Student Presentations Flashcards
What is botox a purified from?
Botulinum toxin
What is the MOA of botulinum toxin?
- Binds to snare protein complex, and cleaves proteins
- Prevents SNARE protein from binding vesicle to axon terminal, and releasing into the synapse
What can Botox be used to treat?
- Muscle spasticity
- Hyperhidrosis
- Incontinence
- Overactive bladder
- Over secretion of salavia
- Cosmetic appearance
What are possible side effects of Botox?
- Headaches
- Malaise
- Mild Nausea
- Numbness
- Spread to surrounding tissues
- Temporary weakness/ paralysis of muscles
- Erythema/ edema/ mild pain at the injection site
How are the effects of Botox overcome by the body?
- Sprouting of new axon terminals
- Restoration of SNARE protein
Are amphetamines synthetic or non-synthetic?
Synthetic
What are the 2 pharmacological effects of amphetamines?
- CNS stimulant
- Appetite suppressant
What are the 4 formulations of amphetamines? Which takes the longest to have effect? What is the least?
Longest: PO (~30mins)
Shortest: Injection
What is the MOA of amphetamines?
- Amphetamines release monoamine and dopamine
- Increases concentration in synaptic cleft
- Activate Alpha-1, Alpha-2, and Beta-1
What effect do amphetamines have at high doses?
Modify action of dopamine and noradrenaline
What is the half-life of amphetamines?
10 hours
How is amphetamine metabolized?
By the liver
What is the protein binding of amphetamines?
15 - 40 %
How lipid soluble are amphetamines?
Highly
Are amphetamines easily or difficultly absorbed?
Easily
What are the clinical treatments of amphetamine?
- ADD in children
- Mental altertness in individuals with narcolepsy
- Suppress appetite
- Suppress/ alleviate fatigue
- Improve mental and physical performance
- Elevate mood
What schedule drug is prescription amphetamine? What are 3 examples?
Schedule II
- Adderall
- Ritalin
- Concerta
What are 3 OTC “look alike” amphetamine drugs?
- Caffeine
- Ephedrine
- Pheynlypropanolamine
What is the effect of amphetamines on the PNS?
- Vasoconstriction
- Hypertension
- Tachycardia
What is the effect of amphetamine on the CNS?
- Agitation
- Insomnia
- Increased alterness
What are 4 short-term side-effects of amphetamines?
- High body temperature
- Nausea
- Headache
- Dry mouth
What are 4 long-term side-effects of amphetamines?
- Difficulty breathing
- Ulcers
- Malnutrition
- Skin disorders
Can physical dependence of amphetamine develop?
No
Can psychic dependence of amphetamine develop?
Yes
How fast does tolerance to amphetamines occur?
Gradually/ slowly
What are signs and symptoms of withdrawal from amphetamines?
`- Aggressive and dangerous antisocial behavior
- Chronic fatigue
- Physical/ Psychological depression
What are 3 commonly abused amphetamines?
- Methanphetamine (Desoxyn)
- Dextroamphetamine (Adderal)
- Methylphenidate (Ritalin)
What can amphetamine abuse cause?
- Euphoria
- Unrealistic sense of power
- Incresaed altertness
- Increased perceived strength
What can long term abuse of amphetamine cause?
- Psychotic behavior
- Violence/ aggression
- Seizures
- Malnutrition
What patient population will be relevant to the use of amphetamines and PT?
- Post CVA in subacute period
How can amphetamines assist patients post-CVA?
- Attention
- Concentration
- Performance of motor memory tasks
How should PT be scheduled in relation to amphetamines?
Time therapy when the drug is in systemic circulation
What is an endogenous glucocorticosteroid? What organ produces it? What is its function?
Adrenocorticosteroid produced by adrenal cortex that acts an immune system mediator
What are exogenous glucocorticosteroids?
- Drugs
In what 4 formulations are exogenous glucocorticosteroids administered?
- Orally
- Topically
- Intravenously
- Intracapsularly
What are 3 clinical uses for glucocorticosteroids?
Treatment of:
- Systemic inflammation
- Localized joint inflammation
- Autoimmune disorders
What specific drug is used for intracapsular, intraarticular, and intramuscular injections? How many injections can be performed per year?
- Dexamethasone
- 4 injections per year
What is the MOA of glucocorticosteroids when used to treat inflammation?
- Increase production of anti-inflammatory proteins
- Inhibit production of pro-inflammatory substances
- Reduces pain
What are 2 side-effects of injections of glucocorticosteroids?
- Decreased sythesis of proteoglycans (which heal and contribute to viscoelastic properties of tendon)
- Human tendon stem cell tendon degradation, which is infiltrated from adipocytes, chondrocytes, and osteocytes
What are 3 systemic side effects of glucocorticosteroids?
- Increased systolic BP for (1-7 days)
- Increased blood glucose levels (1 - 21 days)
- Decreaed adrenocorticotropic hormone
What conditions are treated with glucocorticosteroids?
- DeQuervain’s
- Trigger finger
- OA/ RA
- Bursitis
- Tendonitis
- Synovitis
- Fasciitis
- Carpal tunnel
- Epicondylagia
- Adhesive Capsulitis
- Facet syndrome
What conditions are glucocorticosteroids APPROPRIATE for?
- Bursitis
- Adhesive capsulitis
- Trigger finger
- DeQuervain’s contracture
- RA
What are the implications for PT in relation to glucocorticosteroids?
- Determine if the condition should be treated form a biomechanical perspective (to get to “root” of problem)
- Know glucocorticosteroids have a last effect (joint mobs/ range of motion)
What structures are targeted by the autoimmune process of multiple sclerosis?
- Myelin and axons of CNS
What results from the damage to myelin and axons in the CS by multiple sclerosis?
Plaques throughout SC and brain
What are the 4 types of MS?
- Relapse remitting
- Primary-progressive
- Secondary-progressive
- Progressive-Relasping
What are the 2 etiological/ risk factors for multiple sclerosis?
- Genetics
- Viral infection
What is the 3 step pathogenesis?
- Inflammation
- Demyelination
- Axon loss
What are 3 clinical manifestations of multiple sclerosis?
- Sensory changes
- Optic neuritis
- SC lesions
What is the old drug used to treat MS?
Baclofen
How is baclofen administered?
- Orally
- Intrathecally
What does baclofen treat?
- Muscle spasticity (the symptoms of MS)
What 3 new drugs are used to treat MS?
- Aubagio (Teriflunomide)
- Tysarbri (Natilizumab)
- Lemtrada (Alemtuzumab)
What is the purpose of the new set of drugs used to treat MS?
- Slows the progression
Which new MS drug is not FDA approved?
Lemtrada (alemtuzumab)
What 2 new drugs are prescribed for relapsing MS?
- Aubagio (Teriflunomide)
- Tysarbri (Natilizumab)
What MS drug is an integrin-receptor antagonist?
- Tysarbi (Natilizumab)
What MS drug is an immunomodulatory drug with anti-inflammatory properties?
Aubagio (Teriflunomide
What MS drug is a recombinant DNA-derived humanized monoclonal antibody?
- Lemtrada
What are the 5 implications for PTs treating patients taking MS drugs?
- Side-effects
- Scheduling
- Psychosocial considerations
- Patient educaiton
- Complementary and Alternative MEdicine (CAM)
