exam 1 Flashcards
1
Q
what are the g protein coupled receptors
A
dopamine
NE
serotonin
2
Q
what is the receptor for dopamine
A
D2 antagonist
3
Q
what is the receptor for NE
A
alpha 2 antagonist
4
Q
what is the serotonin receptor
A
5HT agonist
5
Q
what are the dopamine effects
A
antipsych
6
Q
what are the NE effects
A
antidepressant
7
Q
what are the serotonin effects
A
anxiolytic and antidepressant
8
Q
what are the ion channel receptors
A
glutamate
GABA
9
Q
what is the glutamate receptor
A
NMDA antagonist (excitatory)
10
Q
what are the glutamate effects
A
hallucinogenic
anesthetic
antidepressant
11
Q
what is the GABA receptor
A
GABA-A agonist
12
Q
what are the GABA effects
A
anxiolytic effects
13
Q
a1 block SE
A
orthostatic hypotension
14
Q
H1 block SE
A
sedation
weight gain
15
Q
M1 block
A
antichol
-blurry vision, dry mouth, tachy, constipation
16
Q
what are some basics of MS
A
-inflammatory and neurodegenerative
-cause unknown
-tx prevents flares
17
Q
signs and sx of MS
A
-optic neuritis
-weakness
-MS hug
-heat intolerance
-L Hermites sign
18
Q
what is used for acute tx
A
steroids–very high dose
19
Q
how to manage muscle spasms
A
baclofen
20
Q
how to manage urinary incontinence
A
oxybutyin
21
Q
how to manage nerve pain
A
gabapentin
22
Q
how to manage fatigue
A
modafinil
23
Q
interferon beta 1A
A
avonex
rebif
plegridy
24
Q
interferon beta 1B
A
betaseron
extavia
25
interferon B should not be started in what population
uncontrolled depression
26
are interferons safe for preg
likely
27
what are SE of interferon
flu like sx
fatigue
headache
28
what is the safest DMT
glatiramer (copaxone or glatopa)
29
what are the monomethyl furate drugs
-dimethyl
-diroximel
-monomethyl
30
are monomethyls safe in preg
no
31
what drugs require lab monitoring
-interferons
-monomethyls
-terflunomide
32
drugs that have risk of PML
monomethyl
sphingosine (MOD)
natalizumab
33
fingolimod require what
first dose monitoring w EKG
34
what is required for siponimod
genetic testing
35
which drugs have rebound flare upon dc
spingosine
natalizumab
36
teriflunomide is what
teratogenic!!
37
teriflunomide has an active metabolite that lasts for how many yrs
2
38
SE of teriflunomide
hair thinning
neuropathy
hepatotoxicity
39
natalizumab is a mab against
alpha 4
40
natalizumab has what kind of effects
anti-inflammatory and feel good effect
41
natatalizumab is very potent so its considered 1st line in what
very aggressive disease
42
what virus do you need to have testing for with natalizumab
JC virus
-testing at every infusion or q 3 mo
43
what other mab is used for aggressive disease thats not controlled by other agents
alemtuzumab
44
what is required 3 days prior for alemtuzumab
steroids
45
what type of prophylaxis should be used for 2 months for alemtuzumab
herpes
46
what is the dx criteria for neuromyelitis optica spectrum disorder
aquaporin 4 antibodies
47
parkinsons has a deficit for what
dopamine
48
what is the pathway affected in PD
nigrostriatal pathway
49
what is the dopamine pathway for biosynthesis
tyr-->L-DOPA-->dopamine-->DOPAC-->HVA
50
what is the gold standard for PD
L-DOPA therapy
51
why is levodopa combined with carbidopa
bc carbidopa prevents the peripheral metabolism
52
what are the MAO-B inhibitors
selegiline
rasagiline
safinamide
53
which MAO-B has amphetamine metabolites
selegiline
54
what are the ergoline dopamine agonists
bromocriptine
pergoglide
--not really used
55
what are the non-ergoline dopamine agonists
ropinirole
pramipexole
rotigotine
apomorphine
56
what is istradefylline
adenosine ASA receptor agonist
57
what are is used for acute local muscle spasms
antodyne
mephensin
58
what are the muscle spasticity agents
diazepam
baclofen
