Create
Learn
Share

Pharm 55-65

rename
mhewett's version from 2016-07-17 01:21

Chapter 55: Parkinson's Disease

What part of the brain is abnormal in Parkinson's disease? Substantia nigra
What are the four drug classes used to manage Parkinson's disease? (1) Anticholinergics (2) COMT inhibitors (3) Dopaminergic agents (4) MAO inhibitors
What class of drug is the standard of therapy in Parkinson's disease? Dopaminergic agents
What dopaminergic agent requires the concomitant use of a COMT inhibitor? Levodopa
Is levodopa good for early or late stage Parkinson's disease? In what population of patients is this drug contraindicated? Early stage; Patients on antipsychotics
What vitamin is known to increase the breakdown of L-dopa and, thus, decreasing the effect of levodopa? Vitamin B6
What is the mechanism of carbidopa? How does this help a patient with Parkinson's disease? Inhibits peripheral decarboxylase, which causes an increase in L-dopa
In what patient population is rotigotine contraindicated? Patients with sulfite allergies
What is the mechanism of action bromocriptine? Does bromocriptine cause vasoconstriction or vasodilation? Dopamine receptor agonist; Vasoconstriction
In general, does the relationship between acetylcholine and dopamine have a positive or negative correlation? Negative (i.e. as one increases the other decreases)
What antiviral is sometimes used to manage Parkinson's disease? Amantadine
In what three patient populations are anticholinergics contraindicated? (1) Glaucoma (2) BPH (3) Pyloric stenosis
What class of drug is stongly contraindicated in Parkinson's disease? What is its mechanism of action? Antipsychotics; Block dopamine receptors
What drug class do entacapone and tolcapone belong to? COMT inhibitors

Chapter 56: Antipsychotic Medications

What class of drug is stongly contraindicated in Parkinson's disease? What is its mechanism of action? Antipsychotics; Block dopamine receptors
What type of dopamine receptor is primarily blocked by antipsychotic medications? What determines the potency of an antipsychotic drug? D2 receptor; Its affinity for D2 receptors
Are first generation antipsychotics said to be typical or atypical? How about second generation? Typical; Atypical
Are haloperidol, chlorpromazine, fluphenazine, and thioridazine first or second generation antipsychotics? Which of the previous four drugs is known to cause QT prolongation? First generation; Thioridazine
What generation of antipsychotic medication is associated with weight gain, hyperlipidema, hyperglycemia, and diabetes mellitus? Second generation
Which has a higher risk of extrapyramidal side effects, first or second generation antipsychotics? First generation
Are aripiprazole, clozapine, quetiapine, and risperidone first or second generation antipsychotics? Which of the previous four drugs is a common first line drug for psychosis? Second generation; Risperidone
Besides dopamine receptors, what other type of receptors are blocked risperidone? Serotonin
What are the five signs of neuroleptic malignant syndrome? What is the drug of choice for this condition? (1) Fever (2) Encephalopathy (3) Unstable vitals (4) Elevated muscle enzymes (5) Muscle rigidity; MNEMONIC: FEVER; Dantrolene
What is the primary use for antipsychotics? Treatment of schizophrenia
What is the drug of choice for psychosis? Risperidone
All antipsychotic agents block what type of receptors? Dopamine receptors

Chapter 57: Anti-Seizure Drugs

What type of seizure is due to a group of hyperactive neurons confined to a single locus? If the patient loses consciousness how would you describe this seizure? Partial seizure; Complex partial seizure
What type of seizure involves generalized activation of the brain? Does this type of seizure cause loss of consciousness? Generalized seizures; Yes
What is the drug of choice for partial focal and complex seizures? Carbamazepine
What is the most common and most dramatic type of seizure? What is the drug of choice for this condition? Grand mal (tonic-clonic) seizure; Valporic acid
What type of seizure is marked by a brief, abrupt, self-limited loss of consciousness? What is the drug of choice for this condition? Petit mal (absence) seizure; Ethosuximide
What type of seizure is marked by short episodes of muscle contration that recur for several minutes? What is the drug of choice for this condition? Myoclonic seizure; Valporic acid
What type of seizure occurs in children 3 month to 6 years of age in association with illnesses that cause high fevers? What is the drug of choice for this condition? Febrile seizures; Phenobarbital
What is the drug of choice for status epilepticus? Diazepam (valium)
What anti-seizure drug is known to cause gingival hyperplasia, hirsutism, and megaloblastic anemia? Phenytoin
Although not fully understood, what neurotransmitter is thought to be increased by phenobarbital? GABA
What anti-seizure medication is associated with an increased risk of of grand mal seizures? Ethosuximide
What anti-seizure medication is associated with an SIADH and hepatotoxicity? What neurotransmitter does it increase? Valporic acid; GABA
What is the drug of choice for post-hepatic neuralgia? Gabapentin
What is the drug of choice for painful diabetic peripheral neuropathy? Pregabalin
What two drugs, when used by a mother during pregnancy, are associated with neural tube defects? (1) Carbamazepine (2) Valproic acid

