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Pharmacy Drugs > 416 Exam 4 PD, MS, Epilepsy > Flashcards

416 Exam 4 PD, MS, Epilepsy Flashcards

(91 cards)

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1
Q

MOA carbidopa/levodopa (PD)

A

Dopamine replacement

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2
Q

Carbidopa/Levodopa AE

A 
Dyskinesia 
N/V 
Insomnia 
Hallucinations
Confusion 
Hypotension
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3
Q

Carbidopa/Levodopa

A 
Sinemet (25/100)
Sinemet CR (50/200)
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4
Q

Dopamine agonists (PD)

A 
Bromocriptine (rare) 
Pramipexole 
Ropinirole
Rotigotine 
Apomorphine
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5
Q

Dopamine agonists AE

A 
Hallucinations 
Fatigue/somnolence
Edema 
Nausea
Hypotension 
Pleuropulmonary fibrosis 
Impulsivity
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6
Q

MOA of MAOI (PD)

A

Inhibition of DA metabolism- specific for MAO-B receptors

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7
Q

Irreversible MAO-I agents (PD)

A

Selegiline

Rasagiline (monotherapy)

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8
Q

Reversible MAO-I agents (PD)

A

Safinamide

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9
Q

MOA of COMT-I (PD)

A

Inhibition of DA and levodopa metabolism

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10
Q

COMT-I agents (PD)

A

Entacapone (peripherally only)

Tolcapone (BBB)

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11
Q

MOA anticholinergics (PD)

A

Decreases excessive cholinergic activity

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12
Q

Anticholinergic agents for PD

A

Trihexyphenidyl
Benztropine (Cogentin)
Diphenhydramine

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13
Q

MOA of Amantadine for PD

A

Mild increase in DA concentrations

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14
Q

Amantadine SE

A 
Anticholinergic 
Nightmares
Insomnia 
Confusion 
Levido reticularis (discoloration) 
Withdrawal encephalopathy
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15
Q

Amantadine (Symmetrel) immediate release approved for

A

PD motor symptoms but NOT dyskinesia

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16
Q

Amantadine (Gocovri) extended release approved for

A

Levodopa-induced dyskinesia but NOT motor symptoms

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17
Q

Trt depression in PD

A

Pramipexole (D3 receptors)

SSRIs, SNRIs, TCAs

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18
Q

Trt psychosis in PD

A

Quetiapine

Primavanserin

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19
Q

Trt dementia in PD

A

Rivastigmine (approved)

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20
Q

Trt restless leg syndrome in PD

A

Ropinirole
Pramipexole
Levodopa

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21
Q

Trt REM behavior disorder in PD

A

Clonazepam (Klonopin)

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22
Q

Injectable agents for MS

A

IFN B-1a (Betaseron, Extavia)
IFN B-1b (Avonex, Rebif, Plegridy)
Glatiramer acetate (Copaxone)
Daclizumab (Zinbryta)

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23
Q

Oral agents for MS

A

Fingolimod (Gilenya)
Teriflunomide (Aubagio)
Dimethyl Fumarate (Tecfidera)

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24
Q

Infusion agents for MS

A

Natalizumab (Tysabri)
Alemtuxumab (Lemtrada)
Mitoxantrone (Novantrone)
Ocrelizumab (Ocrevus)

