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Neurology Y3 > Neurology drugs > Flashcards

Neurology drugs Flashcards

1
Q

What are examples of dopaminergic drugs?

A

Levodopa

Dopamine agonists (i.e. rotigotine)

MAO-B inhibitors (i.e. selegiline)

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2
Q

Main use for dopaminergic drugs?

A

Treatment of Parkinson’s disease - alleviates motor symptoms

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3
Q

Mechanism of action for dopaminergic drugs?

A

All dopaminergic drugs aim to increase dopamine concentration in the brain

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4
Q

Contraindications and cautions of dopaminergic drugs?

A

Dopamine agonists should be avoided in patients with a history of addiction, obsessive compulsive disorder and impulsive personality

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5
Q

What are the adverse effects of dopaminergic drugs?

A
  • Postural hypotension- can lead to falls
  • Impulse control disorders, including pathological gambling, hypersexuality, bing eating, compulsive spending (all occur much more often with dopamine agonists).
  • Dopamine agonists are more commonly associated with hallucinations and should NOT be prescribed in the elderly.
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6
Q

There is no long term complications of levodopa use. true/false?

A

False

Levodopa provides the greatest symptomatic benefit. Long-term use is associated with motor complications (dyskinesia and motor fluctuations).

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7
Q

Should dopamine agonists (i.e. rotigotine) be prescribed in the elderly?

A

No

Since most commonly associated with hallucinations and should therefore not be prescribed in the elderly especially in those with cognitive impairments.

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8
Q

Long-term complications of dopaminergic drugs?

A
  • Motor fluctuations
  • Non-motor fluctuations
  • Dyskinesia - involuntary choreiform or dystonic movements.
  • Drug-induced psychosis
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9
Q

Route of administration for dopaminergic drugs?

A

PO (orally)

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10
Q

Examples of anti-convulsant drugs?

A

Lamotrigine, perampanel, phenytoin

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11
Q

Main indication of anti-convulsant drugs?

A

Prevent occurrence of epileptic seizures

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12
Q

Adverse effects of anti-convulsant drugs?

A

Some anti-convulsants induce hepatic enzymes

Can alter efficacy of COCP (combined oral contraceptive pill)

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13
Q

Examples of cholinesterase inhibitors and when are they used?

A

Alzheimer’s disease - donepezil, rivastigmine and galantamine.

Dementia with Lewy bodies (DLB) and Dementia with Parkinson’s disease (DPD) - rivastigmine

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14
Q

Main indication for cholinesterase inhibitors?

A
  • Slow cognitive decline for some forms of dementia.
  • More of an effect in DLB/DPD than Alzheimer’s.
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15
Q

Mechanism of action for cholinesterase inhibitors?

A

Inhibit cholinesterase receptors.

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16
Q

Contraindications for cholinesterase inhibitors?

A

May worsen COPD/asthma

17
Q

Adverse effects of cholinesterase inhibitors?

A
  • GI (nausea and diarrhoea most common)
  • Headache
  • Muscle cramps
  • Bradycardias
18
Q

Administration route of cholinesterase inhibitors?

A

PO (orally)

19
Q

Main indication of memantine?

A

Used in moderate or severe Alzheimer’s disease or where cholinesterase inhibitors are NOT tolerated.

Slows cognitive decline and prevents BPSD (behavioural and psychological symptoms of dementia).

20
Q

Mechanism of action for memantine?

A

NMDA receptor antagonist

21
Q

Contraindications and cautions for memantine?

A

May cause hypertension - check BP before starting

22
Q

Adverse effects of memantine?

A
  • Hypertension
  • Sedation
  • Dizziness
  • Headache
  • Constipation
23
Q

Administration route of memantine?

A

PO (orally)

24
Q

Main indications of carbamazepine?

A

First line treatment to control pain intensity and attack frequency in trigeminal neuralgia.

25
Q

Mechanism of action of carbamazepine?

A

Blocks subtypes of voltage-activated Na+ channels that are up-regulated in damaged nerve cells.

26
Q

Main indications for gabapentin and pregabalin?

A
  • Antiepileptics but are used in the treatment of chronic pain.
  • Gabapentin is employed in migraine prophylaxis.
  • Pregabalin is useful in painful diabetic neuropathy.
27
Q

Contraindications and cautions for gabapentin and pregabalin?

A

Contraindicated in pregnancy

28
Q

Route of administration for gabapentin and pregabalin?

A

Po (orally)

29
Q

Rhyme used for patient with anticholinergic toxicity?

A

What would you suspect in a patient who blind as a bat, mad as a hatter, red as a beet, hot as a hare, dry as a bone, the bowel and bladder lose their tone, and the heart runs alone?

Blurred vision

Hallucinations

Increased heart rate

Decreased sweating

30
Q

What is first line treatment for controlling pain intensity and attack frequency in trigeminal neuralgia?

A

Carbamazepine

Neurology Y3 (40 decks)

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