Pharmacology

Question 1

Tissue plasminogen activator

Answer 1

Gold standard for ischemic strokes

Administered with 3 hours of symptom onset (up to 4.5 hours for some patients)

Question 2

Mechanical thrombectomy

Answer 2

Removal of clot after stroke with shape-memory-polymer corkscrew device

Question 3

Anticoagulation therapy for stroke

Answer 3

Heparin (Lovenox)

Warfarin (Coumadin)

Question 4

Antiplatelet therapy after stroke

Answer 4

Aspirin

Question 5

Baclofen

Answer 5

GABA receptor agonist
Oral or intrathecal
For spasticity

Question 6

Diazepam

Answer 6

Valium
Benzodiazepine
Typically for anxiety, but can treat spasticity

Question 7

Dantrolene

Answer 7

Muscle relaxant

Can treat spasticity

Question 8

Botulinum toxin

Answer 8

Neurotoxic protein

Local effects for spasticity lasting 3-4 months

Question 9

Medical interventions for acute SCI

Answer 9

Methylprednisone to reduce extent of damage
Must be administered within 8 hours of injury and for only 24-48 hours after
Anti-inflammatory and immunosuppresion

Question 10

Relapse/exacerbation management in MS

Answer 10

Corticosteroids, IV or oral

High dose, short duration

Question 11

Injectable meds for MS

Answer 11

Disease modifying
Avonex or Rebif (Interferon beta-1a)
Betaseron (Interferon beta-1b)
Copaxone (glatiramir acetate)

Question 12

Oral meds for MS

Answer 12

Disease modifying
Aubagio (teriflunomide)
Gilenya (finfolimod)
Tecfidera (dimethyl fumarate)

Question 13

Infused meds for MS

Answer 13

Disease modifying
Novantrone (mitoxantrone)
Tysabri (Natalizumab)
Lemtrada (Aletzumab)

Question 14

Sinemet

Answer 14

Levopdopa-carbidopa
Levodopa- precursor to dopamine to cross BBB
Carbidopa- prevents levodopa from converting in periphery
Side effects- nausea, drowsiness, orthostatic hypotension, dyskinesia, motor fluctuations, hallucinations

Question 15

Dopamine agonists for PD

Answer 15

Directly stimulate dopamine receptors
Initial or adjunct therapy
May delay or reduce motor fluctuations and dyskinesia
Not as effective as Sinemet but relief of sx with longer half-life
Mirapex, Requip, Neupro

Question 16

COMT inhibitors for PD

Answer 16

Prevent peripheral degradation of levodopa
May decrease off time or reduce levodopa dose necessary for clinical effect
Comtan, Tasmar

Question 17

MAO type-B inhibitors for PD

Answer 17

Block breakdown of dopamine in brain

Selegiline, Rasagiline

Question 18

Anticholinergics for PD

Answer 18

Reduce over-activity of acetylcholine; inhibit dopamine reuptake in striatum
Used mainly for tremors and rigidity
Artane, Cogentin

Question 19

Amantadine for PD

Answer 19

Dopamine agonist and dopamine reuptake inhibitor
Often used to treat dyskinesia
Symmetrel, Kemadrin

Question 20

Tetrabenazine for HD

Answer 20

Specifically approved to suppress chorea

Question 21

Med management for essential tremor

Answer 21

Beta blockers
Anti-seizure meds
Tranquilizers
Botox injections
Anti-psychotics
Antidepressants
DBS

Question 22

Med management for dystonia

Answer 22

Dopaminergics
Anticholinergics
GABA agonists
Anti-convulsants
Botox injection
DBS

Question 23

Disease-modifying drug for ALS

Answer 23

Riluzole
Decreases glutamate release
Prolongs survival 2-9 months
Expensive

Question 24

Acute med management of GBS

Answer 24

Plasma exchange and IVIg- shorten course and severity
IVIg preferred because easier to administer and associated with fewer complications
Oral corticosteroids delay recovery
IV corticosteroids do not affect long-term outcomes

Question 25

Myasthenia gravis meds

Answer 25

Corticosteroids and immunosuppressants