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25
IFN approved for
``` RRMS CIS (except Plegridy) ```
26
IFN SE
- flu like symptoms - injection site pain - leukopenia - hepatic injury - worsening of CHF - hyperthyroidism/thyrotoxicosis - depression
27
Glatiramer acetate approved for
RRMS | CIS
28
MOA of Glatiramer acetate (MS)
Glatiramer cells secrete anti-inflammatory IL-10 cytokines in CNS
29
Glatiramer acetate SE
Flushing, chest pain, palpitations, anxiety, dyspnea, throat constriction, urticaria Lipoatrophy (permanent)
30
Natalizuman approved for
RRMS
31
MOA of Natalizumab (MS)
Block alpha-4 integrin preventing linkage to VCAM-1 ultimately preventing the lymphocyte from stopping to be recruited across the BBB
32
Natalizumab AE
Progressive multifocal leukoencephalopathy (PML) | >2yrs of Natalizumab exposure
33
Fingolimod approved for
RRMS
34
MOA of Fingolimod (MS)
Binds to S1P1 receptors on lymphocytes blocking their capacity to egret from lymph nodes and reducing number of lymphocytes in peripheral blood
35
Fingolimod SE
``` Bradyarrythmia AV block -risk of injection -macular edema -hepatic injury -PML ```
36
Terifluonomide approved for
RRMS
37
MOA of Teriflunomide (MS)
Blocks DHODH | -ultimately exhibits a cytostatic effect on activated lymphocytes in periphery decreasing overreactive immune response
38
Teriflunomide SE
Teratogenic (rapid elimination if pregnant) | -hepatotoxicity
39
Dimethyl fumarate approved for
RRMS
40
MOA of Dimethyl fumarate (MS)
Activates Nrf2 which is unregulated in response to oxidative stress but perhaps not sufficiently
41
Dimethyl fumarate SE
- decreased lymphocyte counts by 30% - PML - flushing - diarrhea and stomach upset - hepatic injury
42
Alemutuzumab approved for
RRMS
43
MOA of Alemutuzumab (MS)
Targets CD52 and targets cells for lysis | -decreases number of new lesions
44
Alemutuzumab SE
Infusion causes cytokine release - fever, shaking chills - flushing and itching - alterations of HR and BP - dyspnea or chest discomfort Premeditated with 1GM of methylprednisolone for 3 days prior to infusion
45
Alemtuzumab AE
- autoimmune thyroid disorder - immune thrombocytopenia - antiglomerular basement membrane disease - thyroid cancer - melanoma - lymphoma
46
Ocrelizumab approved for
RRMS | PPMS
47
MOA of Ocrelizumab (MS)
Directed against CD20 expressing pre-B and mature B lymphocytes -cell surface binding results in antibody dependent cellular cytolysis and complement mediated lysis
48
Ocrelizumab SE
- pruritus - rash or erythema - bronchospasm or dyspnea - throat irritation or oropharyngeal pain - flushing or hypotension - pyrexia - nausea - tachycardia Premeditate with 100mg methylprednisolone and antihistamine
49
Ocrelizumab CI
Active hep B infection
50
Daclizumab approved for
RRMS
51
MOA of Daclizumab (MS)
Specific for CD25 | Selectivity inhibits signaling through the high-affinity receptor inhibiting lymphocyte activation
52
Daclizumab SE
- skin reaction - swollen lymph nodes - non-infectious colitis
53
Mitoxantrone approved for
RRMS (refractory only) SPMS PRMS
54
Mitoxantrone MOA (MS)
Suppresses proliferation of T and B cells and macrophages - enhances T cell suppressor function - decrease secretion or pro-inflammatory cytokines
55
Mitoxantrone CI
Liver dysfunction | Pregnancy
56
Mitoxantrone SE
- cardiotoxicity - secondary acute myelogenous leukemia (AML) - nausea - alopecia - amenorrhea
57
First generation trt of epilepsy
``` Carbamazepine Ethosuximide Phenobarbital Phenytoin Primidone Valproic acid ```
58
Second generation trt for epilepsy
``` Eslicarbazepine acetate Felbamate Lacosamide Levetiracetam Pregabalin Tiagabine Vigabatrin Gabapentin Lamotrigine Oxycarbazepine Perampanel Topiramate Zonisamide ```
