Dizziness Pharmacotherapy Overview
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Questions and Answers

Which of the following are common risk factors for Parkinson's Disease?

  • Age
  • Family History
  • Environmental Exposures
  • Head Trauma
  • All of the above (correct)

    • What is the most effective treatment for motor symptoms in Parkinson's Disease?

  • Beta-blockers
  • Dopamine Agonists
  • Anticonvulsants
  • Levodopa/Carbidopa (correct)

    • What is the primary goal of non-pharmacological treatments for Parkinson's Disease?

    To manage motor symptoms and improve the quality of life.

    Which of the following is NOT a common side effect of levodopa/carbidopa?

    <p>Bradycardia</p> Signup and view all the answers

    COMT inhibitors are used to reduce tremor intensity.

    <p>False</p> Signup and view all the answers

    What is the main difference between resting tremor and postural or kinetic tremor?

    <p>Resting tremor occurs when the limbs are relaxed, while postural or kinetic tremor occurs during voluntary movement.</p> Signup and view all the answers

    Which of the following medications is a first-line treatment for Essential Tremor?

    <p>Propranolol</p> Signup and view all the answers

    Deep brain stimulation (DBS) is an option for Parkinson's Disease patients who are resistant to medications.

    <p>True</p> Signup and view all the answers

    Which of the following is NOT a common side effect of antihistamines?

    <p>Hypotension</p> Signup and view all the answers

    What is the most common type of vertigo?

    <p>Benign Paroxysmal Positional Vertigo (BPPV)</p> Signup and view all the answers

    Which of the following medications is commonly used to reduce fluid buildup in Meniere's Disease?

    <p>Hydrochlorothiazide</p> Signup and view all the answers

    Vestibular rehabilitation is primarily used for conditions like BPPV and vestibular neuritis.

    <p>True</p> Signup and view all the answers

    Which of the following conditions is NOT commonly associated with dizziness?

    <p>Essential Tremor</p> Signup and view all the answers

    What is the most common type of seizure?

    <p>Focal Seizures</p> Signup and view all the answers

    Which of the following is NOT a subtype of generalized seizures?

    <p>Postural</p> Signup and view all the answers

    Genetic mutations are the only cause of epilepsy.

    <p>False</p> Signup and view all the answers

    What are the two main types of epilepsy based on the area of the brain affected?

    <p>Focal and Generalized Seizures</p> Signup and view all the answers

    Which of the following is a first-line treatment for focal seizures?

    <p>Lamotrigine</p> Signup and view all the answers

    Status epilepticus is defined as a continuous seizure lasting more than 5 minutes or recurrent seizures without recovery of consciousness in between them.

    <p>True</p> Signup and view all the answers

    Which of the following medications is NOT used in the first-line treatment of status epilepticus?

    <p>Topiramate</p> Signup and view all the answers

    What is the most important aspect of managing epilepsy long-term?

    <p>Consistent medication adherence</p> Signup and view all the answers

    Which of the following types of headache is characterized by a throbbing pain that is often unilateral and may be accompanied by nausea, photophobia, and phonophobia?

    <p>Migraine</p> Signup and view all the answers

    Which of the following is NOT a common trigger for migraine headaches?

    <p>Alcohol</p> Signup and view all the answers

    Cognitive-behavioral therapy (CBT) is a non-pharmacological treatment option for migraines.

    <p>True</p> Signup and view all the answers

    Which of the following drugs is a first-line abortive medication for migraines?

    <p>Sumatriptan</p> Signup and view all the answers

    Ergots are a second-line treatment option for migraine attacks, but their use is contraindicated in patients with cardiovascular disease.

    <p>True</p> Signup and view all the answers

    Which of the following medications is a first-line preventive treatment for migraines?

    <p>Topiramate</p> Signup and view all the answers

    What is the most common type of headache?

    <p>Tension-Type Headache (TTH)</p> Signup and view all the answers

    Which of the following conditions is typically treated with oxygen therapy?

    <p>Cluster Headache</p> Signup and view all the answers

    Lithium is a second-line treatment option for cluster headaches.

