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44 Cards in this Set
- Front
- Back
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what are the possible causes of AD |
loss of acetylcholine amyloid plaques tau protein abnormal levels |
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what are the drug groupings for AD |
anticholinesterases |
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what is the goal of drug therapy for AD |
delay for 1 year |
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what are the anticholinesterases for AD |
Rivastigmi NE (Exelori) Doneprezil (Articept) Galaantami NE (Razayne) |
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what do the anticholinesterases do for AD |
preserve ACTH |
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why do you nighttime dose anticholinesterases for AD |
reduce GI issues |
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what are contraindications for anticholinesterases for AD |
cardiovascular disease peptic ulcer disease |
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what are ADR of anticholinesterases for AD |
nausea insomnia HA symptomatic bradycardia syncope
doubled fall risk muscle cramping |
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dose for anticholinesterase for AD |
Donepezil (Articept) 10mg qd in the evening |
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who is the NMDA receptor antagonist for AD |
Memantine (Namenda) |
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what do you need to worry about when giving NMDA receptor antagonist for AD |
renal impairment |
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ADR for NMDA receptor antagonist for AD |
Namenda -ataxia, hypokinesia -emotional agitiation, confusion, dizziness, depression, fatigue -constipation |
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dose for NMDA receptor antagonist for AD |
Namenda 10mg BID |
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What is happening in Parkinson's disease |
changes in substantia nigra and striatum with decreased levels of dopamine |
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what are the goals of therapy for parkinsons pts |
increased dopamine and decrease ACTH |
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what are the class drugs for Parkinson's |
dopamine precursor dopamine agonist MAO-B inhibitors kitchen sink anticholinergics COMT inhibitors
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what is the dopamine precursor drug for Parkinson's |
levodopa/carbidopa (Sinemet) |
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do you want to give Sinemet early of late in therapy for Parkinson's? |
late, like almost last resort bc of progressive degeneration of dopamine terminals |
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ADR of Sinemet for Parkinson's |
nausea somnolence, dizziness, HA neurotoxicity older pts: confusion, hallucinations, delusions, agitation, psychosis |
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dose for levodopa/carbidopa for Parkinson's |
Sinemet q8h
immediate release |
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who are the dopamine agonists for Parkinson's |
pramipezole (mirapex) ropinirole (requip) rotigotine (neupro) |
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what other disease are dopamine agonists used for? |
restless leg syndrome |
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ADR for dopamine agonists for Parkinson's |
postural HOTN hallucinations nausea somnolence worsen dyskinesias compulsive behavior |
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dose for dopamine agonists for Parkinsons |
Requip XL 12mg TT qd |
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what is the dose for dopamine agonists for RLS |
Requip XL 4mg qd |
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who are mao-b inhibitors for Parkinson's |
rasagiline (Azilect) selegeline (Eldepryl) |
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MOA of mao-b inhibitors for Parkinson's |
reduce breakdown of dopamine by inhibiting MAO-B enzyme |
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what are you at risk for as a parkinson pts for Parkinson's |
CA |
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what drug interactions occur with mao-b inhibitors for Parkinson's |
tramadol, methadone, cyclobenazaprine, St. John's wort |
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ADR of MAO-B inhibitors for Parkinson's |
insomnia, nervousness confusion nausea orthostatic HOTN |
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dose for MAO-B inhibitor for Parkinson's |
Azilect 1mg qd
give at breakfast and lunch, no dose after that bc of insomnia |
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what is the last random drug for parkinsons |
amantadine (Symmetrel) |
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how does symmetrel work for Parkinson's? |
increase dopamine release inhibit dopamine reuptake stimulate dopamine receptors NMDA receptor antagonist central anicholinergic effect |
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what is the benefit of Symmetrel for Parkinson's |
transient short-term tx in mild disease temporary add-on in advanced parkinsons comes in liquid |
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ADR of Symmetrel for Parkinson's
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pretty well tolerated CNS: confusion, hallucinations, nightmares ankle edema, lived reticularis |
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dose for amantadine for Parkinson's |
Symmetrel 100mg BID |
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who are the anticholinergics for Parkinson's |
benztropine (congentin) trihexyphenidyl (artane) |
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what are anticholinergics for Parkinson's |
slow resting tremor mono therapy in <70 y/o of age, no significant akinesia, or gait disturbance |
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ADR of anticholinergics for Parkinson's |
tachycardia constipation, urinary retention HOTN CNS: disorientation, hallucinations, toxic psychosis |
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dose for anticholinergics for Parkinson's |
trihexphenidyl 2mg TID |
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who are the comt inhibitors for Parkinson's |
tolcapone (tasmar) entacapone (comtan) |
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what do you always use in combo with comt inhibitors for Parkinson's |
levodopa |
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what do comt inhibitors help with for Parkinson's |
motor fulctuations |
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ADR of comt inhibitors for Parkinson's |
heightened rxns from levodopa/carbidopa hepatotoxicity |
