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Pharm 2 Jack > Test 2 > Flashcards

Test 2 Flashcards

1
Q

all antidepressants have a potential for

A

lowering the threshold for seizure activity, especially when alcohol is being consumed

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2
Q

patients consuming this drug should avoid foods high in levels of tyramine…why?

A

Monoamine oxidase inhibitors…MAOis essential for the adequate breakdown of tyramine

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3
Q

what has been reported as a consequence of dietary intake of tyramine in patients taking MAOIs

A

hypertensive emergencies and fatal accelerated hypertension

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4
Q

chief side effects of Tricyclic antidepressants

A

anti-cholinergic signs and symptoms such as dry mouth, constipation, urinary hesitancy, orthostatic hypotension, and sedation

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5
Q

drug where high toxicity is usually due to prolongation of QT interval, leading to arrhythmias

A

Tricyclic antidepressants

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6
Q

class of Amitriptyline/ Elavil

A

TCA

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7
Q

ind. of Amitriptyline/ Elavil

A

major depression, bipolar disorder, migraine and tension headaches, chronic pain

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8
Q

MOA of Amitriptyline/ Elavil

A

CNS modulation of both serotonin and norepinephrine, increasing levels of each of these neurotransmitters

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9
Q

side effects of Amitriptyline/ Elavil

A

Dizziness and marked drowsiness. Anticholinergic effects such as dry mouth, constipation, urinary hesitancy and blurred vision. Stopping treatment abruptly cause withdrawal-like symptoms i.e. nausea, headache, dizziness, lethargy, and flu-like symptoms. This is referred to as discontinuation syndrome.

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10
Q

class of Trazodone/ Desyrel

A

Tetracyclic

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11
Q

ind. of Trazodone/ Desyrel

A

major depressive disorder, anxiety, panic disorder and insomnia

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12
Q

MOA of Trazodone/ Desyrel

A

Serotonin reuptake inhibitor and partial antagonist. Decreased serotonin reuptake at presynaptic cleft allows for increased serotonin levels in the synapse and increased serotonin made available at post-synaptic receptor sites.

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13
Q

side effects of Trazodone/ Desyrel

A

Sedation, orthostatic hypotension, fatigue, possible cardiac dysrhythmias, possible mania in patients with bipolar disorder. Increased risk of suicide.

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14
Q

most commonly prescribed category of antidepressant drugs

A

Selective serotonin reuptake inhibitors (SSRIs)

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15
Q

class of Fluoxetine/ Prozac

A

SSRI

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16
Q

ind. of Fluoxetine/ Prozac

A

major depressive disorder, OCD, bulimia and panic disorder

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17
Q

MOA of Fluoxetine/ Prozac

A

decreased serotonin reuptake at presynaptic cleft allows for increased serotonin levels in the synapse and increased serotonin made available at post-synaptic receptor sites

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18
Q

side effects of Fluoxetine/ Prozac

A

Side effects as noted along with potential for serotonin syndrome with symptoms of fever, agitation, diarrhea and elevated blood pressure. Sexual dysfunction is a very common side-effect with all SSRIs. Common sexual side-effects include lack of interest in sex, impotency and anorgasmia (inability to reach orgasm).

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19
Q

what drug category may interfere and reduce the efficiency of SSRIs and compound risk of GI bleeds caused by SSRI use

A

NSAIDs

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20
Q

drug used for major depressive disorder, general anxiety disorder, painful peripheral neuropathy and fibromyalgia

A

Duloxetine/ Cymbalta

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21
Q

Antidepressant you would give to a patient who also has insomnia

A

tricyclic antidepressants, tetracyclic antidepressants

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22
Q

“depressing” side effect of SSRIs

A

weight gain

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23
Q

class of Bupropion/ Wellbutrin

A

norepinephrine and dopamine reuptake inhibitors (NDRI) and nicotine receptor antagonist

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24
Q

ind. of Bupropion/ Wellbutrin

A

Major depression, bipolar disorder and attention deficit disorder. Aid in smoking cessation is another indication for Bupropion, although it is marketed under the brand name Zyban when it is used as for that purpose.

