Neuromuscular and Movement disorder Drugs

Question 1

Class of drugs used for muscle paralysis in surgery or mechanical ventilation?

Answer 1

Neuromuscular blocking drugs

Question 2

MoA of Drug that causes depolarizing blockade?

Answer 2

Succinylcholine. Strong ACh agonist
Phase I: prolonged depol
Phase II: repolarized but blocked (receptors desensitized)

Question 3

AChE inhibitors - effect on Phase I and II?

Answer 3

Phase I: potentiates block

Phase II: reverses block

Question 4

Complications of depolarizing blockade?

Answer 4

HyperCa, HyperK, malignant hyperthermia

Question 5

Non-depolarizing blockade - drug suffixes (exception), and MoA

Answer 5

-curonium (and tubcurarine); compete with ACh for receptors

Question 6

Reverse non-depolarizing blockade with?

Answer 6

Neostigmine, edrophonium (AChE inhibitors)

Question 7

MoA of drug used in malignant hyperthermia and neurleptic malignant syndrome?

Answer 7

Dantrolene. Prevents release of Ca from sarcoplasmic reticulum of skeletal muscle.

Question 8

Drugs that can trigger malignant hyperthermia?

Answer 8

inhalation anesthetics (except N2O) and succinylcholine

Question 9

PD drugs - DA agonists?

Answer 9

Ergot - Bromocriptine

non-ergot - pramipexole, ropinirole

Question 10

PD drugs - Other use for drug that increases DA?

Answer 10

Amantadine. Antiviral against influenza A and rubella.

Question 11

PD drugs - converted to DA?

Answer 11

L-Dopa

Question 12

PD drugs - MoA of drug that prevents DA breakdown centrally?

Answer 12

Selegiline. MAO-B inhibitor

Entacapone, tolcapone (COMT inhibitors - prevent dopa degradation)

Question 13

PD drugs - Class of drug that curbs excess ACh?

Answer 13

Benztropine. Antimuscarinics.

PARK the BENZ

Question 14

For essential tremors, use?

Answer 14

B-Blocker. Propanolol

Question 15

Full DA treatment?

Answer 15

BALSA
Bromocriptine
Amatadine
Levodopa (with carbidopa)
Selegiline (and COMT inhibitors)
Antimuscarinics

Question 16

MoA of drug given with L-dopa?

Answer 16

carbidopa - peripheral decarboxylase inhibitor. Prevents conversion of L-dopa to carbidopa in periphery

Question 17

Long term use can lead to dyskinesia with doses and akinesia between doses?

Answer 17

L-Dopa

Question 18

increased peripheral DA can lead to?

Answer 18

arrhythmias

Question 19

MoA of drug that may enhance the adverse effects of L-dopa?

Answer 19

Selegiline (inhibits MAO-B)

Question 20

ALZ pt comes in with dizziness, confusion, hallucinations. Mech of Drug with these side effects?

Answer 20

Memantine. NMDA antag - precents Ca excitotoxicity

Question 21

ALZ pit takes drug can won’t go to sleep. Also has nausea and dizzines. MoA of drugs?

Answer 21

Donepezil, galantamine, rivastigmine. AChE inhibitors.

Question 22

Pt with decreased GABA, decreased ACh and increased DA. Goal of treatment? Drugs

Answer 22

Huntington’s - decrease DA.
Tetrabenazine and reserpine - inhibit VMAT (decrease DA packaging)
Haloperidol (DA receptor antag)

Question 23

MoA for Drug for acute migraine.

Answer 23

Sumatriptan. 5HT1b/1d agonist.

1) Inhibits trigeminal nerve activation
2) prevents vasoactive peptide release
3) induces vasoconstriction

Question 24

Pt with chronic episodes of pain comes in with coronary vasospasm and tingling. Drug that could have caused it?

Answer 24

Sumatriptan

Question 24

MoA of drugs that decrease L-DOPA degradation peripherally?

Answer 24

Entacapone, tolcapone (COMT inhibitors - prevent dopa degradation)