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1 Pharmacology > Neuro - Myasthenia Gravis + Parkinson's + Alzheimers > Flashcards

Neuro - Myasthenia Gravis + Parkinson's + Alzheimers Flashcards

1
Q

more ACh means

A

more cholinergic

-sludge dumbells

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2
Q

cholinesterase

A

an enzyme that breaks down ACh

-allows cholinergic neuron to return into its resting state

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3
Q 
cholinesterase inhibitors
drug names (6)
A 
neostigmine
donepazil
edrophonium
pilocarpine
physostigmine
pyridostigmine
(johNE DEPPP)
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4
Q

cholinesterase inhibitors

MOA

A

extends the actionof ACh

-increase ACh effects

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5
Q

cholinesterase inhibitors

AE

A

cholinergic crisis

  • sludge
  • dumbells
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6
Q

cholinesterase inhibitors

CI

A
  • patients receiving succinylcholine

- caution in asthma, bradycardia, low BP

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7
Q

Myasthenia Gravis

A

low ACh

-immune system attacks ACh receptors

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8
Q

Cholinergic Crisis

A

high ACh

-greatly increased secretions + RESPIRATORY DEPRESSION

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9
Q

cholinergic crisis treatment

A

atropine (anti-ACh) + resuscitative equipment (crash cart)

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10
Q

Tensilon Test

A

-give edrophonium 2 mg Q15-60 seconds until transient improvement
or
-give total dose of 10mg

-given via IV

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11
Q

Tensilon Test

results

A

[+ MG] strong hand squeeze

[- MG] weak hand squeeze

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12
Q

should monitor ___ + ____ + _____ during the tensilon test

A
  • SpO2
  • HR
  • BP
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13
Q

if + for MG,

A

indicates that they got too little ACh medication> myasthenic crisis
administer neostigmine or other cholinesterase inhibitor

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14
Q

if - for MG,

A

indicates ACh overdose> cholinergic crisis

administer atropine (anti-ACh)

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15
Q

edrophonium

A

short term acting cholinergic drug

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16
Q

when is tensilon test indicated

A

patient that is receiving Ach medication has trouble breathing
-sign of either too much or too little Ach

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17
Q

Anti-Parkinson’s

medication types

A 
1 first line
2 COMT inhibitors
3 dopamine agonist
4 dopamine releasers
5 centrally acting anti-ACh
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18
Q

anti-prknsn

first line medication

A

carbidopa/levodopa

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19
Q

carbidopa

MOA

A

carbidopa is the car that carries and prevents breakdown of levodopa in the bloodstream
-increases the amt of levodopa that can enter the brain

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20
Q

levodopa

MOA

A

converts itself into dopamine when it enters the brain

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21
Q

which is the most effective symptomatic therapy for parkinson’s?

A

carbidopa/levodopa

aka first line medication for parkinsons

22
Q

carbidopa/levodopa

AE

A

psychosis

-visual hallucinations, nightmares, paranoia

23
Q

carbidopa/levodopa

CI

A
  • melanoma

- skin lesions that haven’t been DDX bc can speed up cancer

24
Q

carbidopa/levodopa

PT teaching

A
  • beneficial effects diminish by the end of year 5
  • monitor protein intake
  • avoid foods w pyridoxine
  • can discolor sweat + urine (red or brown)
25
Q

is carbidopa/levodopa a cure for parkinsons?

A

NO,

it only slows the progression

26
Q

protein + carbidopa/levodopa

A

delays absorption + reduces med effect

-eat SMALL portions of protein throughout the day

27
Q

pyridoxine foods + carbidopa/levodopa

A

B6>interferes w absorption

28
Q

psych A/E of carbidopa/levodopa

A

expect 2nd generation antipsychotic meds

-clozapine or quetiapine

29
Q

COMT inhibitors

A

catelcholamine-O-methyltransferase inhibitors

30
Q

COMT inhibitors

drug names

A

entacalone

31
Q

entacapone [COMPT inhibit]

MOA

A

enhances effect of levodopa

-blocks its breakdown in intestines

32
Q

entacapone [COMPT inhibit]

AE

A

urine turns yellow orange

33
Q

entacapone [COMPT inhibit]

RN teaching

A

monitor for NMS-like s/s

34
Q

NMS

A

Neuroleptic malignant syndrome

-life-threatening idiosyncratic reaction to antipsychotic drugs

35
Q

NMS-like s/s

A
  • hyperpyrexia (+106)

- dystonia (involuntary muscle contractions that cause slow repetitive mvmt)

36
Q

dopamine agonist

drugs

A

pramipexole

bromocriptine

37
Q

pramipexole [dope agonist]

MOA

A
  • activates dopamine receptors
  • 1st line supplement to levodopa
  • —allows for lower dosages
38
Q

pramipexole [dope agonist]

AE

A
  • sudden inability to stay awake

- poor impulse control DO

39
Q

bromocriptine [dope agonist]

AE

A

-supresses breast milk production/lactation

40
Q

bromocriptine [dope agonist]

Tx

A

anti parkinsons

  • poorly controlled DM2 to reduce post meal glucose levels
  • decr triglycerides
41
Q

dopamine releaser

drug name

A

amantadine

42
Q

amantadine [dope releaser]

Tx

A

PD motor symptoms

43
Q

amantadine [dope releaser]

RN

A

monitor for livedo reticularis

44
Q

livedo reticularis

A

netlike pattern of reddish-blue skin discoloration

45
Q

centrally acting anti-ACh

drug names

A

benztropine

trihexyphenidyl

46
Q

benztropine, trihexyphenidyl

Tx

A
  • PD
  • drug induced EPS
  • sialorrhea
47
Q

benztropine, trihexyphenidyl

AE

A
  • dry mouth
  • blurred vision
  • mydriasis
  • urinary retention
  • constipation
  • sedation
48
Q

Alzheimers Medication Types

A
  • Cholinesterase inhibitors

- NMDA Receptor Antagonist

49
Q

Cholinesterase inhibitors

drug name + alzheimer stage

A

donepezil

-early to moderate stage

50
Q

NMDA Receptor Antagonist

drug name + alzheimer stage

A

memantine

-moderate to severe stages of alzheimers

51
Q

NMDA Receptor Antagonist - memantine

AE

A
  • blood clots
  • psychosis
  • HF (syncope)
52
Q

is there a cure for alzheimers?

A

NO,
meds are just to treat cognitive symptoms
-slows progression of disease by like 6 months max

1 Pharmacology (33 decks)

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