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Sam: Neurology > Pharm Animals > Flashcards

Pharm Animals Flashcards

1
Q

When treating seizures, we want to decrease the activity of these types of channels?

A

Voltage-gated

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2
Q

Phenytoin, Carbamazepine, Lamotrigine all decrease activity of ______ gated channels.

A

sodium

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3
Q

Ethosuximide and Lamotrigine decrease activity of ______ gated channels.

A

calcium

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4
Q

When it comes to treating seizures we want to decrease ________ activity and increase _______ activity.

A

Decrease glutamate activity

Increase GABA inhibitory activity

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5
Q

What drugs do we use for tonic-clonic seizures?

A

Carbamazepine, Lamotrigine, Phenytoin, Gabapentin, Valproate

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6
Q

Structural CNS lesion, abnormal EEG, partial seizure type, positive family history, postictal motor paralysis are all risk factors for?

A

Seizures!

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7
Q

If someone has no risk factors, what are the chances that they will have another seizure?

A

10-15%

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8
Q

If someone has 2 or more risk factors, what are the chances that they will have another seizure?

A

100%

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9
Q

What two seizure drugs increase the concentration of P450 enzymes?

A

Carbamazepine and Phenytoin

But mainly Carbamazepine

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10
Q

If you start someone on a new seizure drug, do you abruptly stop the other?

A

No.

Down titrate the original and up titrate the new.

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11
Q

What is our tri-cyclic anti-seizure drug?

A

Carbamazepine

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12
Q

What drug is our cyclic ureides anti-seizure drug?

A

Phenytoin

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13
Q

What drug is our anticonvulsant?

A

Valproic acid

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14
Q

What drug is our succinimide anti-seizure medication that is used for absence seizures in children?

A

Ethosuximide

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15
Q

What seizure medication is a benzodiazepine?

A

Lorazepam (Ativan)

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16
Q

Alzheimer’s disease is caused by a ______ deficit in the ______.

A

acetylcholine, hippocampus

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17
Q

Therapeutic approach to treating Alzheimer’s:

Inhibit _______ metabolism by inhibiting __________.

A

acetylcholine, acetylcholinesterase

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18
Q

Excess glutamate signaling produces increased _____ receptor Ca2+ channel activity

A

NMDA

This then induces secondary cascade leading to neuronal cell death.

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19
Q

What drug is our CNS acetylcholinesterase inhibitor?

A

Donepezil (Aricept)

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20
Q

What drug is our NMDA Receptor Antagonist?

A

NMDA Receptor anatagonist

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21
Q

What 2 seizure medications do you have to supplement folate?

A

Lamotrigine and Phenytoin

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22
Q

Parkinson’s disease is caused by loss of _______ cells in the _______ _______.

A

Dopamine, substantia nigra

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23
Q

4 main symptoms of Parkinson’s?

A

Tremor, rigidity, bradykinesia, and gait abnormalities.

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24
Q

What drug is our anticholinergic for Parkinson’s, and how does it work?

A

Benztropine (Cogentin)

MoA: acetylcholine receptor inhibitor – decreases the imbalance between dopamine and acetylcholine, increasing the amount of dopamine

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25
Q

What drug is our NMDA Receptor Inhibitor and how does it work?

A

Amantadine (Symmetrel)

MoA: decreases levodopa injury to NMDA receptor – modulates levodopa impact on NMDA receptors which leads to bradykinesia, rigidity, and tremor

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26
Q

What drug is our MAO-B inhibitor and how does it work?

A

Selegiline (Eldepryl)

MoA: inhibits MAO-B enzyme with resulting rise in available dopamine in CNS

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27
Q

What really sucks about MAO-B inhibitors?

A

They have a bajillion dx-dx interactions

28
Q

What drug is our dopamine agonist?

A

Ropinrole (Requip)

29
Q

What drug functions as our dopamine replacement?

A

Levodopa/Carbidopa

30
Q

What drug is our COMT inhibitor?

A

Entacapone (Comtan)

31
Q

How does Entacapone work?

A

Decreases levodopa metabolism to 3-OMD allowing more to be metabolized to dopamine

32
Q

MS is an autoimmune disorder that causes CNS __________ and axonal ________

A

demyelination, transection

33
Q

Demyelination leads to the ________ of MS.

Axonal Transection leads to the _______ of MS.

A

Symptoms

Relapses/Progression

34
Q

Most common type of MS is?

A

Relapsing remitting – 85%

35
Q

How do we treat an acute relapse of MS?

A

Steroids

36
Q

What drug is a synthetic myelin basic protein?

A

Glatiramer acetate (Copaxone)

37
Q

By what percent does Glatiramer reduce relapse?

A

28%

38
Q

What sucks about Interferon B-1a

A

Neutralizing antibodies develop to interferon after 18-24 months use; 27% reduction in relapses in year 1

39
Q

What drug is a Monoclonal IgG4 antibody?

A

Natalizumab (Tysabri)

40
Q

What was the first oral medication?

A

Fingolimod (Gilenya)

41
Q

What drug is a sphingosine 1-PO4 receptor inhibitor?

A

Gilenya

42
Q

What drug do we use when all other treatments have failed?

A

Natalizumab (Tysabri)

43
Q

What drug is a Nrf2 Pathway Systemic Immunomodulator?

A

Dimethyl Fumarate (Tecfidera)

44
Q

By what percent does Tecfidera reduce relapse?

A

75%

45
Q

What drug is our peripheral muscle relaxant?

A

Dantrolene

46
Q

What drug is our CNS GABA agonist CNS antispasmodic?

A

Baclofen

47
Q

Trauma and chemical inflammation are what types of pain?

A

Nociceptive

48
Q

B12 deficiency, MS, CVA are examples of what type of pain?

A

Neuropathic

49
Q

If you have a patient complaining of 2/10 pain, what would their treatment look like?

A

Non-opioid analgesic, regular scheduled dosing

50
Q

If you have a patient complaining of 5/10 pain, what would their treatment look like?

A

Add an opioid to the non-opioid, still with regular scheduled dosing.

For example, tylenol with codeine

51
Q

If you have a patient complaining of 8/10 pain, what would their treatment look like?

A

High potency opioid, regular scheduled dosing.

For example: morphine or hydromorphone

52
Q

Acute pain is usually what type of pain?

A

Nociceptive

53
Q

Chronic pain is usually what type of pain?

A

Most commonly a combo of nociceptive and neuropathic

54
Q

Who do we need to avoid using aspirin in?

A

People with asthma + nasal polyps or chronic uritcaria

55
Q

Is aspirin reversible?

A

Nah dog.

56
Q

What is our COX-2 selective drug?

A

Celebrex

57
Q

What are the three CNS opioid receptors?

A

Mu, kappa, delta

58
Q

What is serotonin syndrome?

A

Excess stimulation of peripheral and CNS serotonin receptors

59
Q

What pain medication has the side effects of increased seizure risk and serotonin syndrome?

A

Tramadol (ultram)

60
Q

Codeine is metabolized to?

A

Morphine

61
Q

Hydrocodone + tylenol is?

A

Vicodin

62
Q

Vicodin is metabolized to?

A

Hydromorphone

63
Q

The long-acting monoproduct of oxycodone is?

A

Oxycontin

64
Q

What is the “standard high potency opioid analgesic”?

A

Morphine

65
Q

What are our two drugs for acute treatment of migraines?

A

Eletriptan (Relpax) and Sumatriptan (Imitrex)

66
Q

What drug do we give PPx for migraines?

A

Propranolol

Sam: Neurology (4 decks)

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