Patho-Pharm Week 3 - CNS Flashcards by Niamh Hopkins

What is meningitis?

Inflammation + infection of the meninges

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What type of meningitis is the most severe?

Bacterial

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What type of meningitis goes away on its own?

Viral

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What type of meningitis indicates an underlying immune disease?

Parasite or Fungal

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What are the two most common bacteria causing meningitis?

Meningococcus & Streptococcus

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What are the 3 most common symptoms of meningitis?

Fever + chills
Petechial rash
Neck stiffness

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Basic description of a petechial rash

Blood vessels popping out, showing dots on the skin

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What is Multiple Sclerosis?

Demyelination disease of the white matter plaques

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How is MS treated acutely?

Steroids

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How is MS treated chronically?

Interferon

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How do interferons work?

They work against the immune system

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What is Myasthenia Gravis?

Autoimmune disease mediated by anti-acetylcholine receptor antibodies

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What neurotransmitters allows the muscles to fire?

Acetylcholine

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How do the meds work to treat Myasthenia Gravis?

They provide more acetylcholine to overwhelm the receptors

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What is one of the first signs of Myasthenia Gravis?

Ptosis (eye drooping)

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What test is Myasthenia Gravis diagnosed with?

Tensilon Test

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How does the Tensilon Test work for Myasthenia Gravis?

Giving LOTS of acetylcholine, the patient is normal for 30 mins and then they revert back to normal

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What do EMGs measure?

Muscle response - nerve impulse speed

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What type of drugs is Myasthenia Grais treated with?

Immunosuppressants and steroids

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What is Guillain-Barre Syndrom?

Inflammatory disease in the demyelination of peripheral nerves

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What type of pathogen typically causes Guillain-Barre Syndrom?

Virus

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What does Guillain-Barre Syndrom start with?

Leg paralysis and then goes through the entire body

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What is typically involved with Guillain-Barre Syndrom treatment?

Ventilation

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What is Alzheimer’s Disease?

Progressive Dementia characterized by progressive loss of cognitive mental function

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What are the Sage and Moca tests used to diagnose?

Alzheimer's Disease

What score or below on the Moca test will a person's driver's license be taken away?

What two drugs are used most often for Alzeihmer's?

Aricept and Reminyl

What do aricept and reminyl typically do to Alzheimer's?

Inhibit then enzyme that breaks down acetycholine, slows down the progression, not a cure

What is Parkinson's Disease?

Degenerative disease of dopamine pathway in the substantia nigra (dark become white)

What are the four main symptoms of Parkinson's?

- Resting tremor - Rigidity (cogwheel) - Bradydyskinesia (moving slowly) - Postural instability (trunk of body shrinking)

Describe a resting tremor

Tremor occurs when you are at rest and goes away when you are doing something

What are the 3 types of CNS depressants?

- Anti-psychotics - Opioid analgesics - Sedative-hypnotics

What is the mechanism of action of an opioid?

Binds to an opioid receptor in the CNS of the brain

What type of drug are opioids?

Agonist

What type of response do opioids elicit?

Analgesic response (pain relief) (endorphins)

Which opioid has the biggest/most side effects?

Morphine

Agonist vs. Antagonist

Agonist - binds to receptors, elicits response Antagonist - blocks receptor, blocks response

What is the main use of opioids?

Relieve pain

What are two uses of opioids other than pain relief?

- Cough suppression - Antidiarrheal

Can opioids work with anesthetics to achieve balanced anesthesia?

Yes

Should opioids be used if someone has asthma or respiratory insufficiency?

What happens when a woman with an addiction to opioids has a baby?

The baby will also be addicted to opioids

Should opioids be used if someone has elevated intracranial pressure?

What type of drug did someone take if their pupils are dilated?

Stimulus

What type of drug did someone take if their pupils are constricted?

Depressent (opioid)

What are 4 common side effects of opioids?

- Euphoria - Nausea and Vomiting - Respiratory depression - Pupillary constriction

Can you die from alcohol withdrawal?

Yes

Can you die from opioid withdrawal?

What is the most important vital sign to monitor when a patient is taking opioids?

Respiratory status

What is the best opioid for chest pain?

Morphine

What's the best drug route to take for the longest-lasting effects?

Subcutaneous

Which opioid gets converted to morphine in the body?

Codeine

What differentiates the Tylenols?

Amount of codeine

How much codeine in Tylenol 1?

8mg

How much codeine in Tylenol 2?

15mg

How much codeine in Tylenol 3?

30mg

How much codeine in Tylenol 4?

60mg

With what disease are people not allowed to have acetaminophen (tylenol)?

Liver disease

What is the maximum dose for acetaminophen?

4000mg/24h

What is the antidote for Tylenol overdose?

Acetylcysteine

What are the three types of anesthetics?

- Local - Regional - General

What is the advantage of regional and local anesthesia?

No CNS affected

Where are epidurals injected?

Outside the spine

Where are intrathecals injected?

Inside the spine

Where are infiltrations injected?

In procedure spot

Where are nerve blocks injected?

Around a specific nerve

What is an important requirement for neuromuscular anesthetics?

Mechanical ventilation

What type of effect do benzodiazepines have?

Sedative and hypnosis

What is the ending of benzo medications?

"Pam"

What medical conditions are barbituates used for?

Seizures

What is the antidote for barbiturate overdose?

There is none, you're put under and the body has the clear it

Can you overdose on benzodiazepines?

What are the three intermediate-acting benzodiazepines?

- Alprazolam - Clonazepam - Oxazepam

What are 4 big effects of benzodiazepines?

- Sedation - Skeletal muscle relaxation - Decreased epilepsy activity - Treatment of alcohol withdrawal

How much time do you wait before administering a benzo before sleep time for standard absorption?

15 - 30 mins

What do you never mix with benzos?

Alcohol

What are the two major muscle relaxants?

Baclofen Flexeril

What are the three big CNS stimulants?

- Caffeine - Dextroamphetamine - Methylphenidate

What is dextroamphetamine used to treat?

ADHD

What condition prevents people from taking CNS stimulants?

Seizures

What is the main drug given for Parkinson's?

Levopoda

What does levopoda essentially do?

Replace the dopamine that the substantia nigra is not producing