Pharm 12.1

Question 1

Alzheimer’s disease

Answer 1

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

Question 2

alzheimer’s is the most common form of

Answer 2

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

Question 3

the prevalence of alzheimer’s increases with

Answer 3

each decade of life

Question 4

Alzheimers etilogy

Answer 4

?

Question 5

Alzhemers cures

Answer 5

non

Question 6

alzheimers is assiciated with deposition of

Answer 6

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

Question 7

which cells in the brain are affected with alzheimers

Answer 7

pyramidal cells of cortes and subcortex

Question 8

one hypothesis for AD

Answer 8

reduced cholinergic transmission

Question 9

benefit of pharmacological intervention in AD

Answer 9

short term benefit - do not target neurodegenerative process

Question 10

treatement of AD

Answer 10

Anti cholinesterase inhibitors, NMDA glutamate-receptor antagonist

Question 11

AChE inhibitors

Answer 11

tacrine, donepezil, rivastigmine, galantamine

Question 12

NMDA glutamate-receptor antagonist

Answer 12

Memantine

Question 13

AChE inhibitors are used to

Answer 13

selectivley inhibit AChE in CNS and elevate Ach levels in CNS

Question 14

Tacrine dose limiting side effects like

Answer 14

HEPATOTOXICITY

Question 15

Donepezil half life

Answer 15

long

Question 16

Donepezil dose

Answer 16

once dailiy

Question 17

Rivastigmine and Galantamine dose

Answer 17

2x daily

Question 18

donepezil, rivastigmine, galantamine sideffects

Answer 18

nausea, vomiting, diarrhea

Question 19

NMDA glutamate receptor antagonist are used bc

Answer 19

excitotoxic activation of NMDA receptors contributes to alzheimers

Question 20

Memantine reduces

Answer 20

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

Question 21

what kind of AD is memantine used

Answer 21

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

Question 22

what is the less toxic AD treatment

Answer 22

memantine

Question 23

memantine provides

Answer 23

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

Question 24

Glaucoma is a major cause of

Answer 24

blindness

Question 25

glaucoma increases

Answer 25

intraocular tension

Question 26

Without treatment of increased IOT there is

Answer 26

damage to the retina and optic nerve

Question 27

intraocular tension is determined by

Answer 27

the balance btw fluid input and drainage out of the globe

Question 28

aqueous humor is produced by_..and drained at__

Answer 28

by the ciliary epithelium, filtration angle at the anterior chanmber

Question 29

treat glaucoma by

Answer 29

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

Question 30

90% of drainage of aqueous humor is through

Answer 30

the trabecular route

Question 31

10% passes through

Answer 31

within the ciliary muscle into episcleral vessels (uveoscleral outflow)

Question 32

open angle glaucoma is also callsed

Answer 32

chronic simple glaucoma or wide angle glaucoma

Question 33

glaucoma therapy is aimed at

Answer 33

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

Question 34

glaucoma treatemnt in open angle glaucoma is mainly

Answer 34

pharmacolgical

Question 35

closed angle glaucoma occurs when

Answer 35

the person has a narrow iridocorneal angle and shallow anterior chamber

Question 36

in colsed angle glaucoma a dialated iris can

Answer 36

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

Question 37

obstruction to the drainage of aquous humor leads to

Answer 37

IOT

Question 38

permanent treatment for closed angle glaucoma

Answer 38

surgury (irodectomy), but drugs buy you some time

Question 39

closed angle glaucoma can present as

Answer 39

acute attack (painful) as an emergency condition)

Question 40

drugs for closed angle glaucoma

Answer 40

mannitol, pilocarpine

Question 41

mannitol in glaucoma

Answer 41

hyperosmolar fluid to help save eye

Question 42

pilocarpine in glaucoma

Answer 42

miotic to help save eye

Question 43

beta 1 receptor present

Answer 43

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

Question 44

beta 2 receptor present

Answer 44

in the ciliary blood vessels

Question 45

alpha 1 receptor present on

Answer 45

ciliary body blood vessels and radial muslce

Question 46

alpha 2 receptor present on

Answer 46

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

Question 47

M3 receptor present on

Answer 47

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

Question 48

treatment in open angle glaucoma

Answer 48

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

Question 49

beta blockers in glaucoma

Answer 49

timolol, betaxolol, carteolol, levobunolol, metipranolol

Question 50

beta blockers for glaucoma work by

Answer 50

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

Question 51

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

Answer 51

asthma, COPD, Bradycardia, heart block, heart failure

Question 52

Prostaglandins for glaucoma

Answer 52

latanoprost, travoprost, bimatoprost

Question 53

prostaglandins for glaucoma work by

Answer 53

increasing the aqueos drainage through the alternative pathways - uveoscleral route

Question 54

carbonic anhydrase inhibitors for glaucoma

Answer 54

topical and systemic

Question 55

topical carbonic anhydrase inhibitors

Answer 55

dorzolamide, brinzolamide

Question 56

systemic/oral carbonic anhydrase inhibitors

Answer 56

acetazolamide, dichlorphenamide, methazolamide

Question 57

carbonic anhydrase inhibitors for glaucoma work by

Answer 57

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

Question 58

alpha 2 agonists fro glaucoma

Answer 58

apraclonidine, brimonidine

Question 59

alpha 2 agonists for glaucoma work by

Answer 59

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

Question 60

chlinomimetics for glaumocma are either

Answer 60

direct acting, or indirect acting

Question 61

direct acting cholinomimetics glaucoma

Answer 61

pilocarpine, Carbachol, Demecarium

Question 62

Indirect acting cholinomimetics for glaucoma

Answer 62

physostigmine, echothiophate

Question 63

cholinomimetics for glaucoma work by

Answer 63

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

Question 64

narrow angle glaucoma uses

Answer 64

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

Question 65

other potential durges for glaucoma

Answer 65

PGE2, marijuana

Question 66

drugs contraindicated in glaucoma (particualrly in narow angle)

Answer 66

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

Question 67

conventional glaucoma surgery

Answer 67

trabulectomy

Question 68

Herbal medications

Answer 68

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

Question 69

herbal medications are available

Answer 69

without prescription

Question 70

Echinacea active constituents

Answer 70

chicoric acid, alkamide, polysaccharides