    <p>True</p> Signup and view all the answers

    Which of the following is NOT a common side effect of corticosteroids?

    <p>Hypotension</p> Signup and view all the answers

    What is the main goal of non-pharmacological treatments for headaches?

    <p>To help patients identify and avoid triggers</p> Signup and view all the answers

    Which of the following is NOT a common side effect of triptans?

    <p>Hypotension</p> Signup and view all the answers

    CGRP antagonists are a second-line treatment option for cluster headaches.

    <p>False</p> Signup and view all the answers

    What is the most important consideration for patients when they are taking anti-epileptic medications?

    <p>Adherence to the prescribed treatment regimen</p> Signup and view all the answers

    Which of the following is NOT a common side effect of valproic acid?

    <p>Hypokalemia</p> Signup and view all the answers

    Lamotrigine is often used as a first-line treatment for both focal and generalized seizures.

    <p>True</p> Signup and view all the answers

    Which of the following is a second-line treatment for intractable seizures that is less frequently used due to its adverse effects?

    <p>Phenytoin</p> Signup and view all the answers

    Clonazepam is a benzodiazepine that can be used for the management of status epilepticus and for acute seizure control.

    <p>True</p> Signup and view all the answers

    What is the most widely used non-pharmacological therapy for the management of epilepsy?

    <p>Lifestyle modifications</p> Signup and view all the answers

    Which of the following is NOT a typical sign or symptom of a mild traumatic brain injury (TBI)?

    <p>Seizures</p> Signup and view all the answers

    Secondary brain injury occurs at the time of the initial impact or insult.

    <p>False</p> Signup and view all the answers

    Which of the following medications is NOT a commonly used first-line treatment for increased intracranial pressure (ICP)?

    <p>Corticosteroids</p> Signup and view all the answers

    LMWH is a preferred long-term option for DVT prophylaxes in patients with TBI.

    <p>False</p> Signup and view all the answers

    What is the Glasgow Coma Scale (GCS) used for?

    <p>To assess the severity of a TBI</p> Signup and view all the answers

    Which of the following is a common risk factor for Alzheimer’s Disease?

    <p>All of the above</p> Signup and view all the answers

    Donepezil, rivastigmine, and galantamine are all examples of NMDA receptor antagonists.

    <p>False</p> Signup and view all the answers

    Which of the following medications is FDA-approved for the treatment of Alzheimer's Disease?

    <p>Lecanemab</p> Signup and view all the answers

    Risperidone is an antipsychotic medication that is FDA-approved for the treatment of aggression in dementia.

    <p>True</p> Signup and view all the answers

    Which of the following non-pharmacological strategies is NOT recommended for the management of Alzheimer’s Disease?

    <p>Benzodiazepine Medications</p> Signup and view all the answers

    What are the three main types of medications used to treat Alzheimer’s Disease?

    <p>Cholinesterase inhibitors, NMDA receptor antagonists, and disease-modifying therapies</p> Signup and view all the answers

    Aducanumab was withdrawn from the Canadian market due to a lack of evidence showing clinical benefit.

    <p>True</p> Signup and view all the answers

    Which of the following is NOT a common side effect of memantine?

    <p>Hypotension</p> Signup and view all the answers

    What is the most important aspect of monitoring patients with Alzheimer’s Disease?

    <p>Regularly assess cognitive function, behavioral symptoms, and medication adherence.</p> Signup and view all the answers

    Pharmacists play a significant role in preventing polypharmacy in patients with Alzheimer’s Disease.

    <p>True</p> Signup and view all the answers

    Which of the following is a key consideration for pharmacists when managing patients with Alzheimer’s Disease?

    <p>All of the above</p> Signup and view all the answers

    It is essential to provide education to caregivers about fall risk and wandering in patients with Alzheimer’s Disease.

    <p>True</p> Signup and view all the answers

    Which of the following is NOT a common side effect of cholinesterase inhibitors?

    <p>Dizziness</p> Signup and view all the answers

    The main goal of disease-modifying therapies for Alzheimer’s Disease is to prevent or slow down cognitive decline.

