Parkinson's, ADHD, Bipolar Flashcards
1
Q
main SE of DA agonist
A
psychosis
compulsiveness
2
Q
do all sga treat mania?
A
yes
3
Q
DA agonists (6)
A
Bromocriptine
Cabergoline
Pramipexole
Ropinirole
Apomorphine
Rotiogotine
4
Q
Antipsychotic drugs for BP (4)
A
Olanzapine Quetiapine Risperidone Aripiprazole
5
Q
stalevo
A
levodopa carbidopa entacapone
6
Q
pramipexole MAO
A
d2 agonist D3 agonist
7
Q
lithium target for bp
A
0.8
8
Q
main protein in Lewy Bodies
A
alpha-synuclein
9
Q
COMT inhibitors (3)
A
entacapone
tolcapone
opicapone
10
Q
what % of DA loss is needed before symptoms appear
A
60-80
11
Q
BP 2 mintenance tx (3)
A
quetiapine lithium LMG
12
Q
week 2 BP based on response
A
full: continue tx
m-m: continue, inc. dose
s: inc. dose
13
Q
apomorphine MOA
A
D2,3,4 agonist
14
Q
entacapone pearls (3)
A
must take with sinemet
dealyed onset diarrhea
dark urine
15
Q
do all sga treat mdd
A
no
16
Q
mixed BP episode
A
manic/hypomanic 3 depressive sx most days
17
Q
stage 1 BP tx
A
monotherapy
skip to stage 2 if
euphoric mania and psychosis
or
if acute mania and on chronic tx
18
Q
Selefiline MOA
A
irreversible inhibitor of MOA-B
19
Q
lithium MOA
A
inhibit Ne and Da release inhibit inositol phosphates
20
Q
lithium monitor (2)
A
tsh: hypothyroidism renal
21
Q
Non-motor symptoms of PD (6)
A
neuropsychiatric –dementia, psychosis autonomic –orthoHTN, anti-ach falls sleep disorders –RLDS gI –drooling, dysphagia misc –fatigue, diplopia
22
Q
Thiazide and lithium
A
inc. li
23
Q
Maintenance phase bp tx
A
dose dec.
24
Q
loop and lithium
A
inc. li
25
SE of bromocriptine
pulmonary fibrosis
26
tx for diphasic dyskinesias (5)
more frequent sinemet
add DA agonist
add amantadine
add comt inhibitor
liquid sinemet
27
Rotiogotine MOA
D1,2,3 agonist
5ht agonist
antagonist of alpha adrenergic
28
Define Akinesia
unable to move muscles voluntarily
29
Continuation phase BP
full resonse 4-6 months
30
type of peak dyskinesia (2)
chorieform dystonia
31
acute mania tx (euphoric only) (8) in Bp
lithium
seroquel
divaloproex
asenapine
aripiprazole
paliperidone
risperidone
cariprazine
32
Sinemet MOA
inhibit dopa decarboxylase
33
Bupropion CI
bulemia nervosa seizures
34
TCA ADHD indication
ADHD w/anxiety/depression
35
why slow taper LMG
prevent steven johnson's
36
Stage 1 of PD
unilateral
37
\>\_\_?\_\_\_mg/day of selegiline cause tyramine interaction
10
38
Part 4 of UPDRS of PD
hoehn and yahr staging
39
stage 4 BP
ECT 3 drug combo clozapine is part
40
AED for BP (4)
Valproic/ Divalproex CBZ LMG OXC
41
define bradykinesia
slowness and poverty of movement
42
Part 3 of UPDRS of PD
clinician scored motor evaluation
43
Levodopa effects
most effective for sx
improve mortality
dec. rigidity/hypokinesia
44
tx of wearing off in PD (4)
more frequent sinemet add DA agonist add maoi add comt
45
stage 3 BP
different 2 drug combo depressed: combo w/2 li, LMG, QUE, LUR, OLA-F
46
cabergoline MOA
long acting d2 agonist
low affinity 5ht agonist
antagonist of alpha adrenergic
47
Part 1 of UPDRS of PD
evaluation of mentation, behavior and mood
48
Acute Phase BP
keep full response \>4 weeks
49
Stage 2 of PD
bilateral no postural abnormalities
50
SE of alpha2 agonist
sedation rebound HTN
51
Stage 4 of PD
bilateral postural abnormalites
52
hallucination in PD tx
pimavanserin
53
tx of med related dystonia
dec. individual dose of sinemet
54
indication for bromocriptine
hyperprolactinemia
55
psychosis in PD tx
eliminate ACH/DA agonist
add clozapine or quetiapine
56
CBZ and lithium
inc. li ADE
57
long acting stimulant duraiton
10-12 hours
58
DSMv mania
sx \>7 days 3+ sx (4 if mood only irritable)
59
ace/arb and lithium
inc. li
60
intermediate acting stimulant duration
3-8 hours
61
Antiach for PD (2)
Benztropine Trihexylphenidyl
62
DSMv hypomania
no delusions no hallucinations
63
Amantadine MOA
release endogenous dA
block Da reuptake
can cross BBB
block glutamate receptor
64
acute bp depression tx (3)
lithium LMG Ola-F
65
Stage 5 of PD
severe fully developed disease bed or chair bound
66
what antidepressant do you avoid in BP and MDD?
