Diseases and meds Flashcards
What medication would you use for intermittent relief of an essential tremor?
Propranolol
What 2 medications can you use for persistent essential tremor?
1) Propranolol (higher dose)
2) Primidone
What two medications can you use for intermittent symptoms of Restless Leg Syndrome (RLS)?
1) Levodopa: “on demand” at HS or upon waking at night
2) Clonazepam (Benzo, ONLY for intermittent)
What are some first line RLS meds?
Dopamine agonists:
- Mirapex
- Requip
- Neupro
What are some medications to treat RLS that also treat chronic pain and neuropathy?
- Gabapentin (Neurontin)
- Pregabalin (Lyrica)
What medications can be used for refractory or chronic RLS?
Opioids (last ditch effort)
-oxycodone, codeine, methadone, tramadol
What medication is helpful for treating chorea in Huntington Disease?
Xenazine
- dopamine depleting agent
- very expensive
What neuroleptics treat HD and also treat their psychiatric symptoms?
- Zyprexa
- Risperidal
- Haldol
What antiviral medication is used as the best monotherapy for those with mild, early Parkinson’s Disease? What is a major side effect of the medication?
Amantadine
- orthostatic hypotension
- use only as MONOtherapy
What anticholinergic medications are helpful in treating the sialorrhea and tremor associated with Parkinson’s Disease? Side effects?
-Benztropine (Cogentin)
-Trihexyphenidyl
SEs: Anticholinergic toxidrome:
-MAD as a hatter, DRY as a bone, HOT as a desert, red as a beet, tachycardia, mydriasis, absent BS
What are some dopamine agonists used to treat dyskinesias associated with Parkinson’s Disease? When would you use this med? What are some major side effects?
-Mirapex
-Requip
-Generally would start with these meds in patients <65-70 y/o
-very effective except for patient’s who haven’t shown response to levodopa
SE: ORTHOSTATIC HYPOTENSION, drowsiness, hallucinations, vivid dreams, dizziness, constipation, dyskinesias
What medication will eventually be required for ALL Parkinson’s patients? What other medication is it paired with and why? What are some side effects?
Levodopa (Sinemet)
- paired with Carbidopa to offset the SEs of Levodopa
- SEs: ORTHOSTATIC HYPOTENSION, dyskinesias, dizziness, hallucinations, vivid dreams, nausea, constipation
What medications inhibit the breakdown of dopamine and are used as either a monotherapy early in PD or can be an adjunctive therapy later in the disease?
MAO B inhibitors
- Selegiline (Zelepar)
- Rasagiline (Azilect)
What medications when taken with Levodopa extends the effects of Levodopa to treat PD?
COMT inhibitors
- Talcapone (Tasmar)
- entacoapone (Comtan)
- only effective when given with Levodopa
If someone with Tardive Dyskinesia needs to switch from a typical to an atypical antipsychotic, what are the first two medication choices?
1st choice: Clozapime
2nd: Seroquel
What is the only FDA-approved medication known to extend tracheostomy-free survival in a patient with ALS?
Riluzole (Rilutek)
-prolongs survival by 2-3 months
What 2 medications can be used to treat the pseudobulbar affect associated with ALS?
Nuedextra and Elavil
What medications can be used to treat spasticity in ALS patients?
- Baclofen
- tizanidine (Zanaflex)
What is the 1st line treatment for Myasthenia Gravis?
Mestinon
What medications need to be AVOIDED in Myasthenia Gravis patients?
- Quinolones: Cipro, Levaquin
- Macrolides: Erythromycin, Azithromycin
- Beta blockers: Propranolol, metoprolol, atenolol
- Anesthetics
- Botox
- Calcium-channel blockers
- Dilantin
What are some immunosuppressants used in conjunction with Mestinon therapy in MG patients?
Corticosteroids, cyclosporine, azathioprine, methotrexate
What 2 antidopiminergic meds are used to suppress tics in those with Tourette’s?
- Haldol
- Pimozide
What alpha-adrenergic agonists are used to treat Tourette’s patients who also have ADHD?
- Clonidine (Catapres)
- Guanfacine (Intuniv)
Which professor is going to be nice and give us both the generic and brand name of drugs?
Prof Paulson. Bless her heart