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PHARM CHARM V
Exam 2
| Question | Answer |
|---|---|
| used as an anti-seizure medication, treats absence seizures,myoclonic seizures, and tonic clonic (Grand mal) seizures | Anticonvulsants |
| brief periods of unconsciousness | Absence seizures |
| sudden muscle contractions that last 1 second. It can effect one limb or the entire body. | Myoclonic Seizures |
| Grand Mal seizures. Neuronal discharge spreads throughout both hemispheres of the cerebral cortex. major convulsions muscle rigidity followed by jerks causes pissing but not shitting | Tonic Clonic seizures |
| Convulsionsmay be followed by a loud cry, this is caused by forceful expiration of air across the vocal cords. marked impairment of consciousness CNS depression | Grand mal seizure aka Tonic clonic |
| discharge of neurons w/in a seizure focus reduce the spread of excitiation from seizure foci to other brain area supress the influx of sodium thru sodium channels keeps Na in the cell where it is inactive | MOA for Anticonvulsants |
| supress Ca influx,only in the Hypothalamus enhance GABA-induced inhibitory system | MOA for Amtoconvulsants |
| nystagmus(dancing eyes),ataxia (coordination problems),diplopia (double vision) | side effects of Anticonvulsants |
| the generally recommended treatment for stratus epilectus seizures is? | [Ativan]Lorezapam |
| used for all epilepsies except absence seizures and myoclonic seizures | [Dilantin] PHENYTOIN |
| selectively inhibits Na channels and exerts a stabilizing effect on excitable membranes (hyperactive cells) | MAO of PHENYTOIN[Dilantin] |
| prompt and extended form prodrug(fosphenytoin-IV and MI) | types of PHENYTOIN |
| there is activity w/o causing generalized depression | Phenytoin [Dilantin] advantage |
| inactivated by hepatic enzymes and is subject to enzyme inducers and inhibitors | Phenytoin metabolized |
| plasma concentration is below 10mcg per ml | 1st order rxns of Phenytoin |
| greater than 10 mcg per ml half-life increases exponentially | Zero order rxn of Phenytoin |
| 90% bound to plasma albumin less bound in neonates greater fraction remains in patients w/hypoalbuminemia doses must be freq increased in pregnant women | Pheytoin |
| toxic signs: Cardiac arrythmias and CNS depression when admin Fosphenytoin may be diluted and admin IV at a faster rate than___? | Phenytoin side effects |
| Nystagmus (dancing eyes) Ataxia (coordination prob) Diplopia (double vision) in overdose Gingival hyperplasia-overgrowth of gums (in treating epileptic seizures) | Pheytoin side effects [Dilantin] |
| most common in use take with some foods causes hyperglycemia-high blood sugar level C drug | GI upset of Phenytoin |
| the Elderly are more at risk for toxicity when using? | Pheytoin |
| low levels of folic acid (deficiency) Phenytoin use can cause blood disorder in which there is anemia with larger-than-normal red blood cells Admin of folic acid may reduce the effectiveness of Phenytoin | Megaloblastic Anemia |
| other drugs can DECREASES the rate of metabolism it is a potent INDUCER of other drugs VALPROATE acid-displaces it and causes TOXICITY | Phenytoin drug interactions |
| take extra care of teeth or Gingival Hyperplasia can happen can cause birth defects women may use Carbamazepine (Tegretol) to stop excess hairiness (facial and body hair that is coarse and dark) infants born to mothers taking this drug have bleeding is | Advice in taking Phenytoin |
| Barbituate: drug of choice for febrile seizures in children effective anticonvulsant | Phenobarbital |
| selectively inhibits sodium channels and exerts a stabilizing effect on excitable membranes (hyperactive membranes) well absorbed when given orally | MOA of Phenobarbital |
| low toxicity metabolized in the liver and some in the kidney 25% long half-life given 3x/day (adults:100 hr/neonates:100+ hrs | Phenobarbital dose |
| excessive sedation but tolerance develops megoblastic anemia | Phenobarbital side effects |
