Quiz Two Material Flashcards
(214 cards)
1
Q
What are the 8 causes of Neuro-degenerative diseases?
A
- Hypoxia, 2.Excitatory Amino Acids, 3. Ion fluxes, 4. Free Radicals, 5. Immune Responses, 6. Infections, 7. Apoptosis and 8. Protein Aggregation
2
Q
What two medications directly combat Parkinson’s Disease?
A
Levadopa and Carbadopa
3
Q
What drug inhibits DA breakdown?
A
Azilect
4
Q
What drug improves the affect of Levadopa+Carbadopa?
A
Entacapone
5
Q
What anti-cholenergic drug is used in the early stages of Parkinson’s?
A
Benztropine
6
Q
How does Entacapone work?
A
It inhibits COMT
7
Q
What drug is an agonist for the D2 receptor and fights Parkinson’s?
A
Pramlpexole
8
Q
What is the only MAO inhibitor that seems to slow Parkinson’s?
A
Selegilline
9
Q
Which two areas of the brain can be removed to treat Parkinson’s?
A
Globus Palidus and Thalamus
10
Q
Every anti-Parkinson drug except Selegilline causes what symptom?
A
Xerostomia
11
Q
What other dental problem is common in Parkinson’s?
A
Bruxism
12
Q
What stains saliva in Parkinson’s?
A
L-DOPA
13
Q
How long should a dental appointment be with a Parkinson patient?
A
45 minutes
14
Q
How long after medications are taken should a Parkinson patient be seen?
A
90 minutes
15
Q
How many cartridges of lidocaine are allowed for a Parkinson patient?
A
2-3
16
Q
What mechanistically causes Huntington’s disease?
A
Excess DA
17
Q
What effect does the parent that gave you Huntington’s disease have on the progression of the disease?
A
Father = quicker to surface, mother = later in life
18
Q
What drug depletes DA to combat Huntington’s disease’s spastic motions?
A
Reserpine
19
Q
What are the plaques made of in Alzheimer’s disease?
A
Beta-amyloid
20
Q
What forms the neurofibrillary tangles?
A
Tau Protein
21
Q
What causes the formation of Tau Proteins?
A
Decrease in ACh
22
Q
What should be done physiologically to help Alzheimer’s patients?
A
Increase ACh - do this by inhibiting Cholinesterases
23
Q
What drug is used as an inhibitor of cholinesterases in Alzheimer’s disease?
A
Donepezil
24
Q
What type of drug tends to cause problems with local anesthesia?
A
MAO inhibitors
25
What race has a high incidence of MS?
Scandanavians
26
What race has a low incidence of MS?
Japanese
27
What are the four classifications of MS?
1. Benign, 2. Relapsing remission, 3. relapsing progressive and 4. chronic progressive
28
What should be used to manage MS relapses?
Prednisone
29
What should be used to treat bladder problems in MS?
Tamsulosin
30
What should be used to treat bowel dysfunction problems in MS?
Metamucil
31
What should be used to treat fatigue problems in MS?
Modafinil
32
What should be used to treat pain problems in MS?
gabapentin
33
What should be used to treat tremor problems in MS?
clonazepam
34
What are the three components of pain?
1. Sensory-discriminative, 2. cognitive and 3. emotional
35
What activates TRPV1 and can be used as a pain reliever?
Capsaicin
36
What causes secondary activation of nociceptive nerves?
Substance P/positive feedback loop
37
What is the name used for increased pain in a particular area and is usually used to promote healing?
Hyperalgesia
38
What is the term that describes extreme pain caused by ordinary tasks?
Allodynia
39
How does sensitization occur?
Chemical messengers are released that make nociceptors easier to excite
40
What are the two main chemical messengers of sensitization?
1. Substance P and 2. Prostaglandins
41
Which COX is present in all cells constitutionally?
COX 1
42
Which COX is induced?
COX 2
43
Which COX(s) are targeted by NSAIDs?
COX 1 and 2
44
What drug only targets COX 2?
Celebrex
45
What type of damage is usually associated with visceral pain?
Mechanical
46
What are the fast pain fibers?
Alpha/Delta
47
What are the slow pain fibers?
C axons
48
What is the pain center of the brain?
Thalamus
49
Where is nociceptive input heavily modulated?
Dorsal horn
50
Where is the major site for analgesic drugs?
Dorsal horn
51
Where is the major site for opioids?
