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CNS Pathology > Neurology Pharmacology > Flashcards

Neurology Pharmacology Flashcards

1
Q

What is the use of neuromuscular blocking drugs?

A

Used for muscle paralysis in surgery or mechanical ventilation

Selective for motor nicotinic receptor

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2
Q

What are the two classes of NMB drugs?

A

Depolarizing and Nondepolarizing

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3
Q

What is the mechanism of dantrolene?

A

Prevents the release of Ca2+ from the sarcoplasmic reticulum of skeletal muscle

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4
Q

Clinical use of dantrolene

A

Used in the treatment of malignant hyperthermia, a rare but life-threatening side effect of inhalation anesthetics and succinylcholine

Also used to treat neuroleptic malignant syndrome

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5
Q

What 5 majore drugs are used to treat Parkinson’s?

A

BALSA

Bromocriptine

Amantadine

Levodopa (with carbidopa)

Selegiline (and COMT inhibitors)

Antimuscarinics

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6
Q

What is the strategy of bromocriptine in treating Parkinson’s?

A

Dopamine agonist

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7
Q

What is hte strategy of amantadine in treating Parkinson’s?

A

Increase dopamine

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8
Q

What is the toxicity of amantadine?

A

Tremor

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9
Q

Whatis the strategy of L-dop/carbidopa in treating Parkinson’s?

A

Increase dopamine

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10
Q

What is the strategy of selegiline in treating Parkinson’s?

A

Prevent dopamine breakdown

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11
Q

What enzyme does selegiline inhibit to prevent dopamine breakdown?

A

Selective MAO type B inhibitor

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12
Q

What is the strategy of entacapone and tolcapone in treating Parkinson’s?

A

Prevent dopamine breakdown

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13
Q

What enzyme does entacapone and tolcapone inhibit to prevent dopamine breakdown?

A

COMT

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14
Q

What specific antimuscarinic is used to treat Parkinson’s?

A

Benztropine

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15
Q

What is the strategy of benztropine in treating Parkinson’s?

A

Curb excess cholinergic activity

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16
Q

Why is L-dopa used rather than dopamine to increase level of dopamine in brain?

A

Unlike dopamine, L-dopa can cross the BBB and is converted by dopa carboxylate in the CNS to dopamine

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17
Q

Why is carbidopa used along with L-dopa?

A

It is a peripheral decarboxylase inhibitor to increase the bioavailability of L-dopa in the brain and to limit peripheral side effects

18
Q

Toxicity of L-dopa

A

Arrhythmias from increased peripheral formation fo catecholamines

Long-term use can lead to dyskinesia following administration, akinesia between doses

19
Q

Mechanism of selegiline

A

Selectively inhibits MAO-B which preferentially metabolizes dopamine over NE and 5-HT, thereby increasing the availability of dopamine

20
Q

Clinical use of selegiline

A

Adjunctive agent to L-dopa in treatment of Parkinson’s

21
Q

Toxicity of selegiline

A

May enhance adverse effects of L-dopa

22
Q

Clinical use of memantine

A

Alzheimer’s

23
Q

Mechanism of memantine

A

NMDA receptor antagonist; helps prevent excitotoxicity (mediated by Ca2+)

24
Q

Toxicity of memantine

A

Dizziness

Confusion

Hallucinations

25
Q

Clinical use of donepezil

A

Alzheimer’s

26
Q

Clinical use of galantamine

A

Alzheimer’s

27
Q

Clinical use of rivastigmine

A

Alzheimer’s

28
Q

Mechanism of donepezil, galantamine and rivastigmine?

A

AchE inhibitor

29
Q

Toxicity of donepezil, galantamine and rivastigmine

A

Nausea

Dizziness

Insomnia

30
Q

What neurotransmitter changes occur in Huntington’s?

A

Decreased GABA

Decreased Ach

Increased dopamine

31
Q

Clinical use of tetrabenazine

A

Huntington’s

32
Q

Mechanism of tetrabenazine

A

Inhibit VMAT to limit dopamine vesicle packaging and release

33
Q

Clinical use of reserpine

A

Huntington’s

34
Q

Mechanism of reserpine

A

Inhibit VMAT to limite dopamine vesicle packaging and release

35
Q

Clinical use of haloperidol

A

Huntington’s

36
Q

Mechanism of haloperidol

A

Dopamine receptor antagonist

37
Q

Mechanism Sumatriptan

A

5-HT1B/1D agonist

Inhibits trigeminal nerve activation

Prevents vasoactive peptide release

Induces vasoconstriction

Half-life < 2 hours

38
Q

Clinical use of sumatriptan

A

Acute migraine, cluster headache attacks

39
Q

Toxicity of sumatriptan

A

Coronary vasospasm

Mild tingling

40
Q

Contraindication of sumatriptan

A

Contraindicated in patients with CAD or Prinzmetal’s angine (due to coronary vasospasm side effect)

CNS Pathology (11 decks)

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