| Valporic acid increases the sedative effect additive CNS depression occurs when other CNS depressants are given,i.e. alcohol hepatic microsomal enzyme inducer | Phenobarbital drug interactions |
| treatment of partial, mixed & generlaized seizures not useful for pain or absence seizures | Carbamazepine [Tegretol] "CBZ" |
| selectively inhibits sodium channels and exerts a stabilizing effect on excitanle membranes (hyperactive cells) CBZ induces its own metabolism (AUTOinducer) | CBZ MAO |
| does not cause excess hairiness or coarseness of features | CBZ advantage |
| acute intoxication can result in stupor/coma drowsiness vertigo-dizziness ataxia-lack of musc coord baseline periodic livier fxn tests hemotological testing | Side effects of CBZ |
| enzyme inducer elevated by enzyme inhibitors ex:cimetidine | Drug interactions of CBZ |
| Succinimides: treatment of ABSENCE SEIZURES (DOC) the best drug for treatment of AS | Ethosuximide [Zarontin] |
| blocks calcium T channels w/no effects on Na channels or GABA (glycine) | MAO of [Zarontin]Ethosux |
| plasma half-life is 30-40 hours in adults and 30 hours in children admin once per day largely metabolized by the liver absorbed well after Oral admin | Zarontin/Ethosux metabolism |
| Most common: nausea,vomiting and anorexia (GI) drowsiness,lerthargy,euphoria,diziness,headache(CNS) | Most common side effects of Zarontin |
| this drug is not an inducer or inhibitor | Zarontin |
| treats a variety of types of seizures used for absence seizures tonic-clonic siezures bipolar disorder migraines | Valporic Acid [Depakene] |
| supress sodium and calcium T channels and enhance GABA | Valporic Acid MAO |
| highly bound to plasma albumin food slows absorption but helps with GI | Valporic Acid metabolism |
| minial sedation | advantage of Valporic Acid |
| GI upse fatal pancreatitis is also a black box warning more SE in children youngerthan 2 Pregnancy Category D higher risk in elderly | side effects of Valporic Acid |
| by inhibition of phenobarbital metabolism increases the plasma level Aspirin displaces valporic acid from binding sites increases the risk of toxicity | Valporic Acid drug interaction |
| suppress the spread of seizures from epileptogenic foci largely enhanced by GABA inhibitory mediator | BZ or benzodiazepines |
| used to treat absence seizures and myoclonic seizures | Clonazepam [Klonopin] |
| used to treat Stratus Epilepticus give it IV to prolong duration | Lorazepam{atiVAN] old folks |
| occurs when seizures are repeated so frequently that the person does not return to preseizure state | Stratus Epilepticus |
| treatment of partial seizures treatment of postherpetic neuraglia and other neurologic pain | use of Gabapentin [Neurontin] |
| elimination unchanged by the kidney not affected by enzyme inducers or inhibitor no effect on other drugs given three x a day | Gabapentin [Neurontin] |
| Phenytoin [Dilantin] Phenobarbital Carbamazepine [Tegretol] | Enzyme inducers |
| EthoSUXide [Zarontin] Valporic Acid Clonazepam [Klonopin] | Treats A B S E N C E seizures |
| Clonazepam [Klonopin] in kids | Treats M Y O L O N I C seizures |
| CBZor Carbamazepine [Tegretol] Valporic Acid Phenytoin | Treats T O N I C-C L O N I C seizures aka GRAND MAL Seizures |
| Phenobarbital | Treats F E B R I L E Seizures |
| caused by a loss of dopamine neurons in the substantia nigra there is an excess of excitatory cholinergic activity causes cerebral artherosclerosis vral encephalitis | Parkinson's disease |
| drugs that preventthe axn of dopamine in the basal ganglia | Antiparkinsons drugs |
| resting tremor rigidity bradykinesia (slow movement) | Side effects of ANtiparkinsons drugs |
| Dopaminergic drug: immediate metabolic precoursor of dopamine,replenishing the depleted stores 75% 3-6 week onset | Levodopa |
| relief of tremor and rigidity beneficial response diminishes after 2-5 years | Advantage of Levodopa |
| used in combo w/carbidopa (Sinemet) | Levodopa dose |
| slowed gastric emptying reduces absorption cause on-off metab to dopamine in gut and liver by dopadecarboxylase (1-3% gets to brain) | metabolism of Levodopa |
