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Neurology Week 1 > drugs > Flashcards

drugs Flashcards

1
Q

best meds to use for difficulty falling asleep?

A

non benzo, ambien, lunesta, sontana

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2
Q

ambien

A

zolpidem, rapid onset, used for insomnia

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3
Q

lunesta

A

eszopicione, rapid onset, CI with ETOH, CNS depressant or hx of substance abuse

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4
Q

sontana

A

zaleplon, rapid onset and short half life

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5
Q

best class of drugs for sleep maintenance through out the night?

A

benzos: restoril and prosom

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6
Q

restoril

A

temazepam, is a benzo used as a long acting sleep aid. CI: sleep apnea, acute glaucoma, substance abuse

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7
Q

prosom

A

estazolam: is a benzo used for long acting sleep aid. CI: sleep apnea, acute glaucoma, substance abuse

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8
Q

best chronic insomnia drug class

A

tricyclic antidepressant: amitripyline, nortripyline, and trazodone

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9
Q

amitripyline

A

Elavil, antidepressant, used as a sleep aid and for pain

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10
Q

nortripyline

A

tricyclic antidepressant, used as a sleep aid and for pain issues

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11
Q

trazodone

A

desyrell, tricyclic antidepressant, used as a sleep aid

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12
Q

melatonin agonist ramelteon

A

rozerem. CI: hepatic impairment, Intractions: antifungals, TB drug rifampin and ETOH

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13
Q

narcolepsy medication

A

provigil, ritalin, nuvigil

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14
Q

Provigil

A

Modafinil: used for narcolepsy

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15
Q

Ritalin

A

methyphenidate: Amphetamine used for narcolepsy

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16
Q

Nuvigil

A

Armodafinil: used for narcolepsy

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17
Q

Alzeheimer medications

A

cholinesterase inhibitor, antidepressant, anxiolytic, antipsychotic, NMDA and selegiline

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18
Q

name 3 cholinesterase inhibitors

A

aricept, exelon, reminyl

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19
Q

aricept

A

donepezil: cholinesterase inhibitor used in all stages of AD

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20
Q

exelon

A

rivastigmine:cholinesterase inhibitor used in mild to moderate stages of AD

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21
Q

reminyl

A

galantine: cholinesterase inhibitor used in mild to moderate stages of AD. CI hepatic impairment

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22
Q

common side effects for cholinesterase inhibitor

A

GI issues

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23
Q

NMDA

A

Namenda: glutamate occupies receptors allowing ca+ to enter the cell causing neuronal death. These meds help regulate the level of glutamate and curb progression of AD

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24
Q

Selegiline

A

Eldpryl: mainly used his a parkinson’s drug. It prevents the breakdown of dopamine. used in younger pt and has neuronal preservation characteristics. Many side effects and sometimes used in AD

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25
Q

antidepressants used in AD

A

praxil, celebrex,zoloft

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26
Q

antipsychotics

A

abilify, zyprexa,seroquel, risperdal, geodon,

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27
Q

choice antipchotic drug for delirium?

A

haloperidol(associated with torsade de points and sudden death, risperidone

28
Q

medication for status epilepticus?

A

ABC, start IV of thiamine and then glucose, MIDAZOLAM 2.5mg (benzo) if not available, the second choice is Diazepam 10mg, if not effective use Phenobarbital 18-20mg

29
Q

keppra

A

Levetriacetam (anticonvulsant for generalized or focal seizure and addition med for tonic clonic. decreases abnormal excitement in the brain, start low and go slow. Gradually increase every 2 weeks, do not abruptly stop taking medication

30
Q

Keppra SE

A

depression, hallucinating, thoughts of self harm, sore throat, rash, double vision, ataxia, and HA

31
Q

Topirmate

A

Topamax: anti epileptic. Start low and go slow

32
Q

Topimate/Toprmax SE

A

tiredness, dizziness, nausea, weight loss, confusion, and change in vision

33
Q

first, second line tx for seizures (older drugs)

A

dilantin (phenytoin) and tegretol (carbamazapine)

34
Q

Huntington’s tx options

A

Tetrabenazine, antipsychotics (deplete cerebral dopamine), anticonvulsants, antidepressants

35
Q

Huntington’s anticonvulsants

A

clonazepam (klonopin or valproic acid (dapakote)

36
Q

Huntington’s antipyschotic

A

Resperidone(Resperdal), Olanzapine(zyprexa)

37
Q

how does the antipyschotic drug Resperdal work?