Dorsal horn
52
What is "gate control"?
Inhibition of pain by strong touch stimulation
53
What is the natural opioid?
Endorphin
54
What effect do drugs that enhance the action of 5HT and NE have on pain?
They lower pain
55
What drug type does NO work well with?
NSAIDs
56
What are the four types of nociceptive receptors?
1. Chemical, 2. Mechanical, 3. Thermal and 4. Polymodal
57
What is TRP?
Transient Receptor Potential - basically the ability to change how stimuli occur
58
What are P type nociceptors?
Prostaglandin type and Purino/Pyrimadine receptors
59
What two particular cell types are influenced by substance P?
1. Mast cells and 2. Platelets (inflammation response)
60
In pain modulation, what are the two important pain neurotransmitters?
1. Glutamate and 2. Substance P
61
What is the second anti-nociceptive function of NSAIDs?
Inhibition of synthesis of prostoglandins in the dorsal horn
62
Where in the brain is the key locus?
Mesencephalic periacqueductal gray enkephalin
63
What three types of drugs can lessen neuropathic pain?
1. antidepressants, 2. anticonvulsants and 3. corticosteroids
64
What is a non-opioid, non-NSAID drug used for pain?
acetaminophen
65
How many AAs are in enkephalins?
5
66
How many AAs are in B-endorphines?
91
67
How many AAs are in dynorphines?
17
68
What is the key role of endorphines?
Pain inhibition
69
What do pain suppressants enhance to lessen pain (2)?
5HT and NE
70
What are placebos associated with that can eliminate pain?
Endogenous analgesic system
71
What four side effects are there of salicylates?
1. GI erosion, 2. Reyes syndrome in children, 3. Anti clotting (up to 2 weeks and 4. Tinnitis
72
What type of pain does salicylate medication treat?
Mild to moderate somatic pain
73
What are the three drawbacks to Ibuprofen?
1. GI erosion (less than aspirin), 2. Anti-clotting (less than aspirin) and 3. Cardiac effects
74
What is important about ketoprofen?
It is smaller and more potent than Ibuprofen with similar effects
75
What is important to know about naproxen?
Slower acting and longer-lasting type of Ibuprofen (Aleve)
76
What is a pro of using Celebrex?
No GI or anti-clotting side effects
77
What is the danger of using Celebrex?
Heart problems
78
Despite its potency, why is the Ibuprofen-like non-selective Indomethacin not commonly used?
Bad side effects
79
What is special about Meloxicam?
Preferential inhibition of COX 2 over COX 1, meaning less GI issues
80
What drug is related to salicylates and is supposed to be good for bone pain?
Diflunisal
81
What are the mechanisms of acetaminophen (3)?
1. Not a COX 1/2 inhibitor, 2. Not anti-inflammatory and 3. Inhibits COX 3 enzyme or 5HT
82
What are the benefits of using acetaminophen?
1. Good anti-pyretic in kids and 2. No Ibuprofen/aspirin side effects
83
What is the danger to taking acetaminophen?
Liver damage/failure
84
What are three contraindications to taking NSAIDs?
1. Anticoagulants, 2. Hemophiliac and 3. GI ulcers
85
What is Fentanyl used for?
Opioid narcotic of extreme potency used for cancer patients - .1 mg dose!
86
What is a therapeutic dose of morphine?
10 mg
87
What is a therapeutic dose of Hydromorphone?
1.5 mg
88
What is a therapeutic dose of Oxymorphone?
1 mg
89
What is a therapeutic dose of Codeine?
200 mg
90
What is a therapeutic dose of Hydrocodone + Acetaminophen?
30 mg
91
What is a therapeutic dose of Oxycodone?
20 mg
92
What is important to remember about the opioid narcotic Meperidine?
Moderate pain reliever
93
What is important to remember about the opioid narcotic Pentazocin?
Moderate pain relief with a twist - at high doses this becomes an antiagonist and discourages abuse
94
What is important to remember about the opioid narcotic Methadone?
Moderate to strong painkiller typically used for recovering from opioid addiction
95
What is important to remember about the opioid narcotic Buprenorphine?
Moderate painkiller with agonist/antagonist mix - used for recovering addicts
96
What are the four side effects to taking opioid narcotics?
1. Respiratory depression, 2. Constipation, 3. Sedation and 4. Euphoria/dependence
97
What medication should be used on a patient that has overdosed on opioids?
