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Human Disease and Therapeutics > Quiz Two Material > Flashcards

Quiz Two Material Flashcards

1
Q

What are the 8 causes of Neuro-degenerative diseases?

A
  1. Hypoxia, 2.Excitatory Amino Acids, 3. Ion fluxes, 4. Free Radicals, 5. Immune Responses, 6. Infections, 7. Apoptosis and 8. Protein Aggregation
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2
Q

What two medications directly combat Parkinson’s Disease?

A

Levadopa and Carbadopa

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3
Q

What drug inhibits DA breakdown?

A

Azilect

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4
Q

What drug improves the affect of Levadopa+Carbadopa?

A

Entacapone

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5
Q

What anti-cholenergic drug is used in the early stages of Parkinson’s?

A

Benztropine

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6
Q

How does Entacapone work?

A

It inhibits COMT

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7
Q

What drug is an agonist for the D2 receptor and fights Parkinson’s?

A

Pramlpexole

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8
Q

What is the only MAO inhibitor that seems to slow Parkinson’s?

A

Selegilline

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9
Q

Which two areas of the brain can be removed to treat Parkinson’s?

A

Globus Palidus and Thalamus

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10
Q

Every anti-Parkinson drug except Selegilline causes what symptom?

A

Xerostomia

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11
Q

What other dental problem is common in Parkinson’s?

A

Bruxism

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12
Q

What stains saliva in Parkinson’s?

A

L-DOPA

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13
Q

How long should a dental appointment be with a Parkinson patient?

A

45 minutes

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14
Q

How long after medications are taken should a Parkinson patient be seen?

A

90 minutes

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15
Q

How many cartridges of lidocaine are allowed for a Parkinson patient?

A

2-3

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16
Q

What mechanistically causes Huntington’s disease?

A

Excess DA

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17
Q

What effect does the parent that gave you Huntington’s disease have on the progression of the disease?

A

Father = quicker to surface, mother = later in life

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18
Q

What drug depletes DA to combat Huntington’s disease’s spastic motions?

A

Reserpine

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19
Q

What are the plaques made of in Alzheimer’s disease?

A

Beta-amyloid

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20
Q

What forms the neurofibrillary tangles?

A

Tau Protein

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21
Q

What causes the formation of Tau Proteins?

A

Decrease in ACh

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22
Q

What should be done physiologically to help Alzheimer’s patients?

A

Increase ACh - do this by inhibiting Cholinesterases

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23
Q

What drug is used as an inhibitor of cholinesterases in Alzheimer’s disease?

A

Donepezil

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24
Q

What type of drug tends to cause problems with local anesthesia?

A

MAO inhibitors

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25
Q

What race has a high incidence of MS?

A

Scandanavians

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26
Q

What race has a low incidence of MS?

A

Japanese

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27
Q

What are the four classifications of MS?

A
  1. Benign, 2. Relapsing remission, 3. relapsing progressive and 4. chronic progressive
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28
Q

What should be used to manage MS relapses?

A

Prednisone

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29
Q

What should be used to treat bladder problems in MS?

A

Tamsulosin

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30
Q

What should be used to treat bowel dysfunction problems in MS?

A

Metamucil

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31
Q

What should be used to treat fatigue problems in MS?

A

Modafinil

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32
Q

What should be used to treat pain problems in MS?

A

gabapentin

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33
Q

What should be used to treat tremor problems in MS?

A

clonazepam

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34
Q

What are the three components of pain?

A
  1. Sensory-discriminative, 2. cognitive and 3. emotional
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35
Q

What activates TRPV1 and can be used as a pain reliever?

A

Capsaicin

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36
Q

What causes secondary activation of nociceptive nerves?

A

Substance P/positive feedback loop

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37
Q

What is the name used for increased pain in a particular area and is usually used to promote healing?

A

Hyperalgesia

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38
Q

What is the term that describes extreme pain caused by ordinary tasks?

A

Allodynia

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39
Q

How does sensitization occur?

A

Chemical messengers are released that make nociceptors easier to excite

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40
Q

What are the two main chemical messengers of sensitization?

