Pharm final announcement 3.16.25

Question 1

List the MOAs for the following:
1) Dexamethasone
2) Rifampin
3) Donepezil
4) Metoclopramide
5) Memantine

Answer 1

Dexamethasone = used primarily for their anti-inflammatory effects
Rifampin = Inhibits transcription of DNA to RNA
Donepezil = Reversibly inhibits acetylcholinesterase
COMT inhibitor- breaks down the thing that breaks down dopamine
Metoclopramide = dopamine antagonist, serotonin agonist
Memantine = antagonizes NMDA receptors decreases excitotoxicity

Question 2

BB warnings and REMS (risk, evaluation, mitigation, and strategies) for the following epilepsy drugs:
1) Carbazepine
2) Phenytoin
3) Ethosuximide
4) Lamotrigine

Answer 2

1) Carbazepine(: SJS/TEN, HLAB1502, plastic anemia, agranulocytosis
2) Phenytoin: hypotension, arrythmias when exceeding infusion rates over 50mg/min for adults and 1-3 mg/kg for peds
3) Ethosuximide: blood dyscrasis, SJS, lupus erythematosus, behavioral changes
4) Lamotrigine: SJS/TEN, (esp if given with valproate) (esp if exceeding .3-.8% in peds, .08-.3% in adults)

Question 3

BB warnings and REMS (risk, evaluation, mitigation, and strategies) for the following epilepsy drugs:
1) CL blockers
2) Valproate
3) Perampanel
4) Vigabatrin
5) Felbamate
6) Primidone

Answer 3

1) CL- blockers: Clonazepam, phenobarbital, clobazam: if used with opioids: sedation resp depression, coma, death, abuse, addiction
2) Valproate: hepatotoxicity for kids <2 w mitochondrial disorders, teratogenic, decreased IQ, pancreatitis
3) Perampanel: aggression, hostility, irritability, anger, HI.
4) Vigabatrin: progressive bilat periph vision tunneling, reduced acuity
5) Felbamate: fatal aplastic anemia esp in women or pl w hx of cytopenia, ASD allergy or significant toxicity, viral infection, acute liver failure
6) Primodone: blood dyscrasias, SJS