Quiz 6

Question 1

Cognitive Sx of Alzheimers

Answer 1

1. Impaired memory
2. Disorientation
3. Language difficulties
4. Impaired judgement

Question 2

Non-cognitive Sx of Alzheimers

Answer 2

1. Agitation
2. Anxiety
3. Psychosis
4. Depression

Question 3

Name the antichonlinesterases

Answer 3

1. Exelon
2. Aricept
3. Razadyne

Tries to preserve as much ACh as possible
Used for Alzeihmers

Avoid in Pts w/ CV disease, peptic ulcer disease

Don’t use w/ anticholinergics

Question 4

ADRs anticholineresterases

Answer 4

1. Nausea
2. Insomnia
3. HA
4. Blurred vision
5. Bradycardia
6. Syncope

Question 5

What is the NMDA receptor antagonist & how does it work?

Answer 5

1. Namenda

Dec. [glutamate], cuts down flow of Ca2+ to dec. cellular damage
For Alzheimers
May be neuroprotective
Dose for renal impairment

Question 6

ADRs Namenda

Answer 6

NMDA receptor antagonist

1. Ataxia, hypokinesia
2. Emotional agitation, confusion, dizziness, depression, fatigue
3. Constipation

Question 7

Goals of Parkinson therapy

Answer 7

1. Inc. amount of dopamine in CNS

2. Dec. ACh levels or block ACh

Question 8

What risk comes from stopping Dopamine precursors?

Answer 8

Withdrawal

NMS - Neuroleptic Malignant Syndrome

Question 9

What are the dopamine agonists?

Answer 9

1. Mirapex
2. Requip
3. Rotigotine

Parkinson’s drug

Question 10

What are the dopamine precursors?

Answer 10

Levodopa/Carbidopa

Carbidopa is smaller #

Question 11

ADRs dopamine agonists

Answer 11

More likely to have side effects than dopamine precursor

1. Inducing compulsive behavoir
2. Postural HOTN
3. Hallucinations
4. Nausea
5. Somnolence
6. Worsen diskenesias

Question 12

What are the MAO-B inhibitors?

Answer 12

1. Rasagiline
2. Selegeline

Reduce the breakdown of dopamine

Question 13

What is a good add-on therapy for advanced Parkinson’s?

Answer 13

Amantadine
Renally adjusted
Good for rigidity
Ankle edema, liedo reticularis

Question 14

What are the anticholinergics?

Answer 14

1. Cogentin
2. Artane

Parkinson’s
Good for slow, resting tremor

Question 15

What are the COMT inhibitors and when are they used?

Answer 15

1. Tasmar
2. Comtan

Use w/ Levodopa/carbidopa

Question 16

What antipsychotic is used for hiccups?

Answer 16

Thorazine

Question 17

What are the phenothiazines?

Answer 17

Typical antipsychotics

1. Thorazine
2. Prolixin
3. Trilafon

Blocks D2 & D1

Question 18

ADRs phenothiazines

Answer 18

1. QTc prolongation
2. Hyperprolactinemia
3. Wt gain
4. Tachycardia
5. Dizziness
6. HOTN
7. Impotence
8. Akathisia & distonias
9. Parkinsonian syndrome

Question 19

Which antipsychotic can you use in kids?

Answer 19

Abilify

Strong D2 blockade & serotonin

Question 20

Side effects of 2nd Gen antipsychotics

Answer 20

ex. Abilify
1. Wt gain
2. Hyperlipidemia
3. Hyperglycemia
4. Prolactin elevation
5. Seizures
6. Orthostatic HOTN
7. NMS
8. QTc prolongation
9. Sudden death

Question 21

What are the MAOIs?

Answer 21

1. Tranylcypromine
2. Isocarboxazid
3. Phenelzine
4. Selegeline

Don’t eat tyramine!

Question 22

What are the tricyclic antidepressants?

Answer 22

1. Nortriptyline - 2 amine
2. Amitriptyline - 3 amine

Use Nortriptyline in old people

Question 23

ADRs tricyclic antidepressants

Answer 23

1. Sedation
2. Postural HOTN
3. Blurred vision, dry mouth, constipation
4. Arrythmias, sinus tachycardia, QTc prolongation

Question 24

ADRs SSRI

Answer 24

1. Inc. fall risk
2. Lower bone mineral density
3. Sexual dysfunction
4. SIADH
5. Constitutional Sx

Probably safe in pregnancy

Question 25

What are the preferred antidepressants in old people?

Answer 25

1. Sertarline 2. Bupropion 3. Citalopram

Question 26

What are the benzodiazepines?

Answer 26

1. Xanax 2. Valium 3. Ativan Schedule IV drugs

Question 27

What is the non-benzo for anxiety?

Answer 27

Buspirone No abuse potential

Question 28

ADRs lithium salts

Answer 28

1. Renally dosed 2. Affected by thiazide diuretics, NSAIDs 3. Monitor blood levels - 0.4-1.2 Toxic at 1.5 4. Polyuria & polydipsia 5. Thyroid enlargement 6. Tremor, EEG changes

Question 29

What is the valproic acid derivative?

Answer 29

Depakote Used for seizures & bipolar disorder Polycystic ovarian syndrome risk Life-threatening pancreatitis

Question 30

What is the anticonvulsant?

Answer 30

For bipolar Equetro CYP3A4 substrate Strong inducer of CYP2C19, CYP3A4 & P-glycoprotein

Question 31

ADRs equetro?

Answer 31

1. Ataxia, dizziness, HA 2. Hematologic - agranulocytosis, aplastic anemia, leukopenia 3. SJS