A
  1. Substance P and 2. Prostaglandins
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41
Q

Which COX is present in all cells constitutionally?

A

COX 1

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42
Q

Which COX is induced?

A

COX 2

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43
Q

Which COX(s) are targeted by NSAIDs?

A

COX 1 and 2

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44
Q

What drug only targets COX 2?

A

Celebrex

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45
Q

What type of damage is usually associated with visceral pain?

A

Mechanical

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46
Q

What are the fast pain fibers?

A

Alpha/Delta

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47
Q

What are the slow pain fibers?

A

C axons

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48
Q

What is the pain center of the brain?

A

Thalamus

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49
Q

Where is nociceptive input heavily modulated?

A

Dorsal horn

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50
Q

Where is the major site for analgesic drugs?

A

Dorsal horn

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51
Q

Where is the major site for opioids?

A

Dorsal horn

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52
Q

What is “gate control”?

A

Inhibition of pain by strong touch stimulation

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53
Q

What is the natural opioid?

A

Endorphin

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54
Q

What effect do drugs that enhance the action of 5HT and NE have on pain?

A

They lower pain

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55
Q

What drug type does NO work well with?

A

NSAIDs

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56
Q

What are the four types of nociceptive receptors?

A
  1. Chemical, 2. Mechanical, 3. Thermal and 4. Polymodal
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57
Q

What is TRP?

A

Transient Receptor Potential - basically the ability to change how stimuli occur

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58
Q

What are P type nociceptors?

A

Prostaglandin type and Purino/Pyrimadine receptors

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59
Q

What two particular cell types are influenced by substance P?

A
  1. Mast cells and 2. Platelets (inflammation response)
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60
Q

In pain modulation, what are the two important pain neurotransmitters?

A
  1. Glutamate and 2. Substance P
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61
Q

What is the second anti-nociceptive function of NSAIDs?

A

Inhibition of synthesis of prostoglandins in the dorsal horn

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62
Q

Where in the brain is the key locus?

A

Mesencephalic periacqueductal gray enkephalin

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63
Q

What three types of drugs can lessen neuropathic pain?

A
  1. antidepressants, 2. anticonvulsants and 3. corticosteroids
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64
Q

What is a non-opioid, non-NSAID drug used for pain?

A

acetaminophen

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65
Q

How many AAs are in enkephalins?

A

5

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66
Q

How many AAs are in B-endorphines?

A

91

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67
Q

How many AAs are in dynorphines?

A

17

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68
Q

What is the key role of endorphines?

A

Pain inhibition

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69
Q

What do pain suppressants enhance to lessen pain (2)?

A

5HT and NE

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70
Q

What are placebos associated with that can eliminate pain?

A

Endogenous analgesic system

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71
Q

What four side effects are there of salicylates?

A
  1. GI erosion, 2. Reyes syndrome in children, 3. Anti clotting (up to 2 weeks and 4. Tinnitis
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72
Q

What type of pain does salicylate medication treat?

A

Mild to moderate somatic pain

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73
Q

What are the three drawbacks to Ibuprofen?

A
  1. GI erosion (less than aspirin), 2. Anti-clotting (less than aspirin) and 3. Cardiac effects
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74
Q

What is important about ketoprofen?

A

It is smaller and more potent than Ibuprofen with similar effects

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75
Q

What is important to know about naproxen?

A

Slower acting and longer-lasting type of Ibuprofen (Aleve)

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76
Q

What is a pro of using Celebrex?

A

No GI or anti-clotting side effects

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77
Q

What is the danger of using Celebrex?

A

Heart problems

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78
Q

Despite its potency, why is the Ibuprofen-like non-selective Indomethacin not commonly used?

A

Bad side effects

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79
Q

What is special about Meloxicam?

A

Preferential inhibition of COX 2 over COX 1, meaning less GI issues

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80
Q

What drug is related to salicylates and is supposed to be good for bone pain?

A

Diflunisal

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81
Q

What are the mechanisms of acetaminophen (3)?

A
  1. Not a COX 1/2 inhibitor, 2. Not anti-inflammatory and 3. Inhibits COX 3 enzyme or 5HT
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82
Q

What are the benefits of using acetaminophen?