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25
Q

MOA of Bupropion/ Wellbutrin

A

Blockade of norepinephrine and dopamine reuptake increases the available pool of these amines in the synaptic cleft.

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26
Q

side effects of Bupropion/ Wellbutrin

A

Headache, insomnia, dry mouth, tremors, restlessness, agitation, anxiety, sweating and dizziness.

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27
Q

all antidepressants are being looked at for potential of an increase in

A

suicidal behavior

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28
Q

antidepressant indicated for smoking cessation

A

Bupropion/Wellbutrin

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29
Q

depression may be associated with deficiency in this vitamin

A

folate

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30
Q

active form of folic acid

A

Levomefolic acid aka methyltetrahydrofolate aka 5-MTHF

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31
Q

nutriceutical adjunct therapy for depression

A

Levomefolic acid/ Deplin

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32
Q

adding ___ to anxiolytics and sedatives makes the sedative effect more powerful

A

alcohol

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33
Q

in general anxiolytics have this effect

A

sedation

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34
Q

are receptor sites for barbituates and benzodiazepines in the same place?

A

No, appear to be adjacent but not in the same location as the GABA sites on cell membrane of neurons in CNS.

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35
Q

block GABA can result in

A

seizures

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36
Q

at higher doses barbiturates will result in

A

coma and death

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37
Q

do barbiturates have analgesic properties

A

no

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38
Q

ultra-short acting barbiturates

A

Thiopental/Pentothal

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39
Q

short acting barbiturates

A

Pentobarbital/Nembutal

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40
Q

Intermediate-acting barbiturates

A

Butalbital/Fiorinal

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41
Q

Long-acting barbiturates

A

Phenobarbital/Luminal

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42
Q

reasons why barbiturates have largely been replaced

A

drug tolerance, psychological and physical dependence, severe withdrawal symptoms (can be fatal), potential for coma and respiratory failure esp when alcohol consumed

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43
Q

how do benzodiazepines work

A

Benzodiazepines act by binding to specific, high affinity sites on the cell membrane of neurons in the CNS which are adjacent to but separate from the gamma-aminobutyric acid (GABA) receptor sites.

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44
Q

short-acting benzodiazepines are generally used for

A

patients with sleep onset insomnia (difficulty falling asleep)

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45
Q

short-acting benzodiazepine utilized for sedation and anxiety prior to such procedures as upper and lower G.I. endoscopy as well as prior to general anesthesia and in critical care settings.

A

Midazolam/Versed…also for acute management of aggressive, violent or delirious patients

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46
Q

benzodiazepine with longer duration

A

Diazepam/Valium

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47
Q 
class of 
Diazepam/ Valium
A

benzodiazepine

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48
Q

ind. of

Diazepam/ Valium

A

Anxiolytic, sedative, muscle relaxant and seizure control

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49
Q

MOA of

Diazepam/ Valium

A

Binds to benzodiazepine receptors in the C.N.S. to enhance GABA activity

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50
Q

side effects of

Diazepam/ Valium

A

Drowsiness, impaired mentation, tolerance and addiction. Rebound insomnia may occur after drug discontinuation. Withdrawal can be severe, similar to that of barbiturates, especially when patient has been on chronic therapy.

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51
Q

class of Eszopiclone/ Lunesta

A

Benzodiazepine-like hypnotic

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52
Q

ind. of Eszopiclone/ Lunesta

A

Treatment of insomnia

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53
Q

MOA of Eszopiclone/ Lunesta

A

Potentiation of GABA effect on chloride ion channels by binding to a specific receptor site not involved with the binding of benzodiazepines.

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54
Q

side effects of Eszopiclone/ Lunesta

A

Impaired mentation prior to sedation. Eszopiclone is reported as having minimal drowsiness upon awakening and minimal change in mentation relative to all other benzodizepines. As with almost every medication, the full side effect profile may not be fully appreciated until that drug has been in use for at least five years or more.

