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PC 707 Pharmacology > Module 7 Unit D&E AED & Alzheimer/Parkinson's > Flashcards

Module 7 Unit D&E AED & Alzheimer/Parkinson's Flashcards

1
Q

What is an examples of a Iminostilbenes?

A

Carbamazepine (Tegretol)

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2
Q

What is the indications for Iminostilbenes [Carbamazepine (Tegretol)]?

A

Partial seizures and generalized tonic-clonic seizures. Bipolar. Trigeminal neuralgia.

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3
Q

What is the MOA of Iminostilbenes [Carbamazepine (Tegretol)]?

A

Suppress sodium influx

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4
Q

What adverse effects may be seen with Iminostilbenes [Carbamazepine (Tegretol)]?

A

Depression is a concern for all antiseizure drugs. Bone marrow suppression.

BBW: SJS, allele, agranulocytosis, aplastic anemia

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5
Q

What D2D and food interactions are associated with Iminostilbenes [Carbamazepine (Tegretol)]?

A

Many D2D interactions, particularly OCs and folic acid.

Grapefruit juice can increase the peak and trough of carbamazepine.

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6
Q

What is the BBW associated with Iminostilbenes [Carbamazepine (Tegretol)]?

A

It may cause SJS and TEN. Aplastic anemia and agranulocytosis.

High incidence of SJS in Asian people

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7
Q

What is an examples of a Hydantoin?

A

Phenytoin (Dilantin)

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8
Q

What is the indication for Hydantoin [Phenytoin (Dilantin)]?

A

Tonic-clonic or partial seizures. Epilepsy. Seizures after head trauma, neurosurgery, and hemorrhagic stroke.

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9
Q

What is the MOA of Hydantoin [Phenytoin (Dilantin)]?

A

Suppress sodium influx

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10
Q

What are some safety considerations of Hydantoin [Phenytoin (Dilantin)]?

A

Many drug-to-drug interactions (Decrease BC, warfarin, gluccocorticoids).
Hepatitis.
Teratogenic.
SJS.

Contraindicated in patients with sinus bradycardia, SA block, second and third-degree AV block, and Stokes-Adams Syndrome

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11
Q

What is the BBW associated with Hydantoin [Phenytoin (Dilantin)]?

A

Rapid IV administration can cause severe hypotension and cardiac dysrhythmias.

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12
Q

What is an example of Succinimide?

A 
Ethosuximide (Zarontin) 
Valproic acid (Depakote)
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13
Q

What is the MOA of Succinimide [Ethosuximide (Zarontin) & Valproic acid (Depakote)]?

A

Unknown. May increase GABA concentration in the brain or augment the inhibitory influence of GABA.

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14
Q

What D2D interaction is associated with Valproic acid (Depakote)?

A

Valproic acid is reduced by two carbapenem antibiotics – meropenem and imipenem/cilastatin.

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15
Q

What BBW is associated with Valproic acid (Depakote)?

A

Valproate & valproic acid – fatal hepatic failure risk. Fatal and rapidly progressing pancreatitis. Valproate is highly teratogenic.

Increased fetal neural tube defects.

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16
Q

What is an examples of Cholinesterase Inhibitors?

A

Donepezil (Aricept)

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17
Q

What is the indication for Cholinesterase Inhibitors [Donepezil (Aricept)]?

A

Alzheimer’s

Mild to moderate symptoms [Improved cognition (thinking) and function for patients with AD.]

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18
Q

What is the MOA of Cholinesterase Inhibitors [Donepezil (Aricept)]?

A

Prevent the breakdown of acetylcholine by AChE and increase the availability of acetylcholine at cholinergic synapses.

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19
Q

What D2D interactions are associated with Cholinesterase Inhibitors [Donepezil (Aricept)]?

A

Anticholinergics (first-generation antihistamines, TCAs) reduce effectiveness
NSAIDs, increase risk of GI bleed
antifungals, inhibit metabolism increasing levels

20
Q

What side effect is associated with Cholinesterase Inhibitors [Donepezil (Aricept)]?

