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2010-09-16 21:22:20
seizures parkinsons anesthetics

Disorders of motor function, seizures and anesthetics
Show Answers:

  1. What are the three main symptoms of a seizure?
    • Clonus
    • Tonus
    • Complete relaxation/paralysis
  2. What are the 7 types of generalized seizure?

    • Clonic
    • Absence
    • Tonic
    • Status epilepticus
    • Myotonic
    • Atonic
    • Tonic-clonic
  3. Which seizure involves the whole brain and involves rapidly repeated flexor motions?
    Clonic seizure
  4. What type of seizure involves the whole brain and causes sudden loss of muscle tone?
    Atonic seizure
  5. What type of seizure involves the whole brain and causes muscle contraction/rigidity?
    Tonic seizure
  6. What type of seizure involves the whole brain and lasts for many minutes or returns after a brief pause?
    Status epilepticus
  7. What type of seizure involves the whole brain and causes initial muscle contraction followed by repeated flexor motions?
  8. What type of seizure involves the whole brain and causes sudden muscle contraction that lasts for 1 second?
    Myotonic seizure
  9. What type of seizure involves the whole brain and causes loss of consciousness for 10-30 seconds?
    Absence seizure
  10. What is the MOA of antiepileptic drugs?
    • Raise Na+ channel depolarization threshold
    • Block Ca2+ channels
    • Enhances GABA
  11. What are four AED classes?
    • Hydantoin
    • Benzodiazepines
    • Barbituate
    • Miscellaneou
  12. What is the MOA of hydantoinin the treatment of seizures?
    Blocks Na+ channels
  13. What is the MOA of Benzodiazepinesin the treatment of seizures?
    Increases GABA efficacy
  14. What is the MOA of barbituates in the treatment of seizures?
    Increases GABA efficacy
  15. What four AEDs fall into the miscellaneous class?
    • carbamazepine
    • valproic acid
    • gabapentin
    • ethosuximide
  16. What is the MOA of carbamazipine in the treatment of seizures?
    Blocks Na+ channels
  17. What is the MOA of Valproic Acid in the treatment of seizures?
    Blocks, Na+ channels, Ca2+ channels and increases GABA efficacy
  18. What is the MOA of gabapentin in the treatment of seizures?
    Increases GABA efficacy
  19. What is the MOA of ethosuximide in the treatment of seizures?
    Blocks Ca2+ channels
  20. Which AED is good for all seizures except myoclonic?
  21. Which AED is good only for absence seizures?
  22. What three reasons make it necessary to monitor plasma levels when taking AEDs?
    • Narrow therapeutic window
    • Complex metabolism rates
    • Interaction with other drugs that increase/decrease metabolism of AED
  23. What MOA does phenytoin have in the treatment of seizures?
    blocks Na+ channels
  24. What types of seizures is phenytoin used for?
    • Partial seizures
    • Tonic-clonic seizures
  25. What three booby traps are associated with phenytoin?
    • Highly protein bound
    • Half-life is dose dependent
    • Can be fatal if IV is administered to quickly
  26. What are the adverse effects of phenytoin?
    • Mild sedation
    • Stevens-Johnson Syndrome
    • Gingival hypoplasia
    • Hirsutism
  27. What can be used to more easily administer phenytoin by IV?
  28. What kinds of seizures can carbamazepine be used to treat?
    • Partial
    • Tonic-clonic
  29. What are the booby traps associated with carbamazepine?
    • Can only be taken PO
    • P450 inducer
  30. What are the adverse effects of Carbamazepine?
    • SIADH (water overload)
    • Can affect blood cells
    • Aplastic anemia
    • mild sedation
  31. Which two AEDs do not induce P450 enzymes?
    • Valproate
    • Ethosuximide
  32. What are the major side effects of Valproate?
    • Nausea/vomiting
    • Weight gain
    • Rare/severe hepatotoxicity
  33. What type of seizure is phenobarbitol used to treat?
    • febrile seizure
    • partial
    • tonic-clonic
  34. What is the prodrug for phenobarbitol?
  35. What is the major booby trap associated with phenobarb?
    Major P450 inducer
  36. What are the adverse effects of phenobarbitol?
    • Heavy sedation
    • Folic Acid and Vit. K depletion
    • Increases its own metabolism
  37. What are the major adverse effects associated with ethosuximide?
    • Aplastic anemia
    • Nausea/vomiting
    • Mild neurological effects
  38. What is a precipitating factor for status epilepticus?
    abrupt discontinuation of meds