A

blocks dopamine, which is necessary b/c GABA pathway is broken, so dopamine is left unchecked

38
Q

Huntington’s antidepressants?

A

zoloft, prozac, Nortriptyline (pamelor)

39
Q

Treatment for Essential tremor?

A

beta blockers of anticonvulsants

40
Q

Beta blockers for essential tremors

A

propranolol or atenolol (better it patient has bronchi spasm)

41
Q

anticonvulsants for essential tremor

A

primidone, gabapentin (neurontin)

42
Q

another name for restless leg syndrome

A

wittmaack-ekbom’s syndrome

43
Q

tx for RLS?

A

correct underlying problem, iron deficiency, bath, warm compress, exercise, avoid caffeine and use parkinson’s medications, opiods, or gabapentin

44
Q

meds for RLS?

A

mirapex, requip, sinemet (levadopa) and Lyrica

45
Q

opioids for RLS?

A

codeine, oxycodone/acetaminophen(Percocet, Roxicet) Lortab, vicodin

46
Q

coma meds

A

give 02, thiamin and glucose, narcan (reverses opioids)

47
Q

drug of choice for simple and complex partial seizures

A

• Carbamazepine (Tegretol) – drug of choice

48
Q

list of second choice drugs for simple and complex partial seizures

A
  • Valproic Acid (Depakote, Valproate)
  • Phenytoin (Dilantin)
  • Gabapentin (Neurontin) – (adjunct)
  • Lamotrigine (Lamictal) (monotherapy)
  • Topiramate (Topramax)
  • Phenobarbitol
  • Levetiracetam (Keppra)
49
Q

meds for tonic clonic •

A 
Carbamazepine (Tegretol) Often used first line or used with Dilantin
•	Phenytoin (Dilantin)
•	Valproic Acid (Valproate, Depakote)
•	Lamotrigine (Lamictal) (add on)
•	Gabapentin (Neurontin) (adjunct)
•	Phenobarbital
50
Q

MOA of tegretol

A

blocks NA+ channels, inhibits high frequency repetitive firing, decreases synaptic transmission, inhibits uptake and release of Norepi

51
Q

when taking tegretol what do you monitor?

A

CBC, LFT’s

52
Q

warning for tegretol?

older sleep aid

A

toxic epidermal necrolysis (TEN) and Stevens-Johnson Syndrome (SJS)

53
Q

MOA of Phenytoin (Dilantin)

older sleep aid

A

Alters Na+, K+ and Ca2+ conductance, membrane potentials Alters concentrations of norepi, acetylcholine and GABA
Blocks sustained high-frequency repetitive firing

54
Q

SE of Dilantin

A

Gingival hypertrophy, hirsutism

55
Q

What to monitor when taking Dilantin?

A

CBC, LFT’, Cardiovascular risk associated with rapid infusion

56
Q

dosage for tegretol

A

800-1200mg QD, divided doses bid-qid
Start at 200mg PO BID
Therapeutic level = 4-12 mcg/nl

57
Q

dosage for keppra

A

Dosage is based on medical condition, kidney function and response to treatment. 1000-3000 every ad-bid. Steady State achieved in about 2 days

58
Q

drug of choice for Absence seizures

A

Ethosiximide (Zarontin)

59
Q

Myoclonic (shock like muslce contraction) seizure

A

Gabapentin or Lamotrigine

60
Q

what do you want to monitor during status epileptius?

A

EKG

61
Q

when can patient stop seizure meds

A

2 years seizure free

62
Q

MOA of topramax

A
  • Blocks repetitive firing
  • Na+ channels
  • Inhibits GABA
63
Q

Dosage of topramax?

A

200-600mg/d

64
Q

what to Monitor for when taking topramax?

A

Monitor renal and liver status
Narrow angle glaucoma
Kidney Stones
Weight loss

65
Q

popping ambient, don’t mix with?

A

CNS depressants eg benzodiazepines, opioids, tricyclic antidepressants, ETOH

66
Q

best travel med?

A

melantoin

Neurology Week 1 (10 decks)

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