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Neurology meds Flashcards

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1
Q

What medications are used for Alzheimer’s

A

Donepezil
Memantine

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2
Q

What is the brand name of Donepezil?

A

Aricept

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3
Q

How does Donepezil work?

A

reversibly and noncompetitively inhibits centrally active acetylcholinesterase,

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4
Q

What are the side effects of Donepezil?

A

Gastrointestinal, Symptomatic bradycardia can occur (related to cholinergic toxicity), rhabdomyolysis and/or neuroleptic malignant syndrome

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5
Q

What is the brand name of Memantine?

A

Namenda

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6
Q

How does Memantine work?

A

an NMDA receptor antagonist; is an “open-channel blocker”. This means it can only enter and block the NMDA receptor channel after it has been opened by glutamate.
By blocking excessive glutamate activity at the NMDA receptors, Namenda helps regulate glutamate signaling and prevent overstimulation that could lead to neuronal damage.

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7
Q

What are the precautions of Memantine use?

A

history of seizure disorder, cardiovascular disease, renal or liver impairment, and can raise urine pH

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8
Q

What are the side effects of Memantine?

A

dizziness. headache. confusion, constipation, and increase in urine pH

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9
Q

What meds are used for neuropathic pain?

A

Gabapentin
Pregabalin

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10
Q

What is the brand name for Gabapentin?

A

Neurontin, Gralise

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11
Q

How does Gabapentin work?

A

Binds to the Voltage gated calcium channels=indirectly reduces calcium influx into nerve cells= decreased release of excitatory neurotransmitters, such as glutamate.

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12
Q

What are the side effects of Gabapentin?

A
  • Feeling dizzy, sleepy, tired, or weak
  • Diarrhea, upset stomach, or throwing up
  • Dry mouth

*Trouble controlling body movements

*respiratory depression

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13
Q

What are the precautions with Gabapentin?

A

Use with caution in patients with myasthenia gravis, bariatric surgery, renal impairment, and seizure disorder

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14
Q

What is the brand name of Pregabalin?

A

Lyrica

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15
Q

How does pregabalin work?

A

reduces the synaptic release of several neurotransmitters, apparently by binding to alpha2-delta subunit

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16
Q

What are the side effects of Pregablin?

A

drowsiness, dizziness, edema, weight gain, Blurred vision, decreased visual acuity,

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17
Q

What is Metaxalone used for?

A

Spasticity

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18
Q

What is the brand name of Metaxalone?

A

Skelenix

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19
Q

What are the warnings for Metaxalone?

A

CNS depression, serotonin syndrome, and hepatic/renal impairment

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20
Q

What are the side effects of Metaxalone?

A

dizziness, drowsiness, headache, Serotonin syndrome

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21
Q

What drugs are considered stimulants?

A

Dexmethylphenidate(Focalin)

Lisdexamfetamine (Vyvanse)

Methylphenidate (Ritalin, Concerta)

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22
Q

How do the different stimulants work?

A

Dexmethylphenidate: blocks the reuptake of norepinephrine and dopamine, and increases their release
into the extra neuronal space.

Lisdexamfetamine: prodrug that is converted to the active component dextroamphetamine= release of catecholamines (primarily dopamine and norepinephrine) from their storage sites in the presynaptic nerve terminals.

Methylphenidate: blocks the reuptake of norepinephrine and dopamine into presynaptic neurons; appears to stimulate the cerebral cortex and subcortical structures similar to amphetamines

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23
Q

What are the side effects of the stimulants?

A

Cardiovascular events
growth retardation
Psychosis or Mania
Priapism

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24
Q

What is the brand name of Guanfacine?