  39. What is given to a person having a tonic-clonic status epilepticus seizure to prevent the seizure from returning?
    Loading dose of fosphenytoin or any long-acting anticonvulsant
  40. What is used to stop a status epilepticus seizure?
    Lorazepam or Diazepam (benzodiazepine class AEDs)
  41. What kind of paralysis does damage to upper motor neurons cause?
    spastic paralysis
  42. What kind of paralysis does lower motor neuron damage cause?
    flaccid paralysis
  43. What is myopathy?
    Disease that causes the muscle to be unable to respond to nerve impulse
  44. What is an example of a myopathy?
    Muscular dystrophy
  45. What two treatments are used to treat myasthenia gravis?
    • Immunosuppressants
    • Acetylcholinesterase Inhibitors
  46. What are three Upper Motor neuron diseases?
    • ALS
    • Multiple sclerosis
    • Parkinsons
  47. What disease has a relapsing-remitting condition that makes it difficult to conduct drug trials?
    Multiple sclerosis
  48. What disease is characterized by a demyelination of the nerves in the CNS that is relapsing and remitting and may be autoimmune in nature?
  49. What disease is characterized by progressive death of motor neurons in the CNS?
  50. What are three characteristics of disorders of the basal ganglia?
    • Involuntary movement
    • Alteration in muscle tone
    • Disturbances in body posture
  51. What is tremor?
    Rhythmic shaking or extremity or head.
  52. What is a tic?
    Irregular coordinated movement: winking, grimacing, shrugging
  53. What is chorea?
    Brief, rapid and coordinated graceful movements
  54. What is athetosis?
    slow, continuous, wormlike movement
  55. What is ballismus?
    Violent, sweeping movements
  56. What is dyskinesia?
    rhythmic, repetitive bizarre movements in the face
  57. What kind of motor function disorder is Parkinsons?
    Basal ganglia
  58. What are seven types of involuntary movement?
    • Athetosis
    • Bellasimus
    • Chorea
    • Dystonia
    • Dyskenesia
    • Tremors
    • Tics
  59. What is bradykinesia?
    Difficulty in starting and stopping movement.
  60. What disease is characterized by a reduction in the concentration of dopamine in the striatum?
  61. What are the three main symptoms associated with Parkinsons?
    • Resting tremor
    • Rigidity
    • Bradykinesia
  62. What are three methods used to treat Parkinsons?
    • Increase dopamine concentrations
    • Decrease dopamine loss
    • Decrease ACh concentration or activity
  63. What are five antiparkinson drug treatments?
    • Dopamine replacement
    • COMT inhibitors
    • MAO inhibitors
    • Dopamine agonists
    • Anticholinergics
  64. Two benefits of using carbidopa when treating Parkinsons with dopamine replacement
    • Keeps levodopa from being converted to dopamine in the periphery
    • Can give lower dose of levadopa
  65. What can inhibit levadopa absorption?
    • protein
    • Vitamin B6
  66. What treatment can be used in combination with dopamine replacement?
    Dopamine agonist
  67. What are the side effects of dopamine agonists?
    • Nausea/vomiting
    • Sleep Attacks
    • Inc. risk of orthostatic hypotension, hallucination, dyskinesias
  68. Which PD treatment will cause liver failure if used in conjunction with dobutramine?
    COMT inhibitors
  69. What is the MOA of Amantidine in the treatment of PD?
    Increases release of dopamine and blocks muscarinic receptors (anticholinergic)
  70. Is Amantadine a 1st line or 2nd line drug for PD?
    2nd line
  71. In what kinds of patients should anticholinergic drugs not be used when treating PD?
    • Patients with:
    • Memory Loss
    • Dementia
    • Glaucoma
  72. What three conditions does balanced general anesthesia result in:
    • Loss of consciousness
    • Analgesia
    • Muscle relaxation
  73. Why do people get IV fluids during surgery?
    To counteract the decrease in blood pressure caused by inhalation anesthetics.
  74. What must occur during the reversal phase of general anesthesia?
    The neuromuscular blocker must be reversed as soon as inhalation anesthetics are removed.
  75. What type of drugs are local anesthetics?
    Sodium channel blockers.
  76. Which class of local anesthetics is more likely to induce an allergic reaction?
    Ester class like Novacaine
  77. What is an example of using a local anesthetic to produce regional anesthesia?
  78. What is a common local anesthetic?