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Neuro Clin Med > Pharmacology and Neurological Conditions > Flashcards

Pharmacology and Neurological Conditions Flashcards

1
Q

Why do PT’s need to know pharmacology?

How to _____ ____ medication
How to understand the _____ of ________
How to find _____ _______
What do these ______ _____ mean for practice?

A

look up
mechanism; action
side effects
side effects

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2
Q

Pharmacology and Neurorehabilitation

Types of medications
Those acting on the ______ ______, ______, ________ ______

Those used in prevention of ________ ________ to the nervous system

Those used in treatment of _______ _______ that could impact the nervous system

Those used to treat ________ ________ of nervous system impairment

A

nervous system, brain, spinal cord

adverse events

secondary conditions

secondary complications

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3
Q

CVA:
Acute management
__________

A

clotting

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4
Q

TBI:
Acute management
________ _________

A

secondary complications

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5
Q

MS:
Acute management
________ __________ medications

A

disease modifying

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6
Q

We are looking at the ________ _________ goals not PT management goals

A

pharmacologic management

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7
Q

Outputs from the ________ get to the body in a two-part ______

A

CNS; circuit

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8
Q

UMNs are contained in the _________

A

CNS

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9
Q

LMNs are contained in the ________

A

PNS

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10
Q

UMN symptoms:

Generally _____ T12
_______reflexia
________tone/spasticity
Postive ______ signs
_______ or ________ bladder and bowel

A

above
hyper
increased
UMN
spastic; hyperreflexive

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11
Q

LMN symptoms:

Generally _____ T12
______reflexia
_________
___________ tone/spasticity
________ UMN signs
________ bladder and bowel

A

below
hypo
flaccidity
decreased
negative
flaccid

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12
Q

CVA:
This disorder is caused by an _______ of _________ _________

A

irregularity; blood supply

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13
Q

CVA:
A bleed = _______
A clot = ________

A

hemorrhagic
ischemic

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14
Q

An ischemic stroke can possibly be reversed with this medication?

A

tPA (Tissue Plasminogen Activator)

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15
Q

tPA is a ___________

A

thrombolytic

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16
Q

tPA’s mechanism of action: initiates fibronolysis by binding to fibrin and thrombus, which means what…?

A

It helps break down clots

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17
Q

tPA should be administered within what hours of an ischemic event?

A

3-4.5 hours

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18
Q

tPA is given after ____ or ______ and _______ _______ monitoring to ensure it is ischemic

A

CT; MRI
blood glucose

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19
Q

Contraindications to tPA:
Active ________ ________

Suspected _______ _______

Recent (within 3 months) _______ or _________ surgery or severe ________ ______

__________ hemorrhage

_______ stroke within the last 3 months

A

internal bleeding

aortic dissection

intracranial; intraspinal
head trauma

subarachnoid

Ischemic

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20
Q

What is the main risk of tPA?

A

hemorrhage

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21
Q

If the problem in ischemic CVA is a clot or embolus, medication should target ________

A

anticoagulation

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22
Q

Heparin is typically administered by ?

A

IV (hospital)
injection

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23
Q

________ MOA: works to prevent 2 steps in the clotting cascade from happening

A

Heparin

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24
Q

With Heparin, it’s not always routine post ______ but can be used if there is concern for _______ _______

A

CVA
secondary emboli

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25
Q

What is the main risk/side effect for Heparin, Lovenox, and Coumadin?

A

hemorrhage

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26
Q

PT implications for Heparin:

Check ____/______/_____
At risk for ________ hemorrhage
Not a line you should _______ for mobility!

A

PT/PTT/INR
uncontrolled
disconnect

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27
Q

Lovenox is typically administered by _____ and rarely _____

A

Injection
IV

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28
Q

Lovenox MOA: is a low molecular weight _____, meaning it works the same way but has less effect on _______ compared to heparin and has a longer _____ ______

A

heparin
thrombin
half life

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29
Q

PT Implications for Lovenox:
Check _____/______/______
At risk for uncontrolled _______

A

PT/PTT/INR
hemorrhage

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30
Q

Coumadin is administered _________

A

orally

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31
Q

Coumadin MOA: depletes functional Vitamin _____ availability necessary for ________ of certain clotting factors

A

K
synthesis

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32
Q

Coumadin is often for more _______ stages
-treatment of ______ disorders
- __________ of _____________ complications

A

chronic
cardiac
prophylaxis; thromboembolic

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33
Q

PT implictions for Coumadin:
Check _____/_________/______
At risk for _________ hemorrhage

A

PT/PTT/INR
uncontrolled

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34
Q

INR stands for ?

A

International Normalizing Ratio

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35
Q

INR of ___-_____ is considered normal/normal activity

A

0.8; 1.2

36
Q

INR < 4.0 is safe for _____ and regular ________ program, there should be NO increase in _______ of exercises

A

eval; exercises
intensity

37
Q

An INR ___-_____, the patient should NOT perform resistance exercises and only light exercise

A

4.0; 5.0

38
Q

With an INR of ___-_____, you should hold exercise

A

5.0; 6.0

39
Q

With an INR of > _______, the patient is on bed rest

A

6.0

40
Q

The INR measures what?

A

how long it takes your blood to clot

41
Q

With a high INR a person is more likely to….?

A

bleed excessively

42
Q

_________ + _____ _______ ________ in vessels increases the risk of a clot

A

Hypercoagulability
high blood pressure

43
Q

Antihypertensives treat conditions such as _____

A

CVA

44
Q

Three types of TBI?

