Nervous System, Mental Health, and Musculoskeletal Drug Therapy

Vocabulary practice flashcards covering pharmacology topics including DMARDs, gout, osteoporosis, anticonvulsants, Parkinson's disease, myasthenia gravis, multiple sclerosis, Alzheimer's, ADHD, antidepressants, and bipolar medications.

DMARDs

Disease-modifying antirheumatic drugs that require screening for latent TB before starting and avoiding live vaccines.

Etanercept

A DMARD that is contraindicated in patients with sepsis.

Colchicine

A medication used to treat ACUTE gout attacks.

Allopurinol, Febuxostat, and Probenecid

Medications used to manage chronic or long-term gout.

Bisphosphonates

The most common treatment for osteoporosis; can cause severe bone, joint, and muscle pain.

Glucosamine

A shellfish-derived supplement used for osteoarthritis pain and stiffness.

Misoprostol

A drug that pregnant healthcare workers should avoid handling or wear gloves when handling.

Seizures

Neurological events caused by EXCESSIVE firing of neurons; the goal of anticonvulsant therapy is to reduce seizure FREQUENCY, not to cure.

Anticonvulsants

Medications with a narrow therapeutic index where small manufacturing differences matter; required to be dispensed with a Medication Guide for ALL antiepileptic drugs.

Divalproex sodium

An anticonvulsant that also treats bipolar disorder (brand name Depakote); patients should avoid taking it with aspirin or carbonated beverages.

Gabapentin

An anticonvulsant also used to treat shingles, fibromyalgia, hot flashes, hiccups, restless legs, and diabetic neuropathy.

Topiramate

An anticonvulsant that is also used to prevent migraines.

Carbamazepine

An anticonvulsant sold under brand names including Carbatrol, Tegretol, Equetro, and Epitol (Aptiom and Depakote are NOT carbamazepine brands).

Phenytoin

An anticonvulsant whose hallmark side effect is gingival hyperplasia; fosphenytoin is its prodrug.

Zonisamide

An anticonvulsant medication that must be avoided in patients with a sulfa allergy.

Pregabalin

An anticonvulsant that reduces the release of excitatory neurotransmitters like glutamate.

Tiagabine

An anticonvulsant carrying a boxed warning for increased seizure risk.

Felbamate

An anticonvulsant that requires a signed waiver due to serious adverse effects.

Lamotrigine

An anticonvulsant carrying a boxed warning for fatal rashes.

Levetiracetam

An anticonvulsant originally developed for cognition that is not structurally related to other anticonvulsants.

Lacosamide

An anticonvulsant classified as a C-V controlled substance.

Parkinson's Disease

A neurological condition caused by an imbalance of dopamine and acetylcholine.

Levodopa/carbidopa

The most-used therapy for Parkinson's disease; levodopa crosses the blood-brain barrier and is metabolized into dopamine.

On-off phenomenon

A phenomenon characterized by sudden akinesia, unblinking stare, and stooped posture occurring after years of good control on levodopa.

Pramipexole (Mirapex)

A medication that treats Parkinson's disease AND restless leg syndrome; it is NOT required to be taken on an empty stomach.

Anticholinergic MOA

Mechanism of action defined by blocking muscarinic receptors in the brain.

COMT Inhibitors

Medications (e.g., entacapone) that increase levodopa 'on' time and may allow a reduced levodopa dose; entacapone can discolor urine red, brown, or black.

Myasthenia Gravis

An autoimmune condition causing damage to acetylcholine receptors at the motor end plate; treated with pyridostigmine, azathioprine, and cyclophosphamide (NOT carbidopa).

Cyclophosphamide

An immunosuppressive therapy with side effects including cystitis, hematuria, and nausea (NOT increased appetite).

Multiple Sclerosis

An autoimmune condition characterized by degeneration of myelin sheaths.

Restless Leg Syndrome

A condition treated with gabapentin, pramipexole, and ropinirole (NOT levodopa).

Alzheimer's Disease

A progressive dementia and personality change condition treated with acetylcholinesterase inhibitors (donepezil, galantamine) and memantine (NOT levodopa).

ADHD

Condition treated with CNS stimulants (C-II controlled substances); patients must avoid MAOIs for $2\,\text{weeks}$ before starting methylphenidate.

CNS Stimulants

Medications used for ADHD that carry a boxed warning for potential dependence.

5-hydroxytryptophan

An alternative therapy that may improve motor symptoms in Parkinson's disease.

Depression

A mental health condition characterized by pessimism, worry, sadness, poor concentration, slowed mental processing, and eating or sleeping problems.

Sertraline

An antidepressant drug classified as a Selective Serotonin Reuptake Inhibitor (SSRI).

SSRIs

Selective Serotonin Reuptake Inhibitors; ALL SSRIs are contraindicated with MAOIs.

Cymbalta (duloxetine)

A Serotonin-Norepinephrine Reuptake Inhibitor (SNRI) indicated for both pain AND depression.

Pristiq (desvenlafaxine)

An antidepressant drug classified as an SNRI.

TCAs (Tricyclic/Cyclic Antidepressants)

Antidepressants often used for their sedating side effect and whose anticholinergic effects may decrease urinary urgency; overdose carries a risk of potentially fatal cardiac arrhythmias.

Doxepin

A TCA available as a topical cream for pruritus in adult and geriatric patients.

Trazodone

An antidepressant (not classified as a cyclic antidepressant or MAOI) requiring caution when taken with OTC ginkgo biloba due to interaction risk.

MAOIs

Monoamine Oxidase Inhibitors; antidepressant drugs that inhibit enzymes breaking down catecholamines and require a $2\,\text{week}$ washout period before starting after certain other drugs.

Phenelzine

An MAOI requiring patients to avoid tyramine-containing foods, BP medications, and antihistamines; fresh shellfish is the exception and does NOT need to be avoided.

Selegiline

A drug that treats depression, Parkinson's disease, AND Alzheimer's disease; available as a transdermal patch.

Bupropion (Wellbutrin XL)

An antidepressant that inhibits dopamine and norepinephrine reuptake with no direct serotonin/MAO effect; used for smoking cessation and contraindicated in patients with a history of seizures.

Lithium

A bipolar disorder treatment that requires blood concentration monitoring, especially early in therapy.

Antipsychotics

A class of psychiatric medications whose primary use is schizophrenia.