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55
Q

melatonin agonist

A

Remelteon/Rozerem

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56
Q

MOA of Remelteon/Rozerem

A

melatonin receptor agonist with high binding affinity at the melatonin MT1 and MT2 receptors

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57
Q

most common symptoms of benzodiazepine overdose

A

CNS depression and signs of intoxication with impaired balance, ataxia and slurred speech.

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58
Q

class/MOA of Flumazenil/ Romazicon

A

benzodiazepine receptor antagonist that can rapidly reverse effects of benzodiazepines

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59
Q

effectiveness of Flumazenil/ Romazicon

A

Flumazenil is very effective at reversing the CNS depression associated with benzodiazepines but is less effective at reversing respiratory depression.

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60
Q

main MOA of neuroleptic drugs

A

blockade of dopamine receptors in the brain

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61
Q

For neuroleptic drugs, five dopamine receptors have been identified and the chief antipsychotic effects of the neuroleptics appears related to dopamine blockade at the

A

D2 receptors

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62
Q

what pathway has been linked to psychotic experiences w/ neuroleptic drugs

A

Mesolimbic pathway…Excess release of dopamine in the mesolimbic pathway has been linked to psychotic experiences and it is the blockade of dopamine receptors in this pathway that is thought to control psychotic experiences.

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63
Q

Adverse effects commonly observed with the use of neuroleptics include:

A 
Tremors/ Parkinsonian effects,
Tardive dyskinesia,
Postural hypotension,
Blurred vision, dry mouth, constipation and urinary retention,
Sexual dysfunction,
Increased prolactin release,
Drowsiness
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64
Q

Chronic treatment w/ neuroleptic agents may lead to

A

Parkinsonian-like symptoms such as uncoordinated muscular movement, dystonia (abnormal muscle tone), “pill rolling”, limb rigidity and shuffling gait along with extrapyramidal signs such as akinesia (inability to initiate movement), akathisia (inability to remain motionless), and tardive dyskinesia (facial grimacing and inappropriate posturing of the tongue, neck, trunk and limbs).

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65
Q

Define Tardive dyskinesia

A

Dyskinesia refers to an involuntary movement. Facial grimacing and involuntary movements of limbs are examples of dyskinesias.

The effect of these drugs can be tardive, meaning the dyskinesia continues on or first appears after the drugs are no longer being taken.

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66
Q

addition side effect of neuroleptic drugs that occurs rarely

A

neuroleptic malignant syndrome.

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67
Q

neuroleptic malignant syndrome is characterized by

A

catatonia, fluctuating blood pressure, dysarthria and fever

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68
Q

neuroleptic malignant syndrome may be fatal if what doesn’t happen

A

This syndrome may be fatal if the antipsychotic drug is not immediately discontinued and the patient receives treatment with a dopamine agonist such as Bromocriptine.

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69
Q

Random effect of neuroleptic drugs

A

Most of the neuroleptic drugs have anti-emetic effects that are mediated by blocking D2 dopaminergic receptors in the chemoreceptor trigger zone (CTZ) of the medulla.

Several neuroleptics are useful in the treatment of the severe nausea that occurs as result of cancer chemotherapy.

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70
Q

class of Chlorpromazine/ Thorazine

A

Typical neuroleptic

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71
Q

ind. of Chlorpromazine/ Thorazine

A

psychosis, mania, schizophrenia as well as nausea and vomiting and intractable hiccoughs.

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72
Q

MOA of Chlorpromazine/ Thorazine

A

Chiefly D2 dopaminergic receptor site blockade. Also alpha-adrenergic blockade and H1 blockade (anti-histamine effects).

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73
Q

side effects of Chlorpromazine/ Thorazine

A

significant side effects include onset of Parkinsonian symptoms and extrapyramidal signs such as tardive dyskinesia. Increased release of prolactin commonly occurs as a result of dopamine blockade. Increased prolactin can result in galactorrhea and amenorrhea in women and infertility in both men and women.

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74
Q

Drug with increased release of prolactin commonly occurs as a result of dopamine blockade. Increased prolactin can result in galactorrhea and amenorrhea in women and infertility in both men and women.

