Pharm Exam 6

Question 1

Carbidopa-Levadopa (sinemet)
mechanism of action
administration
side effects
interactions

Answer 1

converted to dopamine in the brain.
carbidopa inhibits the break down of levodopa

PO w/food

agitation, confusion, hypertension, hypotension, GI issues GI bleed, dark sweat and saliva, shortness of breath

antihypertensive, MAOI, foods high in protein

Question 2

Cholinesterase inhibitors
Use/mechanism of action
side effects

Answer 2

Mild to moderate AD
Prevents the breakdown of ACh

Cholinergic side effects SLUDGE
diarrhea
dizziness
headache
bronchoconstriction
liver injury (tacrine)

Question 3

Cholinesterase inhibitors (4)

Answer 3

donepezil
galantamine
rivastigmine
tacrine- causes liver damage

Question 4

Valproic acid
-mechanism of action/use
-other uses
-adverse effects

Answer 4

abscence, tonic-clonic, atonic seizures
supresses sodium channels and calcium influx

bipolar disorders
migraine headaches
assaultive/agitated behavior in dementia

sedation in first 24-72 hours
GI upset
Hepatotoxicity in kids
pancreatitis
not for pregnancy
rash, weight gain, hair loss, blood disorders

Question 5

Phenobarbital
-mechanism of action
-side effects
-drug interactions

Answer 5

Reduce seizures without disruption of CNS
Potentiating effects of GABA

Drowsiness
Paradoxical response in children
Depression in adults, confusion in elderly
Physical dependence
Decrease in Vitamins K and D
!Toxicity signs: abnormal eye movement, ataxia, and CNS depression

-reduces effects of birth control and warfarin
-valproic acid increases plasma levels by 40%

Question 6

Phenytoin
-mechanism of action/use
-pharmacokinetics
-side effects
-Drug interactions
-Patient education

Answer 6

Active against all seizures except absent
Suppresses seizures and not respirations
Prevent spread of seizure in brain

Narrow therapeutic index, 10-20 mcg/ml
half life 8-60 hours

!Toxicity:abnormal eye movement/double vision and ataxia
sedation/cognitive impairment
Stevens-Johnson
Avoid in pregnancy
Decrease synthesis of Vitamin K and D
gingival hyperplasia

Increase levels: diazepam, alcohol (acute), and valproic acid
Decrease levels: alcohol (chronic), carbamazepine, phenobarbital
Decreases effects of birth control, steroids, and warfarin

Discoloration of skin/urine to pink/brown/red
Monitor for folic acid, magnesium, and calcium deficiency
Monitor for hypothyroid
Jaundice or measles-like rash
Do not breast feed
Do not change drug brand

Question 7

Mechanisms of antiepileptics

Answer 7

suppress discharge of neurons
suppress propagation of seizure activity
sodium influx supression
calcium influx supression
potentiation of GABA which is sedative

Question 8

Memantine-Neuronal receptor agonist
mechanism/use
side effects

Answer 8

NMDA receptor antagonist
moderate to severe AD
better tolerated than cholinesterase inhibitors

dizziness
headache
confusion
constipation
Avoid in severe renal impairment

Question 9

Carbamazepine
-mechanism of action/uses
-side effects
-drug interactions

Answer 9

treatment for partial seizures and tonic clonic seizures
Suppressesseizures by delayed sodium reuptake
Long half life
Fewer side effects than phenytoin
Used to treat bipolar disorder and neuralgias

headache first 3 weeks normal
visual disturbances
ataxia
vertigo
Low WBC, RBC, and platelets
Not for pregnancy
Stevens-Johnsons, photosensitivity
hyponatremia

birth control and warfarin
phenytoin and phenobarbital decrease effects
grapefruit juice increases levels by 40%