Alzheimers

Question 1

What is the pathophysiology of Alzheimer’s disease?

Answer 1

It is the formation of beta amyloid and neurotic plaques in the hippocampus and cerebral cortex

Question 2

How do patients with Alzheimer’s brain present on scans?

Answer 2

They show signs of atrophy is a high uptake of the cortical regions

Question 3

What are the risk factors to developing Alzheimer’s disease?

Answer 3

Diabetes, depression, stress, less cognitive activity, head, trauma, orthostatic hypotension, hypertension, in midline, reduced education, poor BMI management, and hypohomocyteanemia

Question 4

What are the two approved drug classes to treat dementia

Answer 4

Acetylcholine esterase inhibitors and NMDA receptor agonists

Question 5

What are the acetylcholine esterase inhibitors used in Alzheimer’s?

Answer 5

Donepezil rivastigmine, and galantamine

Question 6

How do the ACHEIs work in Alzheimer’s disease?

Answer 6

They increase the amount of postsynaptic acetylcholine which enhances its transmission

Question 7

How does galantamine work in Alzheimer’s disease?

Answer 7

Modulates the nicotinic acetylcholine receptors

Question 8

How does Rivastigmine work to treat Alzheimer’s?

Answer 8

It inhibits butylcholinesterase

Question 9

When are acetylcholine estetrace inhibitors indicated?

Answer 9

For mild to moderate dementia
Off label use is moderate to severe dementia vascular dementia, or mixed dementia’s

Question 10

What are the adverse effects of acetylcholineesterase inhibitors?

Answer 10

G.I. upset, headache, abnormal dreams, dizziness, seizures, bradycardia, syncope, second-degree AV block, Rhinitis and extrapyramidal symptoms

Question 11

What three drug classes do ACHEI interact with

Answer 11

First generation antihistamines, tricyclic, antidepressants, and typical antipsychotics

Question 12

What is the NMDa antagonist used in Alzheimer’s

Answer 12

Memantine

Question 13

What is the benefit of using NMDA receptor antagonist

Answer 13

They modulate the effects of glutamate and showed none of the undesirable effects associated with the other drugs in that category

Question 14

When are the MND a receptor antagonist indicated

Answer 14

Only in severe dementia

Question 15

What are the two types of unilateral migraines?

Answer 15

With aura or without aura
Aura is more common than women typically in adolescence and peak prevalence age is 40 years old

Question 16

What are the acute/abortive medication’s used to treat migraines

Answer 16

NSAIDs Triptons lamiditan ergot alkaloids, opioids and barbiturates

Question 17

What are the medications used for prophylactic and prevention of migraines?

Answer 17

Antidepressants, beta blockers anticonvulsant and CGRP antagonists

Question 18

What are the antidepressants used for migraines?

Answer 18

Amitriptyline and venlafaxine

Question 19

What are the beta blockers used for migraines?

Answer 19

Metoprolol and propanolol

Question 20

What are the anti-convulsants used for migraines?

Answer 20

Valproate and topiramate

Question 21

What are the CGRP antagonist used to treat migraines

Answer 21

Ends in mab or ant

Question 22

What two anti-emetics can be used as monotherapy for acute migraines

Answer 22

Metoclopramide and prochlorperazine

Question 23

What two meds are really effective for acute migraines by IV

Answer 23

Ketoroalac

Question 24

What are the small molecule calcitonin gene related peptide receptor antagonist used to treat migraines

Answer 24

Atogepant and rimegepant

Question 25

Which two Tripton drugs are available as a nasal spray for migraines

Answer 25

Sumatriptan and zolmitriptin

Question 26

How did Tripton’s work to Aleve migraines?

Answer 26

They caused vasoconstriction and inhibit the release of vasodilator mediators, which is believed to trigger migraines, and therefore relieves the pressure to abort a migraine

Question 27

What types of headaches is sumatriptan indicated in

Answer 27

They are an acute/abortive method for migraine and cluster headaches

Question 28

What are the adverse effects of sumatriptan?

Answer 28

Injection site reaction, paresthesia, dizziness, drowsiness, sedation, hypertension, chest neck, and jaw, pain, hot, or cold sensation, and flushing

Question 29

Which medication is a five – HT1D agonist

Answer 29

Sumatriptan

Question 30

What is the fungus called that primarily grows on rye plants and produces alkaloids that cause egotism in humans that consume them

Answer 30

Claviceps purpurea

Question 31

What is the prototype that is administered as a nasal spray for ergot alkaloids

Answer 31

Dihydroergotamine

Question 32

What are the adverse effects of DHE?

Answer 32

Teratogenic, nausea, vomiting, diarrhea, hallucinations, andprolonged vasoconstrictions

Question 33

What is the antidote for DHE when patients experience prolonged vasoconstriction?

Answer 33

Nitroprusside

Question 34

What migraine medication should you avoid using antihypertensives with?

Answer 34

Ergotamine

Question 35

Which medication cannot be taken for 24 hours before or after ergotgamine because if it’s vasoconstrictive effects

Answer 35

Triptan

Question 36

What class are Triptans

Answer 36

Serotonin five – HT1B

Question 37

What is the downside for CGRP antagonist?

Answer 37

They cost about $6900 a year and are not covered by most insurances

Question 38

True or false serum CGRP levels are elevated during migraine episodes

Answer 38

True