Term
| Histamine has what effects on the body? |
|
Definition
| Reddening of skin, pain, itching, and bronchospasm |
|
|
Term
| What is histamine's Role? |
|
Definition
Mediator of inflammatory and allergic reaction
role in GI secretion |
|
|
Term
| What is the physiologic anatagonist to histamine? |
|
Definition
|
|
Term
| What H1 receptor antagonist is used to counteract the allergic reactions effect of histamine? |
|
Definition
Diphenhydramine (Benadryl)
Fexofenadine (Allegra) |
|
|
Term
| What drug is used to counteract the motion sickness effects of histamine? |
|
Definition
H1 Blocker:
Dimenhydrinate (dramamine)
Antimuscarinic: Scopamaine
|
|
|
Term
| What drug is used to counteract the N/V experienced during pregnancy? |
|
Definition
|
|
Term
| What is the most common side effect of H1 Blockers? |
|
Definition
|
|
Term
| If a patient is still having moderate to severe symptoms are taking benadryl, what is your recommendation? |
|
Definition
|
|
Term
| Pt presents with hyperreflexia, clonus, HTN, diarrhea, tremor, and hyperthermia. When asking patient questions you realize that she has been taking triptans for her chronic migraines as well as buspirone for her anxiety. What syndrome is she experiencing? |
|
Definition
|
|
Term
| Pt presents with chronic migraines, and you prescribe her a 5-HT1b/1d receptor drug. Which drug did you prescribe her? |
|
Definition
|
|
Term
| Pt present with a high level of anxiety and you suggest a 5HT1A drug. Which drug did you suggest? |
|
Definition
|
|
Term
| You are working in a oncology clinic, and a patient presents with "intractable N/V" x 12 hours, she thought she could fight it off, but it keeps getting worse. What do you prescribe? (Hint: its a 5-HT3) |
|
Definition
|
|
Term
| What two drugs are under the catagory of 5-HT2 receptors? And what are their indications? |
|
Definition
Phenoxybenazime:
pheochromocytoma/HTN emergency
Cyprohepatadine - allergies |
|
|
Term
| A elderly woman presents to your office complaining of memory loss, hallucinations, and a gangrenous ulcer. She states that her doctor recently started her on a new medication. What class of medication is this? |
|
Definition
Ergot Alkaloids
"St. Anthony's Syndrome" |
|
|
Term
| Ergot Alkaloids are used clinically 6 things what are they? |
|
Definition
1. Increase uterine contraction due to an increase in alpha receptors during pregnancy progression
2. Migraines
3. Hyperprolactinemia due to DA antagonism or pit tumor
4. Postpartum hemorrhage - administer during delivery of placenta or immediatly after but NEVER BEFORE
5. Varient/prinzmetal angina
6. senile cerebral insufficiency |
|
|
Term
| When are ergot alkaloids C/I? |
|
Definition
Obstructive Vascular Dz
Collagen Disease |
|
|
Term
| What is the major precursor to all ecosinoids? |
|
Definition
|
|
Term
| Cox is the precursur to what major ecosinoid? |
|
Definition
|
|
Term
| Lox is the precursor to what major ecosanoid? |
|
Definition
|
|
Term
| What is the clinical implication of leukotrienes? |
|
Definition
Bronchoconstriction/spasm
Seen in asthma and anphylaxis
Increased endothelial permeability
Seen in CV disease
|
|
|
Term
| What effects does PGE have on the female reproductive system? And what specific PGE drugs are involved? |
|
Definition
1. Abortion: promotes uterine contraction and ripening of the cervix
Dinoprostone (cervidil); Misoprostol (cytotec); and carboprost trimethamine (hemabate)
2. Facilitate Labor: ripen cervix and naturetic effects (increase labor) - Cervidil
3.Dysmenorrhia - ischemic pain - Tx: NSAIDS |
|
|
Term
| What is an inhibitor of PGE and TX? |
|
Definition
|
|
Term
| What drug inhibits phospholipase A2? |
|
Definition
| Fluticasone (Corticosteroid) |
|
|
Term
| What is a 5-Lox inhibitor? What is the major side effect? |
|
Definition
Zileuton
SE: Hepatotoxicity |
