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PTH 603 - Patho for Neuro > Part 1 - Neuropharmacology > Flashcards

Part 1 - Neuropharmacology Flashcards

1
Q

What are the medications used for Parkinson’s Disease?

A

Levodopa, Carbidopa, (both increase dopamine)

Dopamine Agonists: Pergolide (PERMAX), Pramipexole (MIRAPEX)

MAO Inhibitors:
Selegiline (ELDEPRYL)

COMT Inhibitors:
Talcapone (TASMAR)
Entacapone (COMTAN)

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2
Q

Side effects of Levodopa? (Drug responsible for synthesis & degradation of dopamine)

A

GI, CV, Abnormal movements, psychiatric effects.

Drug incompatibilities and interactions.

  • Pryidoxine
  • Antipsychotic drugs
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3
Q

Side effects of Carbidopa (drug is a peripheral decarboxylase inhibitor; always used in combination with L-Dopa)

A

Does not penetrate the BBB
Decreases peripheral side effects of L-DOPA
Decreases required dose of L-DOPA

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4
Q

What are the 4 considerations of therapy in patients with PD?

A

“Wearing off” effect
“ON-OFF” phenomenon
“Drug Holidays” do not help
Depression needs treatment

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5
Q

What are the 2 direct Dopamine Agonists?

A

Pergolide (PERMAX), Pramipexole (MIRAPEX)

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6
Q

What are the central mechanisms of the 2 direct Dopamine Agonists?

A

Dopamine agonist - increases dopamine effects in basal ganglia

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7
Q

What are the side effects of the 2 direct Dopamine Agonists? (Drugs are used in combo with L-DOPA)

A

Ataxia, dystonia, akathesias, abnormal gait, hypertonia.

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8
Q

What do COMT and MAO Inhibitors do in general?

A

Synthesis and Degradation of Dopamine

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9
Q

What are the two common COMT Inhibitors?

A

Talcapone (TASMAR)

Entacapone (COMTAN)

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10
Q

What do COMT inhibiors do specifically?

A

Increases the duration action of L-DOPA

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11
Q

What are the adverse drug effects of COMT Inhibitors?

A

Abdominal pain, anorexia, confusion, lightheadedness, fever, hallucinations, INVOLUNTARY MUSCLE MOVEMENTS, severe diarrhea

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12
Q

What is the one common MAOI?

A

Selegiline (ELDEPRYL)

  • Selective for MAO-B
  • -Selective for Dopamine
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13
Q

What does MAOI do?

A

May slow the progression of the disease

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14
Q

What are the adverse drug effects of MAOIs?

A

Changes in behavior (mood swings, irritability, confusion, agitation)

Also: Dyskinesias, headache, palpitations

**Use with caution with anti-depressants, decongestants, stimulants

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15
Q

What are the 3 different Anticholinergics listed in the PPT?

A

Trihexyphenidyl (ARTANE)
Benztropine (COGENTIN)
Diphenhydramine (BENEDRYL)

*Avoid in the elderly - decreases acytelcholine instead of increasing dopamine.

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16
Q

Drugs that worsen PD and movement and older patients

A

Anti-psychotic drugs:

Haloperido (HALDOL) and chlorpromazine (THORAZINE)

Used for treatment of behavioral disorders

Actions - Central
Mechanism - Blockade of dopamine receptors
Effects - Parkinson-like, Tremor, Akithisia, akinesia.

17
Q

Drugs that treat spasticity:

A

Baclofen, Botolinium toxin type A (BOTOX), Tizanidine (ZANAFLEX),

18
Q

Drugs that are skeletal muscle relaxants:

A

Antispasmotics:

Chlorzoxazone (PARAFLEX, PARAFON FORTE), Cyclobenzaprine (FLEXORIL), DANTRALENE (DANTRIUM), Metaxalone (Skelaxin),

19
Q

Anti-Histamines

A

Diphenhydramine (BENADRYL), Chlorpheniramine

20
Q

Benzodiazepines (muscle inhibition)

A 
Diazepam (VALIUM, others)
Alprazolam (XANAX)
Clonazepam (KLONOPIN)
Lorazepam (ATIVAN)
Midazolam (VERSED)
21
Q

Anti-epileptic drugs

A

Valproic acid (DEPAKOTE), Phenytoin (DILANTIN), Carbamazepine (TEGRETOL)

22
Q

Stimulants

A

Amphetamine (ADDERALL), methylphenidate (RITALIN)

Bupropion (WELLBUTRIN)?

