of dopamine receptor agonists
NVD
Dizziness
Confusion
Postural hypotension
Headache
45
What is COMT?
An enzyme that eliminates dopamine
46
What do COMT inhibitors do?
Prolong the effect of levodopa
47
COMT inhibitors ex?
Entacapone
48
Entacapone class?
COMT inhibitors
49
Adverse reactions of COMT inhibitors?
Dizziness
orthostatic hypotension
sleep disorders
muscle cramps
Dyskinesia（运动障碍）
Hyperkinesia（运动机能亢进）
Akathisia（静坐不能）
50
Contraindications of COMT inhibitors?
Pregnancy and lactation
Liver dysfunction
51
What do cholinergic-blocking drugs do?
Cholinergic (rest & digest) blocking = fight or flight
Increase hr and GI movement
Block acetylcholine in the CNS, enhance dopamine transmission
52
What is the antidote of cholinergic overdose?
Benztropine (Cogentin)
53
Cholinergic blocking drugs ex?
Benztropine (Cogentin)
Diphenhydramine (Benadryl)
54
Diphenhydramine (Benadryl) class
Cholinergic blocking
55
Benztropine (Cogentin) class
Cholinergic blocking
56
How are cholinergic blockers used in parkinsons?
Adjunctive therapy in all forms of parkinsonism
57
Cholinergic blockers adverse reactions
Dry mouth
Blurred vision
Nausea
Dizziness
Confusion
Urinary retention
Skin rash
Tachycardia
Constipation
58
What is the tx goal for seizure?
Treat the underlying cause
59
Absent seizure definition
Vacant stare, loss of consciousness
60
Myoclonic seizure definition
Sudden, forceful contraction of single/multiple muscles
61
Clonic seizure definition
Longer jerking activity
62
Tonic-clonic seizure definition
Also called the grand mal seizure
Alternate contraction (tonic) and relaxation (clonic) of muscle, loss of consciousness and abnormal behavior
63
Atonic seizure definition
Loss of muscle tone
64
Simple seizure definition
Consciousness not impaired, can involve senses (flashing light, change in taste, speech), and motor ability affected
65
Complex seizure definition
Consciousness impaired, staring gaze, hallucination/delusion, begins focal and becomes generalized
66
Another name for antiepileptics?
Anticonvulsants
67
What are antiepileptics or anticonvulsants used for?
Manage seizure disorders
68
Hydantoins are drugs used for?
Seizures
69
Hydantoins actions
Stabilize hyperexcitability in the motor cortex of the brain
70
Carboxylic acid derivatives are drugs that used for?
Seizures
71
Carboxylic acid derivatives action?
Increase levels of GABA which stabilizes cell membranes
72
Succinimides are drugs used for?
Seizures
73
Succinimides action?
Depress motor cortex, creating a higher threshold before nerves react to the convulsive stimuli
74
Benzoes can be used for anxiety, rest, and?
Seizures
75
Benzoes action when used for seizures?
Elevate seizure threshold by decreasing postsynaptic excitation
76
What does gabapentin do?
GABA agonist
77
Topiramate action?
Blocks seizure activity rather than raising the threshold
78
Can antiepileptics be used prophylactically?
Yes
79
What is phenytoin used for?
Ongoing seizure control
80
What will pt be on if they newly diagnosed with epilepsy?
Long term antiepileptic meds
81
What will antiepileptics decrease the effects of?
Oral contraceptives
82
Felbamate class?
Antiepileptics
83
Carbamazepine class?
Antiepileptics
84
Lamotrigine class
Antiepileptics
85
Clobazam class
Antiepileptics
86
General adverse reactions of antiepileptics
Dizziness
Weakness
Headache
NVD
Anorexia
Constipation
Gingivitis
Slurred speech
Skin rashes
87
Severe adverse reactions of antiepileptics
SJS (lamotrigine)
Pancytopenia (felbamate, carbamazepine)
88
If pt develop pancytopenia with antiepileptics, what precautions will they be on?
Bleeding and infection
89
Phenytoin contraindicated in?
Bradycardia, SA block, AV block, pregnancy and lactation
90
Ethotoin contraindicated in?