|
|
Term
| Which drug is a leukotriene inhibitor? |
|
Definition
|
|
Term
| Pt presents with an acute asthma attack? What is your first line of tx? |
|
Definition
SABA: Albuterol
Use: bronchodilator
AE: tremor, palpitations
OD: arrhythmia
Dose: PRN (more thans 2x/week not in control)
|
|
|
Term
| Pt is currently on a SABA inhaler on a PRN basis, but comes in with a c/c of being constantly SOB and her SABA isnt working. What is your next step in tx? |
|
Definition
LABA - Salmeterol (Advair)
Never use as a monotherapy always use w/ inhaled corticosteroid as it will lead to a higher risk of asthma related death |
|
|
Term
| What asthma drug can be used to reverse airway remodeling, is an anti-inflammatory and reduces mucous prouction? |
|
Definition
| Inhaled Corticosteroids (Flucasone/Flovent) |
|
|
Term
| What are some AE to oral corticosteroids? Should they be used long term? |
|
Definition
NO THEY SHOULDNT BE USED LT
AE: Cataracts, oteroporesis, immunosuppresion, and increased glucose |
|
|
Term
| Patient presents to the clinic in the fall, with a complaint of seasonal allergies to pollen; she says her sx are exacerbated during her daily runs. What is your TOC? |
|
Definition
Mast Cell Stablilizers
Cromyln and Nedocromil |
|
|
Term
| A 14 y/o patient presents w/ seasonal allergies and uncontrolled asthma, what woudld be your tx of choice? |
|
Definition
Leukotriene modifier
Monoleukcast - >12 y/o
Zafirukast - > 5 y/o |
|
|
Term
| Patient presents to the clinic complaining of a "leaky bladder" and insomnia. She is an asthma patient and is currently taking meds. What medication is most likely causing her sx? |
|
Definition
Methylxanthine
(Theophylline) |
|
|
Term
| On a f/u visit your COPD patient present to clinic complaining of an exacerbation of sx, and his SABA is not longer working. What is your TOC for this patient? |
|
Definition
Antimuscarinic/Anticolinergic
Ipatropium Bromide
(Atrovent) |
|
|
Term
| What asthma drug has a slow onset and long duration and is ALWAYS used w/ a corticosteroid? |
|
Definition
|
|
Term
A 30 y/o man is using an albuterol inhaler to relief his chest tightness 2x/week, he complains of symptoms that he relates to his asthma use. Which of the following is not an action of albuterol?
A. Diuretic Effect
B. Positive inotrophic effect
C. Skeletal muscle tremor
D. Smooth muscle relaxant
E. Tachycardia |
|
Definition
|
|
Term
A 10 y/o child has servere asthma and was hospitalized serveral times in the last week for exacerbations. She is now recieving medications to reduce frequency of asthma attacks. Which of the following is most likely to have AE when used daily over long periods of time w/ severe asthma?
A. Albuterol, aerosol form
B. Ipatropium, aerosol form
C. Prednisone, oral form
D. Theophilline, oral form
E. Cromolyn, aersol form |
|
Definition
|
|
Term
| Cromolyn is a prophylactic agent whose major action is to? |
|
Definition
| block mediator release of mast cells |
|
|
Term
| What medication does not have a direct bronchodilator effect? |
|
Definition
|
|
Term
| A patient is admitted to the ED as he believes he has taken too much of a pill that treates his astham. The patient is unsure of the name of the medication, but he has had been unable to fall asleep since. Which of the following medications most often is used in athma by oral route, and is capable of cuasing insomina? |
|
Definition
| Theophylline (Methylxanthine) |
|
|
Term
| What drug in its parenteral form is a life-saving in severe status asthmaticus? |
|
Definition
|
|
Term
A Patient reports that he has been using her albuterol inhaler daily and it has significantly improved her coughing, wheezing, and chest tightness. She also notes when she went to the patk last week she had an asthma attack and used her ipratoprium inhaler which made her feel better.
