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BCGP > Neurologic > Flashcards

Neurologic Flashcards

1
Q

What is Namzaric?

A

Donepezil + memantine once daily capsule

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2
Q

What is Adlarity?

A

Donepezil once weekly patch

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3
Q

What is the maximum daily dose of galantamine in a patient with creatinine clearance less than 60 mL/min?

A

16 mg/ day

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4
Q

Which acetylcholinesterase inhibitor is FDA approved for Parkinson’s disease dementia?

A

Rivastigmine

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5
Q

What is the maximum dose of memantine for a patient w creatinine clearance less than 30 mL/min?

A

5 mg bid (XR 14 mg/day)

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6
Q

What is the indication for Aduhelm?

A

Mild cognitive impairment with beta-amyloid positive PET or CSF findings

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7
Q

What is the dose of aducanumab?

A

10 mg/kg IV every four weeks after titration

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8
Q

What is the clinical efficacy of Leqembi?

A

Lower brain levels of beta amyloid and moderately slow cognitive and functional decline in early stage Alzheimer’s disease

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9
Q

What are the target serum levels for Carbamazepine?

A

4-12 mcg/mL

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10
Q

Carbamazepine is a potent inducer of which enzymes?

A

CYP3A4, CYP2C9, UGT

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11
Q

What are the target serum levels for phenobarbital?

A

15-40 mcg/mL

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12
Q

What are the target serum levels for phenytoin?

A

10-20 mcg/mL (free: 1-2 mcg/mL)

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13
Q

What percent dose reduction is needed for topiramate in a patient with creatinine clearance less than 70 mL/min?

A

50%

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14
Q

What are the target serum levels for valproic acid?

A

50-100 mcg/mL

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15
Q

Carbipenems decrease Serum concentrations of which anticonvulsant?

A

Valproic acid

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16
Q

Which enzyme systems does valproic acid inhibit?

A

UGT and Epoxide hydrolase

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17
Q

Which three antipsychotics may be used in Parkinson’s disease?

A

Pimavanserin, clozapine, quetiapine

18
Q

Which antipsychotic is a CYP3A4 substrate?

A

Pimavanserin

19
Q

What dosing conversion ratio is used to switch from oral tabs to intestinal gel of levodopa/carbidopa?

A

1:1

20
Q

Which medication for Parkinson’s disease interacts with ondansetron?

A

Apomorphine

21
Q

How many PD rescue doses per day can be used?

A

5

22
Q

What rescue treatments are available for Parkinson’s disease?

A

1) Apomorphine subcutaneous pen
2) Apomorphine sublingual film
3) levodopa inhalation powder

23
Q

Is the onset of action of PD rescue therapy?

A

15-20min

24
Q

What is the most effective medication in PD for control of motor symptoms?

A

Levodopa/carbidopa

25
Q

What are the three non-ergot dopamine agonists?

A

Pramipexole, ropinirole, rotigotine

26
Q

What is the only FDA approved non-oral rescue therapy for PD?

A

Apomorphine

27
Q

What are management strategies for off periods in PD (involving how CD/LD is used)? (3)

A

1) Separate CD/LD from high-protein meals
2) Change CD/LD dose, dose frequency or timing
3) change CD/LD formulation to more continuous release

28
Q

What are management strategies for off periods in PD (other than CD/ LD dosing)? (4)

A

1) Include medications that increase levodopa brain bioavailability
2) Add another oral medication
3) Add rescue therapy or switch to non-oral formulations
4) Deep brain simulation

29
Q

How is peak dose dyskinesia managed? (CD/LD adjustments-3)

A

1) Reduce CD/LD dosing (maintain frequency)
2) switch to longer acting (CR)
3) switch oral CD/LD to parenteral

30
Q

How is peak dose dyskinesia managed? (Non CD/LD strategies-3)

A

1) add Amantadine
2) add clozapine
3) deep brain stimulation

31
Q

In a patient with PD who develops dementia, what is the order of stepwise discontinuation of PD drugs?

A

Anticholinergics -> amantadine -> MAO-B inhibitors - > dopamine agonists -> COMT inhibitors - > CD/LD

32
Q

Top 6 medications that reduce the Seizure threshold

A

Diphenhydramine, tramadol, bupropion, meperidine, clozapine, haloperidol

33
Q

Which of the three preferred Anti-seizure medications in older adults?

A

Lamotrigine, levetiracetam, gabapentin

34
Q

Which anticonvulsant requires an ECG prior to initiation and interacts with PR interval, prolonging agents?

A

 Lacosamide

35
Q

Which anticonvulsant is a sulfonamide?

A

Zonisamide

36
Q

Which anticonvulsants have the highest risk of osteoporosis?

A

Carbamazepine, phenytoin, phenobarbital, primidone, valproic acid > oxcarbazepine

37
Q

What is the target vitamin D (25(OHD) level? 

A

> = 30 ng/mL

38
Q

Which Anticonvulsant should be avoided in patients with depression?

A

Levetiracetam

39
Q

What daily dose of carbidopa saturates dopa decarboxylase?

A

70-100mg

40
Q

Predisposing factors for levodopa – induced dyskinesia

A

Younger age at disease onset
Lower body weigh
female sex
Increased disease severity

41
Q

Predisposing patient characteristics for impulse control disorder

A

Male sex
Younger age
History of Impulse control disorder
History of mood disorders
Apathy
Family history of impulse control disorder & Addiction

BCGP (10 decks)

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