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Pharmacology > Pharm2 6 Neuro pt3 > Flashcards

Pharm2 6 Neuro pt3 Flashcards

1
Q

Are most seizures dangerous?

A

Most seizures, of and to themselves, are not dangerous

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2
Q

Anti-seizure medication are drugs to __ seizures (4)

A

abort, control, minimize or prevent seizures

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3
Q

Anti-seizure Medications all act with __ receptors

  1. Stimulate an influx of __ ions (i.e., Valium, Ativan, Neurontin, Phenobarbital, Topamax)
  2. Delay an influx of __ ions (i.e., Dilantin, Cerebyx, Tegretol, Depakote)
  3. Delay an influx of __ ions (i.e., Zarontin, Depakote)
A

GABA
chloride
sodium
calcium

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4
Q

Prototypical Anti-seizure Benzo:

A

Diazepam (Valium®)

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5
Q

Diazepam (Valium®)
Indications
Mechanism of action

A

Indications: Status epilepticus
Mechanism of action: Bind to gama-amino butyric acid (GABA) receptor-chloride channels molecules increasing the effect of GABA, suppressing abnormal neuronal discharges

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6
Q

Diazepam (Valium®)
Adverse Effects
Contraindications

A

Adverse Effects: CNS depression, drowsiness, dizziness, memory impairment, ataxia, hypotension, withdrawal seizures,
Contraindications: Allergy

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7
Q

Prototypical Anti-seizure Barbiturate:

A

Phenobarbital (Nembutal®)

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8
Q

Phenobarbital (Nembutal®)
Indications
Mechanism of action

A

Indications: management of seizures unresponsive to other medications
Mechanism of action: intensify the effects of gama-amino butyric acid (GABA) receptor-chloride channels molecules increasing the effect of GABA, suppressing abnormal neuronal discharges

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9
Q

Phenobarbital (Nembutal®)
Adverse Effects
Contraindications

A

Adverse Effects: Physical and psychological dependence, drowsiness, respratory depression, respiratory arrest, CNS depression, coma , esp. with ETOH
Contraindications: Allergy

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10
Q

Prototypical Anti-seizure Misc:

A

Gabapentin (Neurontin®)

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11
Q

Gabapentin (Neurontin®)
Indications
Mechanism of action

A

Indications: Partial seizures or seizures that could become generalized [post-herpetic neuralgia, migraine prophylaxis]
Mechanism of action: Mimics GABA, speeding up release from brain neurons and suppressing abnormal neuronal discharges

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12
Q

Gabapentin (Neurontin®)
Adverse Effects
Contraindications

A

Adverse Effects: Potentiates CNS depression with other CNS depressants and/or ETOH, somnolence, dizziness, ataxia, fatigue, emotional lability
Contraindications: Allergy, avoid abrupt cessation, pregnancy

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13
Q

Prototypical Anti-seizure Hydantoin:

A

Phenytoin (Dilantin®)

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14
Q

Phenytoin (Dilantin®)
Indications
Mechanism of action

A

Indications: Tonic-clonic psychomotor seizures and seizure prophylaxis, esp. s/p head trauma; anti-arrhythmic
Mechanism of action: Chemically similar to barbiturates (but not addictive), reduces the spread of electrical discharges within the brain

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15
Q

Phenytoin (Dilantin®)
Adverse Effects
Contraindications

A

Adverse Effects: Gingival hyperplasia, dysrhythmias, hypotension, drowsiness, interacts with ETOH, anticoagulants, OCs
Contraindications: Allergy, IV bolus injection, avoid abrupt cessation, pregnancy

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16
Q

Behavioral, emotional, mood, psych disorders are Now, frequently diagnosed by __ , treated by __

A

diagnosed by specialist, treated by generalist

17
Q

What psych disorders are both dx and tx by generalist?

A

Mild to moderate depression, PTSD

18
Q

Prototypical CNS Stimulant for ADD/ADHD:

A

Methylphenidate (Ritalin®)

19
Q

Methylphenidate (Ritalin®)
Indications
Mechanism of action

A

Indications: Treatment of ADD/ADHD in children and narcolepsy in adults
Mechanism of action: Stimulates the cerebral cortex with amphetamine-like action through the release of norepinephrine, dopamine, and seratonin

20
Q

Methylphenidate (Ritalin®)
Adverse Effects
Contraindications

A

Adverse Effects: Seizures, paradoxical excitement, hypertension, psychosis, interacts with anticonvulsants, anticoagulants
Contraindications: Marked anxiety, tension, agitation, uncontrolled glaucoma, history of Tourette’s Syndrome/tics, within 14 days of MAOIs

21
Q

How Sonata differs from Ambien (CNS sleep hypnotics)

A

It has a stronger/quicker onset, and a much shorter offset than Ambien. (i guess it’s if they are having trouble FALLING asleep. ambien would be better if they have trouble STAYING asleep)

22
Q

If seizure patient doesn’t respond to Diazepam ppx, what’s the next drug?

A

Phenobarbital

23
Q

What’s the problem with Phenobarbital? (2nd line seizure ppx drug)

A

10 point IQ drop in mentally handicapped

24
Q

Gabapentin is probably never actually used for antiseizure purposes. What is it really used for? (3)

A

painful diabetic neuropathy, post herpetic neuralgia, and migraine prophylaxis.

25
Q

Gabapentin vs. Pregabalin

A

Gabapentin has nonlinear kinetics (varies)
Pregabalin (Lyrica) has linear kinetics. has all the same indications & issues that Gabapentin does. The difference: way more expensive.

26
Q

Phenytoin (Dilantin) main use is as…

A

anti-arrhytmic

27
Q

Veterans with traumatic brain injuries (and get seizures) get what tx?

A

Phenytoin (Dilantin)

28
Q

After Valium or Ativan stops a seizure, you can then give this other drug that has a much longer half life:

A

Phenytoin (Dilantin)

but i think this is more like a 3rd line drug

29
Q

What anti seizure med causes gums to grow over teeth?

A

Gingival hyperplasia

Phenytoin (Dilantin)

30
Q

You’re concerned about the speed of loading a seizure patient with Phenytoin b/c…

A

deadly cardiac dysthythmia

31
Q

Routes of admin for Phenytoin, and how they come into play

A

Initial loading is IV (not too fast)

Then capsules, and check the level

32
Q

Phenytoin is absolutely CI in:

A

pregnancy

33
Q

According to DSM-5, you can only make the dx of ADHD after what age?

A

5

Pharmacology (54 decks)

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