Narcan
98
What three things can NSAIDs be added to in order to treat pain more potently?
1. Caffeine, 2. Acetaminophen and 3. Narcotics
99
What three drugs are the first treatment for trigeminal neuralgia?
1. Gabapentin, 2. Duloxetine and 3. Nortriptyline
100
What is the next-line treatment of trigeminal neuralgia?
Tramadol
101
How many Americans are abusing drugs?
9 million per year, 4 million on a monthly basis
102
What are the HS senior abuse rates for prescription drugs, Oxycontin, and Vicodin?
Prescription drugs = 15%, Oxycontin = 5% and Vicodin - 4%
103
How many overdose deaths on prescription drugs are there in Utah in a year?
>300
104
What organization monitors drug prescriptions?
DOPL (Division of Occupational and Professional Licensing)
105
What falls under DSM axis I?
All psychiatric categories minus mental retardation and personality disorder
106
What falls under DMS axis II?
Personality disorders and mental retardation
107
What falls under DMS axis III?
Acute medical conditions and physical disorders (such as meningitis)
108
What falls under DMS axis IV?
Psychosocial and environmental factors contributing to the disorder
109
What falls under DMS axis V?
Global assessment of teens and kids under 18
110
What are the six criteria tested for in an MSE?
1. Mood, 2. affect, 3. thought, 4. appearance, 5. cognitive function and 6. dental problems
111
If there is an organic change to the brain, what does that mean?
Disease or accident has changed the brain on the gross scale
112
If there is an inorganic change to the brain, what does that mean?
No particular visible - all changes to the molecular level
113
What are the two biggest reasons that patients do not seek dental care?
1. Cost and 2. Fear
114
What does an EEG measure?
Brain surface electrical activity
115
What does a CT scan show?
Slices - can show gross disruption
116
What does an MRI show?
Blood oxygen and where it goes - can show if there are areas of the brain that are not getting nutrients
117
What does a PET scan show?
Where metabolism is occuring
118
What is psychosis?
Altered sense of reality, cognition and emotions
119
How much do psychotic disorders cost in the US each year?
40 billion
120
What percentage of the population is affected by psychotic disorders?
1%
121
Which psychotic disease lacks the prepulse inhibition?
Schizophrenics
122
What are the DSM criteria for Schizophrenia (3)?
1. Over 6 months, 2. Unable to care for self and 3. No drugs or trauma
123
What sub-type of Schizophrenia has blunted affect (no facial or body expressions), is incoherent, does not have delusions, and has bizarre mannerisms (facial grimacing and distortions)?
Disorganized Type
124
What sub-type of Schizophrenia is non-responsive but aware what is going on, is Gumbi-like, and has rigid posturing?
Catatonic Type
125
What sub-type of Schizophrenia has positive symptoms (delusions/hallucinations), is aggressive and potentially dangerous, and is the best type to treat with medications?
Paranoid Type
126
What sub-type of Schizophrenia has negative symptoms (socially withdrawn), no delusions, flat affect, represents the later stages of the disease, and is the hardest to treat with medications?
Residual Type
127
How much lower is a Schizophrenic's life expectancy than a normal person's?
10-30 years
128
What percentage of Schizophrenics commit suicide?
10%
129
What five features mark a better prognosis for a Schizophrenic?
1. Positive symptoms, 2. Dangerous/violent, but responds to medications, 3. >30 years old, 4. Female and 5. No family history
130
What regular body function is lost in Schizophrenics?
Yawning
131
Should a Schizophrenic exhibit positive symptoms, what neurotransmitter is being released in excess?
DA
132
Should a Schizophrenic exhibit negative symptoms, what neurotransmitters are being released in excess (2)?
1. 5HT and 2. Glutamate
133
What are the odds that both identical twins will get Schizophrenia if one twin gets it?
40-50%
134
What are the odds that both nonidentical twins will get Schizophrenia if one twin gets it?
10%
135
What are the odds that both siblings will get Schizophrenia if one gets it?
10%
136
What are the odds of getting Schizophrenia if one parent has it?
10-15%
137
What are the odds of getting Schizophrenia if both parents have it?
30-40%
138
What mechanism do Schizophrenia medications employ?
Block D2 receptors
139
What are the three benefits of Schizophrenia medications?