A

Estulic, Tenex

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25
How does Guanfacine work?
selective alpha2A-adrenoreceptor agonist that reduces sympathetic nerve impulses, resulting in reduced sympathetic outflow and a subsequent decrease in vasomotor tone and heart rate.
26
What are the side effects of Guanfacine?
dizziness, drowsiness, headache, constipation, xerostomia, impotence, fatigue, insomnia, slowing of cardiovascular system
27
What are the different drugs used for epilepsy?
Carbamazepine (Tegretol) Oxcarbazepine (Trileptal) Lacosamide (Vimpat) Lamotrigine (Lamictal) Phenytoin (Dilantin) Divalproex (Depakote) Phenobarbital (Luminal) Topiramate (Topamax) Levetiracetam (Keppra, Spritam)
28
Brand name of Carbamazepine?
Carbamazepine (Tegretol)
29
What is the mechanism of action for Carbamazepine
Sodium Channel Blocker/Modulator ## Footnote Carbamazepine is used primarily for seizure control and mood stabilization.
30
What are major contraindications for the use of Carbamazepine?
Hypersensitivity to carbamazepine, history of bone marrow depression, co-treatment with MAOIs, nefazodone, other NNRTIs that are CYP3A4 substrates ## Footnote These contraindications are critical to avoid serious adverse effects.
31
What are the adverse drug reactions (ADRs) associated with Carbamazepine?
CNS depression, dizziness, diplopia, blurred vision, nausea, ataxia, hyponatremia, elevated LFTs ## Footnote These reactions can impact patient safety and medication adherence.
32
What is the brand name of Oxcarbazepine?
Trileptal
33
What is the mechanism of action for Oxcarbazepine?
Sodium Channel Blocker/Modulator (Analogue of carbamazepine) ## Footnote Oxcarbazepine is used as an alternative to Carbamazepine with a similar mechanism.
34
What are major contraindications for the use of Oxcarbazepine?
Hypersensitivity to oxcarbazepine ## Footnote This is important to note during patient assessment.
35
What are common ADRs associated with Oxcarbazepine?
CNS depression, dizziness, diplopia, nausea, ataxia, hyponatremia, weight gain, alopecia ## Footnote Monitoring for these effects can help manage patient care.
36
What is the brand name of lacosamide?
Vimpat
37
What is the mechanism of action for Lacosamide?
Sodium Channel Blocker/Modulator ## Footnote Lacosamide is utilized for partial-onset seizures.
38
What are major contraindications for the use of Lacosamide?
Hypersensitivity to lacosamide ## Footnote Identifying hypersensitivity is crucial for safe prescribing.
39
What are common ADRs associated with Lacosamide?
CNS depression, dizziness, headache, nausea, diplopia, ataxia ## Footnote These side effects can interfere with daily activities.
40
What is the mechanism of action for Lamotrigine (Lamictal)?
Sodium Channel Blocker/Modulator ## Footnote Lamotrigine is effective for both seizures and mood stabilization.
41
What is the brand name of lamotrigine?
Lamictal
42
What are major contraindications for the use of Lamotrigine?
Hypersensitivity to lamotrigine ## Footnote Patients must be screened for this before initiation.
43
What are common ADRs associated with Lamotrigine?
CNS depression (less than many other AEDs), nausea ## Footnote Monitoring for CNS effects is important.
44
What is the black box warning for Lamotrigine?
Serious Skin Reactions (including SJS) ## Footnote This warning necessitates patient education on signs and symptoms.
45
What is the brand name of phenytoin
Dilantin
46
What is the mechanism of action for Phenytoin?
Sodium Channel Blocker/Modulator ## Footnote Phenytoin is a long-established treatment for seizures.
47
What are major contraindications for the use of Phenytoin?
Hypersensitivity to phenytoin, sinus bradycardia, AV block ## Footnote These contraindications help prevent severe complications.
48
What are common ADRs associated with Phenytoin?
Gingival Hyperplasia, bone marrow hypoplasia, osteoporosis, CNS depression, ataxia, nausea and vomiting, rash, headaches ## Footnote Long-term use can lead to significant oral health issues.
49
What is the brand name of Phenobarbital
Luminal
50
What is the mechanism of action for Phenobarbital?
GABA Receptor Agonist (Barbiturate) ## Footnote Phenobarbital is used for its sedative and anticonvulsant properties.
51
What are major contraindications for the use of Phenobarbital?
Hypersensitivity to barbiturates, marked liver function impairment, respiratory disease with evidence of dyspnea or obstruction ## Footnote This is crucial for patient safety.
52
