Neuro Pharm Flashcards
(51 cards)
Name pharm
What is SUNCT?
What is paroxysmal hemicrania?
What are trigeminal autonomic cephalgias?
SUNCT: Excruiciating burning in men over 50 –> lamotrigine
Paroxysmal hemicrania: 5x a day clusters –> Indomethacin
hemicranias, Clusters, Sunct. broad catagory
Differentials of stroke
Seizure
HA
hypoglycemia
Name the sxs of MS and tx
6
Spasticity: benzos and baclofen Intention trmeor: beta blocker neurogenic bladder: oxybutynin urinary retention: bethanacol dysethesias: gabapentin fatigue: Amantadine
acute exacerbations
What ar ethe contraindications for seizure meds?
Contraceptives
Osteoporosis
For cluster headaches, what do we use to stop it acutely?
Chronic?
What can cause clusters that is easily treated?
Prednisone
Verapamil –> lithium
Sleep apnea
Pt presents with right down and out eye, pupil is dilated, decerebrate posturing?
Tx
right subarachnoid hemorrhage, with uncal herniation
parasympathetic’s are knocked out first, then oculomotor, then herniation
Clean CAT, whats next? LP. you’ll miss 10% of SAH
Pt presents with Parkinsonisms. If it’s unilateral, what is it most likely?
If it bilateral, what is most likely?
Uni =parkinson
Bilateral= drug induced (metoclopramide, hlaoperidol, mptp)
what is the hallmark of comas?
what ifthe pt is in a coma and presents with asterixis?
anisocoria = pupil weird stuff
Hepatic encaphlopathy
A pt presents with anoxia in the brain and coma; what is the first involved?
They also present with diminisehed corneal reflex, where is the lesion?
Now the pt’s eyes don’t turn the right way when the head is moved, where has been affected?
Cortical involvement
Midbrain
Oculocephalic = mid pons
Pt presents with ringing in ears, feels like acotton swab is in there, and hearing tests show low frequency hearing loss. Whats the tx?
Menieres
- low sodium diet
- diazepam
- Valium for vertigo
If you use DIx Hallpike and there’s a reproducable sx in a certain position what is that diagnostic for?
BPPV
If no - just plain vertigo?
pt prestents difficulty in decision-making and planning, which is of abrupt onset and occurs 3 months after a stroke
Vascular dementia
A pt is dxed with CADASIL, what’s the MOA?
notch3 gene on chr 19 is defective
What paraneoplasm can cause central disequilibrium?
breast/lung = abs against cerebellar purkinje cells
what do you give pts with any sort of dystonic dz?
levodopa in low doses
What are 3 reasons for ataxia?
Parkinson
toxins: MG, Co
Drug: Metoclopramide, haloperidol, MPTP
When you’re brain dead, what reflexes do you lose?
brainstem =
- pupillary
- Corneal
- Oculocephalic
When you’re brain dead, what reflexes do you lose?W
brainstem =
- pupillary
- Corneal
- Oculocephalic
What converets fospropofol –> propofol
alkaline phosphatase
Whats a weird adverse effect of Etomidate?
inhbiits 11b hydroxylase resulting in adrenocroical suppression
What is the MOA of dexmedetomidine? What does it look like?
- a2 agonist acts on locus coeruleus
- Short term ICU sedation; anesthesia that resembles physiologic sleep
When is the best time to use lidocaine?
antiarrhythmic, need long lasting and a pt is allergic to esters
What drug do you use for infiltration anesthesia? What is an infiltration anesthesia? What is the contraindications?
Procaine
- near peripheral nerve
- sulfonamide antibioitcs
What is the MOA of local anesthetics?
What helps with adverse effects, then?
inhibit voltage gated Na+ channels in the inhibitory cortical pathways, so there’s an increased risk of uncontrolled activity =seizure. use a benzodiazepine
also does this in cardiac, so decreases EF, FOC,
