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Pharmacology > Pharm 12.1 > Flashcards

Pharm 12.1 Flashcards

1
Q

Alzheimer’s disease

A

impairment of cognitive abilities that is gradual in on set but relentless in progression

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2
Q

alzheimer’s is the most common form of

A

dementing illness - gradually progressive dementia affecting cognition, behaviour, and functional status

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3
Q

the prevalence of alzheimer’s increases with

A

each decade of life

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4
Q

Alzheimers etilogy

A

?

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5
Q

Alzhemers cures

A

non

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6
Q

alzheimers is assiciated with deposition of

A

beta amyloid in the brain tissue, abnormal phosphorylation of the intracellular tau proteins causing abnormalites of microtubule assembly and collapse fo the cytoskeleton

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7
Q

which cells in the brain are affected with alzheimers

A

pyramidal cells of cortes and subcortex

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8
Q

one hypothesis for AD

A

reduced cholinergic transmission

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9
Q

benefit of pharmacological intervention in AD

A

short term benefit - do not target neurodegenerative process

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10
Q

treatement of AD

A

Anti cholinesterase inhibitors, NMDA glutamate-receptor antagonist

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11
Q

AChE inhibitors

A

tacrine, donepezil, rivastigmine, galantamine

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12
Q

NMDA glutamate-receptor antagonist

A

Memantine

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13
Q

AChE inhibitors are used to

A

selectivley inhibit AChE in CNS and elevate Ach levels in CNS

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14
Q

Tacrine dose limiting side effects like

A

HEPATOTOXICITY

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15
Q

Donepezil half life

A

long

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16
Q

Donepezil dose

A

once dailiy

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17
Q

Rivastigmine and Galantamine dose

A

2x daily

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18
Q

donepezil, rivastigmine, galantamine sideffects

A

nausea, vomiting, diarrhea

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19
Q

NMDA glutamate receptor antagonist are used bc

A

excitotoxic activation of NMDA receptors contributes to alzheimers

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20
Q

Memantine reduces

A

excitotoxicity by binding to NMDA receptors by non-competitive blcokade, slowing progression of disease

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21
Q

what kind of AD is memantine used

A

moderate to sever AD bc it reduces the rate of clinical deterioration

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22
Q

what is the less toxic AD treatment

A

memantine

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23
Q

memantine provides

A

neuroprotective effects and adverse drug effects are mild like head ache and dizziness

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24
Q

Glaucoma is a major cause of

A

blindness

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25
Q

glaucoma increases

A

intraocular tension

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26
Q

Without treatment of increased IOT there is

A

damage to the retina and optic nerve

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27
Q

intraocular tension is determined by

A

the balance btw fluid input and drainage out of the globe

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28
Q

aqueous humor is produced by_..and drained at__

A

by the ciliary epithelium, filtration angle at the anterior chanmber

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29
Q

treat glaucoma by

A

reducing production of aqueous humor, increasing the drainage of aqueous humor

30
Q

90% of drainage of aqueous humor is through

A

the trabecular route

31
Q

10% passes through

A

within the ciliary muscle into episcleral vessels (uveoscleral outflow)

32
Q

open angle glaucoma is also callsed

A

chronic simple glaucoma or wide angle glaucoma

33
Q

glaucoma therapy is aimed at

A

reducing the aqueous humor production and increasing the tone of trabecullae to facilitate drainage

34
Q

glaucoma treatemnt in open angle glaucoma is mainly

A

pharmacolgical

35
Q

closed angle glaucoma occurs when

A

the person has a narrow iridocorneal angle and shallow anterior chamber

36
Q

in colsed angle glaucoma a dialated iris can

A

obstruct the outflow drainage pathway at the angle between the cornea and ciliary body (iridocorneal angle)

37
Q

obstruction to the drainage of aquous humor leads to

A

IOT

38
Q

permanent treatment for closed angle glaucoma

A

surgury (irodectomy), but drugs buy you some time

39
Q

closed angle glaucoma can present as

A

acute attack (painful) as an emergency condition)

