Neurology Flashcards
1
Q
Carbamazepine
A
Dr: Antiepileptics
I:
- Focal and generalized epilepsy
- Bipolar Disorder
- Trigeminal neuralgias
D:
- 200-400mg BD/TDS.
- Max 2g D
M:
- Seizure control such as frequency of seizure, trigger factors
- Suicide ideation
- LFT
- Signs of skin rashes or reaction
- BMD
- TDM
- Alcohol intake
C:
- Take with food. Swallow whole.
- Sedation, alcohol
- Do not stop this medication abruptly, adherence
- Avoid grapefruit juice while on this.
- If notice any signs of mouth ulcers, sore throat, persistent fever, rashes, unexplained bleeding or bruising, tell doctor.
- Lifestyle
PP:
- This medication is called Tegretol.
- It can interact with alot of different medication. Could induce its own enzymatic metabolism
2
Q
Gabapentin
A
Dr: Antiepileptics
I:
- Focal seizures
- Neuropathic pain
D:
- 0.8-1.9g D in divided doses
- Max 3.6g D
M:
- Seizure control such as frequency of seizure, trigger factors
- Suicide ideation
- LFT
- Signs of skin rashes or reaction
- Weight
C:
- Sedation. Avoid alochol
- Do not stop this medication abruptly.
- May cause fatigue and weight increase. Watch what you’re eating
- Lifestyle
PP:
- Neurontin
3
Q
Lamotrigine
A
Dr: Antiepileptic
I:
- Focal and generalized seizures
- Bipolar disorder
D:
- 25-100mg BD
M:
- Seizure control such as frequency of seizure, trigger factors
- Suicide ideation
- LFT
- Signs of skin rashes or reaction
C:
- Sedation. Avoid alcohol as Lamotrigine could increase the effects of alcohol.
- Could cause dizzy, blurred vision.
- Do not stop this medication abruptly.
- Tell doctor if develop swollen glands, rash, fever.
- Lifestyle
PP:
- Lamictal
- Could chew tablets, or swallow whole or disperse into a small volume of water.
- It is very big in skin reaction. It could interact with different antiepileptics. Can easily cause skin rashes. Slowly increase the dose.
4
Q
Levetiracetam
A
Dr: Antiepileptic
I:
- Focal seizures
- Generalized (Adjunct) seizures
D:
- 250-500mg BD
- Max 1.5g BD
M:
- Seizure control such as frequency of seizure, trigger factors
- Suicide ideation
- LFT
- Signs of skin rashes or reaction
- Behavioural changes
C:
- Sedation and dizzy. Avoid alcohol as Levetiracetam could increase the effect of alcohol.
- Do not stop this medication abruptly.
- May cause behavioural changes. Keep an eye out for signs such as abnormal thought, increased aggression, anxiety. Tell your doctor as it may be because of the medication.
- Lifestyle.
PP:
- Keppra
- Once stabilized on adjunct, could move down to monotherapy by ceasing the first drug.
5
Q
Perampanel
A
Dr: Antiepileptics
I:
- Focal and generalized seizures
D:
- 4-8 mg D
- Max 12mg D
M:
- Seizure control such as frequency of seizure, trigger factors
- Suicide ideation
- LFT
- Signs of skin rashes or reaction
- Behavioural changes
- Excessive dizziness
- Falls risk
- Illicit drug use
C:
- Drowsy and dizzy. Avoid alcohol as alcohol could increase the SE of Perampanel.
- Could increase risk of falls
- Tell doctor if notice any significant change in mood or behaviour
- Do not stop taking this medication abruptly
PP:
- Fycompa
- Causes vertigo and behavioural effects (quite big on it, as it could cause aggression, euphoria, paranoia and affects everyone with or without a psychiatric history. It could cause suicidal ideation as well)
6
Q
Valproate
A
Dr: Antiepileptics
I:
- Focal and generalized seizures
- Bipolar disorders
D:
- 1-2g D in divided doses
- Max 2.5g D
M:
- Seizure control such as frequency of seizure, trigger factors
- Suicide ideation
- LFT
- Signs of skin rashes or reaction
- Weight
- BMD
- TDM
- FBC
C:
- Take with food. Swallow whole.
