Cns Flashcards
Examples of H2 receptor antagonist
Cimetidine
Which of the following antipsychotics at the lowest risk of diabetes?
Haloperidol
What treatment do use to mild to moderate Alzheimer’s disease?
Donepezil galantamine or rivastigmine
What is the treatment for Madre Alzheimer’s disease?
Memantine is the drug of choice in patients with severe Alzheimer’s disease
Parkinson disease, dementia treatment
ACH inhibitors donepezil and galantMine
Rivastigmine was the only treatment with the UK marketing authorisation donepezil, galantmine and rivastigmine mean patches off level
When would you consider memantine in Parkinson’s disease dementia
When cholineterase are not tolerated
Management of drooling, saliva in people with Parkinson’s disease
Glycopyrronium
Entacopone can you clear your urine what colour?
Red brown
Can pizotefin cause weight
Increase
Yes
Tamoxifen and fluoxetine
Fluoxetine is predicted to decrease the efficacy of Tamoxifen. Avoid severe.
Which anti-sickness medication is most appropriate to treat post-operative, nausea and vomiting for Parkinson patient
Cyclizine
Pizotifen idnicated
, prophylaxis of migraine
Which medicine is licensed as a twice daily dose by mouth for moderate dementia associated with Parkinson disease 
Rivastigmine is the only licensed ACH inhibitor used for moderate dementia associated with Parkinson disease. The other ACH inhibitors are unlicensed.
What is interaction between propanolol and amirodone
Amirodone is predicted to increase the risk of cardiovascular side-effects, when given with propanolol
Interaction between methadone and fludrocortisone
Severe interaction fludrocortisone and methadone is predicted to increase the risk of tosade de points
Focal seizures treatment
Carbamazepine and Lamotrigine
Find it on in plasma concentration range
Neonate to 3 months, 6 to 15 mg/L, (25-60 micromol/litre) chilc three months to 18 years 10-20mg/L
Lithium and venlaxfine
Risk of serotonin syndrome
Examples of dopamine receptor agonist
Apomorphine bromcriptine cabergoline
What is dementia?
Cause when the brain is damaged by diseases, such as Alzheimer’s drugs or Parkinson
Name 3 Ach inhibitors
Donepezil -nms
Galantamine -sjs-
Rivastigmine- can chase GI disturbance
Cholingeric side effects
Diarrhoea, urination, muscle, weakness, bronchospasm, bradycardia, vomiting, teary, eyes, salvation
When do you use antipsychotics and dementia?
When it is severe risk of increased risk of stroke and death
Tonic clonic seizures
Sodium valproate Lomtragine carbamazepine
Absence seizures
Ethosuximide or valproate
Myoclonic a tonic clonic
Valproate
When can you drive a car in epilepsy
Seizure free for one year established pattern were no influence or unconsciousness. No history of unprovoked, seizures, seizures, due to change or withdrawal.
Policy for seizure while asleep
Can drive if history of history of no wake seizures from one year from 1st to sleep, seizure establish pattern of sleep stages for three years of previous awake seizure
Which drugs do you monitor foetal growth?
Topirmate / levetiracetam
What is vigabatrin
Associated with
Encephalopathic symptoms mark sedation confusion
Why is it important to remember about for phenytoin monitoring plasma
Small changes in dose missed doses change in drug absorption nonlinear relationship between dose on concentration. Phenytoin is highly protein bound drug when the protein binding is reduce monitor the plasma free concentration
What can carbamazepine exacerbate
Atonic clonic and myoclonic seizures
What do pharmacist I need to do every time you dispense valproate?
Patient card remind risk of pregnancy remind of need for annual specialist review dispense asshole packs whenever possible patient guide
Name, the two short acting benzodiazepine
Lorazepam oxazepam
How long does busiprone take to work
2 weeks
How to withdraw benzodiazepines
Gradually convert over one week to equivalent diazepam dose, reduce diazepam dose by wanted to MG increments every 2 to 4 weeks
Atomextine side effect
Suicidal ideation, liver toxicity, QT prolongation
What is a contra indication in bipolar disease?
Do not give antidepressants in rapid cycling bipolar disorder. Recent history of hypo mania, manic episode.
When would you think an antidepressant is it in effective?
Wait, four weeks, six weeks in the elderly
How long to continue antidepressants
Continue for at least six months 12 months in the elderly 12 months in generalised anxiety disorder, two years in recurrent depression
How to switch between antidepressants
Wait two weeks before - MAOI (moobemide does not require washout period )
switching with one week before -SSRI
(5 weeks for fluxteine 2 weeks if sertaline
switching with one to 2 weeks before switching - TCA -3 weeks if imipramine or clomipramine
Which drugs has the highest risk of withdrawal reaction?
Paroxetine and venlafaxine
Interaction between trancypromine clomipramine with pseudoephedrine adrenaline noradrenaline
Hypertensive crisis
Patient counselling for
Moa
Avoid food containing tyramine mature cheese, wine eat only Fresh Food, the dangers of food and drug interactions exist two weeks after stopping

Four: the pain, when would you assess effectiveness?
Try for at least 8 to 10 weeks, if two or more doses are missed then re- assistant reinitiate by specialist
What anti-sickness is used in palliative care
Haloperidol, levomeppromazine
Anti-sickness in chemotherapy or post operative, nausea and vomiting
Granistron ondasteron palonosetron
Anti emetic prevention
Driperidol dexamethasone phenothiazine
5HT receptor antagonist interaction
Increased risk of torsade de pointes with hypokalemia - loop diuretics, corticosteroids
Increased risk of QT prolongnation - amirodaone claithrymycin quinine sumatriptan lithium
Serotonin syndrome - 5ht1 agonist - moa ssri
Breakthrough dose
1-10
or 1/6th of the total daily dose
