NEURODEGENERATIVE DISORDERS

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xjessicax3
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10710
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NEURODEGENERATIVE DISORDERS
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2010-03-15 21:53:30
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Pharm test 2
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NEURODEGENERATIVE DISORDERS Pharm test 2
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  1. Neuromuscular Disorders

    -Four types of NM disorders
    -1. Parkinson's Disease: Chronic Disease that effects the __________ motor tract (which controls ________, ________& _________ characterized by three major features: rigidity, __________ & __________.
    Neuromuscular Disorders

    • -Four types of NM disorders
    • -1. Parkinson's Disease: Chronic Disease that effects the extrapyramidal motor tract (which controls posture, balance & locomotion characterized by three major features: rigidity, bradykinesias & tremors.
  2. Neuromuscular Disorders

    -2. Myasthenia Gravis: Lack of __________ impulses & __________responses at myoneural junctions causing muscle __________ and, at worst, __________ failure & arrest. Due to decreased secretion of __________ or loss of acetylcholine due to an increase in the enzyme __________. Also due to antibodies that __________ the acetylcholine receptor site post synapse.
    Neuromuscular Disorders

    -2. Myasthenia Gravis: Lack of nerve impulses & muscle responses at myoneural junctions causing muscle weakness and, at worst, respiratory failure & arrest. Due to decreased secretion of acetylcholine or loss of acetylcholine due to an increase in the enzyme cholinesterase. Also due to antibodies that block the acetylcholine receptor site post synapse.
  3. Neuromuscular Disorders

    -3. Multiple Sclerosis a disease of lesions on the myelin sheaths called __________
    -4. Alzheimer's Disease - a disease of neuritic plaques thought to be due to degeneration of cholinergic neurons and a deficiency in __________
    Neuromuscular Disorders

    • -3. Multiple Sclerosis a disease of lesions on the myelin sheaths called plaques
    • -4. Alzheimer's Disease - a disease of neuritic plaques thought to be due to degeneration of cholinergic neurons and a deficiency in acetylcholine

  4. Neuromuscular Disorder

    -Muscle Spasms are due to a variety of _________. Can be reduced by the use of skeletal muscle _________
    Neuromuscular Disorder

    -Muscle Spasms are due to a variety of causes. Can be reduced by the use of skeletal muscle relaxants.

  5. Parkinsonism

    -__________ drugs are used to reduce muscle rigidity and some of the tremors but have no effect on __________
    -The anticholinergics are parasympatholytics that inhibit the release of __________.
    -__________, __________, __________ & __________.
    Parkinsonism

    • -Anticholinergic drugs are used to reduce muscle rigidity and some of the tremors but have no effect on bradykinesia
    • -The anticholinergics are parasympatholytics that inhibit the release of acetylcholine.
    • -Artane, Cogentin, Parsidol & Norflex.

  6. Parkinsonism

    -Dopaminergics: Dopamine can not cross the _____________. ___________ is a precursor of Dopamine and it can cross the ________ In the brain, ________ is converted to Dopamine. 99% of ________ is converted to Dopamine in ________ tissue before reaching the brain.
    -________ has a short half-life and must be taken frequently
    -After ____ years of treatment patients experience on/off ________ and may need a dopamine ________ or ________inhibitor to decrease the "off" time and therefore decrease ________.
    Parkinsonism

    • -Dopaminergics: Dopamine can not cross the Blood Brain Barrier. Levodopa is a precursor of Dopamine and it can cross the BBB. In the brain, Levodopa is converted to Dopamine. 99% of Levodopa is converted to Dopamine in peripheral tissue before reaching the brain.
    • -Levodopa has a short half-life and must be taken frequently
    • -After 5 years of treatment patients experience on/off fluctuations and may need a dopamine antagonist or COMT inhibitor to decrease the "off" time and therefore decrease symptoms.

  7. Parkinsonism

    -Dopamine Agonists: _________ dopamine receptors. _________ (amantadine hydrochloride) is an antiviral that acts on _________ receptors
    -_________ is also used to act directly on CNS _________ receptors.
    Parkinsonism

    • -Dopamine Agonists: Stimulate dopamine receptors. Symmetrel (amantadine hydrochloride) is an antiviral that acts on dopamine receptors
    • -Parlodel is also used to act directly on CNS dopamine receptors.

  8. Parkinsonism

    -_________ inhibitors to prevent or slow the breakdown of ________
    -________ inhibitors increase the amount of ________ in the brain by inhibiting the inactivation of ________.
    Parkinsonism

    • -MAO-B inhibitors to prevent or slow the breakdown of dopamine
    • -COMT inhibitors increase the amount of Levodopa in the brain by inhibiting the inactivation of Levodopa.

  9. Myasthenia Gravis

    -Autoimmune disorder in which __________ does not read the post- ______ receptor sites.
    -Antibodies attack the __________ sites
    -Drug used to treat MG include __________.
    Myasthenia Gravis

    • -Autoimmune disorder in which acetylcholine does not read the post- synaptic receptor sites.
    • -Antibodies attack the receptors sites
    • -Drug used to treat MG include cholinesterase.

