chapter 14

Question 1

for epilepsy, is mono or polytherapy better?

Answer 1

monotherapy

Question 2

common symptoms are repeated seizures, changes in electrical impulses in the brain, drooling and tongue biting

Answer 2

epilepsy

Question 3

risk factors include:
hypoxia
birth injury to brain
fever
alcohol intoxication/withdrawal
brain tumors
head trauma
stroke
genetics

Answer 3

all trigger seizures/epilepsy

Question 4

no loss of consciousness

Answer 4

parital seizure

Question 5

loss of consciousness

Answer 5

generalized seizures

Question 6

two types of generalized seizures are

Answer 6

tonic clonic(grand mal)
absence(petit mal)

Question 7

tonic clonic is the____ common

Answer 7

most

Question 8

absence petit mal is most common in

Answer 8

kids

Question 9

how many parts of the brain are affected with a partial seizure

Answer 9

only one part of brain

Question 10

prolonged seizure- lasts 20 min

Answer 10

status epilepticus

Question 11

sedative/hypnotic drug
first antiepileptic drug
second line drug(adults with partial and generalized seizures

Answer 11

phenobarbital/luminal

Question 12

drug of choice for induced seizure caused by LA

Answer 12

phenobarbital/luminal

Question 13

mechanism of action is to decrease excitation (generation of an action potential) on the postsynaptic neuron by elevating GABA(gamma aminobutyric acid)

Answer 13

phenobarbital/luminal

Question 14

class of drug is barbiturate- induces sleep, decrease anti seizure affect

Answer 14

primidone

Question 15

enhances gaba, blocks sodium channel; respiratory dep high abuse potential and can cause dizziness

Answer 15

primidone

Question 16

for partial(both simple and complex) seizures and generalized tonic clonic seizures; used in dentistry to treat trigeminal neuralgia; teratogenic

Answer 16

dilantin(phenytoin)

Question 17

what pregnancy category is dilantin

Answer 17

D

Question 18

monitor for osteomalacia and gingival enlargement; can cause alopecia

Answer 18

dilantin phenytoin

Question 19

1st line of therapy for partial and generalized tonic-clonic seizures; originally developed for treatment of trigeminal neuralgia in dentistry; adverse affect is agranulocytosis

Answer 19

carbamazepine(tegretol)

Question 20

avoid erythromycin, clarithromycin, and doxycycline; dry mouth; blood disorders, can cause hirsutism; oral ulcerations, dry mouth, glossitis

Answer 20

carbamazepine(tegretol)

Question 21

which anticonvulsant medication has been documented to cause osteomalacia

Answer 21

dilantin phenytoin

Question 22

alopecia may be an adverse effect of phenytoin; carbamazapine can cause hirsutism

Answer 22

true; true

Question 23

generalized seizures, including tonic clonic; blocks sodium channels, increases gaba synthesis, inhibits gaba degradation in the brain; may cause nausea and vomiting; black box warnings; can cause dry mouth

Answer 23

valproic acid(depakene)/valproate(depacon)

Question 24

second gen seizure drugs

Answer 24

gabapentin(neurontin)

diazepam(valium)

Question 25

other indications for antiepileptic drugs

Answer 25

anxiety disorders, bipolar disorders, migraine, neuropathic pain

Question 26

increase in extrapyramidal side effects due to a decreased synthesis and release in dopamine (DA) which is responsible for turning off the extrapyramidal system high level of ACH, which controls muscle movement must be a balance between dopamine and ach

Answer 26

parkinsons disease

Question 27

``` symptoms include: resting tremor muscle rigidity(poke face) bradykinesia(muscular movement slow and rigid)(masked facial exp; short step walk) postural instability ```

Answer 27

parkinsons disease

Question 28

converts dopamine in brain;; dopamine cannot get through blood brain barrier and get into brain so levodopa converts dopamine in brain

Answer 28

dopaminergic drugs(dopamine replacement-levadopa)

Question 29

what is added to formula in dopa meds to lessen adverse side effects of l-dopa

Answer 29

carbidopa

Question 30

treating on off effect of levodopa; ortho hypo in dental chair; prototype: bromocriptine(parlodel)

Answer 30

dopamine agonists

Question 31

early or mild stages of disease or later on in combination with carbidopa-levodopa; primarily effects tremors; adverse side effect is xerostomia

Answer 31

anticholinergic agents

Question 32

examp of anticholinergic agent

Answer 32

trihexylphenidyl(artane)

Question 33

prototype drug antichol

Answer 33

benztropine(cogentin)

Question 34

maob end in ____; helps metabolize dopamine

Answer 34

giliine(block enzyme)

Question 35

neurodegenerative disease, destruction of cholinergic and other neurons in cns; accounts for 60% of cases of dementia in people over 65 in US; 10,000 deaths per year

Answer 35

alzheimers

Question 36

do meds stop progression of alzheimers

Answer 36

no

Question 37

prevent breakdown of acetylcholine(alzheimers)

Answer 37

cholinesterase inhibitors including: tacrine(cognex) | donepezil(aricept)

Question 38

antagonist for moderate alzheimers disease

Answer 38

nmda's | memantine(namenda)

Question 39

most antiparkinsonian drugs cause ___ and ____ hypotension, and

Answer 39

anticholinergic side effects and orthostatic(postural) hypotension, xerostomia

Question 40

is there any precautions with vasoconstrictors in LA for alzheimer drugs?

Answer 40

no

Question 41

primary headache disorders

Answer 41

migraine tension-type cluster headaches

Question 42

symptomatic therapy, either prescription or otc should not be used more than how many times a week

Answer 42

twice; acute therapy of migraines;

Question 43

therapy for migraines should start by eliminating all products containing ___ which causes vasoconstriction

Answer 43

caffeine

Question 44

stimulate 5-ht1 receptors(sumatriptan

Answer 44

triptan for migraines

Question 45

migraine drugs:

Answer 45

triptans analgesics(excedrin, Floricet) and nonsteroidal anti-inflammatory drugs ergot betablockers

Question 46

treatment of acute migraine to abort the attack but are not used prophylactically; bind with high affinity to 5-HT1 receptor

Answer 46

triptans

Question 47

referred to as selective serotonin agonists

Answer 47

triptans

Question 48

caution: blood pressure elevation- caution used when using LA containing epi caution when taking with SSRI's

Answer 48

triptans

Question 49

alpha-adrenergic blockers and vasoconstrictors of cranial smooth muscle; elevated levels of norepi occur by inhibiting reuptake elevated blood levels occur when taken with erythromycin and clarithromycin

Answer 49

ergot derivitives

Question 50

timolol and propranolol-nonselective; FDA approved; nonselective; limit use of epi -2 carps

Answer 50

betablockers- only prevent migraines-- does not solve problem like triptan and excedrine

Question 51

during a migraine, stimulation of the _____ nerve, carrying sensory information from the face, may cause referral of pain to any of the nerves three branches, resulting in facial pain

Answer 51

trigeminal nerve