A

Chlorpromazine/ Thorazine

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75
Q

class of Prochlorperazine/ Compazine

A

Typical neuroleptic

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76
Q

ind. of Prochlorperazine/ Compazine

A

Psychosis as well as vertigo and nausea and vomiting, particularly when associated with migraine headaches.

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77
Q

MOA of Prochlorperazine/ Compazine

A

Primarily H1-histamine receptor antagonist as well as alpha-adrenergic receptor antagonist and D2 dopaminergic receptor antagonist.

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78
Q

side effects of Prochlorperazine/ Compazine

A

Significant drowsiness, dry mouth, constipation and urinary retention. Lowers seizure threshold. Extrapyramidal side effects generally seen only when Prochlorperazine is given at high doses over long periods of time.

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79
Q

class of Haloperidol/ Haldol

A

Typical neuroleptic

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80
Q

ind. of Haloperidol/ Haldol

A

Psychosis, Tourette’s syndrome, Huntington’s disease, acute agitated behavior.

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81
Q

MOA of Haloperidol/ Haldol

A

Chiefly D2 dopaminergic receptor site blockade.

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82
Q

side effects of Haloperidol/ Haldol

A

Chiefly Parkinsonian-like symptoms and EXTRAPYRAMIDAL effects, which may be very dramatic. Tremors very common. Less blockade of the muscarinic and the alpha-adrenergic receptors compared to other neuroleptic agents such as Chlorpromazine. The potentially fatal NEUROLEPTIC MALIGNANT SYNDROME (NMS) is a significant possible side effect

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83
Q

drug indicated for acute agitated behavior

A

Haloperidol/ Haldol

84
Q

class of Clozapine/ Clozaril

A

Atypical neuroleptic

85
Q

ind. of Clozapine/ Clozaril

A

Schizophrenia, especially when other anti-psychotic agents have failed or have produced undesirable side effects.

86
Q

MOA of Clozapine/ Clozaril

A

Multiple receptor site blockade yet greatest effects at D2 and 5-HT2 (serotonin) receptor sites.

87
Q

side effects of Clozapine/ Clozaril

A

Relatively diminished extra-pyramidal side effects compared to other neuroleptic agents. Agranulocytosis has been reported in 1 to 2% of patients. (Clozapine should be withheld if granulocyte count is

88
Q

drug with side effects of agranulocytosis and myocarditis

A

Clozapine/ Clozaril

89
Q

class of Respiradone/ Risperdal

A

atypical neuroleptic

90
Q

ind. of Respiradone/ Risperdal

A

psychosis

91
Q

MOA of Respiradone/ Risperdal

A

Exact mechanism of action is unknown yet presumed to be a combination of dopamine and serotonin receptor blockade.

92
Q

side effects of Respiradone/ Risperdal

A

Extrapyramidal effects, tardive dyskinesia, constipation, sedation. Slow withdrawal is recommended to reduce the incidence of acute psychosis. Weight gain, hyperglycemia and diabetes. Increased risk for stroke in elderly patients.

93
Q

Drug type with side effects of weight gain, hyperglycemia, diabetes and increased risk for stroke in elderly patients.

A

Atypical neuroleptics

94
Q

class of Olanzapine/ Zyprexa

A

Atypical neuroleptic

95
Q

ind. of Olanzapine/ Zyprexa

A

Schizophrenia, especially when other antipsychotic agents have failed or have produced undesirable side effects.

96
Q

MOA of Olanzapine/ Zyprexa

A

Multiple receptor site blockade yet greatest effects at D2 and 5-HT2 receptor sites.

97
Q

side effects of Olanzapine/ Zyprexa

A

Relatively diminished extra-pyramidal side effects compared to other neuroleptic agents. Weight gain, hyperglycemia and diabetes. Increased risk for stroke in elderly patients.

98
Q

use of lithium salts

A

Lithium salts are used prophylactically in treating bipolar disorder and in the treatment of manic episodes.

