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Therapeutics II Exam 3
Parkinson's, Epilepsy, Asthma, COPD
44
Medical
Graduate
03/25/2013

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Term
Classic symptoms of PD due to decreased DA (3)
Definition
rigidity
bradykinesia
postural instability
Term
Classic symptoms of PD due to relative increase of Ach (1)
Definition
resting tremor
Term
Diagnosis of PD
Definition
Bradykinesia + one other classic s/sx
Supportive: treatment response, progression
Term
Treatment Options (6)
Definition
1.) Exogenous DA (L-Dopa)
2.) D2 Agonist
3.) Prevent DA breakdown: AADCi & COMTi
4.) Prevent DA breakdown: MAOBi
5.) Decrease excess cholinergic
6.) Modulate neurotransmission
Term
Valproic Acid
Enzyme effects, PPB, ADR, Therapeutic Range
Definition
UGT inhibitor
High PPB
ADR: weight gain, teratogenicity, alopecia
Range: 50-150mcg/mL
Term
Carbamazepine
Enzyme effects, ADR, Therapeutic Range, DDI
Definition
CYP & autoinducer
ADR: SIADH -> hypnatremia, aplastic anemia -> low WBC
Range: 4-12mcg/mL
DDI w/levetiracetam
Term
Phenytoin
Enzyme effects, ADR, PPB, Therapeutic Range, Dosing
Definition
CYP inducer
ADR: extravasation due to antifreeze, nystagmus (dose-dep), gingival hyperplasia (idiosync)
High PPB
Range: 10-20mcg/ml; 1-2mcg/ml free
Dosing: Loading Dose & Maintenance Dose by weight; max dose due to kinetics
Term
Gabapentin
ADR, Elim
Definition
ADR: weight gain, sedation
Renal elim
Term
Pregabalin
ADR, Elim
Definition
ADR: weight gain, sedation
Renal elim
Term
Lacosamide
Elim
Definition
Renal & Hepatic elim
Term
Lamotrigine
Enzyme effects, ADR
Definition
Metabolized by UGT (reduced by OCP; increased by valproic)
ADR: dose-dependent skin rash; AHS
Term
What causes AHS?
Definition
Cabamazepine, Phenytoin, Phenobarbital, Lamotrigine
Term
AHS Cross-reactivity?
Definition
Primidone
Rufinamide
Oxcarbazepine
Lacosamide
Zonisamide
Term
Levetiracetam
ADR, DDI, Elim
Definition
ADR: CNS & behavioral
DDI w/carbamazepine (ataxia & nystagmus)
Renal Elim
Term
Oxcarbazepine
Enzyme effects, ADR
Definition
3A4 inducer (decreases OCP)
ADR: hyponatremia, aplastic anemia (less than carbam)
Term
Topiramate
Enzyme effects, ADR, Elim
Definition
3A4 inducer (decreases OCP)
ADR: weight loss
*migraine relief
Renal elim
Term
Zonisamide
ADR, Avoid When
Definition
ADR: weight loss
Avoid in sulfa allergy; CrCl < 50mL/min
Term
AHS s/sx
Definition
fever, rash, eosinophilia
Term
AEDs possible in pregnancy?
Definition
You can give any 2nd Gen EXCEPT TOPIRAMATE!
Term
beclomethasone
Definition
QVAR
ICS
Term
budesonide
Definition
Pulmicort
ICS
**only safe drug for pregnancy
Term
fluticasone
Definition
Flovent
ICS
Term
mometasone
Definition
Asmanex
ICS
Term
albuterol
Definition
Proventil/ProAir/Ventolin
SABA
Term
pirbuterol
Definition
Maxair
SABA
Term
levalbuterol
Definition
Xopenex
SABA
Term
SABA with dose counter?
Definition
ProAir & Ventolin
Term
circlesonide
Definition
Alvesco
ICS
**DON'T WASH
Term
salmeterol
Definition
Serevent
LABA
Term
formoterol
Definition
Foradil, Perforomist
LABA
Term
fluticasone+salmeterol
Definition
Advair ICS/LABA
Diskus -> 1puff BID
HFA -> 2 puff BID
Term
budesonide+formoterol
Definition
Symbicort ICS/LABA
2 puff BID
Term
mometasone+formoterol
Definition
Dulera ICS/LABA
2 puff BID
Term
theophylline metabolism inhibitors (6)
Definition
EtOH
Zileuton
Cimetidine
Zafirlukast
Propranolol
Ciprofloxacin
Term
theophylline metabolism inducers (6)
Definition
Smoking
Rifampin
Phenytoin
Omeprazole
Phenobarbital
Carbamazepine
Term
zafirlukast
Definition
Accolate
LT Antag
Term
montelukast
Definition
Singulair
LT Antag
Term
zileuton
Definition
Zyflo
5-lipoxygenase inhibitor
Term
omalizumab
Definition
Xolair
Mab against IgE binding mast cells
Dosing based on body weight & serum IgE
Term
ipratropium
Definition
Atrovent
SAMA
Term
albuterol+ipratropium
Definition
Combivent, DuoNeb
SABA/SAMA
Term
tiotropium
Definition
Spiriva
LAMA
Term
theophylline blood levels
Definition
5-15mcg/mL
Term
Major Criteria for Abx Use in COPD (3)
Definition
1.) increased dyspnea
2.) increased sputum
3.) sputum purulence
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