Term
| BBB - Blood Brain Barrier |
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Definition
-prevents protein bound and ionized drugs from entering the CNS
- passage limited to drugs that are lipid-soluble or have a specific transport mechanism
- not fully developed at birth |
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Term
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Definition
- neurodegenerative disroger in which there is a loss of dopaminergic neurons in the substancia nigra in the brain.
- disorder of the extrapyramidal system that regulates movement |
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Term
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Definition
| Tremor, rigidity, instability, slow movement. Can progress to akinesia - no movement, dementia, depresion and memory loss. |
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Term
| Parkinsons' Disease Pathophysiology |
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Definition
| There is an imblanace between ACh, Dopamine, and GABA. GABA is typically an inhibitory NT - it is inhibited by dopamine and stimulated by ACh. Thus, when the dopaminergic neurons are destroyed there is a lack of dopamine to inhibit the GABA, resulting in overstimulation and excessive movement |
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Term
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Definition
| Found in autopsy in Parkinsons' patients. Neurotoxic fibrils made of a-synuclein (protein made by dopamergenic neurons) that accumulate in the brain |
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Term
| Drugs to treat Parkinsons |
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Definition
| Levodopa (w. or w/o Carbidopa), Dopamine Agonists, COMT inhibitors, Selegiline, anti-cholergenics |
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Term
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Definition
| Sinemet. Promotes the synthesis of dopamine. Carbidopa increases the effects to the CNS by inhibiting decarboxylation in the intestine. |
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Term
| Levodopa-Carbidopa Side Effects |
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Definition
Dose-dependent.
N/V
Dykinesis
Increase in BP
psychosis - 20%! |
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Term
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Definition
| FIRST LINE TREATMENT FOR mild to moderate PARKINSONS. Stimulates the dopamine receptors. Less effective but safer, easier than Levo/Carb |
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Term
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Definition
| Inhibit metabolism of Levodopa in intestine and peripheral tissues to increase duration between doses and increase therapeutic effects. |
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Term
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Definition
| MAO-B inhibit that is used with Levo-dopa to reduce "wearing off" effect |
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Term
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Definition
| Relieve Parkinsons by blocking the cholinergic receptors, thus equalizing the imbalance between Dopamine and ACh. |
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Term
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Definition
Neural degenerative disorder that begins in the hippocampus and moves into the cerebral cortex.
Marked by a degernation of cholinergic receptors, neuritic plaques, and neurofibril tangles |
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Term
| B-amyloid/ Neuritic Plaques |
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Definition
| In brain, mainly hippocampus and cerebral cortex. Plaques kill cell by disrupting K+ channels, releasing free radicals, and disrupting blood vessels |
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Term
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Definition
confusion in familiar settings, memory loss, change in personality, judgment.
70-80% have behavior issues. |
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Term
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Definition
confusion in familiar settings, memory loss, change in personality, judgment.
70-80% have behavior issues. |
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Term
| Drug Therapy for Alzheimers |
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Definition
- only slows the disease course by a couple months with a small chance of brief improvement
- Cholinerterase Inhibitors
- NMDA-receptor antagonist
- Vit E/Selegine
- NSAIDS |
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Term
| Cholinerterase Inhibitors |
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Definition
- Donezepil
- prevent breakdown of ACh by ACH-ase in order to allow more ACh for receptors. |
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Term
| Adverse Effects of Cholinerterase Inhibitors |
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Definition
| GI effects, bronchoconstriction r/t increased ACh @ lungs |
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Term
| NMDA receptor antagonists |
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Definition
Memantine. Treats symptoms with less negative effects and modest benefits.
