UTMB pharm exam UPDATED Exam
Questions and CORRECT Answers
what is levodopa/carbidopa for? - CORRECT ANSWER - PD; levoodopa increases
dopamine synthesis; carbidopa allows for more levodopa in CNS to be absorbed.
Combined (sinemet) can lead to abnormal movements and psych disturbances.
Dosage low and gradually increases (CNS drug has tolerance)
Avoid eating protein all at once because protein absorbs this med up
Monitor: CBC, ALT, AST, BUN, creatinine
Adverse effects: CV (orthostatic hypotension), dysrhythmias; psychosis (vivid dreams,
hallucinations, paranoia, use 2nd gen antipsych med clozapine); anxiety and agitation, memory
and cognitive impairment, dark sweat/urine; or drug interactions w/ drugs that block dopamine
receptors (MAOI can cause hypertensive crisis)
Dopamine receptor agonists MOA and what for? - CORRECT ANSWER - MOA: mimic
dopamine in brain
for PD
Pramipexole (Mirapex) is a - CORRECT ANSWER - a dopamine receptor agonist, use
alone in early PD and use combined with levodopa in advancing PD
Adverse effects:
Monotherapy (alone) - n/v, dizziness, daytime somnolence, insomnia, constipation, weakness,
hallucinations
Combined: orthostatic hypotension, dyskinesias or jerky movements, increase in hallucinations
COMT Inhibitor - Entacapone (Comtan) is for - CORRECT ANSWER - COMT is an
enzyme to decrease the production of levodopa metabolizer so it stays in the system longer. (PD)
Adverse effects: dyskinesias, orthostatic hypotension, n/v, diarrhea, constipation, discoloration in
urine
, MAO-B inhibitor - Selegiline (Eldepryl, Zelapor) - CORRECT ANSWER - Inhibits the
dopamine metabolizer
Used w/ levodopa to prolong it staying in the body, improves motor function
Stops working for the most part after 12-24 mo.
Give last dose by 12 noon
Adverse effects: Mainly insomnia, drug interactions w meperidine or SSRIs
Increased amyloid beta chains and decreased acetylcholine production usually means -
CORRECT ANSWER - Alzheimer's disease
Drug for Alzheimer's? How do they work? - CORRECT ANSWER - Reversible
Cholinesterase Inhibitor:
Donepezil (Aricept, Aricept ODT)
keeps more acetylcholine in system.. check ALT/AST before giving b/c metabolized by liver
lots of side effects such as bradycardia, bronchoconstriction
Receptor antagonists (better than cholinesterase inhibitors):
Memantine (Namenda, Namenda XR)
regulates glutamate to help improve memory
Adverse effect besides dizziness, confusion, and HA is constipation
Phenytoin (Dilantin) is for - CORRECT ANSWER - Gold standard drug for tonic-clonic
or partial seizures and some CV problems
Binds to albumin
Adverse effects:
Nystagmus
Ataxia
Sedation
Gingival hyperplasia
Questions and CORRECT Answers
what is levodopa/carbidopa for? - CORRECT ANSWER - PD; levoodopa increases
dopamine synthesis; carbidopa allows for more levodopa in CNS to be absorbed.
Combined (sinemet) can lead to abnormal movements and psych disturbances.
Dosage low and gradually increases (CNS drug has tolerance)
Avoid eating protein all at once because protein absorbs this med up
Monitor: CBC, ALT, AST, BUN, creatinine
Adverse effects: CV (orthostatic hypotension), dysrhythmias; psychosis (vivid dreams,
hallucinations, paranoia, use 2nd gen antipsych med clozapine); anxiety and agitation, memory
and cognitive impairment, dark sweat/urine; or drug interactions w/ drugs that block dopamine
receptors (MAOI can cause hypertensive crisis)
Dopamine receptor agonists MOA and what for? - CORRECT ANSWER - MOA: mimic
dopamine in brain
for PD
Pramipexole (Mirapex) is a - CORRECT ANSWER - a dopamine receptor agonist, use
alone in early PD and use combined with levodopa in advancing PD
Adverse effects:
Monotherapy (alone) - n/v, dizziness, daytime somnolence, insomnia, constipation, weakness,
hallucinations
Combined: orthostatic hypotension, dyskinesias or jerky movements, increase in hallucinations
COMT Inhibitor - Entacapone (Comtan) is for - CORRECT ANSWER - COMT is an
enzyme to decrease the production of levodopa metabolizer so it stays in the system longer. (PD)
Adverse effects: dyskinesias, orthostatic hypotension, n/v, diarrhea, constipation, discoloration in
urine
, MAO-B inhibitor - Selegiline (Eldepryl, Zelapor) - CORRECT ANSWER - Inhibits the
dopamine metabolizer
Used w/ levodopa to prolong it staying in the body, improves motor function
Stops working for the most part after 12-24 mo.
Give last dose by 12 noon
Adverse effects: Mainly insomnia, drug interactions w meperidine or SSRIs
Increased amyloid beta chains and decreased acetylcholine production usually means -
CORRECT ANSWER - Alzheimer's disease
Drug for Alzheimer's? How do they work? - CORRECT ANSWER - Reversible
Cholinesterase Inhibitor:
Donepezil (Aricept, Aricept ODT)
keeps more acetylcholine in system.. check ALT/AST before giving b/c metabolized by liver
lots of side effects such as bradycardia, bronchoconstriction
Receptor antagonists (better than cholinesterase inhibitors):
Memantine (Namenda, Namenda XR)
regulates glutamate to help improve memory
Adverse effect besides dizziness, confusion, and HA is constipation
Phenytoin (Dilantin) is for - CORRECT ANSWER - Gold standard drug for tonic-clonic
or partial seizures and some CV problems
Binds to albumin
Adverse effects:
Nystagmus
Ataxia
Sedation
Gingival hyperplasia
