Drugs Block 4 Flashcards Preview

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Flashcards in Drugs Block 4 Deck (22):
1

Natalizumab

MS drug that blocks cell adhesion molecules (blocks alpha 4 Beta 1) thus preventing diapediesis of T cells and macrophages across BBB

Reduces number of new MS lesions.

2

Nimodipine

MOA: Calcium Channel Blocker

Preferentially effects CNS.

Dialates small vessels to increase collateral circulation and preserve cerebral perfusion (prunuske) Prevents vasospasm (First Aid) Used to treat Sub Arachnoid Hemorrhage

3

Tissue Plasminogen Activator (TPA)

Converts plasminogen to plasmin to break down clots.

Must use within 3 (old) -4.5 (young) hrs. Can use later w/ IR guided TPA.

Contraindications: HEMORRHAGE, BP>185/110, MI, Stroke, or Head Injury in past 3 mo, Anti-coagulation therapy.

4

Levodopa (L-DOPA)*

MOA: Immediate precursor converted into Dopamine via AAAD throughout the body.Dependent on intact presynaptic neuron.

Decreases akinesia, rigidity, and tremor. Better when used early.

Pharmakinetics: short plama half-life, absorbed erratically from GI. Amino acids can compete for transport. Peaks and troughs.

Transported in CNS via amino acid transporters.

Given with carbidopa (blocks action in body but not CNS)

Adverse Effects: Peak dose dyskinesia, Diphasic dyskinesia, off period dystonia, schizophrenia (limbic activation), nausea, vomiting, anorexia (chemoreceptor triggerzone just outside BBB.

5

Entacapone*

COMT Inhibitor

Decreased peripheral metabolism of L-DOPA by COMT. Leading to smoother response and prolonged "on" time.

Used as adjunctive with L-DOPA to reduce L-DOPA dose.

6

Selegiline*

MAOi

Inhibits MAO-B primarily metabolizes dopamine.

Effective early treatment or used in conjunction with L-DOPA. Smooths "on-off" fluctuations, reduce wearing off phenomenon.

7

Pramipexole*

D3 receptor agonist (D2 family). Can be used alone or with Sinemet. Can help with "on-off" fluctuations with L-DOPA.

Also used to treat RLS.

Adverse effects: response fluctuations, dyskinesia (less than L-DOPA)

8

Ropinirole

D2 receptor agonist. Can be used alone or with Sinemet. Can help with "on-off" fluctuations with L-DOPA.

Also used to treat RLS.

Adverse effects: response fluctuations, dyskinesia (less than L-DOPA)

9

Sinemet

L-DOPA and Carbidopa. Standard of Care for PD.

10

Carbidopa

Inhibits AAAD peripherally (doesn't cross BBB). Inhibits L-DOPA peripheral side effects. Reduce L-DOPA dose by 75%.

Co administered with L-DOPA.

11

Trihexylphenidyl*

Muscarinic antagoinst.

ACh is used as a neurotransmitter by a small but important subgroup of striatal interneurons. Unkown mechanism, but believed that with DA loss DA/ACh balance is off leading to excess ACh production.

Side effects: sedation, mental confusion, constipation, urinary retention.

12

Amantadine (Symmetrel)*

Antiviral drug that can be used in conjunction with levodopa. Unclear mechanism of help.

13

Tissue transplantation

Human fetal adrenal medullary tissue into caudate nucleus to treat PD.

Can cause runaway hyperkinesia

14

Electrical Stimulation

Stimulate Thalamus to increase motor activity.

15

Pallidotomy

Electric cutting out of Globus Pallidus

Alleviates akinesia, rigidity, and drug induced dyskinesia

16

Thalamotomy

Ameliorates tremor

17

Stroop Test

Word of one color with other color font.

Used to test the ability to switch attention (parietal damage if positive)

18

Haloperidol

Anti-psychotic that blocks DA receptors.

19

Clozapine

Atypical anti-pscyotic that blocks DA receptors, blocks 5-HT receptors, and blocks Glutamate reuptake

20

MAOi

Antidepressant that blocks the breakdown of NE and 5-HT

21

Imipramine

Tricyclic anti-depressant that blocks the reuptake of NE and 5-HT

22

Fluoxetine

SSRI anti-depressant that selectively blocks the reuptake of 5-HT