A

mild (concussion)
moderate
severe

45
Q

_________ of the brain is a key concern for TBI

A

Swelling

46
Q

Moderate and severe TBIs may come with _______ brain damage from _____, ______, etc

A

structural
bleeds
hematomas

47
Q

What is considered normal ICP?

A

5-20 mmHg

48
Q

___________ : dehydrates intracellular fluid and pulls it into the blood stream to decrease ICP

A

Mannitol

49
Q

Mannitol acts like a _______
Risks: Low _____ and kidney _______

A

diuretic
CPP
necrosis

50
Q

_________ ________ ________: increases the osmolarity of the blood pulling fluid from the extravascular space into the intravascular space decreasing ICP

A

Hypertonic Saline Bolus

51
Q

High- dose pentobarbital/thiopental therapy: Reduce _______ _____ and _______ ______ flow which in turn reduces ICP for a neuroprotective effect

A

brain metabolism
cerebral blood flow

52
Q

Increased ______ can be a side effect of TBI

A

fatigue

53
Q

________ has been used to safely improve arousal and cognition in patients with TBI

A

Amantadine

54
Q

Amantadine side effects with PT implications: ________ _______, ________

A

orthostatic hypotension
dizziness

55
Q

The MOA for Amantadine is _______

A

unknown

56
Q

Benzodiazepines are commonly prescribed after _____

A

TBI

57
Q

This medication’s meta-analysis shows limited impact compared to placebo?

A

Benzodiazepines

58
Q

With Benzodiazepines, long-term studies show ______ rather than

A

injury
benefit

59
Q

These are side effects of taking __________:

Fall risk
Low energy
Memory loss
Anxiety
Resipiratory depression
Syncope
Tremor

A

Benzodiazepines

60
Q

What are the secondary complications with a TBI?

A

Arousal
Anxiety/Depression
Seizures
Spasticity

61
Q

Most seizures after a trauma happen in the first _____ hours

A

24

62
Q

The most common seizure medication is ________ ( _______ )

A

Phenytoin (Dilantin)

63
Q

Phenytoin (Dilantin) MOA: changes ______ ______ channels distribution to make _______ less likely in the motor cortex

A

sodium ion
depolarization

64
Q

_________ ( _______) side effects: slurred speech, ataxia, drowsiness, hypotension, arrthymia, bradycardia, v-fib

A

Phenytoin (Dilantin)

65
Q

Besides Phenytoin (Dilantin), what is another common seizure medication?

A

Levetiracetam (Keppra)

66
Q

Levetiracetam (Keppra) MOA: unknown, but speculated that it effects ______ channels also increases the _______ effect of GABA

A

calcium
inhibitory

67
Q

Side effects of ________ ( ______ ):
depression, paranoid behavior, hallucinations, agitation, suicidal ideation, dyskinesia

A

Levetiracetam (Keppra)

68
Q

Which two medications control spasticity of TBIs?

A

Baclofen
Botox

69
Q

Baclofen MOA: following ______ lesions can become hyperreflexive and have high ______. Baclofen inhibits reflexes at the ______ _____ and dcreases overall spasticity and tone

A

UMN
tone
spinal cord

70
Q

Baclofen can be taken ______ adnd through ________

A

orally
intrathecal

71
Q

With intrathecal administration, a pump is surgically inserted near the _______, and the medicine goes straight into the _____ ______

A

abdomen
spinal canal

72
Q

Side effects of ________: low tone, paresthesias, drowsiness, confusion, severe withdrawal symptoms, nausea/vomiting

A

Baclofen

73
Q

Botox MOA: It is a _______ that acts on the presynaptic side of the neuromuscular junction producing a temporary state of __________ until the nerve fibrils grow back

A

neurotoxin
denervation

74
Q

Botox is typically _______ into targeted specific muscles

A

injected

75
Q

______ side effects: Low tone in certain muscle groups, GI problems, pain

A

Botox

76
Q

Which medicatons are prescribed for MS Acute management or flare ups?

A

Corticosteroids: Methylprednisolone

77
Q

Corticosteroids: Methylprednisolone for MS are often given by _____

A

IV

78
Q

MOA for Methylprednisolone: decreases ________ migration and capillary ________

A

leukocyte
permeability

79
Q

Methylprednisolone side effects: ____ gain, _____glycemia, _____ changes, ________ suppression, and impaired _____ ______

A

weight
hyper
CNS
adrenal
bone growth

80
Q

You have a patient following a brain injury who is having difficulty staying awake during the day. Which of the following medications might the Physical Medicine and Rehabilitation team consider using to remedy this?

A

Amantadine

81
Q

You have a patient who has cardiopulmonary complications and is high risk for DVT following a medical procedure. Which of the following medications would be BEST to administer prophylactically due to having a longer half-life to prevent clots?

A

Lovenox

82
Q

You have a patient who has cardiopulmonary complications and is high risk for DVT following a medical procedure. Which of the following medications would be BEST to administer prophylactically due to having a longer half-life to prevent clots?

A

control blood pressure

83
Q

Which of the following vitals would be most crucial to track in a patient with TBI who had just received Phenytoin (Dilantin) for a seizure?

A

heart rate

84
Q

How does Baclofen
control spasticity?

A

It provides top down inhibitory control UMN signs

85
Q

Lovenox timing of use:

_______ in CVA to prevent secondary clots

  • used in treatment of _____ d/o’s
  • ______, _______ prophylaxis
A

subacute
cardiac
DVT, VTE

Neuro Clin Med (2 decks)

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