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Flashcards in Pharmacology Deck (9)
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1
Q

You are a medical student based in the memory clinic. An 83-year-old female attends. She is on memantine. What is the mechanism of this medication?

A

NMDA Antagonist

Memantine is a clinically useful drug in many neurological disorders, including Alzheimer’s disease. The principal mechanism of action of memantine is believed to be the blockade of current flow through channels of N-methyl-d-aspartate (NMDA) receptors - a glutamate receptor subfamily broadly involved in brain function.

2
Q

What are some side effects of anti-psychotics? (11)

A

Metabolic syndrome.
Hyperprolactinaemia (galactorrhea, impaired glucose tolerance).
Dystonia.
Dyskinesia.
Antiemetic effects.
Extra-pydradimal side effects.
Antimuscarinic (dry mouth, blurred vision, urinary retention, constipation).
Sedation.
Weight gain.
Neuroleptic malignant syndrome (pyrexia, muscle stiffness).
Reduced seizure threshold (greater risk with atypical).

3
Q

What is a potential complication of anti-psychotic medication?

A

Long QT syndrome.

4
Q

What is the mechanism of action of anti-psychotic medications.

A

Act as dopamine D2 receptor antagonists, blocking dopaminergic transmission in the mesolithic pathways.

5
Q

What class of drug is clozapine.

A

Atypical anti-psychotic.

6
Q

What are some extra-pyramidal side effects of anti-psychotic medications? (4)

A

Parkinsonism.
Acute dystonia (e.g. torticollis, oculogyric crisis).
Akathisia (severe restlessness).
Tardive dyskinesia (late onset of choreoathetoid movements, abnormal, involuntary, may occur in 40% of patients, may be irreversible, most common is chewing and pouting of the jaw)

7
Q

What percentage of patients on anti-psychotic medication experience tardive dyskinesia?

A

Approximately 40% of patients.

8
Q

What are the dangers with anti-psychotic medication in elderly patients? (2)

A

Increased risk of stroke.

Increased risk of venous thromboembolism.

9
Q

What is the most likely anti-psychotic to cause long QT syndrome?

A

Halperidol