A. What should you tell the patient concerning her albuterol inhaler?
B. What is the best advice to tell the patient about her ipratropium? |
|
Definition
A. only take albuterol meds PRN
B. The patient should use a product that has a combo of ipratropium and albuterol to relieve an acute exacerbation |
|
|
Term
| What NT is located in the hippocampus and is associated w/ learning and memory? |
|
Definition
|
|
Term
| What NT is widely distributed in the CNS and is used in learning and memory? Excitatory/Inhibitory? |
|
Definition
|
|
Term
| What is the antagonist to Ach? |
|
Definition
|
|
Term
| What is the drug name for Ach used in alheimzers? And what is the MOA? |
|
Definition
Namenda
It blocks AchE and allows release of NMDA |
|
|
Term
| Patient presents with hallucinations and delusions? What is your most likely dx? tx? and moa? |
|
Definition
Schitophrenia
Antiphysogenics
D2 receptor antagonists |
|
|
Term
| What is the etiology behinds parkinsons? |
|
Definition
|
|
Term
| What drugs are used to tx parkinsons? |
|
Definition
Site of DA syntethesis = levadopa
Activates DA receptors = bromocriptine |
|
|
Term
| What NT is located in the pons and brainstem and has an excitatory/inhibitory effect causing wakefulness and CV stimulation? What drugs are agonists for excitatory and ihibitory? Antagonists? |
|
Definition
NE
EPSP: pseudoephedrine and dobutaimine
IPSP: Albuterol
Propranolol |
|
|
Term
| What NT is located in the midbrain and the pons and has excitatory and inhibitory effects? Agonist? Antagonist? |
|
Definition
Serotonin, 5-hydroxyl typtamine
Excitatory - wakeful, mood, indicated for depression
Inhibitory - sensory pain pathway
Agonist: LSD
Anatgonist: ondansetron |
|
|
Term
| What is baclofen action in the CNS? |
|
Definition
inhibitory of GABA
(GABA is an IPSP) |
|
|
Term
| What is strychinine? What is it indicated for in the CNS? |
|
Definition
poison found in mushrooms causes convulsions and seizures
In CNS it is an antagonists of Glycine (IPSP) |
|
|
Term
| What is an example of an opoid peptide and what is indicated for? |
|
Definition
|
|
Term
| What is do a tachykinin do? what is an agonist? |
|
Definition
Excites pain stimuli
Substance P |
|
|
Term
| Endocannabinoids do what? |
|
Definition
| Send retrograde signals to inhibit NT release |
|
|
Term
Which of the following chemicals is not a NT found in the CNS?
A. Ach
B. Cyclic AMP
C. Dopamine
D. NE
E. Substance P |
|
Definition
|
|
Term
| Which mechanisms underlying the actions of CNS drugs is likely to be useful in the management of Parkinson's Disese? |
|
Definition
1. Activation of DA receptors
(bromocriptine)
2. Antagonism of Ach Receptors
3. Increase dopamine synthesis
(Levodopa)
4. Inhibition of DA metabolism |
|
|
Term
|
Definition
1. increase Cl- conductance to cause inhibition (IPSP)
2. Increase K+ conductanc to cause inhibition (IPSP)
3. Increase Na+ conductance to cause excitation (EPSP)
4. Increase Calcium conductance to cause excitation (EPSP) |
|
|
Term
Which statement about opoids is accurate?
A. they are exclusively located in the spinal cord
B. Their binding worsens pain
C. they selectevly activate delta opoid receptors
D. their actions are mainly inhibitory |
|
Definition
Answer: D - actions mainly inhibitory
Not A: b/c widly distributed
Not B: b/c decreases pain
Not C: b/c they activate delta, mu, and kappa
|
|
|
Term
| Seizures can occur with ingestion of strychnine. This is a result of the antagonistic action of the poison at CNS receptors for? |
|
Definition
|
|
Term
| This NT, found in high concentrations in the brain stem and pons, can exert both excitatory and inhibitory actions. Multiple receptor subtypes have been identified, some of which are targets for drugs that can exert both CNS and peripheral actions? |
|
Definition
|
|
Term
What NT(s) play a role in memory and learning and are important in medication therapy for alzheimers patients?
