Neurology Therapeutics Flashcards
1
Q
Mycophenolate
A
- Immunosuppressive agent
- Steroid responsive meningitis arteritis; meningoencephalomyelitis unknown origin (MUO); myasthenia gravis
2
Q
Leflunomide
A
- Immunosuppressive agent
- Steroid responsive meningitis arteritis; meningoencephalomyelitis unknown origin (MUO); myasthenia gravis
3
Q
Cytosine arabinoside (cytarabine)
A
- Immunosuppressive agent = low-dose radiotherapy to brain, chemo
- Meningoencephalomyelitis unknown origin (MUO); possible lymphoma
- Check haem + biochem prior to admin + 7d after injection if unwell
4
Q
Dexamethasone, prednisolone
A
- Corticosteroids - cross BBB, prevent oedema + inflam
- Simple immunosuppression in CNS diseases, listeria meningoencephalitis; myasthenia gravis
- AE - can cause abortion due to high fever
5
Q
Azathioprine
A
- Immunosuppressive, alternative to mycophenolate
- Not in cats
- Myasthenia gravis
6
Q
Lomustine
A
- Immunosuppressive
- Meningoencephalomyelitis unknown origin (MUO); possible lymphoma
- Check haem + bichem prior to admin + 7d after injection if unwell
7
Q
Ciclosporin
A
- Immunosuppressive agent
- Expensive
- Useful for cats + eosinophilic disease
8
Q
GS-5734 (remdesivir)
A
- Nucleoside analogue (legal)
- Metabolised to GS-441524 in cat -> incorporated into viral RNA + prevents replication of virus
- Given IV/SC (start IV)
- FIP
9
Q
GS-441524
A
- Nucleoside analogue
- 50 mg tablets, convert to oral after 2w
- FIP
10
Q
Minocycline
A
- AB
- Reduces neuro-inflam
- For neuronal ceroid-lipofuscinoses (NCL) (seizures, visual loss, cognitive function deficits, difficulties eating)
11
Q
Oral magnesium sulfate
A
- Precipitates lead in GIT
- Lead intoxication
12
Q
IV EDTA
A
- Binds to lead
- Lead intoxication
13
Q
Vinegar
A
- w/ oral fluids to relive bloat
- Urea intoxication
14
Q
Thiamine/Vit B1
A
- Sulfur intoxication, CCN (polioencephalomalacia/cerebrocortical necrosis)
15
Q
Penicillin
A
- Systemic AB
- Streptococcal meningitis (Strep suis type 1)
16
Q
Potentiated sulphonamide, Amoxycillin
A
- Bacterial meningitis (poultry); spinal osteomyelitis (poultry) - enterococcus spp.
17
Q
Cephalosporin (e.g. cephalexin) (+ enrofloxacin = 2nd line)
A
- Broad spectrum AB
- High dose, at least 2 m
- Bacterial discospondylitis; aspiration pneumonia (megaoesophagus) - fulminant (severe + acute onset) myasthenia gravis
18
Q
Pyridostimine bromide (mestinon)
A
- Anticholinesterase
- Titrated slowly to effect, CRI
- Myasthenia gravis
19
Q
Neostigmine
A
- Anticholinesterase - improves muscle tone by preventing ACh attaching to receptors, muscle is less able to tighten
- SQ - shorter-acting
- Myasthenia gravis
20
Q
L-deprenyl (Selegiline)
A
- Monoamine oxidase inhibitor, inc noradrenalin and dopamine, neuroprotective functions: improves memory & longevity; anxiety/social withdraw
- Dogs O.5-1mg/kg PO SID;
- Cats 1mg/kg PO SID (not licensed)
- At least 4 weeks before positive effect may be seen (typically 8 weeks)
- Monoamine oxidase-increased cognitive function disorders
21
Q
Propentofylline
A
- Neuroprotection - increases the molecular signal adenosine, improves cerebral blood flow, glial cell modulator: stimulates astrocytes (protect nerve cells from inflammatory mediators, free radicals + glutamate), depresses microglial cells (inflam cells)
