Pharm Flash Cards 1.txt
Card Set Information
Pharm Flash Cards 1.txt
Cards o' pharmacology
deck code: nervouskey
"Note: DA=dopamine, BBB=blood brain barrier, PD=Parkinson's Dz, SE=side effect, pt or pts=patient(s), HA=headache"
"Generally, what is the purpose of using Carbidopa/Levodopa?"
Increase domamine levels
MOA of Carbidopa/Levodopa?
"inhibits decarboxylation of peripheral L-dopa, together they cross BBB where L-dopa is converted to DA"
Indication of Carbidopa/Levodopa?
"Pt's suffering from PD >65 y/o, younger pt's may suffer worse side effects and drug may be less effective"
Side effects of Carbidopa/Levodopa?
"drug-induced dyskinesias, ""on-off"" motor fluctuations, potentially compulsive behaviors (ie gamble, shop, binge eat)"
Mechanism of action of Pramipexole and Ropinirole?
"they are DA receptor agonists, they directly stimulate DA receptors"
Pluses and minuses with Pramipexole and Ropinidole over Carbidopa/Levodopa?
"Pluses: fewer side effects than L-dopa, minuses: less effective than L-dopa"
Name two older agents that preceded Pramipexole and Ropinidole
Bromocriptine and pergolide- SE include cardiac valve regurgitaion
Indication of Pramipexole and Ropinidole
monotherapy in PD patients <60yo w mild dz. adjunct therapy with L-DOpa in advanced PD
SE of Pramipexole and Ropinidole
"dyskinesia and ""on-off"" motor problems (less than L-Dopa), postural hypotension, hallucination, somnolence esp in elderly"
How is Pramipexole and Ropinidole administered?
Apomorphine is a dopamine receptor agonist. How is it administered?
What is COMT?
"Catechol-O-methyltransferase is one of several enzymes that degrade catecholamines such as dopamine, epinephrine, and norepinephrine. (Wikipedia)"
What type of drug is Entacapone and Tolcopone?
PD drug that acts to inhibit COMT
MOA for entacapone and tolcopone?
inhibit plasma COMT enzyme thereby prolonging T1/2 of L-dopa
Indication of entacapone and tolcopone?
used along with L-dopa in PD patients
SIde effects of entacaopone and tolcopone?
elevated liver enzymes for tolcopone. GI sxs and dyskinesias in entacapone
MOA of trihexiphenidyl?
antimuscarinic agent for patients with PD
Indication of trihexiphenidyl?
young pts with PD w tremor and drooling
SE's of trihexiphenidyl?
this is an anticholinergic agent so SEs include cognitive changes
How is amantidine used in the nervous system?
"although anti-flu agent, also used in mild PD esp in younger pts with bradykinesia. MOA unknown"
SIde effects of amantidine
confusion and ankle swelling
MOA of selegine
inhibits catabolism of dopamine in brain
indication of selegine
"used in early, mild PD"
MOA for opioids
"agonists for mu, delta and kappa opioid receptors, work through Gi/Go proteins to hyperpolarize neurons and inhibit neurotrans release"
Indication for for opioids?
"relief of moderate to severe pain, preop med, adjunct during anesthesia. sometimes used as antitussive and antidiarrheal agent"
Why are opioids judiciously prescribed?
SE of opioids (these are important to know for exams and for life)
constipation bc of decreased peristalsis
How is an opiod OD characterized?
"coma, resp depression, pinpoint pupils, hypotension, decreased bowel sounds"
How do you reverse opioid OD?
Give Naloxone. But risk in withdrawl
MOA of local anesthetics?
"block Na channels, preventing generation and conduction of nerve impulses"
Indication of local anesthetics
local and spinal anesthesia and nerve blocks
SE of local anesthetics
seizures in high doses after intravascular injection or in young kids
Name 4 examples of local anesthetics
"Lidocaine, procaine, bupivicaine, cocaine"
Name the DOC for generalized tonic-clinic (grand mal) seizures
valproate or lamotrigine or levetiracetam
"name the DOC for partial, secondary generalized seizures"
"carbamazepine, lamotriginem oxcarbazepinem, levetiracetam"
name the DOC for absence seizures (petit mal)
ethosuximide or valproate
Name the DOCs for atypical absence myoclonic and atonic seizures
"valproate, lamotrigine, levetiracetam"
Which drug will worsen an absence seaizure?
why is phenytoin no longer the DOC for generalized tonic-clonic or partial seizures?
"complicated pharmakokinetics, inferior adverse effect profile, frequent drug-drug interations"
What is the indication of valproate (valproic acid and divalproex)?
anticonvulsant in tonic-clonic seizures as well as atypical absensem myoclonic and atonic seizures (also used as mood stablizer)
What is the mode of action of valproate?
increases levels of GABA in the brain
side effects of valproate?
"most common SE is nausea/vom, which can be limited by taking enteric coated form (depakote), or take w food or by slow titration. weight gain is relatively common. hepatotoxicity esp in <2yo"
what is the indication for lamotrigine?
"anticonvulsant in most seizures except absence. monoRx in select adults, adjunct Rx in adults and kids >2. valproate decreases its clearance"
SE of lamotrigine?
"rash- diffuse or severe (stevens-johnson synd, aka toxic epidermal necrolysis), often as a result of rapid administration or combo with valproate"
What is the indication for levetiracetam?
"anticonvulsant: pt's >4 with partial seizures, pts >6 with primary generalized seizures, and pts >12 with myoclonic seizures"
MOA of levetiracetam?
"binds selectively to synaptic vesicular protein SV2A, modifying release of glutamate and GABA"
SE of levetiracetam?
"somnolence, dizziness, weakness and irritability. few drug interactions since not metab by CYP450"
What is the indication for carbamazine?
anticonvulsant: Partial and secondary generalized seizures. also to treat trigeminal neuralgia and diabetic neuropathy
MOA for carbamazine?
reduces polysynaptic responses and blocking post tetanic potentiation.
SE for carbamazine?
"rashes, esp in high doses. high risk for Stevens Johnson synd (toxic epidermal necrolysis) for Asians. CNS sxs- HA, drowsiness and decreased cognitive function"
"When treating absence seizures with carbamazine, SE may include..."
"mild leukopenia, hyponatremia and drug drug interaction"
What is the indication for oxycarbamazine?
"like carbamazine, anticonvulsant: Partial and secondary generalized seizures. also to treat trigeminal neuralgia and diabetic neuropathy"
What is the indication for ethosuximide?
anticonvulsant for absence (petit mal) seizures
What are the side effects of ethosuximide?
"usually well tolerated although some nausea/vom, hiccups"
What's the MOA for phenytoin?
"may block Na channels, stablizing threshold against hyperexitablility. may block Ca channels and enhance HABA"
What's the former name of phenytoin?
Indication for phenytoin?
"no longer DOC for generalized tonic clonic seizures due to pharmacokinetic, adverse profile, drug interactions"
SE of phenytoin?
"nystagmus, drowsiness, ataxia, diplopia, rash, gingival hyperplasia"
Indication for gabapentin?
"used in combination therapy for convulsions, also used in pain syndromes and psych disorders"
drug interactions for gabapentin?
few drug interaction
Indication for topiramate?
"adjuvent therapy for seizures, prophylaxis for migraines, treat neuropathic pain"
SEs for topiramate?
"parasthesias, cognitive impairment. metabolic acidosis and inc risk for renal calculi if used chronically"
indication of diazepam?
"treat acute repetitive seizures, can be used as intermittent therapy with other drugs"
mode of administration for doazepam?
Ginkgo and ginseng....
i need more info