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50 drugs > Neurology > Flashcards

Neurology Flashcards

1
Q

Which drugs is used to treat Myasthenia Gravis?

A

Pyrodostigmine

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2
Q

How is Guillian Barre treated?

A

IV immunoglobulin

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3
Q

What is the treatment for migraines?

A

Simple analgesia: Paracetamol, Aspirin, NSAIDs
Triptans: Sumatriptan
+/- antiemetic: domperidone, metoclopramide

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4
Q

What drugs are used for migraine prophylaxis?

A

Beta blockers: propranolol
Tricyclic antidepressants: Amitriptyline, Dosulepin, Nortriptline
Anti-epilepsy drugs: Topiramate, Sodium Valproate

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5
Q

What drugs are given after an ischaemic stroke?

A

Thrombolysis with rTPA i.e. alteplase (intravenously)
Antiplatelets - aspirin 300mg (given immediately unless alteplase has been started)
if aspirin is not tolerated give clopidogril

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6
Q

What route is alteplase administered?

A

Intravenously

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7
Q

What drug is given if aspirin is not tolerated?

A

Clopidogrel

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8
Q

What is the treatment for SAH?

A

Nimodipine

Fluids

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9
Q

What type of drug is Nimodipine? (MOA)

A

Calcium channel blocker
Blocks L type calcium channels, therefore prevents Ca entry into the cells
Myocardial and smooth muscle contractility is depressed – these drugs mainly affect smooth muscle.
Dilate coronary blood vessels and reduce afterload
Nimodipine does not lower heart rate (heart rate may increase)

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10
Q

Which drugs are used for focal epilepsy?

A

Carbamazepine
Levetiracetam
Lamotrigine

Remember: CLL

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11
Q

Which drugs are used for generalised epilepsy?

A

Valproate
Lamotrigine
Levetiracetam

Remember: VLL

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12
Q

What is the mechanism of action of Carbamazepine?

A

Voltage gated Na+ channel blocker on pre-synaptic membrane

Blocks the Na+ influx; reduces neuronal excitability and decreases the action potential

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13
Q

What are the side effects of carbamazepine?

A 
Dizziness
Dry mouth
Ataxia
Fatigue
Headache
Diplopia
Blurred vision
Hyponatraemia
Stevens-Johnson’s syndrome (rarely <0.01%)
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14
Q

What are the important pharmacokinetics of carbamazepine?

A

Enzyme inducer of cytochrome P450; induces metabolism of itself
Interactions with other anti-convulsants
Grapefruit can significantly increase serum levels of this drug - avoid grapefruit

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15
Q

What is the mechanism of action of valproate?

A

Weak sodium ion channel blocker
Inhibitor of GABA degrading enzymes
(Increased GABA stops action potential)

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16
Q

What are the side effects of valproate?

A 
Nausea
Diarrhoea
Gastric irritation
Weight gain
Hyponatraemia
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17
Q

What other drugs (other than CLL or VLL) are used for epilepsy?

A

Phenytoin

Gabapentin

18
Q

What is the mechanism of action of phenytoin?

A

Acts as a voltage-gated Na+ channel blocker on the pre-synaptic neuronal membrane
Limits action potential transmission
Hence limiting spread of seizure activity

19
Q

What are the side effects of phenytoin?

A 
Insomnia
Headache
Rash
Constipation
Vomiting
Gingival hyperplasia
Liver damage
20
Q

What is the mechanism of action of lamotrigine?

A

Inhibits voltage-gated Na+ channels and/or Ca2+ channels
Acts on pre-synaptic neuronal membrane
Reduces action potential and excitatory signals

21
Q

What are the side effects of lamotrigine?

A 
Nausea
Vomiting
Diarrhoea
Tremor
Insomnia
Blurred vision
Aggression
22
Q

What is the mechanism of action of levetiracetam?

A

SV2A is a synaptic vesicle protein required for neurotransmitter release
Levetiracetam blocks this and reduces neurotransmitter release
Induces an anti-epileptic effect

23
Q

What are the side effects of levetiracetam?

A 
Headache
Fatigue
Anxiety
Irritability
Drowsiness
Constipation
24
Q

What is the mechanism of action of both gabapentin and pregabalin?

A

Voltage-gated Ca2+ channel antagonist

25
Q

What are the 4 drug classes in Parkinson’s Disease?

A

L-Dopa
Dopamine agonists
MAO-B inhibitors
COMT inhibitors

26
Q

What is the mechanism of action of L-dopa

A

L-Dopa is taken up by the dopaminergic neurones and decarboxylated to become dopamine within the presynaptic terminals

27
Q

What is l-dopa prescribed with?

A

a dopa-decarboxylase inhibitor e.g. carbidopa

28
Q

What does carbidopa do?

A

It stops l-dopa being metabolised peripherally so more can go to the brain
It also prevents the peripheral side effects of dopamine (nausea and vomiting)

29
Q

What is the combination of l-dopa and carbidopa called?

A

Sinemet

30
Q

What are the PERIPHERAL and CENTRAL side effects of L-dopa?

A

CENTRAL: confusion and hallicunations
PERIPHERAL: nausea, vomiting

31
Q

Give 2 examples of dopamine agonists

A

Ropinirole
Pramipexole
Apomorphine

32
Q

What is the mechanism of action of dopamine agonists?

A

Act directly on the post synaptic dopamine receptors (D2)

33
Q

What are the side effects of dopamine agonists?

A

Dopaminergic side effects, somnolence and impulse control disorders (hyper sexuality/pathological gambling)

34
Q

Give 2 examples of monoamine oxidase inhibitors?

A

Selegiline

Rasagiline

35
Q

What is the mechanism of action of Selegiline?

A

Selegiline inhibits monoamine oxidase, which would break down dopamine, therefore allowing dopamine to act for longer

36
Q

Give 2 examples of COMT inhibitors?

A

Entacapone

Tolcapone

37
Q

What is the mechanism of action of Entacapone?

A

COMT inhibitor

Inhibiting Catechol-o-methyltransferase results in longer L-dopa half-life and duration of action

38
Q

What types of drugs are alteplase and tenectaplase?

A

Recombinant Tissue Plasminogen Activator (rtPA)

thrombolytics

39
Q

What is the MOA of alteplase?

A

Recombinant form of tissue plasminogen activator
Catalyses conversion of plasminogen to plasmin
Promotes fibrin clot lysis

40
Q

What are the indications of alteplase?

A

Acute ischaemic stroke within 4.5 hours of onset
Myocardial infarction within 12 hours of onset
Massive pulmonary embolism

41
Q

What are 2 treatment options for relapsing remitting MS?

A

Adelimumab

Dimethyl fumarate

42
Q

What is the aim of treatment in primary progressive MS?

A

Symptom control

50 drugs (7 decks)

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