99
Q

MOA of lithium salts

A

The exact MOA of lithium as a drug is not known but it may serve to dampen transmission by norepinephrine as well as acting to diminish response to glutamate, an excitatory neurotransmitter.

100
Q

class of Lithium carbonate/ Eskalith

A

lithium salt

101
Q

ind. of Lithium carbonate/ Eskalith

A

Bipolar disorder and manic episodes. Lithium has also being used in the treatment of schizophrenia.

102
Q

thing to remember about Lithium carbonate/ Eskalith

A

Very small therapeutic index such that therapeutic serum levels may be extremely close to toxic levels. Blood levels of lithium must be frequently checked.

103
Q

side effects of Lithium carbonate/ Eskalith

A

A major problem with lithium treatment is lack of compliance, especially due to the side effects of weight gain, cognitive impairment and short-term memory deficits.

104
Q

Most common renal effect of Lithium

A

The most common renal effect of lithium is impaired concentration capacity due to reduced renal response to antidiuretic hormone (ADH).

105
Q

Drug where The incidence of polyuria due to nephrogenic diabetes insipidus is approximately up to 20% of patients receiving chronic treatment.

A

Lithium carbonate/ Eskalith

106
Q

Drug where Hypothyroidism may occur in 5% to 35% of patients on long term therapy.

A

Lithium carbonate/ Eskalith

107
Q

main MOA of anticonvulsant drugs

A

sodium channel blockade and potentiate GABA

108
Q

class of Phenobarbital/ Phenobarb

A

Barbiturate anticonvulsant

109
Q

ind. of Phenobarbital/ Phenobarb

A

Generalized seizures

110
Q

MOA of Phenobarbital/ Phenobarb

A

Enhanced GABA activity

111
Q

Side effects of Phenobarbital/ Phenobarb

A

CNS depression, drowsiness, associated with lowered IQ scores in children undergoing chronic treatment.

112
Q

class of Primidone/ Mysoline

A

Barbiturate anticonvulsant

113
Q

MOA of Primidone/ Mysoline

A

Exact MOA unknown but Phenobarbital is a known metabolite of Primidone so GABA mediated inhibition is considered as chief MOA.

114
Q

ind. of Primidone/ Mysoline

A

All types of seizure disorders except absence seizures.

115
Q

side effects of Primidone/ Mysoline

A

Nausea, anorexia, headache, vertigo, ataxia. Category D – do not use in pregnancy unless life threatening condition.

116
Q

drug with half life of its metabolites > 48 hours

A

Primidone/ Mysoline

117
Q

known metabolite of Primidone/ Mysoline

A

Phenobarbital

118
Q

class of Diazepam/ Valium

A

Benzodiazepine anticonvulsant

119
Q

MOA of Diazepam/ Valium

A

Increased sensitivity of GABA receptor sites to GABA with subsequent increased chloride influx which serves to inhibit CNS synaptic transmission.

120
Q

ind. of Diazepam/ Valium

A

Grand mal seizures. Status epilepticus. Seldom if ever used as a chronic treatment choice for seizures. Anxiety, panic disorder.

121
Q

drug for status epilepticus

A

Diazepam/Valium

122
Q

class of Clonazepam/ Klonopin

A

Benzodiazepine anticonvulsant

123
Q

MOA of Clonazepam/ Klonopin

A

Similar to Diazepam

124
Q

Ind. of Clonazepam/ Klonopin

A

Alternative to Ethosuximide or Valproic acid for absence seizures. Status epilepticus.

125
Q

Side effects of Clonazepam/ Klonopin

A

Drowsiness, altered mentation, additive with CNS depressants, marked abuse potential. Tolerance develops.

126
Q

anticonvulsant with marked abuse potential

A

Clonazepam/ Klonopin

127
Q

class of Phenytoin/ Dilantin

A

Anticonvulsant

128
Q

MOA of Phenytoin/ Dilantin

A

Reduces sodium and calcium and currents across neuronal membranes.

129
Q

ind. of Phenytoin/ Dilantin

A

Prophylaxis for all types of seizures except absence seizures.