A. NE
B. DA
C. Ach
D. Glutamate
E. C&D |
|
Definition
| Answer: E - Ach and Glutamate |
|
|
Term
| What is an example of a Long acting anti-muscarinic? |
|
Definition
|
|
Term
| What are the three effects of NO? |
|
Definition
1. vasodilate
2. promote inflammation
3. NT |
|
|
Term
| What causes NO to be released? |
|
Definition
Septic Shock
Endotoxins attact inflammatory mediators that release NO (e.g. macrophages)
NO --> Hypotension--> shock --> death |
|
|
Term
| What role does NO play in the CNS as a NT? |
|
Definition
| it activates NMDA at the postsynatpic site to enhance learning and memory |
|
|
Term
| What role does NO play in inflamamation? |
|
Definition
| NO actiavtes Cox2 which activates PGE which then casues vasodilation, vascular permeability, edema, acute and chronic inflammation |
|
|
Term
| What inflammatory molecule is a common cause of Rheumatoid Arthritis? |
|
Definition
|
|
Term
| What is the MOA of NO gas in the body when inhaled? |
|
Definition
Dilates pulmonary vessels when inhaled...causing dilationg of the pulmonary arteries and a decresaes in pulmonary pressure as well as increased 02
|
|
|
Term
| What is NO indicated for in neonates? |
|
Definition
Hypoxic respiratory failure (ARDS)
and
Pulmonary HTN |
|
|
Term
| What are 2 example of exogenous NO donors and what is a common toxicity? |
|
Definition
Nitroprusside and Nitrates
Toxicity: Methemoglobinemia |
|
|
Term
How is NO synthesized within the body? |
|
Definition
Arginine --> Citulline + NO
Catalyzed by NOS
Citrulline + NO catalyzes the rxn
Guanyl cyclase --> Activated guanyl cyclase
+ guanyl cyclase catalyzes the reaction of GTP --> cGMP which causes...
Vasodilation, stimulates PGE |
|
|
Term
| What are some example of organic nitrates? what enzyme catalyzes the conversion of organic nitrates to NO? What are the indications? How is tolerance created? |
|
Definition
NTG and Isosorbide dinatrate
Aldehyde Reductase
Indication: CAD/Angina
Tolerance: inhibition to aldehyde reductase but be nitrate free 10-12 hours
|
|
|
Term
| What is an example of an organic nitrite? What is the indication? Are they as effective as organic nitrates? |
|
Definition
Amyl Nirtrite
Indication: Angina
Not as effective as nitrites |
|
|
Term
| What is sodium nitroprusside indicated for? What is the mechanism? |
|
Definition
Indication:
HTN emergency or acute decompensated Heart failure
Mechanism:
Light generates NO |
|
|
Term
| Patient with a PmHx of obesity and diabetes presents with a c/c of inability to "get it up" what type of drug are you going to prescribe? |
|
Definition
Phosphodiesterase Inhibitor
"Sildafil"
Indication: ED |
|
|
Term
| The primary endogenous substate for NOS is? |
|
Definition
|
|
Term
Which of the following is recognized effects of nitric oxide?
|
|
Definition
1. Dilates pulmonary vessels
2. stimulates PGE synthesis
3. Involved in synpatic pathway |
|
|
Term
Which of the following is an approved application for NO administration as a gas?
A. Pulmonary HTN
B. Asthma Exacerbation
C. Impotence
D. PDA
E. Heart Failure |
|
Definition
|
|
Term
Which of the following does NOT contain NO, but causes it to be released from endogenous precursors, resulting in vasodilation?
A. Arginine
B. Ach
C. Isosorbide Mononitrate
D. NTG
E. Nitroprusside |
|
Definition
|
|
Term
| Pt presents with a c/c "twitching" movements on one side of his body, he describe an "aura" prior to the event. What is your dx? |
|
Definition
Partial Seizure
Description:
One hemisphere
unilat/asx movements
Associated w/ "aura" |
|
|
Term
What type of seizure is characterized by:
Both hemisphere involvement
Bilat movement
No Aura |
|
Definition
|
|
Term
| A young mother presents to her family practice with a c/c of her daughter having "unattentiveness". She states sometimes they will be talking and she will just "blankly stare and smak her lips x 1-2 min". What is your most likely dx? |
|
Definition
Absense Seizures
Descriptions:
Type of generalized
Sudden and brief onset
Sx: blank stare, upward rotation of eyes, and lip smaking
|
|
|
Term
|
Definition
Tonic: muscular contractions; deviation of eyes and head to one side; rotation of whole body; LOC; tongue bitting; involuntary urination
Clonic: repetitive jerks; cyanosis; foaming at mouth; small grunting respirations |
|
|
Term
| Patient presents to the ED transported by friends after a "night out with the guys". Patient states he used ETOH the prior night and his friends and himself were concerned because when he awoke he was having convulsions. What is your most likely dx? |
|
Definition
Juvienille seizures
Descriptions:
Precede tonic-clonic
Occur upon awakening
Precipitated by alcohol/loss of sleep |
|
|
Term
| What is a seizure caused by hormonal changes during menstration? |
|
Definition
|
|
Term
| Mother presents to the ED with her 3 mo infant stating that she has witnessed her baby "repetative jerky motions" several times in the am. She is highly concerned. What is your most likely dx? |
|
Definition
Infantile Spasms
Description:
Occur within the first 6 mo of life
Cluster, several x day
increased mortality and morbidity
Colic-type sx |
|
|
Term
| A 4 y/o presents to the clinic, his mother states that his seizures have been becoming more frequent and seem to be different patterns? what is your most likely dx? what is this associated w/? |
|
Definition
Lennox-Gastaut Syndrome
Associated w/ metal retardation and behavior issues. |
|
|
Term
| What is the target and MOA of antiepileptics? |
|
Definition
Target: GABA, Glutamate, and ion conductance
MOA:
1. increase Na channel activation
2. decrease current through T-type calcium channels
3. increase GABA
4. increases anti-gluamate activity |
|
|
Term
What is the oldest non-sedative anti-seizure drug?
