Numbness & weakness Flashcards
Drug targets for numbness and weakness
- Neuropathies: vitamin deficiency
- Peripheral arterial disease
- Varicose veins
- Deep vein thrombosis -> anticoagulants
Drugs implicated for neuropathic pain
- Gabapentinoids -> Gabapentins and pregabalins
- Antidepressants -> amitriptyline, duloxetine and venlafaxine
Drugs implicated for vitamin deficiency associated neuropathic pain
- Vitamin B12
- Folate
Drugs for varicose veins
- Mucopolysaccharide polysulphate
- Drugs for sclerotherapy
Drugs for peripheral arterial disease
haemorheologic agents
Drugs for DVT
Anticoagulant agents
Guidelines for ALA
- Patients intolerant to first-line pharmacotherapies
- Dietary or nutritional supplement
present in food: broccoli, spinach and liver
Drug for diabetic neuropathy
Alpha-lipoic acid (ALA)
MOA of ALA
- Antioxidant -> neutralise free radicals
- Enhance glucose uptake by cells
5 Adverse effects of ALA
- GIT: Nausea, vomiting and stomach cramps
- Hypoglycemia
- Allergic reaction: rare -> rashes
- Thiamine deficiency
- Overdose -> metabolic acidosis due to hypoglycemia, hepatotoxicity and cardiac effects
Which vitamins are given for vitamin-deficiency related neuropathy
Vitamin B12 and Vitamin B9 (folic acid)
MOA of B12
- Vitamin B12 -> Mecobalamin -> conenzyme that is needed for normal CNS function
- Facilitates synthesis of methionine -> crucial for myelin sheaths
Administration of Vitamin B12
Oral, IM and IV
Adverse Effects of B12
Hypersensitivity reactions
MOA of Folic acid
- Precursor for DNA synthesis and repair
- Needed in the formation of methionine -> myelin sheaths
- Crucial for RBC production
Administration of Vitamin B9 (folic acid)
Oral
3 Adverse effects of B9
High doses may mask vitamin B12 deficiency
Nausea and bloating
Hypersensitivity reactions
3 groups of Drugs used for peripheral arterial disease
- Antihypertensives
ACE inhibitors - captopril
Angiotensin II receptor blockers - candasartan - Antilipid
HMG-CoA reductase inhibitor - Atorvastatin - Antiplatelet therapy
ADP receptor inhibitor - clopidogrel
Name a non-selective phosphodiasterase (PDE) inhibitor used for numbness and weakness
Pentoxifylline
MOA of Pentoxifylline
- Non-selective PDE inhibitor
- Adenosine antagonist
- Reduced blood viscosity + reduced platelet aggregating
Adverse effects of Pentoxifylline
- GIT: Belching, bloating, stomach discomfort, nausea and vomiting
- Rare: Angina, palpitations and bleeding -> due to blood thinning effects
Cause of numbness and weakness in calf
Varicose veins
Drugs used for Varicose veins
- Muco-polysaccharide Poly-sulphate -> inflammed and swollen veins
- Polido-canol -> used in sclerotherapy to narrow vein and force blood to flow somewhere else
MOA Mucopolysaccharide polysulphate
- Antithrombotic: Potentiate antithrombin activity
- Anti inflammatory:
- Reduce capillary permeability
- Inflammatory mediators - Promote blood circulation
- Promote collagen synthesis -> wound healing
- Analgesic: mild pain relief
Adverse effects of of Mucopolysaccharide polysulphate
Local reactions: skin irritation and contact dermatitis
Systematic reactions: Hypersensitiv ity
potential for systematic anticoagulation
MOA of Polidocanol
- Non-ionic surfactant
- Localised endothelial damage (at veins) -> inflammation + fibrosis
- Formation of thrombus -> hardening of vein (sclerosis)
causes minimal pain due to mild anesthetic properties
Administration of Polidocanol
IV foam injection
Adverse effects of Polidocanol
Local reactions: Pain and redness + pruritus at injection site. Hyperpigmentation
Systematic reactions: Anaphylaxis, nausea and headache
Serious reactions: Thromboembolism