130
Q

side effects of Phenytoin/ Dilantin

A

Nystagmus, ataxia, gingival hyperplasia, possible hepatotoxicity, and possible bone marrow suppression. I.V. administration may cause hypotension and arrythmias.

131
Q

Drug with side effects of nystagmus and gingival hyperplasia

A

Phenytoin/ Dilantin

132
Q

class of Carbamazepine/ Tegretol

A

anticonvulsant

133
Q

MOA of Carbamazepine/ Tegretol

A

Similar to phenytoin in the reduction of sodium and calcium currents across neuronal membranes.

134
Q

ind. of Carbamazepine/ Tegretol

A

Prophylaxis against all types of seizures except absence seizures. Also used to treat chronic pain such as trigeminal neuralgia and post-herpetic neuralgia. Tegretol has also been used in the treatment of schizophrenia and bi-polar disorder.

135
Q

drug for neuropathic pain

A

Carbamazepine/ Tegretol

136
Q

side effects of Carbamazepine/ Tegretol

A

Vertigo, nausea, vomiting. Possible bone marrow suppression and aplastic anemia (follow blood counts).

137
Q

Carbamazepine/ Tegretol should never be given to

A

Should never be given to patients on monoamine oxidase inhibitors as combination potentially increases risk for all of Carbamazepine side effects as well as increased risk for hypertensive crisis.

138
Q

class of Valproic acid/ Depakote

A

anticonvulsant

139
Q

MOA of Valproic acid/ Depakote

A

Unknown, enhancement of GABA transmission has been postulated.

140
Q

ind. of Valproic acid/ Depakote

A

All seizure types, particularly in absence seizures and combined seizure conditions. Also used to treat bipolar disorder and chronic pain syndromes.

141
Q

side effects of Valproic acid/ Depakote

A

commonly include nausea, insomnia, anxiety. Potential for severe hepatotoxicity. Known to be an antagonist of folic acid. When taken by women who are pregnant, the incidence rates of serious, irreversible birth defects are 3 to 10 times higher than average.

142
Q

class of Ethosuximide/ Zarontin

A

anticonvulsant

143
Q

ind. of Ethosuximide/ Zarontin

A

absence seizures

144
Q

MOA of Ethosuximide/ Zarontin

A

Unknown, possibly affects T-type calcium ion channels

145
Q

side effects of Ethosuximide/ Zarontin

A

Headache, nausea, vomiting, fatigue, ataxia, blurred vision, confusion, skin rashes, insomnia, gingival hyperplasia, notable for possible hepatotoxicity and lupus-like syndrome.

146
Q

Drug with side effects of gingival hyperplasia and lupus-like syndrome

A

Ethosuximide/ Zarontin

147
Q

class of Gabapentin/ Neurontin

A

Anticonvulsant, atypical analgesic

148
Q

MOA of Gabapentin/ Neurontin

A

Appears to potentiate GABA and also affects N-type calcium channels.

149
Q

ind. of Gabapentin/ Neurontin

A

Adjunctive treatment of partial seizures. Also used in chronic pain syndromes such as post-herpetic neuralgia. Migraine headaches.

150
Q

side effects of Gabapentin/ Neurontin

A

Somnolence, dizziness, ataxia, headache and other CNS side effects.

151
Q

drug to treat chronic pain syndrome and post-herpetic neuralgia

A

Gabapentin/ Neurontin

152
Q

class of Lamotrigine/ Lamictal

A

anticonvulsant

153
Q

MOA of Lamotrigine/ Lamictal

A

Unknown. May stabilize neurons by decreasing sensitivity to the exicitatory effects of glutamate and aspartate.

154
Q

ind. of Lamotrigine/ Lamictal

A

Tonic-clonic (grand mal) seizures, complex partial seizures and seizures resistant to other drug treatments.

155
Q

side effects of Lamotrigine/ Lamictal

A

dizziness, headache, rashes, diplopia, somnolence and ataxia.

156
Q

Drug that, in 2003, became the first drug approved by the FDA for treating type I bipolar disorder since lithium, a drug approved almost 30 years earlier.