What are its indications?
AE?
Toxicities?
Does it have a Therapeutic Range? |
|
Definition
Phenytoin
(anything BUT IM)
Indications: Partial and generalized tonic-clonic
Post-traumatic epilepsy
AE: Gingival Hyperplasia and Hirtuism
Warning: Hepatoxic; suicidal ideation; steven johnson
**Has a Therapeutic Range**
|
|
|
Term
| What drug is indicated to give IM during a state of status epilepticus for "life saving measures"? |
|
Definition
Fosphenytoin
Indications:Post-traumatic episelpsy; status epilepticus
Short Term Administatration
AE: hypotension; vasodilate; parathesis
**HLA-B*1502 allelle**
No therapeutic Range |
|
|
Term
| Patient presents with a complain of ax twitching on his right side. He says it occurs once a week, and just wants to make sure nothing is wrong. He states generally the feels an "aura" before his attacks. What is your TOC? |
|
Definition
Carbamazepine
**TOC: partial seizures
Also for: tonic-clonic
AE: hyponatremia, SAIDH, H20 intoxication
Warning: aplastic anemia, hepatoxic
**Therapeutic Range** |
|
|
Term
| Mom presnts to ED with the c/c of her daughter "blankly starring off" she states "her eyes sometimes role back into her head and her lips smack". Pt's mom states that these episodes only last for a few minutes. What is your TOC? and 2nd line tx? |
|
Definition
Ethosuximide
TOC: Absense Seizures
AE: Rash, GI upset, Gum hypertrophy
Warnining: SYSTEMIC LUPUS
2ND LINE TX: VALPRIC ACID |
|
|
Term
| You are a PA in the neurology clinic, and a patient presents with a "butterfly rash" across her cheeks. You check her record and find out that she is currently taking a med that has this a "warning sign". What medication is it? |
|
Definition
|
|
Term
| A 15 y/o patient presents to the ED with a complain "frequent and irregular seizures". What is your most likely dx and your treatment options? |
|
Definition
Dx: Lennox Gastautatone
Tx options:
1. Felbamate:
Indication: Lennox Gastuatone and refractory partial seizures (adj)
AE: anorexia, weight loss, hA
Warning: aplastic anemic, hepatotoxic, suicidal ideations
**no therapeutic range**
2. Rufinaminde
Indication: L.G.
AE: somnolence, dizziness, ataxia
Warning: leukopnia, shortened QT interval
|
|
|
Term
| What drug is 2nd line for parital seizures, has AE of dizziness, ataxia, and peripheral edema, and a warnign sign of "suicidal ideations" and has not signficant drug interactions? |
|
Definition
|
|
Term
| What seizure medication is used for tonic-clonic seizures and is an mono/adjuvant therapy for partial seizures and its MC AE is a "rash" and has a warning of suicidal ideations? |
|
Definition
|
|
Term
| What effect des a combo tx with Valproic Acid and Lamotrigine cause? |
|
Definition
| VPA inhibits metabolism of Lamotrigine causing an exacerbation of the "rash" AE. |
|
|
Term
| Why is concomittant use of OC not advised w/ patient on Lamotrigine? |
|
Definition
Ethynl estradiol induces iaotrigine glucouronidation.
