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DRUGS > neurological > Flashcards

neurological Flashcards

1
Q

madopar

A

L-DOPA/levodopa + benseraizde

antiparkinsonian agent - dopaminergic drug for parkinsons

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2
Q

sinemet

A

levodopa + carbidopa

antiparkinsonian agent

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3
Q

how does sinemetwork?

A

levodopa changes to dopamine in the brain - helps control movement

carbidopa prevents breakdpwn of levodopa in bloodstream

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4
Q

how does madopar work?

A

levodopa is changed to dopamine in the brain

benserazide allows more Ldopa to get to brain before changed to dopamine

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5
Q

indications for sinemet

A

parkinsons disease

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6
Q

contraindications for sinemet

A

elderly with existing cognitive or psychiatric disease - risk of confusion and hallucinations

caution in CVD - hypotnesion risk

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7
Q

side effects of sinemet

A 
nausea
drowisness
confusion
hallucinations
hypotension
dyskinesia at beginning of dosage interbal
on-off effect
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8
Q

interactions of sinemet

A

not combined with antipsychotics or metoclopramide due to contraictory effects on dopamine receptos

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9
Q

levodopa always give with??

why?

A

dopa decarboxylase inhibitor (carbidopa) to reduce conversion to dopamine outside tje brain

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10
Q

inidcations for madopar

A

parkinsons disease

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11
Q

contraindications of madopar

A

elderly with existing cognitive or psychiatric disease

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12
Q

sife effects of madopar

A 
nausea
drowsiness
confusion
hallucinations
hypotension
dyskenesia at beginning of dosage interval - on-off effect
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13
Q

interactions of madopar

A

not used with antipsychotics or metoclopramide due to effects on dopamine receptors are contradictory

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14
Q

phenytoin

A

antiepileptic/anticonvuslant

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15
Q

how does phenytoin work?

A

phenytoin reduces neruonal excitability and electrical conductance among brain cells- inhibits seizure activity

bind to neuronal Na+ channels in inactive state - promoting inactivity and preventing influx

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16
Q

indications of phenytoin

A

control seizures in status epilepticus where benzodiazepines are ineffective

reduce freq of generalised or focal seizures in epilepsy

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17
Q

contraindications of phenytoin

A

margin between therapeutic and toxic dose is low

dose reduced in hepatic impariemtn

not in pregnancy - or take high dose folic acid

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18
Q

side effects of phenytoin

A

change in appearance - skin coasening, acne, hirtusim, gum hypetrophy

neurological effects - cerebellar toxicity and impaired cognition

hypersensitivity reactions to

toxicity- cdeath thorugh cardiovascular collapse and repsiratory depression

19
Q

interactions of phenytoin

A

reduces efficact of drugs metabolised by P450 enzymes

Efficacy of phenytoin is reudced by drugs that lower seizure threshold - SSRIs, tricyclics, antihyschocitcs, tamadol

20
Q

carbamazepine

A

antiepileptic/anticonvulsant

21
Q

how does carbamazepine work?

A

inhibits neuronal sodium channels - stabilising membrane potentials and reducing neuronal excitability

= inhibit spread of seizure activity in epilepsy, controls neruralgic pain

22
Q

Indications for carbamazepine

A

epilepsy - first choice for focal seizures with and without secondary generalisation

trigeminal neuralgia- first line to control pai and reduce freq of attakcs

bipolar disorder fpr prophylaxis in paients reisstant to or intolerant of other meds

23
Q

contraindications of carbamazepine

A

pregnancy - high dose folic acid for conception

antiepileptic hypersensitivity syndrome is contraindication

caution in hepatic, renal or cardiac disease

24
Q

interactions of carbamazepine

A

durgs metabolised by P450 enzymes

efficacy reduced by durgs that lower seizure threshold - SSRIs, tricyclics, antipsychotics, tramadol

25
Q

side effects of carbamazepine

A

GI upset - neausea and vomiting

neuroligical effects - dizziness and ataxia

hypersensitivity - rash

26
Q

sodium valproate

A

antiepile[tic/anticonvulsant

27
Q

how does sodium valproate work?

A

inhibitor of sodium channels - stabilise resting membrane potential and reduce neuronal excitability

increases brain content of GABA - principal inhibitory enurotransmitter = regulates neuronal excitability

28
Q

indications for sodium valproate

A

epilepsy - first choice drug of generalised or absence seizures and option for focal seizures

bipolar disorder - acute treatment of manic episodes and prophylaxis against reucrrance

29
Q

contraindications of sodium valproate

A

pregnancy

hepatic impairment and renal impairment

30
Q

side effects of sodium valproate

A

GI upset - nausea, gastric iiration, diarrhoea

neurological and psychiatric effects – tremor, ataxia, behavioural disturbances

thrombocytopenia

hypersensitivity - hair loss

rare, lifethreatneing idiosyncratic adverse efffects - severe liver injury, pancreatitis, bone marow failure, antiepileptic hypersensitivity syndrome

31
Q

possible interactions of sodium valproate

A

drugs metabolised by P450 enzymes

efficacy lowered by drugs that decrease seizure threshold

32
Q

do not drive if got epilepsy unless seizure free for ___ months or sleep only seizures for ___ years

dotn drive for __ months after stopping or changing treatment

A

12 months

3 years

6 months

33
Q

lamotrigine

A

anti epileptic/convulsant

34
Q

how does lamotrigine work?

A

sodium channel blocker, leading to stabilisation of neuronal membranes

blocks some calcium channels

35
Q

indicatiosn fo lamtrigine

A

on own or in combination to treat focal and generalised seizures, inc tonic-clonic seizures

seizures associated w lennox-gastaut syndrome

absent seizures in children and prevention of depressive episodes associated with bipolar disorder

36
Q

side effects of lamotrigine

A

nausea, vomiting, diarhhoea, dry mouth

aggression, agitation, headache, drowsiness, dizziness, tremor, insomnia, ataxia

back pain,arthralgia, nystag,mus, diplopia, blurred vision, rash

37
Q

interactions of lamtrigine

A

carbamazepine - rasies plasma concentration of an active metaoblite of it

interacts with all other antiepileptics

38
Q

levetiracetam

A

anti-epileptic/convulsant

39
Q

how does levetiracetam work?

A

reduces abdnormal conduction signals in brain by binding to syndaptic vesicle glycoprotein 2A

40
Q

indications for levetiracetam

A

on own or in combination to treat focal seizures with or without secondary generalisation

adjuvant therapy of myoclonic seizures in patints with juvenile myoclonic epilepsy and primary generalised tonic-clonic seizures

sometimes used in myoclonic or absent seizures (not licensed for these)

41
Q

what to not do when taking levetiracetam

A

avoid abrupt withdrawal

42
Q

side effects for levetiracetam

A

anorexia, abdo pain, nausea, vomiting, dyspepsia, diarrhoea, cough, nasopharyngitis, vertigo, drowsiness, ataxia, convulsion, dizziness, headache, tremor, malaise, aggression, depression, insomnia, anxiety, irritability, rash

43
Q

interactions of levetiracetam

A

increase in plasma conc of carbamexapine and methotrexate

DRUGS (13 decks)

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