A

Lamotrigine/ Lamictal

157
Q

class of Levetiracetam/Keppra

A

anticonvulsant

158
Q

MOA of Levetiracetam/Keppra

A

Unknown. May stabilize neurons by inhibition of calcium movement through presynaptic calcium channels.

159
Q

ind. of Levetiracetam/Keppra

A

Tonic-clonic seizures, complex partial seizures and seizures resistant to other drug treatments.

160
Q

side effects of Levetiracetam/Keppra

A

Levetiracetam is generally well tolerated but may cause drowsiness, weakness, unsteady gait, coordination problems, headache, mood changes, nervousness, loss of appetite, vomiting, diarrhea or constipation and rare reports of possible changes in skin pigmentation.

161
Q

treatment for partial (focal) seizures

A

Phenytoin/Dilantin, Phenobarbital/Phenobarb, Primidone/Mysoline

162
Q

treatment for Grand mal (tonic clonic) seizures

A

Valproic acid/Depakote, Lamotrigine/Lamictal, Levetiracetam/Keppra, Topiramate/Topamax

163
Q

treatment for absence (petit mal) seizures

A

Ethosuximide (Zarontin)

164
Q

treatment for status epilepticus

A

Lorazepam (Ativan), Diazepam/Valium, Phenytoin/Dilantin, Ethosuximide/Zarontin…all typically IV route

165
Q

The treatment of parkinson’s disease relies mainly on

A

replacing dopamine with Levodopa (L-Dopa) or mimicking its action with dopamine agonists.

166
Q

chief side effects of Levodopa

A

The chief side effects of L-dopa are nausea, vomiting and anorexia induced by the stimulation of dopamine receptors in the GI tract and the chemotrigger receptor zone (CTZ) in the brain.

167
Q

Levodopa is usually combined with a

A

peripheral dopa-decarboxylase inhibitor such as Carbidopa or Benserazide in order to prevent Levodopa from being prematurely converted into dopamine in the adrenal glands or other peripheral tissues.

168
Q

The most commonly used medications which contain Levodopa with a peripheral dopa-decarboxylase inhibitor

A

Levodopa with Carbidopa/ Sinemet

169
Q

The most frequent side effects of dopaminergic drugs are

A

nausea, sleepiness, dizziness, involuntary writhing movements and visual hallucinations

170
Q

treatment with L-Dopa or with dopamine agonists only proves effective for

A

average of approx. 5 years

171
Q

Levodopa and all its formulations should never be used in conjunction with

A

MAO inhibitor because the combination can lead to a hypertensive crisis.

172
Q

class of L-dopa with Carbidopa/ Sinemet

A

Dopamine precursor (L-dopa) with a peripheral dopamine decarboxylase inhibitor (Carbidopa).

173
Q

ind. of L-dopa with Carbidopa/ Sinemet

A

Parkinson’s

174
Q

MOA of L-dopa with Carbidopa/ Sinemet

A

Increases dopamine levels in the brain, especially in the substantia nigra.

175
Q

side effects of L-dopa with Carbidopa/ Sinemet

A

Prior to addition of Carbidopa, nausea was the most frequent side effect experienced by patients taking L-dopa. While nausea may still occur when Carbidopa is added to L-dopa, this side effect has been significantly reduced. Commonly reported side effects include hallucinations, nightmares, dyskinesias (uncontrolled movement) and serpentine like movement (chorea).

176
Q

difference between Dopamine and pre-cursor L-dopa in terms of BBB

A

Dopamine cannot cross the blood barrier in significnant amounts, but the precursor, L-dopa can cross the blood brain barrier.

177
Q

dopamine agonist drug

A

Bromocriptine/ Parlodel

178
Q 
class of 
Bromocriptine/ Parlodel
A

Dopamine agonist

179
Q

ind. of

Bromocriptine/ Parlodel

A

Parkinson’s disease. Also used in the treatment of prolactin secreting adenomas and acromegaly.

