Unit 2: Medications

Question 1

Medications for Spinal cord injuries (5)

Answer 1

1. Muscle relaxers
2. Steroids
3. Pain Meds (Gabapentin, Pregabalin (Lyrica), NSAIDs)
4. BP Meds (Atropine, Pacing; Vasopressors)
5. Stool softeners

Question 2

What drug class are Tizanidine, Cyclobenzaprine, & baclofen a part of?

Answer 2

Skeletal muscle relaxers

Question 3

What drug can we give directly to the spinal cord injury site?

Answer 3

Intrathecal Baclofen

Question 4

Medications for TBI

Answer 4

1. Mannitol (ICP Mx)
2. BP Meds
3. Antiepileptics
4. Sedatives or Barbituate coma (Ventilator Mx)

Question 5

Medications for Brain tumors (5)

Answer 5

1. Chemo Meds
2. Steroids
3. Anti-epileptics
4. Anti-emetics
5. Pain Meds

Question 6

Medications for MS (5)

Answer 6

1. NSAIDS
2. Immunomodulators
3. Interferon-beta
4. Antispasmodics
5. Intrathecal Baclofen

Question 7

Medications for ALS (5)

Answer 7

1. Riluzole (Rilutek) – PO
2. Edaravone (Radicava) – IV
3. Dextromethorphan + Quinidine (Nuedexta)
4. Tiglutik (thickened Riluzole)
5. Exservan (film Riluzole)

Question 8

Medications for ALS:
Which drug only increases life expectancy by 3-5 months?

Answer 8

PO Riluzole (Rilutek)

Question 9

Medications for GB (2)

Answer 9

1. IV IgG
2. Pain meds

Question 10

Medication for MG (5)

Answer 10

1. Pyridostigmine (cholinesterase inhibitor)
2. Corticosteroids
3. Immunosuppressants
4. IV IgG
5. Monoclonal Antibodies (mabs)

Question 11

Medication for Myasthenic crisis

Answer 11

Pyridostigmine (cholinesterase inhibitor)

Question 12

Medication for Cholinergic crisis

Answer 12

Atropine

Question 13

Medications for TN (3)

Answer 13

1. Pain meds (baclofen, gabapentin, pregabalin)
2. Anticonvulsants/Antiepileptics (carbamazepine, lamotrigine)
3. Nerve block drugs

Question 14

Vitamin Sups for Liver Disease (3)

Answer 14

1. Multivits
2. Thiamine
3. Folate

Question 15

Medication for Ascites

Answer 15

1. Diuretics (furosemide + spironolactone)

Question 16

Medications to PREVENT Esophageal varices

Answer 16

1. Beta-blockers
   Reduces pressure in the Portal Vein

Question 17

Medications to MANAGE Esophageal varices (4)

Answer 17

1. Vasopressors
2. Ocreotide (Sandostatin)
3. IV Protonix
4. Antibiotics (ALWAYS for any GI BLEED!!)
   (Also: Fluids + Blood products)

Question 18

How does Ocreotide work for esophageal varices?

Answer 18

decreases the inflow of blood to portal system by constricting the splanchnic arterioles and significantly reduces intravariceal pressure

Question 19

Medications for Encephalopathy (2)

Answer 19

1. Lactulose (enema if esophageal varices present)
2. Rifaximin

Question 20

What the heck is Rifaximin

Answer 20

Antibiotic! (intestinal antiseptic)
Decreases normal gut flora that produce ammonia

Question 21

Medications for Cholecystitis (4)

Answer 21

1. Pain meds (Opiates!)
2. NSAIDs
3. Antiemetics
4. Ursodiol (Actigall)-dissolve gallstones

Question 22

Medications for Acute Pancreatitis (2)

Answer 22

1. Pain meds (Opioids!!)
2. Antiemetics

Question 23

Medications for Chronic Pancreatitis (2)

Answer 23

1. Pancreatic enzymes** (best for preventing pain r/t pancreatitis/not digesting food)
2. Pain meds (non-opioid)

Question 23

Medications for Panhypopituitarism or Hypophysectomy (pituitary removal)

Answer 23

Hormone replacement therapy
Testosterone (IM, PO, Patch, or gel), Estrogen, Progesterone, Clomid, GnRH, Growth hormone-SQ at night)

Question 24

Medications for Hyperpituitarism (3) (think about drugs specific for certain hormones)

Answer 24

1. Dopamine Agonists (Cabergoline, Bromocriptine) 2. Somatostatin Analogs (Octreotide, Lanreotide) 3. GH-receptor Antagonist/blocker (Pegvisomant)-weekly IM

Question 25

What the heck is Cabergoline? SEs?

Answer 25

Stimulate dopamine receptors in the brain and slow release of GH and Prolactin. SEs: orthostatic hypotension, HA, GI upset (give with food), dysrhythmias, CSF leakage

Question 26

Medications that can induce Diabetes Insipidus (2)

Answer 26

1. Lithium 2. Demeclocycline (tetracycline Abx)

Question 27

Medications that can induce SIADH (7)

Answer 27

1. Antidepressants (SSRIs, TCAs) 2. Opioids 3. General anesthetics 4. Carbamazepine 5. Fluoroquinolone Abxs 6. Vincristine (chemo drug) 7. Chlorpropamide (sulfonylurea; diabetes drug) pg. 1237

Question 28

Medication for Diabetes Insipidus (1)

Answer 28

1. Desmopressin (DDAVP; synthetic ADH)

Question 29

Medication + IV fluid for SIADH if Na+ levels are LOW (2)

Answer 29

1. ADH/Vasopressin Antagonists ("Vaptans") - Tolvaptan (PO), Conivaptan (IV) 2. Hypertonic Saline (3% NaCl)

Question 30

Medication for SIADH if Na+ levels are NORMAL. What disease might we see this used for?

Answer 30

Diuretics (used less often) Used primarily with HF with “normal” Na+ levels

Question 31

Medications for Addison's Disease (3) (think about electrolyte imbalances too)

Answer 31

1. Hormone Replacement therapy - Hydrocortisone, Dexamethasone, Cortisone, Prednisone-most used) - Fludrocortisone (mineralocorticoid) 2. Kayexalate (if hyperkalemia emergency) 3. IV Glucose or Glucagon (hypoglycemia)

Question 32

Medications for Cushing's Disease (3)

Answer 32

1. Steroidogenesis inhibitors (Metyrapone, Aminoglutethimide, Ketoconazole, Mitotane, Etomidate) 2. VitD (Ca2+?) 3. PUD prophylaxis

Question 33

What SEs should we watch for r/t Steroidogenesis inhibitors?

Answer 33

1. Wt loss 2. Increased U/O 3. F&E imbalances (ECG changes, etc.)