This decreases the serum concentration of lamotrigine |
|
|
Term
| What anti-seizure medication is used on patients as young as 4 y/o with a hx of either partial seizures (mono/adjuvant tx) or generalized seizures and has a decreased efficacy w/ OC? |
|
Definition
|
|
Term
What Anti-seizure medication is used as a second-line tx for "partial seizures", has a Warning of sucidial ideation, AE of "dizziness, weight gain, peripheral edema, and somnolence" and has
"NO REPORTED DRUG INTERACTIONS"? |
|
Definition
|
|
Term
| What anti-seizure medication is indicated in a patient with neonatal seizures and refractory status epilelpticus? |
|
Definition
Phenobarbitol
"baby barb"
AE: Sedation, depression, pardoxical hyperactivity, and rash
Warning: delayed intellectual development, metabolic bone disease,
**controlled substance
**theurapeutic range
|
|
|
Term
| What drug is a first-line therapy for partial seizures and is also used for tonic clonic seizures, has AE of ataxic congntive and physcomotor dysfunction; and has a warning of nephrolithiasis and acute angle glaucoma? |
|
Definition
|
|
Term
| Patient presents with c/c "generalized seizures" what is the TOC? |
|
Definition
Valproic Acid
Indication: TOC for generalized seizures; absense seizures, and partial (mono/adjuvant)
AE: n/v, weight gain, alopecia, polycystic ovarian-like syndrome
Warning: pancreatitis, hepatotoxicity, thrombocytopnia
**Therapteutic Range** |
|
|
Term
| What is a partial seizures adjuvant therapy that has a warning of "nephrolithiasis and oligohydrosis" |
|
Definition
|
|
Term
| Patient presents w/ myoclonic seizures what is your treatment options? |
|
Definition
Levetiracem
AE: sedation, coordination difficulty, and irritability
Warning: suicidal ideations
Other option:
Ethosuximide |
|
|
Term
| What drug is indicated for a "grand mal" seizure or "physcomotor focal epileptic seizures"? |
|
Definition
Primidone
AE: ataxia, vertigo
Warning: megaloblastic anemia, Agranulocytosis
**Therapeutic Range** |
|
|
Term
| What drug is indicated for "infantile spasms" and has a "black box label"? |
|
Definition
Vigabatrin
Indication: infantile spasms
AE: somnolence, weight gain, anemia, edema, peripheral nephropathy
Warning: vision loss, suicidal ideations, neurotoxic, and abnormal MRI changes to the brain |
|
|
Term
|
Definition
1. restricted distribution program
2. prescribers and pharmacies register
3. Patient must be enrolled |
|
|
Term
|
Definition
| needing a higher dose to get the effect |
|
|
Term
|
Definition
| person needs the drug to function |
|
|
Term
|
Definition
| Abruptly stoping drug with withdrawl symptoms - insomia, CNS excitability, irritability |
|
|
Term
|
Definition
| compulsive use of substances despite dangerous effects |
|
|
Term
| What are 4 examples of antiemetics? |
|
Definition
1. Ondanseteron - intractable N/V in oncolongy
2. Doxyamine - pregnancy
3. Scopolamine - antimuscarinic
4. H1 blockers |
|
|
Term
| What are the three medications for migraines? |
|
Definition
1. B-Blockers (propranolol)
2. Ergot Alkaloids
3. Tiptans (5-HT1d/1b)
|
|
|
Term
| What medications require therapeutic levels? |
|
Definition
"3Ps CEV"
Phenytoin
Phenobarbitol
Primidone
Carbamazepine
Ethosuximate
Valproic Acid |
|
|
Term
| If someone is having an active seizure what can you give them? |
|
Definition
1. Diazepam (Long acting Benzodiapines) rectally - NO IV
2. Fospheytoin - IM
3. Phenobarbitol (infant/neonate) |
|
|
Term
| What meds do you use for an absense seizures? |
|
Definition
| Ethosuximide and Valproic Acid |
|
|
Term
| TOC for Partial seizures? |
|
Definition
|
|
Term
| Gingival hyperplasia is associated with what 2 anti-seizure meds? |
|
Definition
| Phenytoin and Ethosuximide |
|
|
Term
| What are the 5 consideration in women pertaining to seizures? |
|
Definition
1. Estrogen - seizure activator
2. Progresterone - seizure protector
(Think P - protects)
3. Highest Volunerablity: during or right before menstrual period
(think when are girls most volunarable)
4. Decreased efficacy of OC with antiepletics - b/c of enzyme induction; must suppliment OC
5. Pregnancy - increased maternal seizures, pregnancy complications; teratrogenic effects |
|
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Term
What are the 4 methods for successful withdrawal of seizure meds?