A
  1. Good anti-pyretic in kids and 2. No Ibuprofen/aspirin side effects
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83
Q

What is the danger to taking acetaminophen?

A

Liver damage/failure

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84
Q

What are three contraindications to taking NSAIDs?

A
  1. Anticoagulants, 2. Hemophiliac and 3. GI ulcers
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85
Q

What is Fentanyl used for?

A

Opioid narcotic of extreme potency used for cancer patients - .1 mg dose!

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86
Q

What is a therapeutic dose of morphine?

A

10 mg

87
Q

What is a therapeutic dose of Hydromorphone?

A

1.5 mg

88
Q

What is a therapeutic dose of Oxymorphone?

A

1 mg

89
Q

What is a therapeutic dose of Codeine?

A

200 mg

90
Q

What is a therapeutic dose of Hydrocodone + Acetaminophen?

A

30 mg

91
Q

What is a therapeutic dose of Oxycodone?

A

20 mg

92
Q

What is important to remember about the opioid narcotic Meperidine?

A

Moderate pain reliever

93
Q

What is important to remember about the opioid narcotic Pentazocin?

A

Moderate pain relief with a twist - at high doses this becomes an antiagonist and discourages abuse

94
Q

What is important to remember about the opioid narcotic Methadone?

A

Moderate to strong painkiller typically used for recovering from opioid addiction

95
Q

What is important to remember about the opioid narcotic Buprenorphine?

A

Moderate painkiller with agonist/antagonist mix - used for recovering addicts

96
Q

What are the four side effects to taking opioid narcotics?

A
  1. Respiratory depression, 2. Constipation, 3. Sedation and 4. Euphoria/dependence
97
Q

What medication should be used on a patient that has overdosed on opioids?

A

Narcan

98
Q

What three things can NSAIDs be added to in order to treat pain more potently?

A
  1. Caffeine, 2. Acetaminophen and 3. Narcotics
99
Q

What three drugs are the first treatment for trigeminal neuralgia?

A
  1. Gabapentin, 2. Duloxetine and 3. Nortriptyline
100
Q

What is the next-line treatment of trigeminal neuralgia?

A

Tramadol

101
Q

How many Americans are abusing drugs?

A

9 million per year, 4 million on a monthly basis

102
Q

What are the HS senior abuse rates for prescription drugs, Oxycontin, and Vicodin?

A

Prescription drugs = 15%, Oxycontin = 5% and Vicodin - 4%

103
Q

How many overdose deaths on prescription drugs are there in Utah in a year?

A

> 300

104
Q

What organization monitors drug prescriptions?

A

DOPL (Division of Occupational and Professional Licensing)

105
Q

What falls under DSM axis I?

A

All psychiatric categories minus mental retardation and personality disorder

106
Q

What falls under DMS axis II?

A

Personality disorders and mental retardation

107
Q

What falls under DMS axis III?

A

Acute medical conditions and physical disorders (such as meningitis)

108
Q

What falls under DMS axis IV?

A

Psychosocial and environmental factors contributing to the disorder

109
Q

What falls under DMS axis V?

A

Global assessment of teens and kids under 18

110
Q

What are the six criteria tested for in an MSE?

A
  1. Mood, 2. affect, 3. thought, 4. appearance, 5. cognitive function and 6. dental problems
111
Q

If there is an organic change to the brain, what does that mean?

A

Disease or accident has changed the brain on the gross scale

112
Q

If there is an inorganic change to the brain, what does that mean?

A

No particular visible - all changes to the molecular level

113
Q

What are the two biggest reasons that patients do not seek dental care?

A
  1. Cost and 2. Fear
114
Q

What does an EEG measure?

A

Brain surface electrical activity

115
Q

What does a CT scan show?

A

Slices - can show gross disruption

116
Q

What does an MRI show?

A

Blood oxygen and where it goes - can show if there are areas of the brain that are not getting nutrients

117
Q

What does a PET scan show?

A

Where metabolism is occuring

118
Q

What is psychosis?

A

Altered sense of reality, cognition and emotions

119
Q

How much do psychotic disorders cost in the US each year?