- Not licensed in cats
- Cognitive decline
22
Q
Melatonin, Alprazolam
A
- Sundown syndrome/sleep disorder
23
Q
Dexdomitor
A
- Sedative - reduces muscle spasm + brain metabolic requirements
- Stupor/coma mangement
24
Q
Prazosin
A
- Alpha-adrenergenic antagonist (smooth muscle relxant), reduces internal sphincter tone)
- Neurogenic bladder - relax urinary sphincter + express bladder 20 - 30 min after admin (UMN relaxation)
- Caution renal disease
- Monitor BP
25
Q
Phenoxybenzamine
A
- Alpha-adrenergenic antagonist (smooth muscle relaxant), reduces internal sphincter tone)
- Neurogenic bladder - relax urinary sphincter + express bladder 20 - 30 min after admin (UMN relaxation)
- Expensive
- AE: hypotension, CNS, GI effects
26
Q
Diazepam
A
- Skeletal muscle relaxant
- Neurogenic bladder - relax urinary sphincter + express bladder 20 - 30 min after admin (UMN relaxation)
- Caution in cats (liver failure)
27
Q
Bethanechol
A
- Promotes detrusor activity (only works if there is already some detrusor activity present), so not used often
- Cholinergic agent
- Neurogenic bladder - only when no urethral spasm/outflow obstruction (not for UMN bladder in T/L spinal disease)
- AE: salivation, lacrimation, cholinergic crisis
28
Q
Phenylpropanolamine (incurin)
A
- Sympathomimetic
- Sphincter mechanism incompetence (leakage of urine during storage) - e.g. neuromuscular disease in male dogs (polymyositis)/older female spayed dogs -> inc contractions
- AE: Restlessness, irritability, hypertension, anorexia
29
Q
Imepitoin (pexion)
A
- Short half-life (1.5h), steady state in 3 day
- Targeted action (binds when GABA present synapse (partial agonist) -> opens ion channel -> ions enter to balance out +ive ions)
- No therapeutic monitoring (no blood monitoring) but need to ensure that dose is therapeutic (serum)
- Less adverse effects: sedation, hepatoxicity, PUPD, polyphagia
- Anxiolytic effect; epilepsy/seizure
30
Q
Toxicoid vaccine
A
- Tetanus injection
31
Q
L-carnitine
A
- Non-specific mitochondrial disease Tx, useful for metabolic brain disease
- Neuronal ceroid-lipidfuscinoses (NCL)
32
Q
Mannitol
A
- Improves cerebral blood flow; free radical scavenger; reverses blood-brain osmotic gradient; reduces extracellular fluid; lowers blood viscosity
- AE: repeated administration can result in hyperosmolar state and lead to acute renal failure, maybe give 30 - 60 min post furosemide
- Vasogenic cerebral oedema - brain tumour, coma
- Osmolar substance, give IV over 30 - 60 min
- E.g. Hepatic encephalopathy
33
Q
KBr
A
- Bromide - more likely to cross channel instead of Cl- dec positive charger (polarise)
- Can be used in combo w/ PB/Imepitoin
- Seizures
- AEs: sedation, GI irritation - megaoesophagus, inc dietary salt, takes 4 - 6m to become stable, PUPD, pancreatitis - affects Cl- channels -> chronic D+, neurological/NM deficits
34
Q
Phenobarbital
A
- Epilepsy control
- AEs: initial sedation, inc appetite, hepatotoxicity, PUPD
- Serum conc aim: 100 - 140 µmol/L / 20 - 28 µg/mL
35
Q
Valacyclovir
A
- Antiviral
- Equine herpes myeloencephalopathy
36
Q
Betamethasone
A
- Salt poisoning / water deprivation in pigs