- Sedation. Avoid alcohol
- Do not stop this medication abruptly
- Increase appetite and cause weight gain. Therefore eat healthy balanced diet, watch what you’re eating.
- Signs of rash, fever, sore throat, abdominal pain, unexplained bleed or bruise, jaundice tell doctor.
- Lifestyle
PP:
- Require to check complete blood count. Thrombocytopenia happens commonly, dose related.
- Could also cause EPS and tremor, dose related
- Pancreatitis is very important! Could be fatal.
- Thinning and loss of scalp hair could happen and is normally temporary.
7
Q
Cabergoline
A
DC: Ergot derivative dopamine agonist
I:
- Parkinson’s disease
- Hyperprolactinaemia
D:
- Hyperprolactinaemia: 500mcg weekly in 1 to 2 doses
- Parkinson’s 0.5-1mg once daily. Increase up to 3mg once daily
M:
- Improvement of movement and mobility
- Excessive nausea
- BP
- On and off period
- Inappropriate behaviours
- Signs of cardiac fibrosis and lung fibrosis
- Sudden sleep onset
C:
- Take with food to decrease the chance of nausea or stomach upset.
- Start this medication at night
- This medication could make you drowsy and dizzy. Do not drive or operate machinery
- If you’re feeling dizzy, sit down or lie down and if you need to stand up, do so gradually from the chair or bed
- If you notice any signs of overspending, excessive sexual activity, or gambling , tell your doctor immediately as it may be because of the medication
- If you notice any signs of cough, chest pain or shortness of breath seek medical help immediately.
PP:
- Could cause sudden sleep onset too.
- Women need additional contraception as may restore fertility in hyperprolactinaemia.
- Inhibit prolactin secretion, and reducing the size of prolactinomas.
- Those with psychiatrist disorders would have an increase risk of developing impulse control disorders
- Adverse effects are dose related: generally nausea and vomiting, may cause dizziness and orthostatic hypotension.
- Psychiatric disorders has been shown such as impulse control disorders.
- Ergot derivatives has an increase risk of serious fibrotic adverse effects, mainly affecting the heart and lung.
8
Q
Donepezil
A
DC: Anticholinesterases
I:
- Alzheimer’s disease
D:
- 5mg for a minimum of 4 weeks. Could increase up to 10mg if tolerated
M:
- Improvement of cognition
- Memory function
- Signs of cognition decline
- Increase agitation
- MMS examination
- Adherence
- Sleeping disturbances
C:
- This medication may make you dizzy and affect your mental alertness. If affected do not drive or operate machinery
- Best to take it at night, however if you develop insomnia or vivid dreams while taking these, take it in the morning instead.
- Tell your doctor if you develop urinary incontinence with this medication as well.
PP:
- Increase risk of hypo or bradycardia if taken together with drugs that could cause Brady
- Contraindicated in patients with active peptic ulcers.
- This medication decreases the breakdown of acetylcholine therefore reducing the deficiency of cholinergic neurotransmitter activity in Alzheimer’s disease.
9
Q
Baclofen
A
DC: GABAa agonist: Muscle relaxant
I:
- Chronic spasticity associated with MS and spinal lesions
- Chronic spasticity of cerebral origin
D:
- 10-20mg TDS
M:
- Improvement of symptoms
- Frequency of muscle spams
- Exacerbation of chronic conditions such as psychiatric or cardiovascular conditions
- Signs of withdrawal effects
- Pain score
- Quality of life
- Respiratory depression
- Renal function
- Liver function
- BGL
C:
- Take this medication with food to minimise stomach upset
- This medication could cause drowsiness and dizziness. Do not drive or operate machinery. If you are feeling dizzy, sit down or lie down.
- Avoid alcohol while you are on this medication as it could worsen some side effects of baclofen
- Avoid stopping this medication abruptly as it would potentially have severe withdrawal effects.
PP:
- SEVERE WITHDRAWAL SYMPTOM. It could cause seizures, anxiety, high fever, altered mental alertness, then to rhabdomyolysis then death. Do not stop this medication abruptly
- This medication is primarily renally excreted. Hepatic impairment could also increase adverse effect. Therefore, monitor both renal and hepatic function.