A

40 billion

120
Q

What percentage of the population is affected by psychotic disorders?

A

1%

121
Q

Which psychotic disease lacks the prepulse inhibition?

A

Schizophrenics

122
Q

What are the DSM criteria for Schizophrenia (3)?

A
  1. Over 6 months, 2. Unable to care for self and 3. No drugs or trauma
123
Q

What sub-type of Schizophrenia has blunted affect (no facial or body expressions), is incoherent, does not have delusions, and has bizarre mannerisms (facial grimacing and distortions)?

A

Disorganized Type

124
Q

What sub-type of Schizophrenia is non-responsive but aware what is going on, is Gumbi-like, and has rigid posturing?

A

Catatonic Type

125
Q

What sub-type of Schizophrenia has positive symptoms (delusions/hallucinations), is aggressive and potentially dangerous, and is the best type to treat with medications?

A

Paranoid Type

126
Q

What sub-type of Schizophrenia has negative symptoms (socially withdrawn), no delusions, flat affect, represents the later stages of the disease, and is the hardest to treat with medications?

A

Residual Type

127
Q

How much lower is a Schizophrenic’s life expectancy than a normal person’s?

A

10-30 years

128
Q

What percentage of Schizophrenics commit suicide?

A

10%

129
Q

What five features mark a better prognosis for a Schizophrenic?

A
  1. Positive symptoms, 2. Dangerous/violent, but responds to medications, 3. >30 years old, 4. Female and 5. No family history
130
Q

What regular body function is lost in Schizophrenics?

A

Yawning

131
Q

Should a Schizophrenic exhibit positive symptoms, what neurotransmitter is being released in excess?

A

DA

132
Q

Should a Schizophrenic exhibit negative symptoms, what neurotransmitters are being released in excess (2)?

A
  1. 5HT and 2. Glutamate
133
Q

What are the odds that both identical twins will get Schizophrenia if one twin gets it?

A

40-50%

134
Q

What are the odds that both nonidentical twins will get Schizophrenia if one twin gets it?

A

10%

135
Q

What are the odds that both siblings will get Schizophrenia if one gets it?

A

10%

136
Q

What are the odds of getting Schizophrenia if one parent has it?

A

10-15%

137
Q

What are the odds of getting Schizophrenia if both parents have it?

A

30-40%

138
Q

What mechanism do Schizophrenia medications employ?

A

Block D2 receptors

139
Q

What are the three benefits of Schizophrenia medications?

A
  1. Reduce psychotic symptoms, 2. Enhance cognition and 3. Alleviate depression
140
Q

What are the two Extrapyramidal side effects seen in Schizophrenic medications?

A
  1. Tardive dyskinesia and 2. Parkinson’s-like tremors
141
Q

What are the four biggest drawbacks to using a Schizophrenic medication?

A
  1. Sleepiness, 2. Endocrine disruption, 3. Pseudo depression and 4. Weight gain
142
Q

What two anti-Schizophrenic drugs are grouped under Phenothiazines?

A
  1. Chlorpromazine and 2. Thioridizine
143
Q

What are three benefits to taking a phenothiazine?

A
  1. Least expensive, 2. less extrapyramidal side effects, and 3. anti-vomiting
144
Q

What are two drawbacks of taking a phenothiazine?

A
  1. Heavy sedation and 2. high weight gain
145
Q

What anti-Schizophrenic drug is grouped under Butyrophenones?

A

Haloperidol

146
Q

What is the pro of taking Butryophenones?

A

They lack the anticholenergic side effects

147
Q

What is the con of taking Butryophenones?

A

High extrapyramidal side effects

148
Q

What is an advantage of Haloperidol?

A

Inexpensive due to high usage

149
Q

What mechanism of action do Atypical Antipsychotic drugs have?

A

D2 and 5HT2A antagonism

150
Q

What is the pro of using an Atypical Antipsychotic drug?

A

Little extrapyramidal effects

151
Q

What symptoms are Atypical Antipsychotic drugs most useful against?

A

Negative symptoms

152
Q

What are the three Atypical Anticpsychotic drugs that we need to know?