180
Q

MOA of

Bromocriptine/ Parlodel

A

Mimics dopamine in stimulation of dopamine receptor sites.

181
Q

side effects of

Bromocriptine/ Parlodel

A

The usefulness of Bromocriptine and all of the dopamine agonists is limited by the large number of potential side effects such as nausea, hypertension or hypotension, confusion, hallucinations, headache, depression, dyskinesia and possible seizures. Pulmonary fibrosis has been reported as an uncommon adverse effect when bromocriptine was used in extremely high doses.

182
Q

which drug can be used in treatment of prolactin secreting adenoma (or growth hormone producing tumor)

A

Bromocriptine/ Parlodel

183
Q

anticholinergic drug

A

Benztropine/ Cogentin

184
Q

class of Benztropine/ Cogentin

A

anticholinergic

185
Q

ind. of Benztropine/ Cogentin

A

Parkinson’s disease, especially when tremor or drooling are prominent symptoms. Appears to also help with cognitive symptoms due to Parkinson’s disease. In addition, used to diminish side effects of the antipsychotic drugs.

186
Q

MOA of Benztropine/ Cogentin

A

Anticholinergic antagonist at muscarinic receptor sites.

187
Q

side effects of Benztropine/ Cogentin

A

Dry mouth, blurred vision, urinary retention, constipation, confusion, drowsiness, disorientation, memory impairment, visual hallucinations and possible exacerbation of pre-existing psychotic symptoms.

188
Q

drug used to diminish side effects of the antipsychotic drugs

A

Benztropine/ Cogentin

189
Q 
class of 
Amandatine/ Symmetrel
A

Anti-Parkinson’s and anti-viral agent

190
Q

ind. of

Amandatine/ Symmetrel

A

Parkinson’s disease and influenza A.

191
Q

MOA

A

Unclear but probable NMDA receptor antagonism accounts for anti-Parkinson’s effects.

192
Q

side effects of

Amandatine/ Symmetrel

A

Light headedness, confusion, drowsiness, nightmares, dry mouth, constipation, urinary retention, nausea and vomiting.

193
Q

what is an antiviral drug used for Parkinson’s

A

Amandatine/ Symmetrel

194
Q

how long do benefits of Amandatine/ Symmetrel last

A

about 6 months

195
Q

order of efficacy of meds used to treat Parkinson’s disease

A

L-dopa > Bromocriptine > Amantadine > anticholenergics

196
Q

Anticholinergic medications have long been observed to commonly cause

A

memory impairment and confusion.

197
Q

basis for the neurologic deficits associated with Alzheimer’s disease

A

The cholinergic hypothesis postulates that the destruction of basal forebrain cholinergic neurons and the resultant deficit in cholinergic transmission in the brain is the basis for the neurologic deficits associated with Alzheimer’s disease.

198
Q

mechanism for dementia drugs

A

AChE inhibition is believed to result in the increased synaptic cleft concentrations of acetylcholine, thus providing the brain with enhanced cholinergic transmission.

This enhanced cholinergic transmission is felt to be responsible for the reduction of the signs and symptoms of Alzheimer’s dementia placed on drugs of this class.

199
Q

MOA of Donepezil/ Aricept

A

centrally acting reversible acetylcholinesterase inhibitor.

200
Q

The most commonly experienced side effects of Donepezil and the other agents in this class of drugs include

A

bradycardia, nausea, diarrhea, anorexia, abdominal pain and vivid dreams.

201
Q

Drug that could potentially increase and improve the vocab and expressive language of autistic children

A

Donepezil/ Aricept

202
Q

MOA of Rivastigmine/ Exelon

A

centrally acting, reversible acetylcholinesterase inhibitor.

203
Q

drug for dementia that is available via a transdermal patch

A

Rivastigmine/ Exelon

204
Q

antidote for acetylcholinesterase inhibiting drug overdose

A

atropine

205
Q

MOA of Memantine/ Namenda

A

antagonist of NMDA glutamate receptors

206
Q

drug proven to work for moderate to severe dementia

A

none

Pharm 2 Jack (7 decks)

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