DECREASED OVERSTIMUATION OF NEURONS B"Y GLUTAMATE. Adv. rxns : dizziness, sedation |
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Term
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Definition
| No good for treatment, but may be preventative. Decrease risk by 80%., |
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Term
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Definition
| - Immune attack of CNS myelin sheaths. |
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Term
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Definition
| parethesias - numbness and tingling, muscle-motor problems, visual impairment |
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Term
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Definition
1. Immunosuppressants and Immunomodulators - modify disease process by decreasing frequency and severity of relapses.
2. Glucocorticoid Steroids - treat acute relapses by decreasing inflammation, duration and severity |
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Term
| "ABC" drugs - Avonex, Betaseron, Copaxone |
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Definition
Immunomodulators/suppressants for M/S
Interferon-a, B - rxns: flu-like symptoms, hepatotoxicity, immune suppression, injection site reactions
Copaxone - increases number of anti-inflammatory cells. rxn: itchy, rash. inj. sit rxn. |
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Term
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Definition
Methylprednisone. Used for M/S exacerbation to decrease inflammation and supress immune system.
Cushing-like adv. rxns. |
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Term
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Definition
- caused by focus - a group of high frequency discharge from hyperexcited neuron
- congential, hypoxia @ birth, head trauma, cancer |
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Term
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Definition
1) suppress discharge of focus
2) suppress focus from spreading to other areas of the brain
- By: suppressing NA, CA, glutamate
increasing GABA to inhibit excitability
- Phenobarbital (oldschool)
- ... newer, better tolerated |
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Term
| Convulsive Status epilepticus |
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Definition
Tonic-clonic seizure > 30 mins.
=> tachycardia, high BP,
goal of trtmt: terminate seizure, maintain ventilation, correct hypoglycemia.
DRUG: Epinephrine |
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Term
| Pencillins - PCN, Amoxicillin, Augmentin |
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Definition
Target GRAM POSITIVE BACTERIA
CIDAL - inhibits the bacterial cell wall
Preg B
Excreted via kidneys
Adv. Rxns: ALLERGY, superinfection |
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Term
| Cepalosporin - cefemine, cefe... |
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Definition
GRAM NEGATIVE BACTERIA, the new 4th generation is BROAD SPECTRUM
CIDAL by inhibiting bact. cell wall.
Preg B.
Excreted via kidneys.
Risk of allergy , superinfection.
10% CROSS ALLERGY WITH PCN |
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Term
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Definition
GRAM NEGATIVE BACTERIA
CIDAL by inhibiting cell wall
Excreted by kids
MRSA FIRST LINE DRUG
C-DIFF SECOND LINE - only PO use
Adv. Rxn: Otoxicity, Nephrotoxicitiy, Red-man syndrome, phlebitis |
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Term
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Definition
| Damage to CN8 - acoustic (cochlear-vestibular). Damage to hearing, balance. Dizziness. |
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Term
| Tetracycline - doxycycline |
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Definition
BROAD SPECTRUM - ricksettias, chylamydias, pnuemonias, community aquired MRSA, Lyme Disease.
STATIC by inhibiting protein synthesis.
Excreted by KIDNEY.
Adv. Rxn: GI upset, photosensitivity, superinfection
- GIVE ON EMPTY STOMACH - chelated by Fe, Mg, Ca, Al.
CONTRAINDICATED IN PREGNANCY: X |
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Term
| Macrolides (Clindamycin, Linezoid) |
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Definition
BROAD SPECTRUM
CIDAL by inhibiting protein synthesis
Preg B/C. Excreted by liver.
Adv. Rxn: GI upset, inhibits metabolism of other drugs via site competition
- FIRST LINE COM. Acq. PNEUMONIA
- Used for staph/strep in PCN-allergic
- Administer IV over 1 hr
- Administer probiotics to prevent superinfection |
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Term
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Definition
Damage to kidneys by drugs.
Monitored by keeping eye on kidney function - BUN, CR Clearance lab tests |
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Term
| Aminoglycosides - Gentamycin, Tobramycin, Amakin |
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Definition
GRAM NEGATIVE BACTERIA
CIDAL by inhibiting protein synthesis
PREG CLASS D
Excreted by KIDNEYS
Adv. Rxns: Ototoxicity, neuromuscular block |
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Term
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Definition
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Term
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Definition
BROAD SPECTRUM for UTI, pneumocystisis
STATIC by inhibiting bacteria synthesis of folic acid
PREG: X
Metabolized by LIVER, excreted via KIDNEY
Adv. Rxn: rash, photosensitivity, Stevens-Johnson syndrome, kernicterus, rare hemolytic anemia.