abilify
67
Part 2 of UPDRS of PD
self evaluation of ADLs
68
BP2
hypomnic MDE
69
entacapone MOA
selective, reversible inhibitor of COMT does not cross BBB
70
alpha2 adrenergic agonist for ADHD (2)
Guanfacine Clonidine
71
TCA MOA ADHD
block NE and 5HT presynaptic transporter site
72
stage 2 BP
2nd drug combo therapy -if depressed add lurasidone or olanzapine-fluoxetine
73
acute mania w/ psychosis tx in BP
quetiapine + LI/DVP aripiprazole + Li/DVP Risperidone + Li/DVP Asenapine + Li/DVP
74
alpha2 agoinst indicaiton (5)
monotherapy w/ tic disorder
aggression
anger
disruptive behavior
SE management: sleep
75
how much carbidopa needed to inhibit decarboxylation and prevent N/V
75mg/day
76
Methylphenidate - dexmethylphenidate MOA
block DA reuptake
77
what sga treat mania and mdd
latuda seroquel
78
atomoxetine MOA
selective NE reuptake inhibitor
79
BP tx d/c
\>6 months of remission
80
tx of peak dose dyskinesias (5)
lower sinemet dose
amantadine \>300mg/day
add DA agonist
Add comt inhibitor for sx
do not switch to CR sinemet
81
week 4 BP
full: continue, m-m: inc. dose, next stage s: inc. dose, next stage
82
Benztropine MOA
h1 antagonist inhibit DA reuptake
83
2 TCA for ADHD
desipramine imipramine
84
1st line agitation BP
Aripiprazole Lorazepam Loxapine Olanzapine
85
anxiety tx in PD (2)
SSRI venlafaxine
86
nsaids and lithium
in li
87
ADHD and MVA
4x more serious MVA in ADHD
88
safiniamide MOA
reversible inhibitor of MOAb
block na, ca channels
inhibit gluatamate release
89
amphetamine MOA
enhance release of NE and DA
90
Stage 3 of PD
bilateral mild postural abnormalities
91
tx of disease related dystonia (2)
hs dose of sinemet cr
hs dose of DA agonist
92
lithium CI (3)
CV disease
Kidney disease
untreated thyroid disorder
93
ropinirole MOA
D2/D3 agonist
94
Stimulants MOA
block NE and DA reuptake
95
amantadine indication
initial for rigidity/bradykinesia
96
week 8 BP
full: continue, transition? m-m: inc. dose, next stage s: next stage
97
pramipexole renal adjustment
crcl \<50
98
mood stabilizer onset
7-14 days initial response 4-8 weeks ful response
99
Freezing tx in pd
non-pharm first apomorphine
100
Trimethobenzamide?
use with apomorphine for N/V 3 days prior and 60 days after
101
MOA levodopa
increase DA in striatum BBB cross
102
when to use lifetime mood stabilizers
\>2manic episodes 1 severe manic episode
103
alpha2 adrenergic agonist MOA
inhibit NE release
104
DSMv ADHD
age 4-18 inattention
* 6+ sx for 6+months
* (\>17 only need 5)
Hyper/impulsive
* 6+ sx for 6+ months
105
drugs that exacerbate dementia in PD (5)
Anti-ach
selegiline
amantadine
DA agonist
tCA
106
other signs of PD
masked faces
hypophonia
micrographia
gait abnormaility
107
tx of on-off fluctuation in pd (2)
add da agonist liquid sinemet
108
short-acting stimulant duration
3-6 hours
109
ssri/snri and lithium
inc. serotonin syndrome
110
Week 6 BP
full: continue, transition? m-m: inc. dose, next stage s: inc dose, next stage
111
atomoxetine onset
2-4 week 6-8 week max effect
112
CI for alpha2agonist (2)
depression syncope dehydration
113
ADHD tx ages 3-5
behavior mod
114
BP 1
MANIC \>7 days also MDE
115
clinical presentation of PD acronym
TRAP T: tremor R: rigidity A: akinesia/bradykinesia P: postural instability
116
Bupropion indication for ADHD
ADHD w/ depression
117
BP 2 depression tx
quetiapine
118
BP 2 hypomania tx (3)
lithium divalproex atypical
119
MAO-B for PD (3)
Selegiline Rasagiline Safiniamide
120
Part 5 of UPDRS of PD
schwab and england ADL scale
121
2 main DA areas of brain for PD
substantia nigra nigrostriatal
122
maintenance BP drugs (6)
lithium
LMG
Olanzapine
Aripiprazole
Risperdal consta
ziprasidone
123
tx rapid cycling (3)
AED + AED
lithium + AED w/ atypical
Lithium or AED w/atypical
124
type of dystonia (2)
disease related -early morning foot dystonia medication related
125
what PD drug has more amount of motor complications
sinemet
126
highest risk of antidepressant switching in order
TCA MAOI venlafaxine ssri bupropion
127
caffeine, theophylline, osmotic diuretics and lithium
dec. li
128
SE apomorphine (3)
powerful emetic qt prolongation priaprism
129
TCA effect ADHD
dec. hyperactivity
improve mood and sleep
does not affect concentration
130
BP 1,2 suicide risk?
2\>1
131
Benztropine indication
initial therapy for tremor
132
depression tx in PD (5)
nortiptyline
desipramine
venlafaxine
citalopram
paroxetine
133
what drugs for PD contain sulfites (2)
apomorphine Rotiogotine
134
NOT recommended tx for BP (5)
2 antipsychotics
2 SRIs
SRI + MAOi
SRI + TCA
LMG + antidepressant
135
anti-ach contraindication in PD
\>65 cognitive impairment
136
define rapid cycling
\>4 mood disturbances in 12 months for MDD, mixed, manic, or hypomanic episode
