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62 Cards in this Set

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What is parkinson's disease?
- NS disorder
- characterizes: movement abnormalities= tremor of head and extremities, difficulty coordinated fine muscles
- hypokinesia
What is the substantial nigra?
important to initiation and control of muscular movement
What causes PD? what is lost?
- unknown
- lack of dopaminergic activity in substantial nirga leads to imbalance between dopamine and acetycholine

- dopamine producing cells in the brainstem
What are the four primary symptoms of PD?
1- tremor, arms, hand, jaw, face trembling
2- rigidity, stiffness of limbs, trunk
3- braykinesia, slowness of movement
4- postural instability
how does the acetylcholine- dopamine scale of parkinsons disease look?
acetylcholine outweights dopamine
What is the treatment of PD?
- no cure
- drugs manage symptoms

- attempts to rebalance dopamine and acetycholine
How do PD treatments attempt to rebalance dopamine and acetycholine?
- decrease muscarinic activity
- increase dopamingeric activity: blocking breakdown, or mimicking action
What are parkinsons patents usually prescribed?
levodopa combined with carbidopa
What does carbidopa do?
delays conversion of levodopa into dopamine and replenishes the dwindling supply
Which symptoms respond best to the drug?
braykinesia and rigidity
How do anticholinergic drugs work?
- inhibit muscarinic receptors, blck ffect of acetylcholine
- only use centrally acting antiocholinergics
What are the common side effects of anticholinergics?
confusion
anxiety
decrease sweating, heat release
dry mouth
agitation
what are the serious side effects of anticholinergics?
urticaria
urine retention
paresthess
sinus tachycardia
What is Kava?
a natural product taken as a dietary supplement to reduce stress and anxiety
Who should not take kava? what drugs should not be taken with kava?
PD patients
- antipschtics, barbituate
benzodiazepines
CNS depressants
brand name of bentropine?
Cogentin
brand name of trihexyphenidyl?
artane
What is the MOA of dopaminergics?
precise MOA unknown, dopamingercs are precursors of dopamine
most common dopaminergic is?
l-dopa
What are dopaminergics used for?
to treat PD
- parkionsonism associated with manganese and CO poisoning
What are the common adverse effects of dopaminergics?
dyskinesia, hallucinations and mental confusion
What are the long term advise effects of dopaminergics?
lost of efficacy
What happens of dopaminergics are abruptly discontinued?
neuroleptic maligant syndrom
What is neuroleptic malignant syndrome?
tachycardia
musclular rigidity
fever
mental status changes
diaphoresis
tachypnea
What are the contraindications of dopaminergics?
causious: cardiac disease
- should not be used in patients with history of allergy
What are dopamine agonists?
- are not changed into dopamine
- mimic effects of dopamine in the brain and cause neurones to react as though it is present
what are MAO B inhibitors?
- help prevent breakdown of the natural and synthetic dopamine.
- do this by inhibiting the activity of the enzyme MAO B
What are catechol O-methyltransferase inhibitors? (COMT)
prolong effect of carbidopa -levodopa therapy, by blocking enzyme that breaks down levodopa.
what are the side effects of COMT
linked to liver damage and failure.

- so only used when all else is not working
What is schizophrenia?
abnorm perceptions or expression of reality
- most common: auditor hallucinations, paranoid, bizarre delusions,
- disorganized speech, thinking with significant social or occupational dysfunction

- onset in young adult hood, 0.4-0.6 % of pop affected
What are the positive symptoms of schizophrenia?
exaggerations of normal function: hallucinations and delusions
what are the negative symptoms of schizophrenia?
terse speech, social withdrawal, apathy, anhedonia
When were antipsychotic med first available? what are the older types called?
1950's
typical
What were the atypical newer antispychotic meds introduced?
1990s
What is a serious side effect to using clozapine?
agranulocytosis
what is agranulocytosis?
cute condition involving a severe and dangerous leukopenia (lowered white blood cell count), most commonly of neutrophils causing a neutropenia in the circulating blood.[1][2] It represents a severe lack of one major class of infection-fighting white blood cells. People with this condition are at very high risk of serious infections due to their suppressed immune system.
wat is the brand name of chlorpromazine?
Thorazine
wat is the brand name of haloperidol?
Haldol
wat is the brand name of prochlorperazine?
Compazine
wat is the brand name of clozapine?
clozaril
wat is the brand name of risperidone?
Risperdal
What is the MOA of antipsycotics?
block postsynaptic dopaminergic receptors
what are antipsychotics used for?
positive symptoms of schizophrenia
- sam antiemetic and antinausea
what are the common side effects of antipsychotics?
sedation, dry mouth, sexual dysfunction, akathisia, bradykinesia, tardive dyskinesia, drowsiness, dizziness when changing positions, blurred vision, rapid heartbeat, sensitivity to the sun, skin rashes, menstrual problems for women.
WHAT IS THE MOA OF LITHIUM?
- not known
Why is lithium used?
control and prophylaxis of acute mania
- in acute manic phase of bipolar disorder
what are the common adverse effects of lithium?
nausea
tremors
what happens on overdosage to lithium?
vomiting, diarrhea, dizziness, headache, drowsiness, tinnitus, disorientation, short- term memory loss
what happens when toxic levels of lithium are taken>
kidney and heart damage
what are the symptoms of depression?
feelings of doom, lack of self worth, inability to sense pleasure, loss of energy, inability to concentrate, changes in sleep habits, thoughts of suicide
What are the three types of antidepressants
1) tricyclic antidepressants (TCA)
2) monoamine oxidase inhibitors (MAOIS)
3) selective serotonin reuptake inhibitors inhibitors (SSRIS)
How does TCA work? what is is used for?
increase the effects of norepinephrine and serotonis in the CNS by blocking reuptake by neuron

- used to treat endogenous depression and reactive depression
What is the TCA MOA?
TCAs binds to 5-HT and noreadrenaline reuptake transporters and this prevents the reuptake of these monoamins from the synaptic cleft and there subsequent degradation.
What are the side effects of TCAs?
- sedation (histamine H1 receptor blocked)
- postural hypotension (alpha adrenoreceptor blockade)
- blurred vision
- dry mouth, constipation (muscarnic acetylcholine receptor blockade
-
What are the serious side effect of TCAs?
- hyperpyrexic crisis
- tachycardia
- seizures
What are the serious side effect of TCAs?
- hyperpyrexic crisis
- tachycardia
- seizures
What are the serious side effect of TCAs?
- hyperpyrexic crisis
- tachycardia
- seizures
What are the serious side effect of TCAs?
- hyperpyrexic crisis
- tachycardia
- seizures
What are the serious side effect of TCAs?
- hyperpyrexic crisis
- tachycardia
- seizures
TCAs: Contraindications
Avoid in patients during acute recovery from myocardial infarction or severe renal and hepatic impairment.
What does St. Johns wort interact with?
TCAs, MAOIS, SSRIS, alcohol
- foods high in termini or catecholamines
What foods have tryamine?
cheese
yogurt
beef
coffe
tea
caffeninated soda
chocolate
red wine