Neuro Drugs
Diabetes Drugs
Neuro General
Diabetes General
Old Content
100

Adverse Effects/Teaching of Levodopa-Carbidopa 

Adverse effects: orthostatic hypotension, tachycardia, palpitation, N/V

Teaching: administer 30 minutes before food, don't eat with a high protein diet, not given with multivitamins that contain Pyridoxine

100

Rare but serious side effect of Metformin use

Lactic acidosis

100

Hemorrhagic Stroke Causes

HTN, certain brain tumors, aneurysms, arteriovenous malformation 

100

S/S of hypoglycemia

Blood glucose <70 mg/dL
Severe <40 mg/dL
Often sudden
Shaky, tachycardiac, sweating, dizzy, anxious, hungry, blurry vision, weakness or fatigue, headache, irritable
"cool and clammy need some candy"

100

S/S of Hyponatremia 

Cardiac: Tachycardia, Hypotension

Neuro: Seizure, confusion, coma

GI: Nausea, vomiting

GU: Increased urination

MSK: General weakness which is worse in extremities


200

NMDA Receptor Agonist (Name, MOA, Adverse Effects)

Namenda 

Prevents NMDA binding to glutamate (glutamate causes excess excitation and cell injury)

falls risk & hypersensitivity (dyspnea & bronchospasms)

200

Pramlintide (Drug Name, MOA)

Bonus: Type 1 or Type 2?

Pramlintide acetate 

decreases gastric emptying, decrease glucagon secretion

200

Modifiable Risk Factors for Stroke

HTN, Dyslipidemia, Diabetes, Smoking, Obstructive sleep apnea, Excessive alcohol consumption, Migraine, Obesity, Sedentary Lifestyle, Hypercoagulation States (Pregnancy, Cancer, OCP), Atrial Fibrillation, Carotid Stenosis

200

Diagnosis of Diabetes

symptoms AND lab values
Symptoms: polyuria, polydipsia, polyphagia, unexplained weight loss, fatigue, blurred vision, slower wound healing, recurrent infections (UTIs, fungal, etc.)
Fast Blood Glucose (FBG): >126 mg/dL x 2 occasions
Random Blood Glucose: >200 mg/dL WITH symptoms
Hgb A1c: >6.5% x 2 occasions OR 1 x if BG >200 mg/dL

200

Carbapenems (Name, Special Aspect)

Imipenem-cilastatin

The kidneys rapidly degrade imipenem so cilastatin acts as a protector to increase half-life and efficacy

300

Catechol-O-methyltransferase Inhibitor and Decarboxylase Inhibitor/Dopamine Precursor (Name, MOA, Adverse Effects, Teaching)

levodopa-carbidopa-entacapone (Stalevo)

levodopa is a dopamine precursor, carbidopa prevents peripheral metabolism by block AADC, and entacapone prevents metabolization by COMT, increasing the amount of levodopa that makes it through BBB  

increases risk of melanoma, diarrhea - drug induced colitis, somnolence

may turn urine orange-brown, falls risk (orthostatic hypotension)

300

DPP-4 Inhibitor (Name, MOA, dosage)

"gliptins"

Increases insulin activity after food intake by blocking DPP-4, an enzyme that breaks down GLP-1; inhibits glucagon secretion by the pancreas, improves BG control after a meal 

once daily dosing 

300
Parkinson's Disease Pathophysiology

1. destruction of dopaminergic neuronal cells in the substania nigra in the basal ganglia

2. degeneration of the dopaminergic nigrostriatal pathway

3. depletion of dopamine stores

4. imbalance of excitatory (acetylcholine) and inhibitory (dopamine) neurotransmitters 

5. impairment of extrapyramidal tracts controlling complex body movements

6. tremors, rigidity, bradykinesia, postural changes 

300

Chronic Diabetes Complications

Microvascular Disease: Retinopathy - glaucoma, cataracts, poor night vision; Diabetic nephropathy - renal failure
Diabetic Neuropathies: Autonomic (type of peripheral, innervate our vessels) or peripheral
Macrovascular Disease: coronary artery disease, stroke, peripheral arterial disease, dementia
Infection: gingivitis/carries, fungal, UTI/cystitis (inflammation of the bladder)