INHIBITS METABOLISM OF WARFARIN |
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Term
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Definition
ANAEROBIC BACTERIA, PROTOZOA, GIARDIASIS,
CIDAL by DAMAGING Bacteria DNA
LIVER metabolism, KIDNEY excretion
Adv. Rxn: Disulfrum-like rxn with alcohol - n/v. H/A.
INCREASES EFFECT OF WARFARIN, PHENYTOIN
FIRST LINE FOR C. DIFF |
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Term
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Definition
BROAD SPECTRUM - most effacious.
CIDAL by inhibiting DNA gyrase
PREGNANCY X
Hepatic metabolism. Excreted in stool/urine.
Adv. Rxn: GI upset, CNS effect, tendone rupture, superinfection
- chelated by Fe, Ca, Mg, Al |
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Term
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Definition
UTI, E.coli
Metabolized by LIVER, excreted by KIDNEY
Adv. Rxns: GI upset, blood dyscrasia, hemolytic anemia, neuropathy
- * URINE TURNS BROWN
- Psuedomonias, Klebsettia, Proteus are insensitive. |
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Term
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Definition
SYSTEMIC FUNGAL INFECTION
Adv. Rxn: nephtotoxicity, infusion rxns
"shake and bake" - chills and sweats.
* Premedicate with tylenol, benadryl |
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Term
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Definition
Fungals. TOPICAL for skin/vag
Adv. Rxn: hepatotoxic when PO, IV
- Inhibits metabolism of other drugs |
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Term
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Definition
| USED OF ORAL/CUTANEOUS THRUSH |
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Term
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Definition
Oral: onchomycosis
Topical: tinea
Adv. Rsn: hepatotoxicity
- Avoid alcohol |
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Term
Acyclovir
(valacyclovir, famicyclovir) |
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Definition
- TREATS HPV
Adv. rxns: N/V, diarrhea, vertigo
nephrotoxic
*Most effective at first sign of herpes |
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Term
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Definition
Vaccine for Herpes Zoster
Can cause live virus in immunocompromised patients |
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Term
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Definition
CHRONIC HEPATITIS B, C
Blocks viral entry into cells, and RNA synthesis.
Adv. rxn: flu-like symptoms, depression, inj. site rxn
- SUBQ INJ |
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Term
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Definition
INFLUENZA VIRUS
Inhibits virus enzyme for replication |
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Term
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Definition
INFLUENZA VIRUS
Inhibits virus enzyme for replication
Adv. Rxn: N/V
- most effective within 12 hours of starting to feel ill
- decreases severity, durtation
- give with food |
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Term
| Isonizid, Rifampin, Pyramizade, Ethambutol |
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Definition
TREATS TB
Adv. Rxn: Nephrotoxictiy
Rifampin turns body fluids ORANGE
Monitor vision with ethambutol
Excreted RENALLY |
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Term
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Definition
-PPD - preliminary skin screening
- Chest X-ray
- Acid-fast bacilli in sputum
- Culture (takes weeks) |
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Term
| Chylamydia (trachomatis) symptoms |
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Definition
| non-gonococcal urethritis in males, asymptomatic women. eye infection in babies |
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Term
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Definition
| 1 DOSE Azithromycin or 7day Doxycycline |
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Term
| LGV - lymphogranuloma vererum |
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Definition
Doxycycline 21 days
Symptomgs: gential erosion, lymphatic swelling and obstruction
NEW: SOME CASES IN SOUTHERN US |
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Term
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Definition
TRTMT: Ceftriaxone, Ceftixime.
Symptoms: Male- mucopurulent urethritis.
Women - asymptomatic until PID, mucopurulent cervitis.
CAN LEAD TO SEPSIS, SKIN LESIONS, ARTHRITIS
CAN CAUSE BLINDESS IN UNTREATED INFANTS |
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Term
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Definition
TRTMT: Ceftriaxone, Ceftixime.