A
  1. Clozapine, 2. Quetiapine, and 3. Olanzepine
153
Q

What is the drawback to using Clozapine?

A

1-2% of patients have serious agranulocytosis

154
Q

What is the advantage of using Quetiapine or Olanzepine?

A

Newer drugs with less side effects

155
Q

What three things make up a case of Acute psychotic disorder?

A
  1. Stress related, 2. delusions/hallucinations possible and 3. fast recovery
156
Q

What disease is Schizoaffective like?

A

Bipolar disorder

157
Q

Who is a well-known case of Schizoaffective?

A

Mary Todd Lincoln

158
Q

What percentage of the population is subject to some sort of mood disorder?

A

3-8%

159
Q

What are the five classifications for someone to likely be diagnosed with Dysthymia depression?

A
  1. > 2 years, 2. lowered mood/anhedonia, 3. 6% of population, 4. 2:1 female:male ratio and 5. 20-30 years old
160
Q

What is cyclothymia?

A

Cyclical changes from dysthymia to mania

161
Q

What are the three classifications for someone to likely be diagnosed with Cyclothymia?

A
  1. > 2 years, 2. No gender bias and 3. no drugs used
162
Q

What percentage of the population has major depression?

A

6%

163
Q

How long does it take anti-depression drugs to kick in?

A

4-8 weeks

164
Q

What is the effective percentage of anti-depression drugs?

A

70%

165
Q

What anti-depression medication group was the first to be discovered?

A

MAO Inhibitors

166
Q

What are the six side effects of using an MAOI?

A
  1. Altered autonomics, 2. Orthostatic hypotension, 3. weight gain, 4. some act as stimulants, 5. may interact with cheese and beer to cause sympathomimetic effects and 6. May interact with OTC cold medicines
167
Q

What are two examples of MAOIs?

A
  1. Phenelzine (MAO A/B) and 2. Selegilline (MAO B)
168
Q

What is the benefit of taking a tricyclic antidepressant?

A

Long-lasting - one pill a day

169
Q

What is the mechanism of action for tricyclic antidepressants?

A

Block NE reuptake and vary affinity of 5HT transporter

170
Q

What are the four side effects of using a tricyclic antidepressant?

A
  1. Dry mouth, 2. H1 blockade (works against allergies/has hypnotic effect), 3. some orthostatic hypotension and 4. withdrawals occur if abruptly ended
171
Q

What are three examples of tricyclic antidepressants?

A
  1. Amytriptyline, 2. Desipramine and 3. Doxepin
172
Q

What are the four benefits to using a 5HT monoamine uptake blocker?

A
  1. Well tolerated, 2. very popular, 3. relatively wide margin of safety and 4. No anticholenergic activity
173
Q

What are the four side effects of using a 5HT monoamine uptake blocker?

A
  1. GI upset, 2. sexual dysfunction, 3. depression (adolescents) and 4. headaches
174
Q

What are two examples of 5HT monoamine uptake blockers?

A
  1. Fluoxetine (Prozac) and 2. Sertraline (Zoloft)
175
Q

What is the advantage of using an NE monoamine uptake blocker?

A

Reasonably well tolerated

176
Q

What are the two disadvantages of using an NE monoamine uptake blocker?

A
  1. More CVS side effects and 2. A moderate CNS stimulant (leads to anxiety, insomnia, etc.)
177
Q

What two drugs are examples of NE monoamine uptake blockers?

A
  1. Venlafazine and 2. Duloxetine
178
Q

How does lithium carbonate likely work?

A

By interfering with second messengers

179
Q

What are the three advantages of using lithium carbonate?

A
  1. Slow onset, 2. can be combined with anti-depressants and 3. Amongst the most potent mood stabilizers
180
Q

What are the six disadvantages of using lithium carbonate?

A
  1. Blood checks (due to narrow therapeutic window), 2. Tremors, 3. Kidney damage, 4. Weight gain, 5. Edema and 6. Compliance problems
181
Q

What are the two advantages to using anti-epileptic drugs for treating bipolar disorder?

A
  1. Fewer side effects and 2. Better compliance
182
Q

What are the three disadvantages of using anti-epileptic drugs for treating bipolar disorder?