40
Q

drugs for closed angle glaucoma

A

mannitol, pilocarpine

41
Q

mannitol in glaucoma

A

hyperosmolar fluid to help save eye

42
Q

pilocarpine in glaucoma

A

miotic to help save eye

43
Q

beta 1 receptor present

A

on the base of ciliary body (beta blockers reduce aqueos humor production)

44
Q

beta 2 receptor present

A

in the ciliary blood vessels

45
Q

alpha 1 receptor present on

A

ciliary body blood vessels and radial muslce

46
Q

alpha 2 receptor present on

A

ciliary body epithelium and the presynaptic sympathetic fibers supplying the ciliary body

47
Q

M3 receptor present on

A

the circular (constrictor) smooth muscle of the iris and the ciliary muscles

48
Q

treatment in open angle glaucoma

A

beta blockers, prostaglandins, carbonic anhydrase inhibitors, alpha agonists, cholinomimetics

49
Q

beta blockers in glaucoma

A

timolol, betaxolol, carteolol, levobunolol, metipranolol

50
Q

beta blockers for glaucoma work by

A

decreasing the production of aqueous humor by ciliary epitheliam (given as topical eye drops)

51
Q

bc some of the drug can enter systemic absorption and cause CVS symptoms, contraindications for beta blockers are patients with

A

asthma, COPD, Bradycardia, heart block, heart failure

52
Q

Prostaglandins for glaucoma

A

latanoprost, travoprost, bimatoprost

53
Q

prostaglandins for glaucoma work by

A

increasing the aqueos drainage through the alternative pathways - uveoscleral route

54
Q

carbonic anhydrase inhibitors for glaucoma

A

topical and systemic

55
Q

topical carbonic anhydrase inhibitors

A

dorzolamide, brinzolamide

56
Q

systemic/oral carbonic anhydrase inhibitors

A

acetazolamide, dichlorphenamide, methazolamide

57
Q

carbonic anhydrase inhibitors for glaucoma work by

A

blocking the formation of aqueous humor by blocking the carbonic anhydrase enzyme required for the synthesis of it (need bicarbonate)

58
Q

alpha 2 agonists fro glaucoma

A

apraclonidine, brimonidine

59
Q

alpha 2 agonists for glaucoma work by

A

reducing the fromation of aqueos humor, and also exert a direct neuroprotective effect

60
Q

chlinomimetics for glaumocma are either

A

direct acting, or indirect acting

61
Q

direct acting cholinomimetics glaucoma

A

pilocarpine, Carbachol, Demecarium

62
Q

Indirect acting cholinomimetics for glaucoma

A

physostigmine, echothiophate

63
Q

cholinomimetics for glaucoma work by

A

contraction of cilliary muscle open the trabecular spaces so that aqueos humor drains more easily, iris pulled from angle fo anterior chamber bidining the filtration angle and opening the trabecular network, increased outflow of aqueos humor, decreased intraocular pressure

64
Q

narrow angle glaucoma uses

A

mannitol/glycerol, pilocarpine/carbachol, acetazolamide, permanent treatment - laser surgery for pathway to be widened - irdotomy

65
Q

other potential durges for glaucoma

A

PGE2, marijuana

66
Q

drugs contraindicated in glaucoma (particualrly in narow angle)

A

antimuscuranics (ex. Atropine produces mydriasis and exacerbate problem) and alpha 1 agonists

67
Q

conventional glaucoma surgery

A

trabulectomy

68
Q

Herbal medications

A

Echinacea, Garlic, Ginkgo, Ginseng, Kava, Milk Thistle, St John’s wort, Saw palmetto, Dehydroepiandosterone (DHEA), Melatonin, Glucosamine

69
Q

herbal medications are available

A

without prescription

70
Q

Echinacea active constituents

A

chicoric acid, alkamide, polysaccharides

Pharmacology (15 decks)

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