Neuro treatments Flashcards
(26 cards)
Tx for myasthenic crisis for rapid response?
chronic?
Plasmapheresis or IVIG
Chronic- Corticosteroids
How do you use Entacapone and Tolcapone in the tx of Parkinsons
Use as adjunctive tx
MOA- prevents dopamine breakdown.
1st line tx for tension headaches
NSAIDS, aspirin, acetaminophen
Drug of choice for mild Tourettes (simple tics)? (smartypance)
simple tics- Lorazepam
Simple and complex tics- Clonidine (may be effective)
Abortive tx for migraines
- Triptans or Ergotamines
- NSAIDs/Acetominophen if mild sxs
Parkinson Disease:
What medication may help early on with mild sxs and improves long-term levodopa induced dyskinesias.
Amantadine
Tx for Huntington Disease?
No cure
Tx for chorea- Tetrabenzine
What medication can be helpful in treating the fatigue in MS?
Amantadine
What can be used to tx seizures in Cerebral Palsy?
antiepileptics
Parkinson Disease:
What are 7 alternative treatments to Levodopa/Carbidopa
- Dopamine agonists (used in young patients to delay use of Levodopa d/t bad S/e):
- Bromocriptine
- Pramipexole
- Ropinirole
- Anticholinergics (<70 w/ tremor predominance- helps with ttremors and drooling):
- Trihexyphenidyl
- Benztropine
- MAO-B inhibitors (mild sxs- JUST tremors):
- Selegiline
- Rasagiline
Abortive tx for cluster headache
- 1st line= 100% O2
- SQ Sumitriptan
5 tx options for Alzheimers?
“the man with Alzheimers lost his MEMory while GALAvanting DOwn the RIVer looking for TACos”
- Ach-esterase inhibitors:
- Donepezil
- Tacrine
- Rivastigmine
- Galantamine
- NMDA antagonist:
- Memantine
Prophylaxis for Cluster headaches
1st line= Verapamil
Corticosteroids, Ergotamines, Valproic acid, Lithium, Cyprophetadine
What can be used to improve spasticity in Cerebral Palsy? (2)
Baclofen
Diazepam
1st line tx for Myasthenia Gravis? (2)
Pyridostigmine*
Neostigmine
Tx for tension HAs in severe or recurrent cases, prophylaxis`
TCAs (ex. Amitriptyline)
Beta Blockers
Tx for acute exacerbations of MS?
1st line: IV corticosteroids (high dose)
Plasmapheresis (if not responsive to steroids)
What is (are) the drug(s) of choice for mild cases of Parkinson Disease (mild meaning that the main or only symptom is tremor)?
A. Amantadine
B. Trihexyphenidyl
C. Levodopa-Carbidopa
D. Ropinirole or Pramipexole
E. Selegiline or Rasagiline
E. Selegiline or Rasagiline
(Levodopa-carbidopa is still the cornerstone of treatment, although dopamine receptor agonists (ropinirole and pramipexole) or monoamine oxidase (MAO) type B (MAOB) inhibitors (selegiline or rasagiline) or amantadine can be used as monotherapy early in the disease or as adjunctive therapy in later stages. Anticholinergic agents are helpful in treating tremors and drooling in patients with Parkinson disease. Although the drug of choice is still levodopa-carbidopa, its use should be delayed as long as possible because of the side effect profile and the eventual development of tolerance to these medications. Catechol O-Methyltransferase inhibitors (tolcapone or entacapone) along with levodopa-carbidopa are useful for patients with motor fluctuations. Follow liver function test results and watch for postural hypotension and nausea. Bromocriptine is a dopamine agonist but is not used too often because of its side effect profile.)
Tx for relapse-remitting/progressive MS:
2 meds that decrease #/severity of relapses?
_B-interferon*_
or
Glatiramer acetate
Tx for Essential tremor?
1st line- Propanolol
2nd line (or adjunct)- Primidone
3rd line- Alprazolam
Tx for severe Tourettes
antipsychotics, such as haloperidol, olanzapine, resperidone, or pimozide
2 tx for GBS
- Plasmapheresis (best if done early)
- IVIG
- +/- mechanical ventilation
PREDNISONE CONTRAINDICATED
Tx for TIA?
What is contraindicated?
Aspirin +/- Dipyridamole or Clopidogrel
** Thrombolytics contraindicated!!**
Prophylactic tx for migraine headaches
- Beta blockers, CCBs
- TCAs
- Valproate
- Topiramate
- NSAIDs