How must the withdrawl be done and why? |
|
Definition
1. Seizure free for 2-4 years
2. complete seizure control within 1 years
3. seizure onset between 2-35 y/o
4. normal neuro and EEG
Gradual Withdrawal:
Risk of status epilepticus
Recurrences of seizures |
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Term
|
Definition
reduces anxiety - induces calming effect
use low doses |
|
|
Term
|
Definition
produces drowsiness
high doses - induces increased Stage 2 NREM sleep and decreases everything else |
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|
Term
| What drug is a competitive antagnoist to benzodiazepine and is approved for reversal of CNS depressent effects of BSD OD (e.g. sedative effect)? |
|
Definition
Flumazenil
Short half life - repeat admin |
|
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Term
What is one of the more prominant clinical uses of sedative hypnotics?
|
|
Definition
Insomnia
Others: anxiety, amnesia (surg); epilepsy; seizure; control ETOH withdrawal; muscle relaxant |
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|
Term
| What are some toxic effects of sedative hyponotics? |
|
Definition
Dose-related CNS depression
Dose-related anterograde amnesia
Respiratory depression - aspirate |
|
|
Term
| What are some non-pharacological tx for insomnia? |
|
Definition
tx underlying problem
proper diet and exericise
avoid stimulants
comfortable sleeping enviro
regular sleep schedule |
|
|
Term
What are some clinical uses for benzodiazepines?
Common SE? |
|
Definition
Muscle relaxant
Anxiety
Seizures
ETOH withdrawl
SE: Sedation
|
|
|
Term
| What are the Short acting, intermediate acting, and long acting Benzos? |
|
Definition
Short Acting:(minute time)
Midazolam and Triazolam
Intermediate Acting:(TEAL)
Temazepam, estazolam, alprazolom, lorazepam
Long Acting (CCDF)
Clonazepam, Clorazepate; Diazepam; and Flurazepem |
|
|
Term
| What is the PK of Benzos? |
|
Definition
Lipophilic
Cross placenta barrier and detectable in breast milk |
|
|
Term
| What is the most frequently used hypnotic drug in the U.S.? |
|
Definition
Zolpidem
Biphasic release
decreases sleep latency and nocturnal awaking
--> increasing sleep time
"Sleep driving", "Sleep Eating" |
|
|
Term
| What hypnotic drug is indicted for long term use up to 6 months and have a half life of 5-6 hours? |
|
Definition
|
|
Term
| Which hypnotic is indicated for a "rapid onset" and "middle of the night awakening" that has a short half life and not effect on next day physcomotor performance? |
|
Definition
|
|
Term
| What asthma medication is a tx for moderate-severe asthma and has a side effect of a "site reaction"? |
|
Definition
| IgE Ab inhibitor - Omalizumab |
|
|
Term
| A patient presents with dementia, hallucinations, and gangrenous ulcer. You look in the chart and see she is taking a specific med. What medication is this? Syndrome? |
|
Definition
| St. Anthony's Fire - Ergot Alkaloids |
|
|
Term
| What is drug inhibit gastric secretions? What is an example? |
|
Definition
H2 blockers - (-tidine)
Example: rantidine |
|
|
Term
| Receptors for Ergot alkaloids? |
|
Definition
| Dopamine, a-adrenoreceptor, and 5-HT |
|
|
Term
| what is an irreversible inhibitor of Cox? |
|
Definition
|
|
Term
| what is an irreversible inhibitor of Cox? |
|
Definition
|
|
Term
| what is an irreversible inhibitor of Cox? |
|
Definition
|
|
Term
| what is an irreversible inhibitor of Cox? |
|
Definition
|
|
Term
| What is an irreversible inhibitor of Cox? |
|
Definition
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