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Year 3 - Drug Profiles > Neurological > Flashcards

Neurological Flashcards

1
Q

what type of drug are Madopar/Sinemet?

A

Levodopa

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2
Q

how does levodopa work?

A

Pre-cursor to dopamine and acts by replenishing depleted striatal dopamine (given with extracerebral dopa-decarboxylase inhibitor to reduce peripheral conversion of levodopa to dopamine to reduce side effects)

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3
Q

what are the indications to take levodopa?

A

parkinsons disease

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4
Q

what are the contraindications to taking levodopa?

A

Caution with severe cardio or respiratory disease, psychiatric illness, endocrine disorders and history of convulsions or peptic ulcer

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5
Q

what are the side effects of levodopa?

A

Nausea, vomiting, taste disturbances, dry mouth, anorexia, arrhythmias, palpitations, postural hypotension, syncope, drowsiness, fatigue, dementia, psychosis, confusion, euphoria, abnormal dreams, insomnia, depression, anxiety, dizziness

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6
Q

what are the interactions of levodopa?

A

Anaesthetics (increased risk of arrhythmias); MAOIs (risk of hypertensive crisis, avoid for at least 2 weeks after stopping MAOI)

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7
Q

what class of drug is phenytoin?

A

anticonvulsant

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8
Q

how does phenytoin work?

A

Reduction of sensitivity of muscle spindles to stretch causing muscle relaxation

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9
Q

what are the indications to take phenytoin?

A

Tonic-clonic seizures, focal seizures, prevention and treatment of seizures during or following neurosurgery or severe head injury, status epilepticus, trigeminal neuralgia if carbamazepine inappropriate

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10
Q

what are the contraindications to taking phenytoin?

A

Sinus bradycardia, heart block, stroke’s-adams syndrome, acute porphyria

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11
Q

what are the side effects of phenytoin?

A

Nausea, vomiting, constipation, drowsiness, insomnia, transient nervousness, tremor, paraesthesia, dizziness, headache, anorexia, gingival hypertrophy and tenderness, rash, acne, hirsutism, coarsening of facial appearance

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12
Q

what are the interactions with phenytoin?

A

is a P450 inducer - therefore reduces efficacy of other drugs metabolised by P450 e.g. warfarin, and
oestrogens

same vice versa

other anti-epileptics - alter metabolism and cause complex interactions

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13
Q

how does carbamazepine work?

A

Inhibits neuronal sodium channels, stabalising resting membrane potentials and reducing neuronal excitability - may inhibit spread of seizure activity in epilepsy, block synaptic transmission of pain

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14
Q

what are the indications to take carbamazepine?

A

epilepsy (focal seizures with and
without secondary generalisation and for primary generalised seizures.)

trigeminal neuralgia

bipolar disorder

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15
Q

what are the contraindications to taking carbamazepine?

A

pregnancy - neural tube defects
hepatic, renal or cardiac disease, due to increased risk of toxicity
history of bone-marrow depressions, acute porphyria

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16
Q

what are the side effects of carbamazepine?

A

Headache, ataxia, drowsiness, nausea, vomiting, blurred vision, dizziness, unsteadiness, allergic skin reactions (all dose related), may exacerbate tonic, atonic, myoclonic and absence seizures (avoid if present

17
Q

what are the interactions with carbamazepine?

A

P450 inducer - reduces efficacy of drugs that are metabolised by P450
enzymes (e.g. warfarin, oestrogens)
other antiepileptic drugs as most alter drug metabolism.
The efficacy of antiepileptic drugs is reduced by
drugs that lower the seizure threshold (e.g. SSRIs,

18
Q

how does sodium valproate work?

A

Inhibitor of neuronal sodium channels, stabilising resting membrane potentials and reducing neuronal excitiabilty. Also increases GABA in brain (principle inhibitory transmitter)

19
Q

what are the indications to take sodium valproate?

A

epilepsy (control of generalised or
absence seizures and as a treatment option for focal seizures.)
bipolar

20
Q

what are the contraindications to taking sodium valproate?

A

Personal/family history of severe hepatic dysfunction, porphyria, known/suspected mitochondrial disorders

21
Q

what are the side effects of sodium valproate?

A

GI upset, weight gain, tremor, extrapyramidal disorders, stupor, somnolence, convulsion, memory impairment, headache, nystagmus, confusion, aggression, hyponatraemia, thrombocytopenia, anaemia, haemorrhage, menstrual disturbance, transient hair loss, deafness

22
Q

what are the interactions with sodium valproate?

A

Inhibits P450 so increases conc and toxicity of drugs metabolised by P450 (warfarin and other antiepileptics, lamotrigine, sodium oxybate), plasma conc of valproate reduced by P450 inducers (carbamazepine, phenytoin), adverse effects increased by P450 inhibitors (macrolides, protease inhibitors), aspirin, SSRIs, tricyclic antidepressants, antipsychotics, tramadol

23
Q

how does lamotrigine work?

A

Inhibition of sodium channels, stabilising neuronal membranes

24
Q

what are the indications to take lamotrigine?

A

focal seizures and generalised seizures including tonic-clonic seizures, seizures assocites with Lennox-Gastaut syndrome, monotherapy of typical absence seizures in children, prevention of depressive episodes with bipolar disorder

25
Q

what are the side effects of lamotrigine?

A

Nausea, vomiting, diarrhoea, dry mouth, aggression, agitation, headache, drowsiness, dizziness, tremor, insomnia, ataxia, back pain arthralgia, nystagmus, diplopia, blurred vision, rash

26
Q

what are the interactions with lamotrigine?

A

Oestrgen, rifampicin (reduce plasma conc of lamotrigine); sodium valproate (increase plasma conc of lamotrigine) tricyclic and SSRI antidepressants, antipsychotics (anticonvulsant effect antagonised by these) orlistat (increased risk of convulsions)

27
Q

what class of drug is Levetiracetam (keppra)?

A

anticonvulsant

28
Q

how does keppra work?

A

Selectively prevents hypersynchronisation of epileptiform burst firing and propagation of seizure activity.

29
Q

what are the indications to take keppra?

A

therapy treatment of focal seizures with/without secondary generalisation and for adjunctive therapy of myoclonic seizures in patients with juvenile myoclonic epilepsy and primary generalised tonic-clonic seizures, can also be prescribed under specialist supervision for absence seizures

30
Q

what are the contraindications to taking keppra?

A

Depression, kidney disease, hallucination, decreased count of any blood cell type, having thoughts of suicide

31
Q

what are the side effects of keppra?

A

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

32
Q

what are the interactions with keppra?

A

Methotrexate (plasma conc increased by levetir); SSRI and tricyclic antidepressants, antipsychotics, mefloquine (anticonvulsant effect antagonised), orlistat (increased risk of convulsions)

Year 3 - Drug Profiles (9 decks)

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