Hepatic abnormalities
91
Succinamides contraindicated in?
Bone marrow depression (pancytopenia), hepatic/renal impairment
92
Oxcarbazepine contraindicated in?
Dementia
93
Carbamazepine contraindicated in?
MAOIs within 2 weeks/14 days
Bone marrow suppression
Hepatic/renal impairment
Pregnancy
94
What can oxcarbazepine and carbamazepine cause?
Hyponatremia
95
Valproic acid contraindicated in?
Renal impairment
Pregnancy
96
Skeletal muscle relaxants ex?
Baclofen, chlorzoxazone, carisoprodol
97
Baclofen class
Skeletal muscle relaxants
98
Chlorzoxazone class
Skeletal muscle relaxants
99
Carisoprodol class
Skeletal muscle relaxants
100
Skeletal muscle relaxants action
Relieves pain, reduce muscle spasms
101
What are skeletal muscle relaxants used for?
Strains and back pain, pre-op use to relax muscle tone
102
Skeletal muscle relaxants adverse reactions
Sedation, drowsiness, constipation/diarrhea, bradycardia/tachycardia, rash
103
Baclofen contraindications
Muscle spasms caused by rheumatic disorders (ex: rheumatoid arthritis)
104
Carisoprodol contraindications
Hypersensitivity to meprobamate
105
Cyclobenzaprine contraindications
Recent MI, cardiac disorders, hyperthyroidism
106
Oral dantrolene contraindications
Lactation, active hepatic disease, muscle spasm caused by rheumatic disorders
107
What is DMARDs action?
Immunosuppressant
108
DMARDs uses
Chronic musculoskeletal conditions (autoimmune disorders)
(Rheumatoid arthritis, cancer therapy, fibromyalgia)
109
Methotrexate class
DMARDs
110
Adverse reactions of DMARDs
Alopecia (hair loss), nausea, flu-like symptoms, skin rash, GI upset and pancytopenia (Sulfasalazine)
111
DMARDs contraindications
Methotrexate: renal insufficiency, liver disease, alcohol abuse, pancytopenia, folate deficiency
Biological DMARDs: CHF, neurological demyelinating diseases
112
What are bone resorption inhibitors called?
Bisphosphonates
113
What do bisphosphonates do?
Increase bone marrow density
114
What are bisphosphonates used for?
Postmenopausal osteoporosis
Hypercalcemia
Paget disease of bone
115
Adverse reactions of bisphosphonates
NVD, increased/recurrent bone pain, headache, dyspepsia, abd pain
116
How should pt take bisphosphonates to prevent GI issues?
Take in the morning, 30 min before food and do distraction activities (shower, reading, watch TV), remain in upright position
117
Bisphosphonates ex?
Alendronate, risedronate
118
Risedronate class
Bisphosphonates
119
Alendronate class
Bisphosphonates
120
Bisphosphonates contraindications
Hypocalcemia, pregnancy, renal impairment
121
Allopurinol class?
Uric acid inhibitors (antigout)
122
Febuxostat class
Uric acid inhibitors
123
Colchicine class
Uric acid inhibitors
124
Pegloticase class
Uric acid inhibitors
125
Probenecid class
Uric acid inhibitors
126
What do allopurinol do?
Reduce uric acid levels and urate crystals in joints
127
What do febuxostat do?
Reduce uric acid levels
128
What do colchicine do?
Reduce inflammation caused by urate crystal deposit in joints
129
What do pegloticase do?
Reduce uric acid levels
130
What do probenecid do?
Reduce uric acid levels
131
Uric acid inhibitors adverse reactions
NVD, headache, skin rash (allopurinol), SJS, bone marrow depression (colchicine)
132
Colchicine contrindicstions
Serious GI/renal/hepatic/cardiac disorders
133
Probenecid contraindications
Uric acid kidney stones, <2 y.o.
134
How are pegloticase usually given?
IV
135
Pegloticase infusion often has what adverse reaction?
Anaphylatic reaction
136
What should you do before pt start IV pegloticase?
Premedicate with antihistamines and corticosteroids due to possible anaphylatic reactions