59
Drugs with MOA of sodium channel inhibition
``` Carbamazepine Eslicarbazepine Lacosamide Lamotrigine Oxcarbazepine Phenytoin/Fosphenytoin Rufinamide ```
60
Carbamazepine approved for
Partial seizures Primarily generalized tonic-clonic seizures - may make absence seizures worse - may make myoclonic seizure worse
61
Genetic sequence that identifies SJS with carbamazepine
HLA-B 1502
62
Eslicarbazepine approved for
Partial seizures (monotherapy)
63
Lacosamide approved for
Partial seizures (monotherapy)
64
AE of Lacosamide
- dizziness - ataxia - somnolence - nausea - PR interval prolongation - atrial fibrillation
65
Lamotrigine approved for
- partial seizures - primary generalized tonic-clonic (adjunct) - Lennox-gastaut syndrome (adjunct)
66
AE of Lamotrigine
- dizziness - HA - diplopia - nausea - rash - hypersensitivity (SJS/TEN) - aseptic meningitis
67
Oxcarbazepine approved for
Partial seizures - may make absence seizures worse - may make myoclonic seizures worse
68
AE of oxcarbazepine
- hyponatremia (<125) - dizziness - HA - somnolence - diplopia - nausea - hypersensitivity (SJS/TEN) - HLA-B 1502 positive status
69
Phenytoin/Fosphenytoin approved for
Partial seizures - primarily generalized tonic-clonic seizures - may make absence and myoclonic seizures worse
70
AE of phenytoin
- CNS dose related (dizziness, confusion, ataxia) - long term use (coarsening of facial features, neuropathy, vit D and folic acid deficiency) - CV with IV preps - SJS/TEN - lupus - bone marrow suppression - injection site necrosis
71
Rufinamide approved for
Lennox-Gastaut syndrome (adjunct)
72
AE of Rufinamide
- dizziness - HA - fatigue - somnolence - nausea - QT interval shortening
73
Calcium channel inhibition MOA
Ethosuximide Gabapentin Pregabalin
74
Ethosuximide approved for
Absence seizures only (DOC)
75
AE of Ethosuximide
- nausea - HA - dizziness - bone marrow suppression - SJS/TEN - psychiatric manifestations
76
Gabapentin approved for
Partial seizures (adjunct) -may make myoclonic seizures worse
77
AE of Gabapentin
- dizziness - somnolence - ataxia - weight gain - emotional liability - hyperkinesis - angioedema
78
Pregabalin approved for
Partial seizures (adjunct) -may make myoclonic seizures worse
79
AE of Pregabalin
- dizziness - somnolence - ataxia - weight gain - angioedema
80
Potentiation of GABA activity MOA
Clobazam Phenobarbital Tiagabine Vigabatrin
81
Clobazam approved for
Lennox-Gastaut syndrome (adjunct)
82
AE of Clobazam
- somnolence - drooling - aggression (high dose) - SJS/TEN
83
Phenobarbital/Primidone approved for
- partial seizures - primarily generalized tonic-clinic - not generally considered primary therapy for any seizure disorder - may make absence seizures worse
84
AE of phenobarbital/primidone
- dependence - paradoxical hyperactivity in children - dizziness - sedation - respiratory depression - SJS/TEN - necrosis
85
Tiagabine approved for
Partial seizures (adjunct) - may make absence seizures worse - may make myoclonic seizures worse
86
AE of Tiagabine
- dizziness - asthenia - tremor - somnolence - new onset seizures in pts w/o epilepsy
87
Vigabatrin approved for
Complex partial seizure (adjunct) | -very refractor seizures ONLY
88
AE for Vigabatrin
- somnolence - dizziness - fatigue - weight gain - permanent loss of peripheral visual field - anemia
89
Glutamate inhibition MOA
Perampanel
90
Perampanel approved for
- partial seizures in pts >12ys | - primarily generalized tonic-clonic seizures (adjunct)
91
AE of perampanel
- somnolence - dizziness - fatigue - gait disturbances - hostility/aggression

Pharmacy Drugs (37 decks)

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