23
Q

Anticonvulsants

A 
Phenytoin (DILANTIN)
Carbamazepine (TEGRETOL)
Valproic Acid (DEPAKOTE)
Ethosuximide (ZARONTIN)
Gabapentin (NEURONTIN)
Lamotrigine (LAMICTAL)
24
Q

Amphetamine, Methylphenidate

A

Release of norepinephrine, serotonin and dopamine

Increases attention, decreases impulsivity while producing stimulation in ADHD

25
Q

NE reuptake inhibitor

A

Atomoxetine (STRATTERA)

26
Q

ANTIPSYCHOTICS

A

1st generation (Typical)
Chlorpromazine (THORAZINE)
Thioridazine (MELLARIL)
Haloperidol (HALDOL)

2nd generation (Atypical)
Clozapine (CLOZARIL)
Risperidone (RISPERDAL)
Quetiapine (SEROQUEL)
Olanzepine (ZYPREXA)
27
Q

Anti-depressants

A

Tricyclic Antidepressants (TCAs)
Nortriptyline (PAMELOR)
Amitriptyline (ELAVIL)
Desipramine (NORPRAMIN)

Selective Serotonin Reuptake Inhibitors (SSRIs)
Fluoxetine (PROZAC)
Paroxetine (PAXIL)
Sertraline (ZOLOFT)
Citalopram (CELEXA)
Escitalopram (LEXAPRO)
Fluvoxamine (Luvox) 
Heterocyclics
Venlafaxine (EFFEXOR) - SNRI
Duloxetine (Cymbalta) 
Bupropion (WELLBUTRIN)
Trazodone (DESYREL)

Herbals
St. John’s Wort

Monoamine Oxidase Inhibitors (MAOIs)
Tranylcypromine (PARNATE)

28
Q

Anti-manic

A

Lithium (ESKALITH)
Carbamazepine (TEGRETOL)
Valproic Acid (DEPAKENE)
Lamotragine (LAMICTAL)

29
Q

SSRIs

A

Fluoxetine (PROZAC), paroxetine (PAXIL), sertraline (ZOLOFT), fluvoxamine (LUVOX)

30
Q

Drug that is potent in blocking reuptake of both norepinephrine and serotonin [SNRI]

A

Venlafaxine (Effexor)

31
Q

Drug of choice in the treatment of manic/depressive disorder

A

Lithium

32
Q

Anti-convulsants in mania

A

Valproate (DEPAKOTE)
First choice

Carbamazepine (TEGRETOL)
Lamotragine (LAMICTAL)
Gabapentin (NEURONTIN)

33
Q

Sedative-Hypnotics

A

Barbiturates
Phenobarbital (LUMINAL)

Benzodiazepines
Diazepam (VALIUM, others)
Alprazolam (XANAX)
Clonazepam (KLONOPIN)
Lorazepam (ATIVAN)
Midazolam (VERSED)

BZ1 Agonists
Zolpidem (AMBIEN)
Zaleplon (SONATA)
Eszopiclone (LUNESTA)

Buspirone (BUSPAR)

34
Q

Non-benzodiazepine Benzodiazepine Receptor Agonists

A

Zolpidem (Ambien, Ambien CR)
Zaleplon (Sonata)
Eszopicone (Lunesta) – longer acting

35
Q

Melatonin

A

Ramelteon (Rozerem)

36
Q

MEDICATIONS THAT TREAT SEIZURES!

A 
Anti-epileptic drugs:
Valproic acid (DEPAKOTE), Phenytoin (DILANTIN), Carbamazepine (TEGRETOL)

Gabapentin (NEURONTIN) - used for seizure disorders

Lamotrigine (LAMICTAL) - Solo or adjunctive med for generalized or partial seizures, may be effective against absence seizures

PTH 603 - Patho for Neuro (7 decks)

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