Neurology and Analgesic Pharmacology Lecture Notes

Practice vocabulary flashcards covering therapeutic approaches, neurology (Myasthenia Gravis, Parkinson's, Alzheimer's, Seizures), migraine treatments, sedatives, anesthesia, and opioid pharmacology.

Curative Therapy

A therapeutic approach that eliminates the underlying cause of a disease.

Disease Modifying Therapy

A treatment approach that alters the underlying disease process or slows its progression.

Symptomatic Therapy

A therapeutic approach that reduces or relieves signs and symptoms without curing the condition; encompasses most drugs learned.

Myasthenia Gravis

An autoimmune disorder characterized by the destruction of acetylcholine receptors at the neuromuscular junction.

Pyridostigmine

A medication used to make up for lost acetylcholine in myasthenia gravis; excessive doses can trigger a cholinergic crisis.

Cholinergic Crisis

A crisis most likely caused by too high a dose of pyridostigmine, presenting with salivation, N/V/D, abdominal cramping, sweating, and bradycardia; treated with atropine.

Myasthenia Crisis

A crisis occurring when a patient with myasthenia gravis does not take their medications, leading to respiratory depression.

Levodopa / Carbidopa (L-dopa)

The gold standard combination drug given to Parkinson's disease patients to supply dopamine and avoid symptoms; symptom improvement confirms diagnosis, and it can cause vitamin B deficiency.

Amantadine

A second line of defense medication for Parkinson's disease that increases dopamine levels.

Dopamine Receptor Agonists (Pramipexole and Ropinirole)

Parkinson's disease medications that stimulate dopamine activity.

Selegiline

A Parkinson's disease medication that prevents the catabolism of dopamine.

Donepezil

A cholinesterase inhibitor used early in Alzheimer's disease to provide modest symptomatic benefit by slowing symptom severity; causes GI side effects including weight loss, anorexia, and N/V.

Memantine

An NMDA receptor antagonist used to slow the progression of Alzheimer's disease; offers modest benefits and can cause neuropsychiatric side effects.

Amyloid Targeted Therapies (Lecanemab and Donanemab)

Disease-modifying monoclonal antibodies for early Alzheimer's disease that clear amyloid beta deposits to slow disease progression by 4 to 5 months.

Amyloid-Related Imaging Abnormalities (ARIA)

Abnormalities associated with amyloid-targeted therapies that require monitoring via serial MRIs every 4 to 5 months to assess brain activity.

Status Epilepticus

A seizure lasting longer than 5 minutes or multiple seizures occurring without the patient returning to baseline.

Phenobarbital

A traditional barbiturate antiepileptic drug that causes sedation and drowsiness.

Phenytoin

A traditional antiepileptic drug requiring therapeutic drug level monitoring and good oral care due to the adverse effect of gingival hyperplasia.

Fosphenytoin

An IV antiepileptic drug used to load up a patient prior to sending them home.

Levetiracetam (Keppra)

A newer antiepileptic drug available PO and IV that can be administered quickly if the patient is unable to take medications orally.

Carbamazepine

An antiepileptic medication that can cause bone marrow suppression, requiring a CBC test every 3 to 6 months.

Valproic Acid

An antiepileptic drug that is a vesicant; if extravasation occurs, do not flush, stop the medication, suck out remaining drug, elevate the site, and notify the provider.

Lamotrigine

An antiepileptic medication administered exclusively via the PO route.

Abortive Migraine Therapy

Therapy designed to stop an active migraine attack, starting primarily with simple analgesics for mild to moderate symptoms.

Sumatriptan

An oral, intranasal, or SubQ triptan taken immediately at migraine symptom onset; must never be given IV push because it causes vasoconstriction leading to cardiac arrest.

Dihydroergotamine

An intranasal or SubQ medication taken at symptom onset for moderate to severe migraines; noted to be less effective than triptans.

Prochlorperazine and Metoclopramide

IV/IM anti-emetics used for pain and nausea in moderate to severe ER migraines; can produce extrapyramidal symptoms and are often administered with diphenhydramine (Benadryl) to reduce adverse effects.

Zolpidem

A sedative sleep aid associated with complex sleep-related behaviors like sleepwalking.

Trazodone

A sedative drug used off-label (not FDA approved for sleep) to promote sleep in hospitalized patients.

General Anesthesia

Medication-induced reversible unconsciousness accompanied by the loss of protective reflexes.

Propofol

An IV anesthetic used for hypnosis; nurses cannot push this medication but are permitted to maintain a continuous drip.

Neuromuscular Blocking Agents

Paralytic drugs (e.g., succinylcholine, rocuronium, vecuronium) that cause muscle relaxation; require emergency airway equipment, an endotracheal tube, and a provider prepared to manage the airway.

Rapid Sequence Intubation (RSI)

An emergency intubation procedure consisting of administering an anesthetic plus a paralytic, followed by intubating the patient.

Opioid Mechanism of Action

Binding to mu, delta, and kappa receptors in the central nervous system to stimulate the brain to feel less pain, provide analgesia, and produce reward.

Opioid Tolerance

The condition in which repeated exposure to an opioid produces less of an effect from the same dose.

Opioid Dependence

A physiological state where abrupt cessation or a sudden decrease in opioid dose produces signs and symptoms of withdrawal.

Opioid Use Disorder

A problematic pattern of opioid use or misuse, such as stealing to obtain more drug.

Buprenorphine

A medication-assisted therapy (MAT) for opioid use disorder that binds mu receptors as a partial agonist.

Methadone

A medication-assisted treatment (MAT) dispensed at specialized clinics; dosed to prevent withdrawal without producing a reward feeling or respiratory depression.