pharm II week one

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pharm II week one
2012-09-28 18:52:12
myasthenia gravis cholinesterase inhibitors parkinsons

myasthenia gravis, cholinesterase inhibitors, parkinsons, ADHD
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  1. prototype drug for myasthenia gravis?
    neostigmine (prostigmin)
  2. main action of cholinesterase inhibitors?
    prevents breakdown of acetylcholine. (therefore making it more available)

    more specifically - inhibits acetylcholinesterase (which normally breaks down acetylcholine)
  3. two types of cholinesterase inhibitors?
    reversible - short-acting effects.

    irreversible - longterm effects
  4. myasthenic crisis
    undermedicated.  lack of ACh causes extreme muscle weakness
  5. what to give for myasthenic crisis?
    neostigmine (undermedicated)
  6. cholinergic crisis
    overmedication of cholinesterase inhibitors.  causes extreme muscle weakness
  7. how to diagnose cholinergic vs myasthenic crisis?
    • give Tensilon (edrophonium):
    • - worsening symptoms >> cholinergic
    • - improvement in symptoms >> myasthenic
  8. what to give for cholinergic crisis?
    atropine (overmedicated - reverses effects)
  9. prototype drug for Parkinsons?
  10. pathophys behind parkinsons?
    dopaminergic neurons degenerate >> decrease in dopamine >> imbalance of ACh & dopa >> unopposed ACh causes increased amount of GABA >> overactive GABA neurons causes PD symptoms.
  11. types of dopamine replacement therapies
    levodopa OR levodopa+carbidopa (Sinemet)
  12. what is the usual first drug selected for mild PD?
    • selegiline. (MAO-B inhibitor)
    • - suppresses destruction of dopamine; may delay progression of PD
  13. first-line treatment of choice (class) for a patient with more severe symptoms of PD?
    • dopamine replacement (levodopa/carbidopa) or
    • dopamine agonist
  14. types of dopamine agonists?
    • pramipexole (Mirapex)
    • bomocriptine (Parlodel)
  15. uses for dopamine agonists? adverse effects?
    first-line treatment for PD or supplement to levodopa for more advanced cases

    adverse effects: psychological symptoms/hallucinations.
  16. COMT inhibitor prototype?  use for COMT inhibitors?
    • entacapone (Comtan)
    • - prolongs half-life of levodopa.
  17. centrally acting anticholinergics for PD? effects?
    • Artane and Cogentin
    • - reduce tremor and rigidity
  18. indications for CNS stimulants?
    ADHD or narcolepsy
  19. 3 types of amphetamines used clinically
    • dextroamphetamine
    • amphetamine/dextroamphetamine
    • methamphetamine