Essential tremor, chorea, tics, and related disorders Flashcards
Which drugs can be used to suppress chorea in Huntington’s disease? (5)
Tetrabenazine Haloperidol [unlicensed] Olanzapine [unlicensed] Risperidone [unlicensed] Quetiapine [unlicensed]
What drug can you use for the treatment of tardive dyskinesia if switching or withdrawing the causative antipsychotic drug is not effective?
Tetrabenazine
- Oral: Initially 12.5 mg daily, dose to be gradually increased according to response
Which drugs can be used to treat Tourette syndrome? (4)
Haloperidol
Pimozide [unlicensed]
Clonidine hydrochloride [unlicensed]
Sulpiride [unlicensed]
Which drugs can be used to relieve intractable hiccup? (2)
Chlorpromazine hydrochloride
Haloperidol
Which drugs are used to treat essential tremor? (2)
Propranolol (or other beta-blocker)
Primidone
Which drug can be used to treat myoclonus of cortical origin?
Piracetam
After an acute episode attempts should be made every 6 months to decrease or discontinue treatment
What drug can be used to extend life in patients with motor neurone disease who have amyotrophic lateral sclerosis?
Riluzole
What can be used after an acquired non-progressive brain injury if rapid-onset spasticity causes postural or functional difficulties?
Botulinum toxin type A
What are the indications for the use of botulinum toxin type A? (10)
- Hand and wrist disability due to upper limb spasticity associated with stroke
- Foot and ankle disability due to lower limb spasticity associated with stroke
- Blepharospasm
- Hemifacial spasm
- Spasmodic torticollis
- Severe hyperhidrosis of the axillae
- Prophylaxis of headaches in chronic migraine
- Temporary improvement of moderate to severe upper facial lines in adults under 65 years
- Management of bladder dysfunctions
- Chronic sialorrhoea (due to neurological disorders)
What are the contraindications of using botulinum toxin type A to treat bladder disorders? (4)
- Acute urinary retention
- Catheterisation difficulties
- Presence of bladder calculi
4 Urinary tract infection
What are the risks that require caution when using botulinum toxin type A to treat blepharospasm or hemifacial spasm?
- Increased risk of angle-closure glaucoma
- Reduced blinking can lead to:
- corneal exposure
- persistent epithelial defect
- corneal ulceration
Botulinum toxin type A should be avoided in women of child-bearing age unless using effective …(?)
contraception
What do you need to warn patients about before using botulinum toxin type A?
Signs and symptoms of toxin spread
- muscle weakness
- breathing difficulties
What are the indications for the use of chlorpromazine hydrochloride? (7)
- Schizophrenia and other psychoses
- Mania
- Short-term adjunctive management of severe anxiety
- Psychomotor agitation, excitement, and violent or dangerously impulsive behaviour
- Intractable hiccup
- Relief of acute symptoms of psychoses
- Nausea and vomiting in palliative care (where other drugs have failed or are not available)
What are the contraindications to the use of chlorpromazine hydrochloride? (4)
CNS depression
Comatose states
Hypothyroidism
Phaeochromocytoma
What lifestyle change may require dose adjustments of chlorpromazine hydrochloride?
Smoking - starting or stopping during treatment
What are the indications for the use of clonidine hydrochloride? (4)
- Hypertension
- Prevention of recurrent migraine
- Prevention of vascular headache
- Menopausal symptoms, particularly flushing and vasomotor conditions
What symptoms in palliative care can haloperidol be used to treat?
Restlessness
Confusion
What lifestyle change may require dose adjustments of haloperidol?
Smoking - starting or stopping during treatment
(drug?) can be used to treat severe tics in Tourette’s syndrome and mild-to-moderate chorea in Huntington’s disease
Haloperidol
Haloperidol can be used to treat severe (?) in Tourette’s syndrome and mild-to-moderate chorea in Huntington’s disease
tics
Haloperidol can be used to treat severe tics in (?) syndrome and mild-to-moderate chorea in Huntington’s disease
Tourette’s
Haloperidol can be used to treat severe tics in Tourette’s syndrome and mild-to-moderate (?) in Huntington’s disease
chorea
Haloperidol can be used to treat severe tics in Tourette’s syndrome and mild-to-moderate chorea in (?) disease
Huntington’s
What are the contraindications to the use of haloperidol? (12)
- CNS depression
- Comatose states
- Congenital long QT syndrome
- Dementia with Lewy bodies
- History of torsade de pointes
- History of ventricular arryhthmia
- Parkinson’s disease
- Progressive supranuclear palsy
- QTc interval prolongation
- Recent acute myocardial infarction
- Uncompensated heart failure
- Uncorrected hypokalaemia
What are the common side effects of haloperidol? (9)
- Depression
- Eye disorders
- Headache
- Hypersalivation
- Nausea
- Neuromuscular dysfunction
- Psychotic disorder
- Vision disorders
- Weight decreased
Which type of antipsychotic is haloperidol?
First-generation (typical)
Which type of antipsychotic is chlorpromazine hydrochloride?
First-generation (typical)