What are common ADRs associated with Phenobarbital?
CNS depression/sedation, respiratory depression, ataxia, irritability ## Footnote These effects can lead to increased fall risk and sedation.
53
Brand name of Topiramate
Topamax
54
What is the mechanism of action for Topiramate?
Glutamate Blocker ## Footnote Topiramate has a unique action compared to other AEDs.
55
What are major contraindications for the use of Topiramate?
Hypersensitivity to topiramate, alcohol use for the ER formulation ## Footnote This is particularly relevant for patients with a history of substance use.
56
What are common ADRs associated with Topiramate?
CNS depression, cognitive impairment, paresthesias, kidney stones, ataxia ## Footnote Adequate hydration is recommended to minimize kidney stones.
57
Brand name of Levetiracetam
Keppra, Spirtam
58
What is the mechanism of action for Levetiracetam?
Glutamate Blocker ## Footnote Levetiracetam is often chosen for its favorable side effect profile.
59
What are major contraindications for the use of Levetiracetam?
Hypersensitivity to levetiracetam ## Footnote Identifying hypersensitivity is essential for patient safety.
60
What are common ADRs associated with Levetiracetam?
Mood changes, irritability, CNS depression ## Footnote Monitoring mood and behavior is important in patients taking this medication.
61
What medications are used for Parkinson's?
Carbidopa/Levodopa (Sinemet, Rytary, Duopa) Pramipexole (Mirapex) Ropinirole (Requip) Benztropine (Cogentin)
62
Brand name for carbidopa/levidopa
Sinemet, Rytary, Duopa
63
How does carbidopa/levidopa work?
Dopa Decarboxylase Inhibitor/Dopamine Precursor
64
What are the contraindications for carbidopa/levidopa?
concurrent use with non-selective monoamine oxidase inhibitors (MAOIs)
65
What are the side effects of carbidopa/levidopa?
Peak-dose dyskinesia, nausea/vomiting, orthostatic hypotension, neuropsychiatric effects, Parkinsonism-hyperpyrexia syndrome with sudden withdrawal
66
What are the brand names for Pramipexole and Ropinirole?
Pramipexole (Mirapex, Mirapex ER) Ropinirole (Requip)
67
MOA for Pramipexole
dopamine agonist
68
ADRS for pramipexole?
Impulse control disorders, peak-dose dyskinesia, somnolence and sleep attacks, nausea/vomiting, orthostatic hypotension, neuropsychiatric effects
69
What is the brand name of Benztropine?
Cogentin
70
MOA for Benztropine
anticholinergic
71
When cant you use Benztropine?
glaucoma
72
Side effects of Benztropine?
Anhidrosis, Blurred vision, constipation,
73
What drugs are used for migraines?
Eletriptan (Relpax) Rizatriptan (Maxalt) Sumatriptan (Imitrex)
74
How does rizatriptan work?
Selective serotonin 5- HT1B,1D receptor agonist in cranial arteries
75
When cant you use Rizatriptan?
–History of stroke or transient ischemic attack – Peripheral vascular disease – Uncontrolled hypertension
76
What are the side effects of Rizatriptan?
Dizziness, Drowsiness, Nausea, Chest tightness/pressure/heaviness, Passing out, Shortness of breath, Elevated blood pressure
77
What medication is used for narcolepsy?
Modanafil (Provigil)
78
What are the side effects of Modanafil?
Headache, Decreased appetite, Nervousness, anxiety, Nausea, Rash, Hallucinations, delusions, mania, psychosis, suicidal ideation
79
What are the drugs used for insomnia?
Eszopiclone (Lunesta) Zolpidem (Ambien, Intermezzo)
80
How does zolpidem work?
nonbenzodiazepine benzodiazepine-receptor agonist hypnotic – Enhances GABA
81
What is the BBW associated with Zolpidem?
complex sleep behaviors (sleep walking, sleep driving, engaging in other activities while not fully awake) – Discontinue immediately if patient experiences complex sleep behavior
82
What are the side effects of Zolpidem?
Drowsiness, Dizziness, Nausea, Complex sleep behaviors, Mood changes
83
What is Varenicline used for?
Smoking cessation aid
84
What is the brand name of Varenicline?
Chantix
85
How does varenicline?
partial nicotine agonist
86
What are the side effects of Varenicline?
CNS depression (caution with driving), Nausea, vomiting, Headache, Insomnia, Abnormal dreams, neuropsychiatric events
87
What is Phentermine used for?
Anorexiant (reduces appetite)
88
What is the brand name of Phentermine?
Adipex
89
When cant you use Phentermine?
H/o cardiovascular disease (e.g. arrhythmias, heart failure, CAD, stroke, uncontrolled hypertension)
90
What are the side effects of Phentermine?
– CNS effects (mania, psychosis, delirium) – Cardiac effects (hypertension, tachycardia, arrhythmias)

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