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pharm exam 2 > NEURO > Flashcards

NEURO Flashcards

1
Q

ANTI EPILPETIC DRUGS
NA CHANNEL INHIBITORS

MOA / INDICATIONS / CONTRADICTIONS, SIDE EFFECTS, ADVERSE

A

Phenytoin

  1. Oldest non sedative
  2. Highly metabolized in cyp 450 system
  3. First choice For partial and generalized tonic colonic seizures
    1. Some efficacy in other seizure types.
    2. No effect on infantile spams or absence seizures
  4. Interactions
    1. Decreases blood levels of many meds
    2. Increase blood levels of phenobarbital and warfarin
  5. Adverse effects
    1. Hirsutism and coarsening of facial features
    2. Acne
    3. Gingival hyperplasia
    4. Decreased serum concentrations of folic acid, thyroxine and vit k
    5. Fetal hydantoin syndrome
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2
Q

ANTI EPILPETIC DRUGS
NA CHANNEL INHIBITORS

MOA / INDICATIONS / CONTRADICTIONS, SIDE EFFECTS, ADVERSE

A

carbamazepine

  1. Affects metabolism o many drugs and can be affected by many drugs
  2. May need to determine plasma levels
    1. Adverse effects
      1. Diplopia and ataxia, GI, sedation
      2. Sometimes water retention rash hyponatremia / agitation in kids or idiosyncratic blood dyscrasias , (rare)
  3. Oxcarbazepine
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3
Q

ANTI EPILPETIC DRUGS
NA CHANNEL INHIBITORS

MOA / INDICATIONS / CONTRADICTIONS, SIDE EFFECTS, ADVERSE

A

valproic acid

  1. MIXED
  2. Increases Gaba production and decrease gaba metabolism
  3. Acts on sodium and calcium channels
  4. For simple, complex partial and generalized
  5. Used for myoclonic absence and atonic seizures
  6. Good for photosensitive and juvenile myoclonic epilepsy
  7. Don’t use with liver disease
    1. Adverse effects
      1. Weight gain,
      2. Tremor
      3. Hair loss
      4. PCOS
      5. Bone loss
      6. Ankle swelling
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4
Q

ANTI EPILPETIC DRUGS
NA CHANNEL INHIBITORS

MOA / INDICATIONS / CONTRADICTIONS, SIDE EFFECTS, ADVERSE

A

topiramate

  1. MIXED
  2. Enhances post synaptic gaba receptor currents
  3. Adjunct therapy for partial and primary generalized seizures
  4. Decrease tonic and atonic seizures in children with lennox gastaut syndrome
  5. Adverse effects
    1. Nervousness and paresthesia’s
    2. Psychomotor slowing
    3. Weight loss and anorexia
    4. Metabolic acidosis
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5
Q

ANTI EPILPETIC DRUGS
NA CHANNEL INHIBITORS

MOA / INDICATIONS / CONTRADICTIONS, SIDE EFFECTS, ADVERSE

A

lamotrigine

  1. Decreases glutamate ( excitatory neurotransmitter) by blocking sodium channels.
  2. Epilepsy and bipolar maintenance
    1. Side effects
      1. Dizzy, drowsy, blurred vision
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6
Q

anti epileptic
enhancement of GABA inhibition
barbituate drugs

MOA / INDICATIONS / CONTRADICTIONS, SIDE EFFECTS, ADVERSE

  1. Gaba inhibitory neurotransmitter which counterbalances neural excitation
    1. Calming neurotransmitter
    2. Sold OTC as supplement for anxiety, insomnia add
A

phenobarbital

  1. Second choice for partial and generalized tonic colonic seizures
  2. Rapid absorption has made it a common choice for seizures in infants, but adverse cognitive effects cause it to be used less in older children and adults
  3. Status epilepticus drug of choice
  4. Contraindications
    1. Absence seizures
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7
Q

anti epileptic
enhancement of GABA inhibition
barbituate drugs
Increases the duration of gaba activated cl – channel opening

MOA / INDICATIONS / CONTRADICTIONS, SIDE EFFECTS, ADVERSE

A

primidone

  1. Adjuvant or monotherapy for partial an generalized tonic colonic seizures
  2. May control refractory generalized tonic colonic seizures
  3. Contraindications
    1. History of porphyria ( abnormality of heme related compounds)

Adverse effects ( of both drugs )

Agitation and confusing in the elderly

Worsening of pre – existing hyperactivity and aggressiveness in kids

Sexual side effects and physical dependance SEXUAL SIDE EFFECTS

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8
Q

anti epileptic
enhancement of GABA inhibition
BENZOS’S

MOA / INDICATIONS / CONTRADICTIONS, SIDE EFFECTS, ADVERSE

A

diazepam

  1. Status epilepticus
  2. Painful to inject
  3. Intermittent use for control of seizure clusters
  4. Frequently mixed and combined with phenytoin
  5. Don’t give to children less than six months
  6. Narrow angle glaucoma
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9
Q

anti epileptic
enhancement of GABA inhibition
BENZOS’S

Increases the frequency of gaba activated cl channel opening
MOA / INDICATIONS / CONTRADICTIONS, SIDE EFFECTS, ADVERSE

  1. Hypotonia, dysarthria
  2. Muscle in – coordination
  3. Behavioral disturbances
  4. Dependance !!!
A

lorazepam

MORE TOLERABLE in acute treatment

status epilepticus

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10
Q

anti epileptic
blockade of calcium channels

MOA / INDICATIONS / CONTRADICTIONS, SIDE EFFECTS, ADVERSE

Inhibit low threshold ca 2+ currents, especially in thalamic neurons that act as paceakers to generate rhythmic cortical discharge

A

gabapentin

Originally designed to be centrally acting gaba agonist

Selective inhibition of selected na, ca, channels

Inhibition of excitatory transmission

Indications

Adjunct therapy in adults and children with partial and secondarily generalized seizures

Post herpetic neuralgia

Off label: fibromyalgia, migraines, psych disorders , neuro pain , anxiety

Contraindications

Can exacerbate myoclonic and absence seizures

Adverse effects

Weight gain with ankle edema

Irritability / behavior problems

Movement disorders

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11
Q

anti epileptic
blockade of calcium channels

MOA / INDICATIONS / CONTRADICTIONS, SIDE EFFECTS, ADVERSE

A

pregabalin

  • can also be used for migraines

Same as gabapentin

Adjust therapy for partial and secondarily generalized seizures

Prescribes for neuro pain, fibromyalgia,

Can also be used for migraines

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12
Q

HEADACHES

PREVENTATIVE TREATMENT

A

TTH

  • TCA’s ( first lien agents)
  • muscle realxers

SSRI’s

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13
Q

PREVENTATIVE MEDS
moa, indications, contradiction, side effects, adverse, method of admin.

A

TCA’S

MOA:

  • reuptake inhibitors of seretonin and noradrenaline
  • inhibition of norepi reuptake and antgonism of n methyl d asparate receptors, may be more likely to meditate the anaglgesic affect of tryclycics.

0 may reduce pericranical mucle tenderness

  • metabloism hepatic - p450 and cyp2d6

in orlder adults may have increaed plasma levels and prolonged t1/2.

use in caution with CV

MAY INCREASE SI - BLACK BOX

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14
Q

HEADACHES

RESCUE TREATMENT

A

TTH

  • nsaids
  • aspirin
  • acetopminopeh
  • otc analgeiscs with caffience
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15
Q

rescue MEDS
moa, indications, contradiction, side effects, adverse, method of admin.

A
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pharm exam 2 (7 decks)

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