A

It may cause dizziness.

21
Q

What is an examples of a NMDA receptor antagonists?

A

Memantine (Namenda)

22
Q

What is the indication for NMDA receptor antagonists [Memantine (Namenda)]?

A

Alzheimer’s Moderate or severe

Helps treat symptoms of AD but no evidence that it modifies the underlying disease process.

23
Q

What is the MOA of NMDA receptor antagonists [Memantine (Namenda)]?

A

Blocks glutamate from excessive excitation of NMDA (glumate excitation is cytotoxic)

24
Q

What side effect is associated with NMDA receptor antagonists [Memantine (Namenda)]?

A

Dizziness – risk for falls.
headache
constipation

25
Q

What D2D interactions are associated with NMDA receptor antagonists [Memantine (Namenda)]?

A

Drugs with memantine and sodium bicarb may have an undesired additive effect.

26
Q

What is an example of a Dopamine replacement?

A

Levodopa & Carbidopa

27
Q

What is the MOA of Dopamine replacements (Levodopa&Carbidopa)?

A

Undergoes conversion to DA in the brain and activates DA receptors (Carbidopa blocks destruction of Levodopa in the periphery.

28
Q

What is the indication for Dopamine replacements (Levodopa&Carbidopa)?

A

Parkinson’s-Good for initial treatment of PD.

First-line drug, or used as a supplement to a dopamine agonist.

29
Q

What side effects are associated with Dopamine replacements (Levodopa&Carbidopa)?

A

n/v, tremor, palpitations, dizziness. Possible psychosis.

30
Q

What patient education should be reviewed with Dopamine replacements (Levodopa&Carbidopa)?

A

*Must avoid high protein meals.

31
Q

What are examples of non-ergot derivate dopamine agonists?

A

Apomorphine
Ropinirole
Rotigotin

32
Q

What are examples of ergot derivate dopamine agonists?

A

Bromocriptine

33
Q

What is the indication for dopamine agonists (Apomorphine, Ropinirole, Rotigotin, & Bromocriptine)?

A

It may be used as a supplement to Levodopa.

34
Q

What is theMOA of dopamine agonists (Apomorphine, Ropinirole, Rotigotin, & Bromocriptine)?

A

Activate dopamine receptors in the striatum

35
Q

What side effects are associated with dopamine agonists (Apomorphine, Ropinirole, Rotigotin, & Bromocriptine)?

A

Hallucinations, sleep attacks, postural hypotension

36
Q

BBW Selegiline (dopamine agonist)

A

contraindicated in patients less than 12 years of age because of the potential for a hypertensive crisis

37
Q

What is the indication for the Anticholinergic Drug [Benztropine (Cogentin)]?

A

Supplement to Levodopa-Increase benefits of Levodopa

38
Q

What is the MOA of the Anticholinergic Drug [Benztropine (Cogentin)]?

A

Block cholinergic receptors in the CNS; help restore the balance between dopamine and ACh.

39
Q

What side effects are associated with the anticholinergic drug [Benztropine (Cogentin)]?

A

Dry mouth, blurred vision, photophobia, urinary retention, constipation, tachycardia.

40
Q

Contraindications of Dilantin

A

Contraindicated in patients with sinus bradycardia, SA block, second and third-degree AV block, and Stokes-Adams Syndrome

41
Q

Patient teaching with dilantin

A

Avoid taking with high protein meals (may reduce absorption).

42
Q

Lab monitoring with depakote

A

Plt count

43
Q

Avoid using Aricept with these conditions:

A

bradycardia, conduction defects, asthma, COPD,

44
Q

Side effects ARicept

A

GI-related: Weight loss, nausea, vomiting, diarrhea,

dizziness, muscle cramps, may increase seizure risk (rare)

45
Q

Caution using NMDAs with this condition

A

renal impairment

46
Q

D2D with levadopa

A

first-generation antipsychotic drugs, MAOIs, anticholinergics, and pyridoxine

PC 707 Pharmacology (39 decks)

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