Pharm Neuro drugs

• First line treatment for Alzheimer's

  acetylcholinesterase inhibitors

  improves cognitive function

  drugs:

  donepezil

  galantamine

  rivastigmine
• What is the glutamate hypothesis?

  Abnormal glutamine activity leads to mild chronic

  activation of NMDA receptors

  • leads to cognitive deficits and neuronal death
• What is the NMDA receptor antagonist:

  memantine

  • approved for moderate to sever conditions of alzheimer's
• Migraine medication

  DHE

  serotonin agonists

  narcotic analgesics

  non-narcotic analgesics

  prednisone

  antiemetics
• Migraine - serotonin agonists

  ends with - triptan

  • sumatriptan
  • rizatriptan
  • almotriptan
  • naratriptan
  • zolmitriptan
  • eletriptan
• Migraine - CGRP antagonists

  erenumab

  atogepant

  eptinezumab

  rimegepant

  uburogepant

  fremanezumab

  galcanezumab
• CGRP antagonist side effects

  drowsiness

  nausea and vomiting

  elevation of liver enzymes

  injection site reaction

  drug interactions
• Chronic Tension headache treatment

  abortive:

  NSAID

  acetaminophen

  muscle relaxant

  preventative:

  antidepressants

  anticonvulsants

  NSAID
• Cluster headache treatment

  abortive:

  oxygen

  5HT receptor agonist

  intranasal lidocaine

  preventative:

  calcium channel blockers

  steroids

  valproate

  antihistamines
• Trigeminal neuralgia treatment

  carbamazepine

  gabapentin

  baclofen

  phenytoin

  valproate
• What are the targets of anti epileptic drugs (AED)?

  increase inhibitory neurotransmitters - GABA

  decrease excitatory neurotransmitters - glutamte

  block voltage gated inward positive channels - sodium or calcium

  increase outward positive channels - potassium
• AEDs that act on GABA

  benzodiazepines

  barbiturates

  gabapentin

  tiagabine

  vigabatrin
• AEDs that act on NA+ channels

  phenytoin

  carbamazepine

  eslicarbazepine

  oxcarbazepine

  zonisamide
• Phenytoin (Dilantin)

  first line for partial seizures

  NA+ channel blocker
• Carbamazepine (Tegretol)

  NA+ channel blocker
• Phenobarbital

  modulates GABA receptors

  long half life

  more sever CNS sedation, second line drug in adults
• Primidone (Mysoline)

  converts to phenobarbital
• Benzodiazepines and clonazepam

  modulators of GABA receptors
• Valproate

  partial seizures, first line drug for generalized seizures

  Enhances GABA transmission, blocks Na+ channels, activates K+ channels
• Ethosuximide (Zarontin) and Methsuximide (Celontin)

  absence seizures

  blocks T-type Calcium currents in the thalamus