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2a Pharmacology > Neuro > Flashcards

Neuro Flashcards

1
Q

Mannitol

Class

A

Osmotic diuretic

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2
Q

Mannitol

MofA

A

Mannitol elevates blood plasma osmolality, resulting in enhanced flow of water from tissues, including the brain and cerebrospinal fluid, into interstitial fluid and plasma.

As a result, cerebral oedema, elevated intracranial pressure, and cerebrospinal fluid volume and pressure may be reduced.

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3
Q

Carbamazepine

Uses

A
  • 1st line in partial/focal epileptic seizures
  • 3rd line in primary generalised epileptic seizures
  • 1st line for trigeminal neuralgia
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4
Q

Carbamazepine

MofA

A
  • Inhibits neuronal sodium channels
  • Stabilises resting membrane potentials and reducing neuronal excitability
  • Inhibits spread of seizure activity in epilepsy
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5
Q

Carbamazepine

Side effects

A
  • GI upset - nausea/vomiting

- Neuro effects - dizziness and ataxia

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6
Q

Carbamazepine

Contraindications

A
  • AVOID IN TONIC/CLONIC/MYOTONIC SEIZURES
  • Pregnancy (neural tube defects, cleft palate, cardiac/urinary tract problems)
  • Anti epileptic sensitivity syndrome
  • Renal, hepatic, cardiac disease
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7
Q

Carbamazepine

Interactions

A
  • Drugs metabolised by P450 (warfarin, oestrogens, progestogens)
  • Cytochrome P450 inhibitors
  • Other anti epileptic drugs
  • SSRI’s. tricyclic antidepressants, anti psychotics, tramadol
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8
Q

Valproate

Uses

A
  • 1st line for absence/primary generalised seizures

- Bipolar disorder

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9
Q

Valproate

MofA

A
  • A weak inhibitor of neuronal sodium channels, stabilising resting membrane potentials and reducing neuronal excitability
  • Also increases brain content of GABA
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10
Q

Valproate

Side effects

A
  • GI upset
  • Neuro/psych effects -(tremor, ataxia, behavioural disturbances)
  • Thrombocytopenia
  • Increase in liver enzymes
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11
Q

Valproate

Contraindications

A
  • Women of child bearing age (particularly around conception/1st trimester)
  • Hepatic or renal impairment
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12
Q

Valproate

Interactions

A
  • Drugs metabolised by P450 (warfarin)
  • Cytochrome P450 inhibitors (macrolides)
  • Other anti epileptic drugs
  • SSRI’s. tricyclic antidepressants, anti psychotics, tramadol
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13
Q

Dopaminergic drugs for Parkinsons

A
  • Early Parkinson’s –> Dopamine agonists may be preferred over levodopa
  • Later Parkinson’s –> Levodopa = integral part of management, with dopamine agonists as an option for add-on therapy
  • Both are also options for secondary parkinsonism
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14
Q

Dopamine agonists

Examples

A
  • Ropinirole

- Pramipexol

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15
Q

Dopamine agonists

MofA

A

Increases dopaminergic stimulation to the striatum

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16
Q

Levodopa (L-dopa)

MofA

A
  • Precursor of dopamine
  • Can enter the brain via a membrane transporter (unlike dopamine, which cannot cross the blood-brain barrier)
  • Taken up by remaining dopaminergic neurons –> metabolised into dopamine and fired as usual
  • Levodopa is ALWAYS given with a peripheral dopa-decarboxylase inhibitor (e.g. Carbidopa) to reduce its conversion to dopamine outside of the brain
17
Q

Dopaminergic drugs

Side effects

A
  • Nausea
  • Drowsiness
  • Confusion
  • Hallucinations
  • Hypotension
  • Levodopa –> ‘wearing off effect’
  • Dopamine agonists –> ‘soft’ side effects such as tiredness, gambling, hypersexuality
18
Q

Dopaminergic drugs

Contraindications

A
  • Use cautiously in elderly
    and those with existing cognitive or psych disease
  • CVD
19
Q

Dopaminergic drugs

Interactions

A
  • Should not be combined with anti psychotics or metclopramide
20
Q

COMT/MAO-B

MofA

A
  • Prevents breakdown of dopamine by catechol-o-methyl transferase and monoamine-oxidase in the synaptic cleft
  • Dopamine continues to bind to receptors
  • Not very powerful, but helpful in some patients
21
Q

What should you NOT use in Parkinsons?

A

ANTICHOLINERGICS

- too many side effects

22
Q

Monoclonal antibodies in treating MS

Examples and MofA

A
  • Alemtuzumab –> acts against T-cells

- Natalizumab –> stops lymphocytes moving across blood-brain barrier

23
Q

Antiglutamatergic drugs

Example, Use and MoA

A

Example: Riluzole
Use: Treatment of motor neuron disease
MofA: Inhibits glutamate release and slows disease progression

24
Q

What drug is used as an adjuvant chemo for people undergoing GBM resection?

A

Temozolomide

25
Q 
What class of drugs might you use to treat Alzheimer's?
Give three examples
A

Acetylcholine esterase inhibitors

E.g. Rivastigime or Donezepril or Galantamine

26
Q

What thrombolytic drug might be used in the treatment of an ischaemic stroke?

A

Alteplase

27
Q

Alteplase

MofA

A

Converts plasminogen to plasmin, so promotes the breakdown of a fibrin clot

28
Q

MOA

2 examples

A

Rasagiline

Selegiline

29
Q

Give two examples of anti-spasticity drugs

A
  • Baclofen

- Tizanidine

30
Q

Baclofen

MofA

A
  • GABA analogue
  • Reduces calcium influx
  • Suppresses release of excitatory neurotransmitters

2a Pharmacology (9 decks)

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