  10. Myasthenia Gravis

    -Crises:
    -1. _______ crisis: too little drug, too little acetylcholine, too little activity--> very weak patient (needs airway control then more drug)
    -2. _______ crisis: too much drug, too much acetylcholine, too much activity-->
    -very weak patient with severe _______ cramping (needs airway control then overdose _______ )
    Myasthenia Gravis

    • -Crises:
    • -1. Myasthenic crisis: too little drug, too little acetylcholine, too little activity--> very weak patient (needs airway control then more drug)
    • -2. Cholinergic crisis: too much drug, too much acetylcholine, too much activity-->
    • -very weak patient with severe abdominal cramping (needs airway control then overdose antidote)

  11. Myasthenia Gravis

    -Drugs used for the treatment of MG
    -_________-cholinesterase inhibitor
    -immunosuppressant _________
    -_________
    Myasthenia Gravis

    • -Drugs used for the treatment of MG
    • -Mestinon-cholinesterase inhibitor
    • -immunosuppressant Imuran
    • -Prednisone

  12. Multiple Sclerosis

    -Autoimmune disease that affects _______sheaths causing ______ to form
    -There is currently no _____ and no _____ drug therapy.
    -______are still being tried.
    -Drug therapy is aimed at phases of the disease including ______ attack, ______ & ______ & ______ progressive.
    Multiple Sclerosis

    • -Autoimmune disease that affects myelin sheaths causing plaques to form
    • -There is currently no cure and no satisfactory drug therapy.
    • -Protocols are still being tried.
    • -Drug therapy is aimed at phases of the disease including Acute attack, remission & exacerbation & chronic progressive.
  13. Alzheimer's Disease

    -________ dementia
    -Numerous changes related to multiple therapies about what causes Alzheimer's including:
    -1. ________ found with twists inside the neurons.
    -2. Accumulation of ________
    -3. ________ that promotes the formation of neuritic plaques bindings ________ in the plaques
    -4. Degeneration of ________ neurons and deficiency in ________.
    Alzheimer's Disease

    • -Incurable dementia
    • -Numerous changes related to multiple therapies about what causes Alzheimer's including:
    • -1. Neurofibrillary found with twists inside the neurons.
    • -2. Accumulation of amyloid
    • -3. Apolipoprotein that promotes the formation of neuritic plaques bindings amyloid in the plaques
    • -4. Degeneration of cholinergic neurons and deficiency in acetylcholine.
    • -5. Neuritic plaques that forms outside the neurons and inside the cerebral cortex.
  14. Alzheimer's Disease

    -no known _________ to cure the disease
    -FDA approved four medications to treat Alzheimer's including:
    -1. _________to treat memory loss
    -2. _________ inhibitors including:
    -A. _________ (tacrine)
    -B. _________ (donepezil)
    -C. _________ (rivastigmine)
    -These drugs increase _________ function by increasing the levels of _________.
    Alzheimer's Disease

    • -no known medications to cure the disease
    • -FDA approved four medications to treat Alzheimer's including:
    • -1. Hydergine to treat memory loss
    • -2. Cholinesterase inhibitors including:
    • -A. Cognex (tacrine)
    • -B. Aricept (donepezil)
    • -C. Exelon (rivastigmine)
    • -These drugs increase cognitive function by increasing the levels of acetylcholine.

  15. Alzheimer's Disease

    -Several drug for treating Alzheimer's are under investigation including the non-______ ant-inflammatories ______ , ______ channel blocker, ______ inhibitors, CNS stimulants like ______ , ______ inhibitors & vitamin__.
    Alzheimer's Disease

    -Several drug for treating Alzheimer's are under investigation including the non-steroidal ant-inflammatories Indocin, Calcium channel blocker, MAO-B inhibitors, CNS stimulants like Ritalin, ACE inhibitors & vitamin E.

  16. Central Acting Muscle Relaxants

    -____________ result from increased muscle tone from ___________ neurons caused by increased stimulation of cerebral neurons or lack of inhibition in the ___________ in the skeletal muscle.
    -These drugs _________ neurons activity in the spinal cord or brain and act directly on ___________ muscles.
    Central Acting Muscle Relaxants

    • -Spasticity result from increased muscle tone from hyperexcitable neurons caused by increased stimulation of cerebral neurons or lack of inhibition in the spinal cord in the skeletal muscle.
    • -These drugs depress neurons activity in the spinal cord or brain and act directly on skeletal muscles.

  17. Spasticity

    -Centrally acting muscle relaxants acts on the ______ cord
    -Such drugs include:
    -______(Baclofen), ______ (Dantrium) &
    -______ (Zanaflex)
    -Centrally acting muscle relaxants can --> drowsiness, lightheadedness, ______.
    Spasticity

    • -Centrally acting muscle relaxants acts on the spinal cord
    • -Such drugs include:
    • -Iioresal (Baclofen), dantrolene (Dantrium) &
    • -Tizanidine (Zanaflex)
    • -Centrally acting muscle relaxants can --> drowsiness, lightheadedness, headaches.

  18. Muscle Spasm

    -These are drug that are used for muscle spasm to _______ pain and _______ range of motion.
    -These drugs have a _______ effect and therefore should not be taken with CNS _______ like _______, _______, or _______.
    -This group of drug include:
    -_______, _______, _______ & _______.
    Muscle Spasm

    • -These are drug that are used for muscle spasm to decrease pain and increase range of motion.
    • -These drugs have a sedative effect and therefore should not be taken with CNS depressant like barbiturates, narcotics, or alcohol.
    • -This group of drug include:
    • -Soma, Flexeril, Robaxin & Norflex.

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