1. Reduce psychotic symptoms, 2. Enhance cognition and 3. Alleviate depression
140
What are the two Extrapyramidal side effects seen in Schizophrenic medications?
1. Tardive dyskinesia and 2. Parkinson's-like tremors
141
What are the four biggest drawbacks to using a Schizophrenic medication?
1. Sleepiness, 2. Endocrine disruption, 3. Pseudo depression and 4. Weight gain
142
What two anti-Schizophrenic drugs are grouped under Phenothiazines?
1. Chlorpromazine and 2. Thioridizine
143
What are three benefits to taking a phenothiazine?
1. Least expensive, 2. less extrapyramidal side effects, and 3. anti-vomiting
144
What are two drawbacks of taking a phenothiazine?
1. Heavy sedation and 2. high weight gain
145
What anti-Schizophrenic drug is grouped under Butyrophenones?
Haloperidol
146
What is the pro of taking Butryophenones?
They lack the anticholenergic side effects
147
What is the con of taking Butryophenones?
High extrapyramidal side effects
148
What is an advantage of Haloperidol?
Inexpensive due to high usage
149
What mechanism of action do Atypical Antipsychotic drugs have?
D2 and 5HT2A antagonism
150
What is the pro of using an Atypical Antipsychotic drug?
Little extrapyramidal effects
151
What symptoms are Atypical Antipsychotic drugs most useful against?
Negative symptoms
152
What are the three Atypical Anticpsychotic drugs that we need to know?
1. Clozapine, 2. Quetiapine, and 3. Olanzepine
153
What is the drawback to using Clozapine?
1-2% of patients have serious agranulocytosis
154
What is the advantage of using Quetiapine or Olanzepine?
Newer drugs with less side effects
155
What three things make up a case of Acute psychotic disorder?
1. Stress related, 2. delusions/hallucinations possible and 3. fast recovery
156
What disease is Schizoaffective like?
Bipolar disorder
157
Who is a well-known case of Schizoaffective?
Mary Todd Lincoln
158
What percentage of the population is subject to some sort of mood disorder?
3-8%
159
What are the five classifications for someone to likely be diagnosed with Dysthymia depression?
1. >2 years, 2. lowered mood/anhedonia, 3. 6% of population, 4. 2:1 female:male ratio and 5. 20-30 years old
160
What is cyclothymia?
Cyclical changes from dysthymia to mania
161
What are the three classifications for someone to likely be diagnosed with Cyclothymia?
1. >2 years, 2. No gender bias and 3. no drugs used
162
What percentage of the population has major depression?
6%
163
How long does it take anti-depression drugs to kick in?
4-8 weeks
164
What is the effective percentage of anti-depression drugs?
70%
165
What anti-depression medication group was the first to be discovered?
MAO Inhibitors
166
What are the six side effects of using an MAOI?
1. Altered autonomics, 2. Orthostatic hypotension, 3. weight gain, 4. some act as stimulants, 5. may interact with cheese and beer to cause sympathomimetic effects and 6. May interact with OTC cold medicines
167
What are two examples of MAOIs?
1. Phenelzine (MAO A/B) and 2. Selegilline (MAO B)
168
What is the benefit of taking a tricyclic antidepressant?
Long-lasting - one pill a day
169
What is the mechanism of action for tricyclic antidepressants?
Block NE reuptake and vary affinity of 5HT transporter
170
What are the four side effects of using a tricyclic antidepressant?
1. Dry mouth, 2. H1 blockade (works against allergies/has hypnotic effect), 3. some orthostatic hypotension and 4. withdrawals occur if abruptly ended
171
What are three examples of tricyclic antidepressants?
1. Amytriptyline, 2. Desipramine and 3. Doxepin
172
What are the four benefits to using a 5HT monoamine uptake blocker?
1. Well tolerated, 2. very popular, 3. relatively wide margin of safety and 4. No anticholenergic activity
173
What are the four side effects of using a 5HT monoamine uptake blocker?
1. GI upset, 2. sexual dysfunction, 3. depression (adolescents) and 4. headaches
174
What are two examples of 5HT monoamine uptake blockers?
1. Fluoxetine (Prozac) and 2. Sertraline (Zoloft)
175
What is the advantage of using an NE monoamine uptake blocker?
Reasonably well tolerated
176
What are the two disadvantages of using an NE monoamine uptake blocker?
1. More CVS side effects and 2. A moderate CNS stimulant (leads to anxiety, insomnia, etc.)
177
What two drugs are examples of NE monoamine uptake blockers?