Symptoms: Male- mucopurulent urethritis.
Women - asymptomatic until PID, mucopurulent cervitis.
CAN LEAD TO SEPSIS, SKIN LESIONS, ARTHRITIS
CAN CAUSE BLINDESS IN UNTREATED INFANTS |
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Term
| Adverse Effects of Levodopa/Carbidopa |
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Definition
| Dopamine Excess: N/V, spastic dyskinesias, orthostatic hypotension, psychosis |
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Term
| Adverse reactions of Anti-cholergenic drugs (Benzotropine) |
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Definition
- Anticholinergic effects: Increased HR, BP, decreased GI motility
constipation, urine retention, dry mouth, dilated pupils
TREATS PARKINSON TREMOR as supplement to Dopamine Agonists or Levo/Carb |
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Term
| Cholinesterase Inhibitors |
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Definition
INCREASES AVAILABLE ACH
Adv. Rxn: Cholinergic - increased GI motitlty, lowerd HR. N/V/D, anorexia, bradycardia --> fainting.
REALISTIC EXPECTATIONS OF EFFECTS ON ALZHEIMERS! |
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Term
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Definition
M/S - inhibits inflammatory WBC from entering CNS and attacking myelin. Immunomodulator.
Adv. Rxn: flu-like symptoms, hepatoxicitiy, bone marrow suppression, inj. site rxn, depression.
DECREASES EXACERBATIONS
NEEDS AST, ALT, CBC Tests |
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Term
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Definition
| must be monitored with CBC test to count RBC/WBC |
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Term
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Definition
| Liver damage. Monitor function via AST, ALT lab tests |
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Term
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Definition
INDICATIONS: Seizure, Bipolar Mgmt, Migraines, Neuropathic pain.
Works by closing Na, Ca channels and increasing inhibitory GABA
- HAVE NARROW THERAPEUTIC INDEXES |
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Term
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Definition
Anticonvulsant. closes Na channels.
Adv. Rxns: CNS suppression, gingival hyperplasia, skin rash - can turn into Stevens-Johnson syndrome
INDUCES METABOLISM OF OTHER DRUGS, lower efficacy.
THERAPEUTIC RANGE: 10-30 mcg/mL
-Must be diluted in saline
-Drug levels must be lab tests |
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Term
| THERAPEUTIC RANGE OF PHENYTOIN -DILANTIN |
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Definition
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Term
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Definition
Seizure ctrl, bipolar, trigeminal neuralgia. Closes NA channels.
Adv. Rxn: CNS depression, bone marrow depression, Stevens-Johnson syndrome with increased risk in Asians with HLA-B1502 gene.
INDUCES METABOLISM OF OTHER DRUGS, lowering efficacy.
Test CBC and blood drug levels.
THERAPEUTIC RANGE - 4-13 mcg/mL |
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Term
| IV Ativan, Benzodiazapine, Corzepam |
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Definition
Tranquilize to stop status epilepticus seizures.
CAN CAUSE RABDMYLOLYSIS - blockage of kidney with proteins from dead cells. |
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Term
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Definition
MOOD STABILIZER OF CHOICE FOR BIPOLAR. Also, seizure ctrl, migraine prevention. Closes NA, CA channels and increases inhibitory GABA.
Adv. Rxns: CNS DEPRESSION, hepatotoxicity, pancreatitis, hair loss, temeor, bone marrow suppression.
THERAPEUTIC RANGE OF VALPROIC ACID: 40-100 mcg/mL.
CBC, ALT, AST, drug levels must be tested |
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Term
| THERAPEUTIC RANGE OF VALPROIC ACID - DEPAKOTE |
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Definition
|
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Term
| THERAPEUTIC RANGE OF CARBZMAZEPINE - TEGRETOL |
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Definition
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Term
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Definition
Neuropathic pain. Increases GABA.
Can cause CNS depression. |
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Term
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Definition
SEIZURE CONTROL MED OF CHOICE
Unknown MOA.
Can cause sedation but not a narrow therapeutic range drug AND no sig interactions with other drugs. |
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