| metab of ____to dopamine. Results in: nausea vomiting | metabolism of Levodopa |
| to decrease the peripheral metabolism of levodopa | it is combined with carbidopa, a peripheral dopa decarboxylase inhibitor |
| dose dependent orthostatic hypotension early in therapy are anorexia nausea vomiting dyskinesia behavioral disturbances | Side effects of Levodopa |
| when use of the drug is discontinued there are: precipitous returns of symptoms on-off phenomena | when use of Levodopa is discontinued |
| Pyridoxine (Vit B6) interferes w/effectiveness of dopa carbidopa interferes with levopoda [Sinemet] resulting in increased peripheral avail of levodopa do NOT give with antipsychotics (antagonist) | Drug interactions of Levodopa |
| inhibits the intracerebral metab of dopamine max the therapeutic efficacy of concomitantly admin levopoda | Selegiline [Deprenyl] |
| dose dependent orthostatic hypotension early in therapy are anorexia nausea vomiting dyskinesia behavioral disturbances | Side effects of Selegiline [Deprenyl] |
| relatively selective MAO-B enzyme inhibitor (given in doses less than 10mg) does not cause potentiation of peripheral catecholamines | Selegiline [Deprenyl] |
| Dopamine agonist: bind to and activate dopamine recep good for PD | Mirapex MOA |
| does not have to be converted! | Advantage of Mirapex |
| causes nausea hallucinations | Mirapex Side effects |
| Rotigotine is a transdermal Pramipexole and Ropinirole are both indicated for treatment of restless leg syndrome | Types of Pramipexole [Mirapex] |
| normally added to levodopa regimen to enhance benefits treatment of extrapyramidal (EPS) symptoms blocking dopaminergic recep causing a balance btwn dopamine and acetylcholine | Benzotropine [Congentin] |
| mydiasis cuclopegia dry mouth tachycardia confutation (glaucoma} | Side effects of Benzotropine [Congentin] |
| cord problems | Spasticity |
| drugs acting on the spinal cord | Baclofen[Lioresal] |
| useful in reducing the frequency and severity of flexor or extensor spasms primary site of axn is the spinal cord | Baclofen[Lioresal] |
| most effective treatment of spasticity (cord problems) caused by MS or traumatic spinal cord lesions! | BACLOFEN |
| inhibitory neurotransmitter GABA (glycine) Diazepam enhances the GABA effect | MAO of Baclofen |
| drowsiness insomnia dizziness weakness ataxia mental confusion | Side effects of Baclofen |
| Acts on muscles | DANTROLENE[Dantrium] |
| prevents the body temp from going up so high that the body temp kills the patient! used in contraction of skeletal muscle by decreasing the amount of Ca released from the sarcoplasmic rectum used to treat malignant hyperthermia(increase in body temp) | [Dantrium] Dantrolene |
| serious potential to cause hepatoxcity (liver damage) | [Dantrium]Dantrolene |
| used to treat muscle spasms | [Flexeril] Cyclobenzaprine |
| given in conjunction with DRs orders to REST and get PHYSICAL THERAPY.Alleviates Muscle spasm. | [FLEXERIL}Cyclobenzaprine |
| drowsiness GI upset (affects the ability to drive) | [FLEXERIL]Cyclobenzaprine |
| Of the following, the drug choice for treating generalized tonic-clonic seizures in adults is? | Phenytoin [Dilantin] |
| Early signs of toxicity in a patient with epilepsy receiving phenytoin [Dilantin] include: | Nystagmus and Ataxia |
| When your patient was started on Carbamazepine [Tegretol] therapy the total drug regimen should have been carefully reviewed because Carbamazepine is a potent? | hepatic enzyme inducer |
| The drug generally considered by many as "first line" in the emergency treatment of seizures and status epilepticus is the IV use of? | [Ativan]Lorazepam |
| Your friend has had back pain due to muscle spasma after lifting some heavy objects. His physician has ordered rest and physical therapy and prescribed the muscle relaxant Flexeril [Cyclobenzaprine]. You should warn him that this drug? | may make him drowsy |
Created by:
boomer_bevo
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