1. Venlafazine and 2. Duloxetine
178
How does lithium carbonate likely work?
By interfering with second messengers
179
What are the three advantages of using lithium carbonate?
1. Slow onset, 2. can be combined with anti-depressants and 3. Amongst the most potent mood stabilizers
180
What are the six disadvantages of using lithium carbonate?
1. Blood checks (due to narrow therapeutic window), 2. Tremors, 3. Kidney damage, 4. Weight gain, 5. Edema and 6. Compliance problems
181
What are the two advantages to using anti-epileptic drugs for treating bipolar disorder?
1. Fewer side effects and 2. Better compliance
182
What are the three disadvantages of using anti-epileptic drugs for treating bipolar disorder?
1. More $, 2. Less potent and 3. Used for maintenance after lithium start
183
What are the three examples of anti-epileptic drugs that can be used for treating bipolar disorder?
1. Valproic Acid, 2. Carbamazepine and 3. Lamotrigene
184
What mechanism do Benzodiazepines use to treat anxiety?
Modulate GABA A
185
What are the four benefits to using Benzodiazepines?
1. Little effect on respiration, 2. most popular CNS depressant, 3. Anxiolytic and 4. Treats seizures
186
What are the three side effects of using Benzodiazepines?
1. Muscle relaxation, 2. Insomnia and 3. Alcohol withdrawal
187
What are the seven adverse effects of using Benzodiazepine?
1. Tolerance/dependence, 2. Synergism with depressants, 3. Drowsiness/motor impairment (don't drive), 4. Decrease cognition, 5. Children have paradoxical reaction, 6. Elderly have increased depressant action and 7. Shouldn't be used on people with intellectual disability or major depression
188
What two drugs are the sedative version of Benzodiazepine?
1. Diazepam and 2. Alprazolam
189
What two drugs are the hypnotic version of Benzodiazepine?
1. Lorazepam and 2. Triazolam
190
How long do Benzodiazepine sedatives last?
8-12 hours
191
How long do Benzodiazepine hypnotics last?
2-4 hours
192
How do Barbituates function?
They enhance GABA
193
What is pentobarbital used for?
Anesthesia induction
194
What are the four disadvantages of using Barbituates?
1. Major depression of respiration, 2. Severe tolerance/addiction, 3. Narrow margin of safety and 4. major interactions with liver
195
What are the three indications for Bupropion?
1. Anxiety or tension with everyday stress, 2. Co-existing depression (often) and 3. Short-term use
196
What are four potential side effects of using Bupropion?
1. Not particularly addicting, 2. Rare movement problems and seizures, 3. Irregular heart beat (rare) and 4. Interacts with MAOI and antiseizure medications
197
What are the two treatment options for severe acute anxiety panic attacks?
1. SSRI (selective Seratonin reuptake inhibitors) and 2. Antidepressants with mixed effects
198
What should be used to treat phobic disorders?
SSRIs
199
What two stimulant drugs are typically used to treat ADD/ADHD?
1. Amphetamines (Adderol) and 2. Methylphenidate (Ritalin)
200
What non-stimulant drug can be used to treat ADD/ADHD?
Modafinil
201
What are the three benefits of using Modafinil?
1. Better tolerance, 2. Less abuse potential and 3. Less side effects
202
What are the three side effects of using Modafinil?
1. Upset GI, 2. Minor headaches and 3. Alters sleep
203
What three diseases have been linked to autism?
1. Fragile X syndrome, 2. Congenital rubella syndrome and 3. PKU
204
What are autistic patients more vulnerable to?
Mercury
205
What type of medication may help autistic patients with aggression, repetitive or psychotic behavior?
SSRIs (Atypical antipsychotics)
206
What is the only medication that was listed to treat anorexia/bulemia?
Fluoxetine (Anti-depressant)
207
How much does alcohol cost the US in billions of dollars each year?
185
208
How much does smoking cost the US in billions of dollars each year?
161
209
What percentage of the population are alcoholics?
10%
210
What ratio of patients suffer from some sort of addiction?
1/3
211
What percentage of patients use marijuana?
30%
212
What percentage of patients are addicted to prescription drugs?
10%
213
What mechanistic function do almost all addictive substance have in common?
Release DA in nucleus accumbens
214
What percentage of the population inherent drug vulnerability?
40-60%
