pharmacology

Question 1

what is neuroleptic malignant syndrome associated with

Answer 1

withdrawal of anti-parkinsons drugs

Question 2

pathophysiology of neuroleptic malignant syndrome

Answer 2

sudden decrease in central dopamine activity

Question 3

clinical presentation of neuroleptic malignant syndrome

Answer 3

hyperthermia, altered mental status, lead pipe rigidity

Question 4

investigation indicating malignant neuroleptic syndrome

Answer 4

elevated CK !!!

Question 5

what is leadpipe rigidity

Answer 5

involuntary increase in muscle tone present throughout the range of movement

Question 6

management of neuroleptic malignant syndrome

Answer 6

cessation of dopamine antagonists or restarting dopamine agonists
rehydration + cooling

Question 7

when does neuroleptic malignant syndrome usually occur

Answer 7

within 10 days of onset/alteration of drugs

Question 8

what is serotonin syndrome

Answer 8

drug-induced condition that occurs because of excess serotonin in the central nervous system

Question 9

when does serotonin syndrome usually present

Answer 9

within 24 hours of a medication overdose

Question 10

name some drugs typically associated with serotonin syndrome

Answer 10

antidepressants, triptans and tramadol

Question 11

classic presentation of serotonin syndrome

Answer 11

altered mental status
autonomic hyperactivity: hyperthermia, tachycardia, hypertension, flushing
neuromuscular abnormalities: tremor, clonus, rigidity

Question 12

what is the mechanism of action of sodium valproate

Answer 12

enhances GABA synthesis

Question 13

name a common dopaminergic drug and its indication

Answer 13

levodopa in parkinsons

Question 14

name some adverse effects of dopamine agonists

Answer 14

impulse control disorders !!
hallucinations are commonly associated in elderly patients

Question 15

name some cholinesterase inhibitors and their indication

Answer 15

slow cognitive decline in dementia
donepezil, galantamine

Question 16

contraindication for cholinesterase inhibitors

Answer 16

may worsen COPD or asthma

Question 17

when is memantine indicated

Answer 17

in moderate and sever alzheimers or when cholinesterase inhibitors aren’t tolerated

Question 18

mechanism of action of memantine

Answer 18

NMDA receptor antagonist

Question 19

what needs to be checked before starting memantine and why

Answer 19

blood pressure - can cause hypertension

Question 20

what receptors do opioids work on

Answer 20

G protein coupled receptors

Question 21

what is used to reverse opioid toxicity

Answer 21

naloxone

Question 22

name 2 NSAIDs

Answer 22

naproxen and ibuprofen

Question 23

what is the main indication for NSAIDs

Answer 23

inflammatory pain

Question 24

mechanism of action of NSAIDs

Answer 24

inhibit COX 1 and 2

Question 25

when are NSAIDs contraindicated

Answer 25

GI bleeding and ulceration

Question 26

what can be given in conjunction to NSAIDs to reduce adverse effects

Answer 26

PPIs

Question 27

name some tricyclic antidepressants

Answer 27

amitriptyline, clomipramine, nortriptyline

Question 28

what is an indication for carbamazepine

Answer 28

first line in trigeminal neuralgia

Question 29

whats the difference between opioids and opiates

Answer 29

opioids are any substance that bind to opioid receptors opiates are made from opium all opiates are opioids but not all opioids are opiates