A
  1. More $, 2. Less potent and 3. Used for maintenance after lithium start
183
Q

What are the three examples of anti-epileptic drugs that can be used for treating bipolar disorder?

A
  1. Valproic Acid, 2. Carbamazepine and 3. Lamotrigene
184
Q

What mechanism do Benzodiazepines use to treat anxiety?

A

Modulate GABA A

185
Q

What are the four benefits to using Benzodiazepines?

A
  1. Little effect on respiration, 2. most popular CNS depressant, 3. Anxiolytic and 4. Treats seizures
186
Q

What are the three side effects of using Benzodiazepines?

A
  1. Muscle relaxation, 2. Insomnia and 3. Alcohol withdrawal
187
Q

What are the seven adverse effects of using Benzodiazepine?

A
  1. Tolerance/dependence, 2. Synergism with depressants, 3. Drowsiness/motor impairment (don’t drive), 4. Decrease cognition, 5. Children have paradoxical reaction, 6. Elderly have increased depressant action and 7. Shouldn’t be used on people with intellectual disability or major depression
188
Q

What two drugs are the sedative version of Benzodiazepine?

A
  1. Diazepam and 2. Alprazolam
189
Q

What two drugs are the hypnotic version of Benzodiazepine?

A
  1. Lorazepam and 2. Triazolam
190
Q

How long do Benzodiazepine sedatives last?

A

8-12 hours

191
Q

How long do Benzodiazepine hypnotics last?

A

2-4 hours

192
Q

How do Barbituates function?

A

They enhance GABA

193
Q

What is pentobarbital used for?

A

Anesthesia induction

194
Q

What are the four disadvantages of using Barbituates?

A
  1. Major depression of respiration, 2. Severe tolerance/addiction, 3. Narrow margin of safety and 4. major interactions with liver
195
Q

What are the three indications for Bupropion?

A
  1. Anxiety or tension with everyday stress, 2. Co-existing depression (often) and 3. Short-term use
196
Q

What are four potential side effects of using Bupropion?

A
  1. Not particularly addicting, 2. Rare movement problems and seizures, 3. Irregular heart beat (rare) and 4. Interacts with MAOI and antiseizure medications
197
Q

What are the two treatment options for severe acute anxiety panic attacks?

A
  1. SSRI (selective Seratonin reuptake inhibitors) and 2. Antidepressants with mixed effects
198
Q

What should be used to treat phobic disorders?

A

SSRIs

199
Q

What two stimulant drugs are typically used to treat ADD/ADHD?

A
  1. Amphetamines (Adderol) and 2. Methylphenidate (Ritalin)
200
Q

What non-stimulant drug can be used to treat ADD/ADHD?

A

Modafinil

201
Q

What are the three benefits of using Modafinil?

A
  1. Better tolerance, 2. Less abuse potential and 3. Less side effects
202
Q

What are the three side effects of using Modafinil?

A
  1. Upset GI, 2. Minor headaches and 3. Alters sleep
203
Q

What three diseases have been linked to autism?

A
  1. Fragile X syndrome, 2. Congenital rubella syndrome and 3. PKU
204
Q

What are autistic patients more vulnerable to?

A

Mercury

205
Q

What type of medication may help autistic patients with aggression, repetitive or psychotic behavior?

A

SSRIs (Atypical antipsychotics)

206
Q

What is the only medication that was listed to treat anorexia/bulemia?

A

Fluoxetine (Anti-depressant)

207
Q

How much does alcohol cost the US in billions of dollars each year?

A

185

208
Q

How much does smoking cost the US in billions of dollars each year?

A

161

209
Q

What percentage of the population are alcoholics?

A

10%

210
Q

What ratio of patients suffer from some sort of addiction?

A

1/3

211
Q

What percentage of patients use marijuana?

A

30%

212
Q

What percentage of patients are addicted to prescription drugs?

A

10%

213
Q

What mechanistic function do almost all addictive substance have in common?

A

Release DA in nucleus accumbens

214
Q

What percentage of the population inherent drug vulnerability?

A

40-60%

Human Disease and Therapeutics (9 decks)

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