dantrolene
tizanidine
botulinum toxin
59
diazepam is a what agonist
GABA-A
60
baclofen is a what agonist
GABA-B
61
dantrolene is acts on what
RYR antagonism
62
what does the ryanidine receptor
control Ca release which decreases skeletal muscle force
63
tizanidine is a what agonist
alpha 2
64
botlinum toxin inhibits what
Ach release
65
parkisons is based on a what diagonsis, not LAB
clinical
66
what are protective factors of PD
smoking
coffee
alcohol
67
does MRI help w PD
not really useful
68
what is secondary parkinsonism
med related
69
what is the most common first sx in PD
tremor (asymmetrical)
70
how to officially diagnosis PD
clincal sx plus positive response to levodopa
71
is parkinsons worse or better w dementia
worse
72
what class is the most useful for treating tremor
anticholinergic
73
what are the anticholinergic agents
benzotropine
trihexyphenidyl
74
anticholinergics should not be used in who
old ppl
w/o tremor
w dementia
75
what is the COMT inhibitor
entacapone
76
what blocks the uptake and enhances release of dopamine
amantadine
77
dopamine agonist as an initial therapy can delay the need for what
levo
78
what are some acute SE releated to dopamine agonists
neuropsych
hallucinations
edema
impulse behavior control
79
what should you watch out for with MAO-B
tyramine surge
80
apomorphine is specifically used as a what for motor offs
rescue relief
81
if there is psychosis in pt w PD then you should
avoid anticholinergic
d/c amantadine, selegiline and COMt inihibtors
82
if constipation, you should dc what
antichol
83
what lab tests should be ran for RLS
iron
renal
fasting glucose
b12
folate
thyroid
84
what to avoid with RLS
tobacco
alc
caffeine
antihistamines
85
what is the first line for RLS
dopamine agonist
86
C/L can be used for RLS but what problems does it cause
rebound
augmentation
87
for pt w painful RLS and neuropathy can use
gaba
lamotrigine
carbamazepine
88
opioids are good in RLS if pt has
neuropathy and doesnt respond to gaba
-intermittent basis
-oxy, codeine, tramadol, methadone
89
what is another med option for RLS
iron
90
what is first line for ET
propranolol
91
what is 2nd line for propranolol
primidone
92
what should be avoided w central post stroke pain
NSAIDs
ketamine
lidocaine
cannabinoids
botulinum
93
what is beneficial for central post stroke pain
amitriptyline
lamotrigine
venlafaxine
gaba
94
what should be avoided with hemiplegic shoulder pain
NSAIDS
95
what is 1st line for hemiplegic shoulder pain
ice
heat
soft tissue management
96
what is 2nd line for hemiplegic shoulder pain
steroid injections
97
what should be used for post stroke spasticity
IM botulinum
98
what meds can be used for fatigue
modafanil
amantadine
methylphendiate
99
for stroke, what should be used for pain and dyspnea
opioids
100
for stroke what should be used for agitation
haloperidol
101
for stroke what should be used for oropharyngeal secretions
glycopyrrolate
AVOID scopolamine or atropine
102
what drugs should be used for orthostatic hypotension--PD
midodrine
droxidopa
103
what is the big SE with midodrine
supine hypertension
104
what is 2nd line for urinary sx in PD
mirabegron
105
what drugs worsen constipation--PD
propantheline
oxybuy
toleradine
trospium
solifenancin
106
rivastigime is approved for what
PD dementia
107
ALS--for cramps sx
mexiletine
108
ALS--spasticity sx
baclofen, tizanidine, PT
109
ALS--pain sx
NSAIDs, opioids
110
ALS--depression sx
TCAs
SSRIs
SNRIs
111
ALS--fatigue sx
modafinil
dc riluzole
112
ALS--secretions sx
atropine drops
amitriptyline
glycopyrrolate
113
what is pseduobulbar effect
pathological outburst of laughter or crying
114
what is the tx of pseudobulbar
TCA
SSRIs
dextromethorphan/quinidine
