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Justin Lyle Cards > Neuro 8 > Flashcards

Neuro 8 Flashcards

1
Q

peripheral metabolism of levodopa is decreased when administered with ________________, thus increasing plasma levels, increasing half-life, thus allowing more to reach the brain

A

dopa-decarboxylase inhibitors (Carbidopa)

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2
Q

levodopa + Carbidopa decreases daily dose of levodopa by _________%

A

75

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3
Q

benefits of levodopa often diminish after __________________

A

3-4 years

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4
Q

adverse effects of levodopa

A
  1. anorexia, N/V 2. cardiac arrhythmias (tachycardia, afib) 3. postural hotn 4. behavioral effects (more common with combo therapy) 5. tardive dyskinesia
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5
Q

what are tardive dyskinesia sx

A
  1. grimacing 2. lip smacking 3. lip puckeringn 4. pursing of lips 5. excessive eye blinking 6. tongue smacking
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6
Q

80% of patients on levodopa for > 10 years will have what sx ?

A

tardive dyskinesia

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7
Q

do not give levodopa with ___________________ meds, for they reduce the effectiveness of it

A

phenothiazines (esp compazine)

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8
Q

what are your dopamine agonist drugs used in the tx of parkinsons

A
  1. pramipexole 2. ropinirole 3. rotigotine
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9
Q

pramipexole is a drug used with parkinsons, that has a high affinity for the __________ receptor

A

D3

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10
Q

which dopamine agonists can be used as monotherapy for parkinsons

A
  1. pramipexole 2. ropinirole
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11
Q

ropinirole is used in tx of parkinsons, that has a high affinity for what receptor

A

D2

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12
Q

which dopamine agonists can be used to allow the dose of levodopa to be reduced

A

pramipexole and ropinirole

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13
Q

which dopamine receptor agonists can be used in patients with advanced parkinsons dz

A

pramipexole and ropinirole

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14
Q

which dopamine agonist (in parkinsons tx) is rapidly absorbed and excreted mostly unchanged in the urine

A

pramipexole

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15
Q

which dopamine agonist for parkinsons tx is metabolized by the CYP450 system

A

ropinirole

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16
Q

what dopamine agonist in parkinsons tx is a skin patch that provides more continuous dopaminergic stimulation than oral meds in early dz

A

rotigotine

17
Q

what is the con with rotigotine in tx of parkinsons

A

since it is a patch, has localized reactions at application site

18
Q

adverse effects of dopamine agonists

A
  1. anorexia 2. N/V 3. constipation, dyspepsia, reflux, peptic ulcer bleeding 4. postural hotn 5. cardiac arrhythmias 6. periperhal edema 7. tardive dyskinesia 8. confusion, hallucination, and delusions
19
Q

what s/e with dopamine agonists would you d/c the tx

A

cardiac arrhythmias

20
Q

what meds other than dopamine agonists, levodopa, and carbidopa can be used in parkinsons (sx) tx?

A
  1. MAOI (selegiline & rasagiline [more potent]) 2. catechol-o-methytransferase inhibitors (tolcapone & entacapone) 3. apomorphine hydrochloride 4. acetycholine blockers
21
Q

toxicity of chlorpromazine (Thorazine)

A
  1. extension of effects of alpha and muscarinic blockade 2. block of dopa R –> akathisia, dystonia, parkinsonian sx, TD, and hyperprolactinemia
22
Q

effects of chlorpromazine

A
  1. alpha blocker 2. muscarinic blocker 3. H1 blocker 4. CNS depression 5. decreases seizure threshold
23
Q

MOA of haloperidol

A

blockage of D2&raquo_space; 5HT2a

24
Q

effects of haloperidol

A
  1. some alpha blockade 2. minimimal M blockade 3. much less sedation than phenothiazines (chlorpromazine)
25
Q

clinical applications of haloperidol

A
  1. schizophrenia (alleviates positive sx) 2. bipolar (manic phase) 3. huntingtons dz 4. tourrettes
26
Q

s/e of haloperidol

A
  1. extrapyramidal dysfunction
27
Q

Clozapine MOA

A

blockade of 5-HT2a receptors > D2 block

28
Q

effects of Clozapine

A
  1. some alpha blockade 2. some M blockade 3. variable H1 block
29
Q

clinical applications of clozapine

A
  1. schizophrenia (+ and - sx) 2. agitation in alzheimers & parkinsons
30
Q

s/e with clozapine

A
  1. agranulocytosis 2. DM 3. hypercholesterolemia 4. weight gain
31
Q

effects of lithium (as antipsychotic)

A
  1. no significant antagonistic actions on ANS R or specific CNS receptors 2. no sedation
32
Q

clinical application of lithium

A
  1. bipolar affective d/o 2. prophylactic use can prevent mood swings btwn mania and depression 3. depression
33
Q

s/e (toxicity) of lithium

A
  1. tremor 2. edema 3. hypothyroidism 4. renal dysfx 5. dysrhythmias 6. pregnancy category D
34
Q

clearance of lithium is decreased by _______________ and some __________

A

thiazides; NSAIDs

35
Q

MOA of carbamazepine as an antipsychotic

A

MOA unclear for bipolar

36
Q

effects of carbamazepine

A

dose-related diplopia and ataxia

37
Q

clinical application of carbamazepine

A
  1. acute mania 3. prophylaxis of mania in depressive stage of bipolar
38
Q

s/e of carbamazepine

A
  1. hematotoxicity 2. induction of CYP450 metabolism

Justin Lyle Cards (27 decks)

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