Pharmacology

Question 1

Antiepileptic agents

Answer 1

Action: reduce seizure activity in brain. Inhibit firing of cerebral neurons
Side effects: ataxia, skin issues, behavioral changes, GI distress, headache, blurred vision, weight gain
Chemical classifications: barbiturates, benzodiazepines, carbosylic acids, hydantoins, iminostilbenes, succinimides
Examples: Seconal (secobarbital), Klonopin (clonazepam), Depakote (valproic acid), Dilantin (phenytoin), Tegretol (carbamazepine), Celotin (methsuximide), Neurotin (gabapentin)

Question 2

Antispasticity Agents

Answer 2

Action: Promote relaxation in a spastic muscle.
Side effects: drowsiness, confusion, headache, dizziness, generalized muscle weakness, hepatotoxicity potential with Dantrium, tolerance, dependence
Examples: Lioresal (baclofen), Valium (diazepam), Dantrium (dantrolene), Zanaflex (tizanidine)

Question 3

Cholinergic Agents

Answer 3

Action: Mimics acetylcholine and binds to cholinergic receptor (direct) or stimulates increased cholinergic synapse activity by inhibiting acetylcholinesterase (indirect)
Indications: glaucoma, dementia due to Alzheimer’s, post-op decrease in GI motility, myasthenia gravis, reversal of anticholinergic toxicity
Side effects: GI distress, impaired visual accommodation, bronchoconstriction, bradycardia, flushing, parasympathetic effects
Examples: Direct: Duvoid (bethanechol), Pilocar (pilocarpine). Indirect: Aricept (donepezil), Tensilon (edrophonium), Prostigmin (neostigmine), Cognex (tacrine)

Question 4

Dopamine Replacement Agents

Answer 4

Action: relieve symptoms of Parkinson’s disease due to decrease in endogenous dopamine.
Side effects: arrhythmias, GI distress, orthostatic hypotension, mood and behavioral changes, tolerance
Examples: Sinemet or Madopar (levadopa), Symmetrel (amantadine)
PT implications: maximal benefit from scheduling therapy 1 hour after administration of levodopa

Question 5

Muscle Relaxant Agents

Answer 5

Action: promotes relaxation in muscles that present with spasm or tonic contraction. Spasms usually occur secondary to musculoskeletal or peripheral nerve injury rather than CNS injury.
Side effects: sedation, drowsiness, dizziness, nausea, vomiting, headache, tolerance, dependence
Examples: Valium (diazepam), Flexeril (cyclobenzaprine), Paraflex (chlorzoxazone)