Chapter 58: Antiemetic Drugs

What is the drug of choice for motion sickness? What is its mechanism of action? Scopolamine; Muscarinic blocker
What type of receptor increases GI motility, relaxes GI sphincters, and empties the contents of the rectum? Are these sympathetic or parasympathetic responses? M3; Parasympathetic
What are the two brainstem areas associated with vomiting? Which area is associated with motion sickness? (1) Chemoreceptor trigger zone (CTZ); (2) Vomiting center
In terms of mechanism of action, what are the two components to the antiemetic effects of metoclopramide? (1) Blocks chemoreceptor trigger zone (CTZ) (2) Blocks M3 receptors in the GI tract
What is the major alkaloid found in marijuana? What is the name of its pharmaceutical equivalent? THC (tetrahydrocannabinol); Dronabinol
What are the two clinical uses for dronabinol? (1) Severe emesis in chemotherapy (2) Appetite stimulation
What is the drug of choice for vertigo? What is its mechanism of action? Meclizine; Blocks H1 receptors
What is the drug of choice for chemotherapy induced nausea? Metoclopramide
What class of antiemetics is reserved for nausea and vomiting associated with serious medical condition? What suffix is shared by most of these agents? 5-HT3 inhibitors; -serton

Chapter 59: Laxatives

Does bowel distension increase or decrease peristalsis? Increase
What are the two laxatives known to irritate the bowel in order to promote peristalsis? Which one can pass into breast milk? (1) Castor oil (2) Senna; Senna
How do non-absorbable salines like magnesium salts cause increased peristalsis? Draw water into intestine via osmosis and cause significant bowel distension and thus increased peristalsis
Is mineral oil a stool softener, lubricant, or both? Both
How do bulk forming agents/stool softners cause increased peristalsis? They form gels in the colon that serve to retain water. The retained water softens the stool and increases bowel distension (which increases peristalsis)

Chapter 60: Osteoporosis

What is the drug of choice for the treatment and prevention of osteoporosis? Bisphosphonates
Prevention and treatment of osteoporosis always involves the administration of _____ and _____. Calcium; Vitamin D
How dose low dose estrogen slow the progression of osteoporosis? Inhibits osteoclast activity
Any woman on estrogen replacement, at any dose, who has not had a hysterectomy should also be administered _____. Progesterone
How does calcitonin slow the progression of osteoporosis? Inhibits osteoclast activity
What medication, used in the management of osteoporosis, has analgesic properties, making it the preferred agent for acute treatment of osteoporosis-mediated fractures? Calcitonin
What drug class has been shown to effectively stop osteoporosis and reduce the risk of breast cancer? Selective estrogen receptor modulators (SERMs)
Which of the selective estrogen receptor modulators (SERMs) used to treat osteoporosis has shown no propensity to increase the risk of endometrial cancer? Raloxifene
What is the drug of choice for Paget's disease and chronic hypercalcemia resulting from malignancy? Bisphosphonates
Bisphosphonates should never be administered with _____. Calcium/Calcium-containing foods
What are the four drug classes used to manage osteoporosis? (1) Hormone replacement therapy (HRT) (2) Calcitonin (3) Selective estrogen receptor modulators (SERMs) (4) Bisphosphonates
What suffix do most bisphosphonates share? -dronate
In what four patient populations are bisphosphonates contraindicated? (1) Poor renal function (2) Inability to be upright for at least 30 minutes (3) History of esophageal or gastric disorders (4) Inflammation problems with jaws or gums
What suffix do most selective estrogen receptor modulators (SERMs) share? -oxifen