NR 413 Exam #4 [Pharm] Questions
With Correct Answers
The acronym *SLUDGEM* is used to describe Parasympathetic (cholinergic)
effects. What does it stand for? - ANSWER *S*alivation
*L*acrimation
*U*rination
*D*efecation
*G*astroenteritis
*E*mesis
*M*iosis
Cholinergic Crisis - ANSWER -Crisis of too much acetylcholinesterase inhibitor
medications
-Bradycardia, pallor, sweating, severe muscle weakness
Myasthenic Crisis - ANSWER -Crisis of inadequate amounts of
acetylcholinesterase inhibitor medications (not enough)
-Severe generalized muscle weakness, dysphagia, weakness, fatigue, ptosis
Edrophonium Chloride (Tensilon) - ANSWER -Agent used to *diagnose*
Myasthenia Gravis
-Ultrashort acting AChE Inhibitor
-If ptosis improved, diagnosis is most likely Myasthenia gravis or Myasthenic
Crisis
Pyridostigmine Bromide (Mestinon) - ANSWER -Cholinesterase Inhibitor (AChE
Inhibitor)
-Intermediate action and helps with maintenance treatment of myasthenia gravis
-Side effects: increased salivation, miosis, bradycardia, hypotension
Antidote for cholinergic crisis? - ANSWER Atropine (anticholinergic)
Beta-Interferon - ANSWER -Immunomodulator
-Suppresses the inflammatory response and T-cell activation
-Can slow disease progression/prevent relapses of MS
-Side effects include SOB, chest pain, edema, neutropenia
Methylprednisolone (Solu-Medtrol) - ANSWER -Immunosuppressant
Corticosteroid
-Treats acute inflammation
, -Utilize for acute exacerbations of MS
Cyclobenzaprine HCl (Flexeril) - ANSWER -Centrally acting muscle relaxant
-Not fully understood, but relieves muscle spasms by acting in the *brain*. No
action on neuromuscular junction or muscles involved
-Side effects: anticholinergic side effects, angioedema, MI, sedation
Dantrolene - ANSWER -Peripherally acting muscle relaxant
-Decreases muscle spasm and increases ROM
Baclofen (Lioresal) Pumps - ANSWER -Central Acting Muscle Relaxant
-For muscle spasms caused by MS and spinal cord injury
-OD may cause CNS depression
Contraindications of Centrally Acting Muscle Relaxants? - ANSWER -Renal or
liver disease
-Should not be taken concurrently with any other CNS depressants
-Don't stop abruptly! Rebound spasms can occur
2 Agents that treat Parkinson's Disease? - ANSWER -Dopaminergics
-Anticholinergics
Parkinson's disease - ANSWER -Loss of dopamine producing neurons in the
Basal Ganglia
-Extrapyramidal symptoms
Levodopa - ANSWER -Dopaminergic
-Levodopa is converted into dopamine via an enzyme called dopa decarboxylase
(will decrease symptoms of Parkinson's)
Problem with Levodopa? - ANSWER -Only small amounts were able to cross the
BBB and produce therapeutic effect
What drug is combined with Levodopa to inhibit the dopa decarboxylase in the
gut to increase % of Levodopa to reach the brain? - ANSWER Carbidopa
What is contraindicated with Carbidopa? - ANSWER Glaucoma! Drug increases
intraocular pressire
Concerns with Levodopa/Carbidopa? - ANSWER -Wearing off phenomenon
(gradual loss of drug effects)
-On-off phenomenon: causes abrupt loss of drug effects (Tell pts to avoid high-
protein diet)
Bromocriptine - ANSWER -Stimulates dopamine receptors directly in the CNS,
cardiovascular system and the GI tract
With Correct Answers
The acronym *SLUDGEM* is used to describe Parasympathetic (cholinergic)
effects. What does it stand for? - ANSWER *S*alivation
*L*acrimation
*U*rination
*D*efecation
*G*astroenteritis
*E*mesis
*M*iosis
Cholinergic Crisis - ANSWER -Crisis of too much acetylcholinesterase inhibitor
medications
-Bradycardia, pallor, sweating, severe muscle weakness
Myasthenic Crisis - ANSWER -Crisis of inadequate amounts of
acetylcholinesterase inhibitor medications (not enough)
-Severe generalized muscle weakness, dysphagia, weakness, fatigue, ptosis
Edrophonium Chloride (Tensilon) - ANSWER -Agent used to *diagnose*
Myasthenia Gravis
-Ultrashort acting AChE Inhibitor
-If ptosis improved, diagnosis is most likely Myasthenia gravis or Myasthenic
Crisis
Pyridostigmine Bromide (Mestinon) - ANSWER -Cholinesterase Inhibitor (AChE
Inhibitor)
-Intermediate action and helps with maintenance treatment of myasthenia gravis
-Side effects: increased salivation, miosis, bradycardia, hypotension
Antidote for cholinergic crisis? - ANSWER Atropine (anticholinergic)
Beta-Interferon - ANSWER -Immunomodulator
-Suppresses the inflammatory response and T-cell activation
-Can slow disease progression/prevent relapses of MS
-Side effects include SOB, chest pain, edema, neutropenia
Methylprednisolone (Solu-Medtrol) - ANSWER -Immunosuppressant
Corticosteroid
-Treats acute inflammation
, -Utilize for acute exacerbations of MS
Cyclobenzaprine HCl (Flexeril) - ANSWER -Centrally acting muscle relaxant
-Not fully understood, but relieves muscle spasms by acting in the *brain*. No
action on neuromuscular junction or muscles involved
-Side effects: anticholinergic side effects, angioedema, MI, sedation
Dantrolene - ANSWER -Peripherally acting muscle relaxant
-Decreases muscle spasm and increases ROM
Baclofen (Lioresal) Pumps - ANSWER -Central Acting Muscle Relaxant
-For muscle spasms caused by MS and spinal cord injury
-OD may cause CNS depression
Contraindications of Centrally Acting Muscle Relaxants? - ANSWER -Renal or
liver disease
-Should not be taken concurrently with any other CNS depressants
-Don't stop abruptly! Rebound spasms can occur
2 Agents that treat Parkinson's Disease? - ANSWER -Dopaminergics
-Anticholinergics
Parkinson's disease - ANSWER -Loss of dopamine producing neurons in the
Basal Ganglia
-Extrapyramidal symptoms
Levodopa - ANSWER -Dopaminergic
-Levodopa is converted into dopamine via an enzyme called dopa decarboxylase
(will decrease symptoms of Parkinson's)
Problem with Levodopa? - ANSWER -Only small amounts were able to cross the
BBB and produce therapeutic effect
What drug is combined with Levodopa to inhibit the dopa decarboxylase in the
gut to increase % of Levodopa to reach the brain? - ANSWER Carbidopa
What is contraindicated with Carbidopa? - ANSWER Glaucoma! Drug increases
intraocular pressire
Concerns with Levodopa/Carbidopa? - ANSWER -Wearing off phenomenon
(gradual loss of drug effects)
-On-off phenomenon: causes abrupt loss of drug effects (Tell pts to avoid high-
protein diet)
Bromocriptine - ANSWER -Stimulates dopamine receptors directly in the CNS,
cardiovascular system and the GI tract
