Neuro Flashcards
Name 3 drugs which:
decrease REM/delta sleep
- Alcohol
- Benzos
- Barbs
Name 1 drug which:
decreases REM only
Norepinephrine
2 drugs for treating Bedwetting (sleep enuresis).
Which is preferred? Why?
- oral desmopressin (ADH analog)
- imipramine
Desmopressin > Imipramine (too many side effects)
Drug for treating Night terrors/ Sleepwalking
Benzos
Name the 4 dopaminergic pathways in the brain
- mesocortical
- mesolimbic
- Nigrostriatal
- tuberoinfudibular
Which dopaminergic pathway…
- is affected little by antipsychotic drugs?
- is the therapeutic target for positive symptoms?
- is the major dopaminergic pathway in the brain?
- is affected significantly by Movement disorders?
- is affected significantly by antipsychotic drugs?
- Mesocortical
- Mesolimbic
- Nigrostriatal
- Nigrostriatal
- Nigrostriatal
effects of prolactin (5)
- decrease libido/ sex dysfunction
- galactorrhea
- gynecomastia
- amenorrhea
- infertility
Antipsychotic drugs help treat which better- + or - symptoms
+ (mesolimbic)> - (mesocortical)
treatment for essential tremor (2)
- nonselective BB (propranolol)
2. primidone
Treatment of Subarachnoid Hemorrhage(2)
- stabilize
2. start on Ca+2 blocker to decrease cerebral ischemia
Treatment of TIA(2)
- full work up
2. prescribe low-dose aspirin
Treatment of Ischemic Stroke (4)
- tPA (within 3-4.5hrs)
- aspirin/clopidogrel
- BP control/ BS control/ lipids
- treat condition (like A.fib)
Treatment of Pseudotumor Cerebri
- weight loss
- acetazolamide
- topiramate
- invasive procedures (repeat LP, CSF shunt, optic nerve fenestration surgery)
ALS treatment
Riluzole (increase survival by 6mos)
Treatment of Facial nerve palsy (Bell’s palsy)
2
- Corticosteroids
2. Acyclovir
Sensorineural hearing loss due to otoxoic drug presents as:
- Tinnitus
2. Vertigo
Lens for correcting Hyperopia
“Far-sighted”
Convex
Lens for correcting Myopia
“Nearsighted”
Concave
Lens for correcting Presbyopia
Reading glasses
What medicine should be avoided with acute closed angle glaucoma?
When can this drug be used?
Epinephrine (b/c of its mydriatic effect)
- useful in chronic glaucoma to decrease aqueous humor production
Treatment for Uveitis
Steroids
Treatment for Conjunctivits:
Bacterial
Viral
Bacterial= abx
Viral (commonly adenovirus) self-resolving
Treatment of Wet Age-related macular degeneration
anti-VEGF injections (like RANibizumab)
(remember “BEVerly RAN for her VEGtables” Bev=bevacizumab”
Prevention of Dry Age-related macular degeneration
multivitamin/ antioxidant supplement
Treatment of Nonprolif. Diabetic Retinopathy
blood sugar control
Treatment of Prolif. Diabetic Retinopathy
- peripheral retinal photocoagulation
- surgery
- anti-VEGF(like ranibizumab)
Treat Multiple Sclerosis:
Slow progression of disease-modifying therapies (3)
- IFN-B
- glatiramer (polymer of 4a.a. in Myelin Basic Protein)
- natalizumab (alpha4-integrin, check for JC virus)
Treat Multiple Sclerosis: acute flares (1)
- IV steroids
Treat Multiple Sclerosis: symptomatic treatment for Neurogenic bladder(2) spacticity(2) pain(1)
Neurogenic bladder:
- catheterization
- muscarinic antagonists(“On The Darn Toilet, Sorry”)
Spacticity:
- Baclofen
- GABA-b-R agonists
Pain:
1. opioids
Treatment of Acute Inflammatory Demyelinating Polyradiculopathy(3)
(subtype of Guillain-Barre)
- Respiratory support
- Plasmapheresis
- IVIG
- NO STEROIDS
Treatment of Cluster HA: (2)
Prophylaxis of Cluster HA: (1)
Tx: 1. Sumatriptan
2. 100% O2
Px: Verapamil
Treatment of Tension HA (3)
Chronic tension HA (1)
Tx: 1. Analgesics
- NSAIDs
- Acetaminophen
Chronic: Amitriptyline
Treatment of Acute Migraines (3)
- NSAIDs
- Triptans
- Dihydroergotamine
Prophylaxis of Migraines(6)
- lifestyle changes (sleep, exercise, diet)
- BB
- Ca+2 Channel blocker
- amitriptyline
- topiramate
- valproate
2 uses for Triptan
- Migraines
2. Cluster HA
Treatment of Trigeminal Neuralgia
Symptoms (3)
Tx: Carbamazepine
- repetitive
- unilateral
- shooting pain in distribution of CN V that lasts typically less than 1 min
Epinephrine, Brimonidine: Use/drug class MOA Adverse(6) Contra
Glaucoma
Epi (a1 agonist)= decrease Aqueous production via Vasoconstriction
Brimonidine (a2 agonist)= decrease Aqueous production
- Mydriasis (a1)
- Blurry vision
- Ocular hyperemia
- foreign body sensation
- ocular allergic rxn
- ocular pruritus
Contra: CLOSED-ANGLE GLAUCOMA
Timolol, Betaxolol, Carteolol: Use/drug class MOA Adverse Which has the most systemic effects?
Glaucoma/ BB (‘-olol’)
decrease Aqueous production
- No pupillary or vision changes
- Timolol most likely to have systemic effects if drained into lacrimal system