Term
| Brand Name: Sinemet, Parcopa |
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Definition
Generic Name: carbidopa/levodopa
Drug Class: Decarboxylase inhibitor (Carbidopa), Dopamine precursor (Levadopa)
Indications: Parkinson's Disease & RLS |
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Term
| Brand Name: Depakote, Stavzor, Depakene |
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Definition
Generic Name: divalproex sodium
Drug Class: Anticonvulsants |
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Term
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Definition
Generic Name: donepezil
Drug Class: Acetylcholinesterase inhibitors |
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Term
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Definition
Generic Name: levetiracetam
Drug Class: Anticonvulsants |
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Term
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Definition
Generic Name: memantine
Drug Class: NMDA Antagonists |
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Term
| Brand Name: Dilantin, Phenytek |
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Definition
Generic Name: phenytoin
Drug Class: Anticonvulsants |
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Term
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Definition
Generic Name: pramipexole
Drug Class: Dopamine agonists |
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Term
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Definition
Generic Name: ropinirole
Drug Class: Dopamine agonists |
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Term
| Phenytoin clinical pearls |
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Definition
Phenytoin is first line therapy for most types of seizures & is available as oral pill, suspension, and injection
Narrow range between toxic and therapeutic doses - must monitor blood levels. |
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Term
| Phenytoin Adverse Effects |
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Definition
Common: GI upset, somnolence, gingival hyperplasia, hirsutism, nystagmous with elevated levels.
Serious: with toxic levels: ataxia, coma, seizures. |
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Term
| Phenytoin drug interactions |
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Definition
Phenytoin has MANY drug interactions - always screen medication list.
Interactions: decreased antifungal concentration, decreased efficacy of contraception, decreased statin concentration, enhanced warfarin activity |
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Term
| Divalproex adverse effects |
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Definition
Common: alopecia - hair loss, tremor, GI upset
Serious: Thrombocytopenia - platelet decrease |
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Term
| Divalproex black box warning |
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Definition
Liver failure resulting in fatality has occurred. Children < 2 years are at risk for developing liver toxicity.
Life threatening pancreatitis has been reported.
May cause birth defects. |
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Term
| Levetiracetam adverse effects |
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Definition
| CNS (behavioral symptoms, somnolence, headache), Nausea & vomiting, Somnolence, Headache |
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Term
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Definition
| chronic progressive neurodegenerative syndrome characterized by a decline in memory and at least one other cognitive function. |
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Term
| Dementia signs and symptoms |
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Definition
| Memory loss, loss of speech, loss of ability to perform activities, disorientation, impaired executive function, depression, psychotic symptoms, behavioral disturbances, inability to care for oneself. |
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Term
| Donepezil mechanism of action |
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Definition
| Slow degradation of acetylcholine by blocking enzyme |
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Term
| Donepezil adverse effects and counseling point |
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Definition
Adverse effects: GI effects – dose related, bradycardia
Counseling: Give at bedtime |
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Term
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Definition
| No adverse effects frequently occur |
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Term
| Alheimer's Disease Clinical Pearls |
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Definition
| These medications DO NOT reverse AD. They may delay progression. They must be titrated up to recommended dose. Typically start with acetylcholinesterase inhibitor & may combine with memantine in moderate to severe disease |
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Term
| Carbidopa mechanism of action |
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Definition
| Decarboxylase inhibitor- blocks breakdown of levodopa in the periphery so more crosses to the CNS. |
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Term
| Levodopa mechanism of action |
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Definition
| Dopamine precursor- converted in the CNS to dopamine. |
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Term
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Definition
| Ropinirole and Pramipexole |
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Term
| Carbidopa/Levodopa clinical pearl |
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Definition
| Parkinson's Disease patients experience on/off syndrome which can be managed by giving lower, more frequent doses of Sinemet or by adding a dopamine agonist |
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Term
| Carbidopa/Levodopa adverse effects |
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Definition
Common: nausea, somnolence, dizziness, orthostatic hypotension
Serious: confusion, hallucinations, delusions, agitation |
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Term
| Carbidopa/Levodopa interactions |
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Definition
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Term
| Carbidopa/Levodopa Clinical pearl |
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Definition
| Patients with PD often develop dementia. It may be difficult to differentiate psychosis caused by dementia vs. PD meds |
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Term
| Acetylcholinesterase inhibitors Mechanism of action |
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Definition
| Slow degradation of acetylcholine by blocking enzyme |
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