Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pharmacology > Neurology Medications > Flashcards

Neurology Medications Flashcards

1
Q

Dopamine Replacement Therapy

A

levodopa-carbidopa (Sinemet)

Indication = PD

MOA: L-dopa = precursor to dopamine that can cross BBB and be converted to have CNS action.
Carbidopa = stops breakdown of l-dopa to dopamine in periphery so more l-dopa crosses BBB

AE = Motor disturbances

  • Delayed on or no on - med not having effect
  • *On period dyskinesia - due to peak levels of drug
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Dopamine Agonist

A

ropinirole (Requip)

1st line

Indication = PD

MOA = binds to and agonizes dopamine receptors

AE = nausea, drowsiness, dizziness, syncope

  • Monitor for lightheadedness and OH (especially when starting or increase dose)
  • *Can be used for monotherapy (especially younger pts) or adjunct therapy with l-dopa.
  • **Can cause impulsive behaviors
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Disease Modifying Therapies 1

A

Interferon B

Indication = MS
Route = subcut or IM

MOA = unknown, but interferon is a protein produced by fibroblast and has impact on immune function

AE = flu-like symptoms; HA, injection site reaction, fatigue, depression, pain, nausea, weakness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Miscellaneous Biologic Agent

A

glamitramer acetate

Indication = MS
Route = subcut or IM

MOA = reduce autoimmune response to myelin by reducing T-cell response against myelin

AE = injection site reaction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Sphingosine 1 Phosphate (S1P) Receptor Modulator

A

fingolimod

Indication = MS

MOA = converted to active metabolite which blocks release of lymphocytes into CNS = decreases inflammation.

AE = HA, increased LFTs
Rare = macular edema, infection

*Monitor for bradycardia (esp after 1st dose)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Disease Modifying Therapy 2

A

dimethyl fumerate

Indication = MS

MOA = unknown in MS, anti-inflammatory properties

AE = GI (N/V/D), flushing
Rare = hepatotoxicity
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Disease Modifying Therapy 3

A

monoclonal antibodies
(“-mabs”)

Indication = MS

MOA = decreases inflammation in CNS

AE = infusion related reaction, HA, fatigue, arthralgia

*Monitor for infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Cholinesterase Inhibitors

A

donepezil (Aricept)

Indication Alzeihmer’s

MOA = inhibits ACHe = increases ACh, which helps correct the ACh.

AE = SLUDGE and DUMBELLS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

NMDA

A

memantine (Namenda)

Indication = Alzeihmer’s

MOA = antagonize NMDA receptor = stops excessive receptor activation by glutamate = decrease excitation and neuronal death.

*monitor for falls

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Alpha 2 Agonist

A

tizanidine (Zanaflex)

Indication = spasticity
Route = PO 2-3x/day
*start at bedtime

MOA = selectively bind alpha 2 receptors in CNS to decrease release of excitatory NT from presynaptic terminals and decrease excitability of postsynaptic neurons.

AE = drowsiness, dizziness, asthenia

  • sedation 30 min after dose, peak 1.5 hours after dose
  • *hypotension in 33% within 1 hour and peak 2-3 hours after dose.
  • **take w/ or w/o food but consistency is key
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Centrally Acting Antispasmodics

A

cyclobenzaprine (Flexeril)

Indication = Spasticity

MOA = unknown
used for short term

AE = sedation, dizziness

BEERS LIST

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Neuromuscular Blocker

A

botulinum toxin (Botox)

Indication = spasticity
Route = IM

MOA = blocks ACh release into NM junction

AE = antibodies can develop after long-term use = decrease efficacy

Boxed warning: rare but can spread to distal tissues hours to weeks after injection.

Rare = distant paralysis (risk highest in kids)

24-72 hour onset
3-6 month duration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Direct Acting Agent for Spasticity

A

baclofen

Indication = spasticity 
Route = oral, intrathecal (ITB)

MOA = inhibitory effect on alpha motor neuron through inhibition of excitatory neurons = reduced spasticity.

  • binds to GABAergic interneuron, blocks Ca+ influx into presynaptic terminal = decrease NT release
  • postsynaptic binding increase K+ influx to enhance inhibition effect.

AE = CNS depressant

Boxed warning = ITB stopping abruptly can lead to: high fever, AMS, rebound spasticity and rigidity, rnhabdomylosis, organ failure

ITB: pump refills every 3 months, takes 30-40 min process; battery last 4-5 years

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

SSRI

A

sertraline (Zoloft)
escitalopram (Lexapro)

1st line = efficacy and tolerability

Indication = depressant

MOA = inhibits reuptake of 5-HT (serotonin) in CNS

AE = HA, N/V/D, insomnia, sexual side effects
*most are activating (take in AM)
Less common AE = hyponatremia, bleeding

**Other uses = PTSD, OCD, anxiety, eating, disorder, bipolar, vasomotor menopausal symptoms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

SNRI

A

venlafaxine (Effexor)
duloxetine (Cymbalta)

1st line if concomitant neuropathic pain of fibromyalgia
Indication = depression

MOA = inhibit reuptake of 5-HT and NE in CNS

AE = HA, nausea, dry mouth, sweating, sexual dysfunction, insomnia

Other uses = anxiety, OCD, PTSD, panic disorder, fibromyalgia, neuropathic pain, migraine prevention, vasomotor menopausal symptoms.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

NE/Dopamine reuptake inhibitors

A

bupropion (Wellbutrin)

Indication = depression

MOA = inhibits NE and DA reuptake

AE = HA, nausea, significant insomnia, tremor, dry mouth, decrease appetite.

  • risk of seizures at high dose or electrolyte abnormalities
  • *other uses = ADHD, weight loss
17
Q

Benzodiazepines (“benzos”)

A

alprazolam (Xanax)

Indication = anxiety

MOA = bind BZD receptors on GABA channels to enhance GABA inhibitory effects.
*prn for acute anxiety or short term while waiting on maintenance med to take effect

AE = sedation, ataxia, memory problems
Less common = paradoxical excitement or anxiety
build up of metabolites
**can have psychologic and physiologic dependence so avoid using as maintenance
**taper if using long term to avoid rebound and withdrawal

18
Q

Anxiolytic Drug

A

buspirone (Buspar)

Indication = anxiety; less common in panic disorders

MOA = unclear in anxiety, but known to bind 5-HT and DA receptors

AE = dizziness, takes 3 weeks to see impact, less effective in severe anxiety, potential paradoxical increase in anxiety, metabolized by CYP enzymes = DDIs

*Advantages = no risk of abuse, no physiologic dependence or withdrawal, limited motor and memory impairments.

19
Q

Second Generation Antipsychotic (SGA)

A

qurtiapine (Seroquel)

Indication = schizophrenia

MOA = block D2 receptors but less than FGA; more affinity for 5-HT
Variable effect on histamine, muscarinic, and alpha receptors = variable AE

AE = less frequent extrapyramidal symptoms; commonly happen at therapeutic doses

D2 receptor: tardive dyskinesia, tremor, gynecomastia, malignant syndrome
H1: sedation, weight loss
Muscarinic: anticholineergic
A1 receptor: hypotension, dizziness, syncope, reflex tachycardia.

20
Q

Bipolar Disorder

A

Lithium

MOA = not known
Roles = management of acute manic or hypomanic episode (5-10 days for response); prevention of further manic and depressive episodes

AE = GI (N/V/D, cramps), weight gain, polydispsia/polyuria, CNS; very effective (can decrease suicide)
*requires frequent plasma plasma monitoring

Pharmacology (10 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions