Diseases and meds Flashcards
What medication would you use for intermittent relief of an essential tremor?
Propranolol (or Alcohol)
What 2 medications can you use for persistent essential tremor?
1) Propranolol (higher dose)
2) Primidone (anticonvulsant)
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?
Tetrabenzine (Xenazine)
- dopamine depleting agent
- very expensive
What neuroleptics treat HD and also treat their psychiatric symptoms?
- Olanzapine (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
-NOT effective 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?
Pyridostigimine (Mestinon)
Acetylcholine esterase inhibitor
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
What medication can reduce the wrinkles you’ll acquire from crying in PA school but also treats focal tics in Tourette’s patients?
Botox
What is an SSRI used to treat Tourette’s patients who also have OCD?
1st line: Prozac
If ineffective, can use 2nd gen antipsychotics: Seroquel, Abilify, Zyprexa
What medication is used to treat depression in elderly patients and also is helpful in stimulating appetite? (Especially good for those with Adult Failure to Thrive)
Mirtazapine (Remeron)
What are first line meds used to treat peripheral neuropathy? What’s a side effect to watch out for?
- Gabapentin (Neurontin)
- Pregabalin (Lyrica)
- SE: swelling, be careful prescribing to CHF patients
- make sure to taper!
What are some TCA antidepressants used to treat peripheral neuropathy? Side effects?
-Nortriptyline (Pamelor)
-Amitriptyline (Elavil)
SEs: dry mouth, sedation (take at night)
*Very bad to OD on
What are some SNRI antidepressants used to treat peripheral neuropathy?
- Duloxetine (Cymbalta)
- Effexor
- helpful in treating painful PN
- can be expensive
What are some topical treatments you can use to treat PN?
Capsaicin, Lidocaine patches, Voltaren (diclofenac), CBD
What are 2 classes of abortive migraine medications? What are your concerns with them?
Triptans and Ergotamines
- serotonin agonists
- VASOCONSTRICTORS: be careful prescribing to pt’s with hx of CVA/MI
What’s a strong pain killer you can give to treat migraines? Pros/Cons
Butalbital (Fioricet)
Pro: NOT a vasoconstrictor, ok for patient’s with bleeding issues
Con: very addictive, sedating
What’s in a headache cocktail?
Toradol: painkiller (hard on stomach and kidneys)
Benadryl: antihistamine (makes pt sleepy)
Compazine: nausea med
What is a medication option for someone with migraines AND neck pain?
Muscle relaxers: Flexeril, Tizanidine
What is a medication option for someone with migraines AND trouble sleeping?
SEs?
Amitriptyline/Nortriptyline
SE: Dry mouth
What is a medication option for someone with migraines AND doesn’t want to gain weight?
SEs?
Topiramate/Topamax
SE: Kidney stones, word finding difficulty “Dope-a-max”
Treatment options for cluster headaches
- O2 (high dose, 6L)
- Injectable/nasal triptans or ergots
- Verapamil
- Flexeril
- Melatonin
- Lithium
What medication can you use to treat chronic intracranial hypertension?
Acetazolamide (Diamox)
SEs: numbness in hands and feet, kidney stones
What medications can you use for post-concussion syndrome?
- Medrol dosepak: breaks the headache cycle
- Amitriptyline: slowly taper
What medication is most commonly used in the hospital to treat seizures? SEs?
Keppra
SEs: cranky, depression, drowsiness.
Works FAST and doesn’t damage kidneys or liver
What medication is used to treat seizures and improves mood and IQ? SEs?
Lamotrigine (Lamictal)
-good for outpatient use, start low and go slow
SE: can cause itchy rash if dose increased too quickly, very rarely can trigger SJS
What medication can be used to treat migraines and/or seizures but can cause weight gain?
Valproic acid (Depakote)
Treatment options for Group A Step (GABHS)
1) PCN CK
2) Cephalosporins- cefdinir or cefpodoxime
3) If allergic to PCN: azithromycin, clindamycin, clarithromycin
What is the dosage for Oseltamivir (Tamiflu) in an adult who has the flu?
Tamiflu: 75mg PO BID x5 days
What is the preventative dosage for oseltamivir in an adult who has been exposed to someone with the flu?
Tamiflu: 75mg PO QD x 10 days
Besides oseltamivir, what are two other medications used to treat flu?
1) Baloxivir (Zofluza) - dosage is weight based
2) Zanamivir (Relenza) - inhaled form (contraindicated in asthmatic patients), dose: 2 puffs Q12 hrs x5 days
What targeted antibiotic would you use for someone with an active H. influenzae meningitis infection?
Ceftriaxone
If a patient had been in contact with someone infected with H. influenzae meningitis, what antibiotic would you use for prophylactic treatment?
Rifampin
What routine immunization is given to children to prevent H. flu meningitis?
b-Hib
What targeted antibiotic would be used to treat someone with neisseria meningitides?
Ceftriaxone
Ceftriaxone is the targeted antibiotic of choice for what two organisms causing meningitis?
Neisseria meningitides and H. influenzae
What prophylactic antibiotic would you use for someone who was in contact with a case of Neisseria meningitides?
Ciprofloxacin
What vaccines work against neisseria meningitides strains A,C, and Y?
Menomume
Menactra
Menveo
What vaccines work again neisseria meningitides strain B?
Trumemba
Bexsero
What targeted antibiotic would you use with someone who has strep pneumo meningitis?
Vancomycin
Are there prophylactic antibiotics to treat strep pneumo meningitis?
Nope, it’s not as contagious as the other bacterial organisms
What are two vaccines used to prevent strep pneumo meningitis?
Prevnar and Pneumovax
What antibiotic would you use to treat listeria monocytogenes meningitis?
Ampicillin IV
What antiviral would you use to treat HSV encephalitis? What dose?
Acyclovir IV 10mg/kg Q8 hrs
You ate some pork fried rice at a $1.35 per scoop Chinese restaurant and now you have Taenia solium tapeworm eggs eating your brain (was it worth it?) They are in active parasite phase, what medication should be used?
Albendazole