300

Peripheral Artery Disease (What is it, typically caused by what, S/S)

A form of peripheral vascular disease in which there is partial or total blockage of an artery, usually one leading to a leg or arm 

typically caused by atherosclerosis (associated w/ type 2 DM & smoking)

intermittent claudication, weak pedal pulses, cool and pale skin, shiny/discolored skin, dependent rubor, hair loss, slow wound healing

400

Thrombolytic Therapy (names, MOA, adverse effects, calculation, antidote)

"plase" (tPA)

promotes the conversion of plasminogen into plasmin which lyses unwanted fibrin blood clots

bleeding

0.9mg/kg body weight, 10% of the dose given as IV bolus and remaining given on IV drip 

Aminocaproic acid

400

Name all types of insulin and peak start time

Rapid Acting: Humalog (0.5-1.5)

Short Acting: Regular (2.5-5)

Intermediate Acting: NPH (4-12)

Long Acting: Lantus (No peak)

400

tPA criteria

-older than 18
-Clinical diagnosis of ischemic stroke
-Systolic blood pressure ≤185 mm Hg; diastolic ≤110 mm Hg
-Glucose >50 mg/dL
-Platelet count ≥100,000/mm
-No hx of seizure, TIAs, head injury, major surgery, or pregnancy within last 3 months
- stroke within last 3 hours

400

HHNS (stands for? type of diabetes? S/S?) 

Hyperglycemic Hyperosmolar Non-ketonic Syndrome

Type 2 DM

BS >600 mg/dL, polyuria, polydipsia, hypotension, tachycardia, normal blood pH, normal bicarbonate level, no ketones present

400

Aliskiren (type, MOA, adverse effects, important points) 

Direct Renin Inhibitor

MOA: binds tightly to renin and inhibits the cleavage of angiotensinogen into angiotensin I

Adverse effects: angioedema, cough, GI effects, hyperkalemia, fetal injury and death
Expensive, hasn't proven to be better or worse than ACE inhibitors or ARBS. More GI effects than ACE and ARBS
Contraindicated in individuals with decreased kidney function

500

Name all 6 Dopamine Receptor Drugs in SEARS

Sinemet, Eldepryl, Apokyn, Requip, Symmetrel  

500

Name all 9 types of Diabetes medication & their medication/naming convention

Biguanides (Metformin), GLP-1 Inhibitors (tide), SLGT-2 Inhibitors (flozin), DPP-3 Inhibitors (gliptins), Sulfonylureas (ide or starts with G), TZD (Actos), Alpha Glucosidase Inhibitor (Acarbose), Meglitinides (glinides), Pramlintide (Pramlintide acetate)

500

Neurologic Deficits Stroke (Motor/Verbal, Visual/Sensory, Cognitive, Emotional)

Motor/Verbal: hemiparesis, hemiplegia, dysarthria, dysphagia, expressive aphasia, receptive aphasia

Visual/Sensory: hemianopia, paresthesia, agnosia

Cognitive: short term and long term memory loss, short attention span, altered judgement

Emotional: depression, withdrawal, feeling of isolation   

500

Compare and contrast DM 1 & DM 2 (Patho, Onset, Risk Factors, Complications, Treatment)

Patho: Insulin deficiency, autoimmune beta cell destruction vs. Insulin resistance & liver produces too much glucose

Onset: rapid onset at a younger age vs insidious onset at an older age

Risk Factors: genetic vs obesity & sedentary lifestyle 

Complications: DKA vs HHNS

Treatment: 

500

Name all of the MSK drugs + Use

Colchicine (gout treatment & prophylaxis)

Allopurinol (primary and secondary gout)

Cyclobenzaprine hydrochloride (Flexeril) Muscle relaxant - used for muscle spasms 

Baclofen (Lioresal) Muscle relaxant - used for muscle spasticity and pain 

Calcium/Vitamin D osteoporosis

Bisphosphonates osteoporosis