Chapter 22 Exam

Question 1

Anticonvulsants

Answer 1

•reduce the number and/or severity of seizures in patients with epilepsy

Question 2

Epilepsy

Answer 2

recurrence of unprovoked seizures, characterized by sudden attacks of altered consciousness, motor activity, or sensory impairment

Question 3

Generalized seizures

Answer 3

bilaterally symmetrical and without local onset

Question 4

generalized seizures occur in what percent of patients with epilepsy?

Answer 4

40%

Question 5

what causes partial seizures?

Answer 5

•Caused by a lesion in the temporal lobe of the brain and limited to one cerebral hemisphere

Question 6

partial seizures account for what percent of new cases of epilepsy?

Answer 6

•account for up to 60% of new cases of epilepsy

Question 7

simple=?

Answer 7

no loss of consciousness

Question 8

partial seizures usually have what type of symptoms?

Answer 8

complex symptoms

Question 9

Status epilepticus

Answer 9

•seizures are prolonged or so frequent that the patient doesn’t regain consciousness between seizures

Question 10

status epilepticus is considered….

Answer 10

a true neurological emergency

Question 11

Unilateral seizures

Answer 11

•Affect only one side of the body

Question 12

First-Generation Anticonvulsants

Answer 12

•Prophylactic treatment of generalized and partial seizures should start with a single drug such as valproate, lamotrigine, levetiracetam, carbamazepine, oxcarbazepine, or phenytoin

Question 13

Goal of first-generation anticonvulsants

Answer 13

•Aim of therapy is to prevent seizures without oversedation; dosage adjusted as needed

Question 14

what is an example of first-generation anticonvulsants

Answer 14

•valproic acid (Depakote) is a broad-spectrum anticonvulsant

Question 15

Drug Therapy for Febrile Seizures-

Answer 15

•Involves searching for the cause of the fever and taking measures to control it

Question 16

Second-Generation Anticonvulsants examples

Answer 16

•gabapentin (Neurontin), lamotrigine (Lamictal), levetiracetam (Keppra), oxcarbazepine (Trileptal), topiramate (Topamax), etc.

Question 17

what are 2nd generation anticonvulsants used for?

Answer 17

•For adjuvant treatment of partial (psychomotor) and generalized seizures

Question 18

2nd generation compared to 1st generation anticonvulsants

Answer 18

• Not yet considered superior in efficacy for seizure control
• Fewer adverse effects and drug interactions; does not require drug level monitoring; daily dosing

Question 19

Parkinson’s disease

Answer 19

•Chronic neurological disorder characterized by fine, slowly spreading muscle tremors, rigidity, and generalized slowness of movement

Question 20

what is one of the most common neurodegenerative diseases in adults?

Answer 20

parkinson’s disease

Question 21

pathology of parkinsons….

Answer 21

Underlying pathology is not completely understood

Question 22

is there a a cure for parkinsons disease?

Answer 22

NO

Question 23

Timeline of patients with parkinsons

Answer 23

•Patients with PD progress to severe disability over 10 to 20 years

Question 24

how do antiparkinsonian drugs work?

Answer 24

•Normal dopamine activity as it relates to acetylcholine is diminished, with resulting relative overactivity of cholinergic output

Question 25

goal of treatment for parkinsons disease…

Answer 25

relieve symptoms and maintain mobility

Question 26

Levodopa function

Answer 26

crosses the blood-brain barrier, where it is converted to dopamine

Question 27

what does carbidopa do?

Answer 27

enhances effects of levodopa, increasing therapeutic effect of dopamine in CNS and reducing adverse reactions

Question 28

what is sinemet?

Answer 28

a combination of levodopa and carbidopa

Question 29

when is sinemet most often used?

Answer 29

is most often used for long-term treatment

Question 30

as PD progresses patients with most likely require what?

Answer 30

•As PD progresses, most patients will eventually require treatment with levodopa

Question 31

what medicines are commonly used in conjunction with levodopa to delay the onset of levodopa-caused motor complications or used alone in early PD?

Answer 31

pramipexole (Mirapex) & ropinirole (Requip)

Question 32

what effect can the dopamine agonists have?

Answer 32

• May reduce the required dose of levodopa for patients with advanced Parkinsons

Question 33

amantadine

Answer 33

• antiviral agent that alters dopamine release and has anticholinergic properties

Question 34

what does amantadine treat?

Answer 34

• Treats parkinsonism (extrapyramidal reactions)

Question 35

when in parkinsons disease is amantadine used?

Answer 35

• Used early in the disease as monotherapy

Question 36

amantadine’s efficacy

Answer 36

• Its efficacy may wane rather quickly (weeks or months)

Question 37

amantadine’s benefit when added to ledopa

Answer 37

• Of little benefit when added to levodopa

Question 38

COMT inhibitors function

Answer 38

• block the enzyme responsible for metabolizing peripheral levodopa

Question 39

COMT inhibitors increase concentration of _____+_____

Answer 39

levodopa and dopamine

Question 40

COMT inhibitors related to levodopa

Answer 40

• Allows for the patients dose of levodopa to be lowered and results in a decrease in the incidence or severity of the dose-related side effects of levodopa

Question 41

what are drugs used to treat primary RLS?

Answer 41

• dopamine agonists pramipexole (Mirapex), ropinirole (Requip), and rotigotine (Neupro patch) are FDA-approved treatments

Question 42

what second line agents are used to treat specific symptoms?

Answer 42

• Second-line agents gabapentin (Neurontin), benzodiazepines (such as clonazepam), and opioids (hydrocodone, oxycodone) are used for specific symptoms

Question 43

RLS may be secondary to other causes including-

Answer 43

• Iron deficiency
• Renal failure
• Diabetes
• Rheumatoid arthritis
• Fibromyalgia, etc.
• Treatment of secondary RLS focus on identifying and treating the underlying cause

Question 44

Cholinesterase Inhibitors function…

Answer 44

• the delay of symptoms in AD

• Prevent breakdown of acetylcholine in the synaptic cleft, thereby increasing acetycholine levels and improving cognitive function