    <p>True</p> Signup and view all the answers

    What are the key highlights of the provided document?

    <p>The document highlights the pharmacotherapy overview of Dizziness, Movement Disorders, Seizures and Epilepsy, Headaches, Multiple Sclerosis, Traumatic Brain Injury, and Cognitive Impairment. It provides a detailed overview of each condition, outlining its pathophysiology, risk factors, non-pharmacological and pharmacological therapies, monitoring and follow-up, and important considerations.</p> Signup and view all the answers

    Which of the following is NOT a central cause of dizziness?

    <p>Benign Paroxysmal Positional Vertigo (BPPV)</p> Signup and view all the answers

    Which of the following is a risk factor for dizziness?

    <p>Cardiovascular conditions</p> Signup and view all the answers

    Which non-pharmacological therapy is used primarily for conditions like BPPV and vestibular neuritis?

    <p>Vestibular rehabilitation</p> Signup and view all the answers

    Low-salt diet for Meniere's disease is implemented to reduce fluid retention in the inner ear.

    <p>True</p> Signup and view all the answers

    What are the classic symptoms of Parkinson's Disease?

    <p>Tremor at rest, rigidity, bradykinesia, and postural instability</p> Signup and view all the answers

    Which of the following is a surgical option for Parkinson's Disease?

    <p>Both A and B</p> Signup and view all the answers

    Essential Tremor is always caused by genetic mutations.

    <p>False</p> Signup and view all the answers

    Which of the following is a first-line treatment for Essential Tremor?

    <p>Beta-blockers</p> Signup and view all the answers

    What is the main characteristic of Essential Tremor?

    <p>Rhythmic, involuntary shaking, typically of the hands</p> Signup and view all the answers

    A ______ is a transient disturbance in brain function due to abnormal electrical activity.

    <p>seizure</p> Signup and view all the answers

    Which of the following is NOT a common trigger for seizures?

    <p>High blood pressure</p> Signup and view all the answers

    Which of the following is NOT a type of seizure?

    <p>Hypnotic</p> Signup and view all the answers

    Which of the following medications is a first-line treatment for focal seizures?

    <p>Lamotrigine</p> Signup and view all the answers

    What is the primary goal of surgical therapy for refractory focal seizures?

    <p>Removal of the seizure focus</p> Signup and view all the answers

    Which of the following dietary interventions is used to manage seizures?

    <p>Both A and B</p> Signup and view all the answers

    Status epilepticus refers to a single seizure lasting more than 5 minutes.

    <p>False</p> Signup and view all the answers

    Therapeutic drug monitoring (TDM) is crucial for drugs like phenytoin, valproic acid, and carbamazepine to ensure appropriate levels and avoid toxicity.

    <p>True</p> Signup and view all the answers

    Which of the following is NOT a common side effect of phenytoin?

    <p>Hypoglycemia</p> Signup and view all the answers

    Which of the following is a common side effect of valproic acid?

    <p>All of the above</p> Signup and view all the answers

    Which of the following is a common side effect of carbamazepine?

    <p>All of the above</p> Signup and view all the answers

    Many antiepileptic drugs are teratogenic, so regular pregnancy testing and counseling are essential for women of childbearing age.

    <p>True</p> Signup and view all the answers

    What is the recommended dosage of levetiracetam for adults?

    <p>500 mg BID, titrate by 500 mg q2w, max 1500 mg BID</p> Signup and view all the answers

    What is the loading dose range for phenytoin?

    <p>15-20 mg/kg</p> Signup and view all the answers

    What is the main goal of treatment for status epilepticus?

    <p>Stop the seizure activity and prevent further brain damage</p> Signup and view all the answers

    The Epley maneuver is a physical therapy technique used for BPPV, involving repositioning displaced otoliths.

    <p>True</p> Signup and view all the answers

    What category of headache is characterized by recurrent, moderate-to-severe throbbing headaches, often unilateral, associated with nausea, photophobia, or phonophobia?

    <p>Migraine Headache</p> Signup and view all the answers

    What is thought to be the underlying mechanism of Tension-Type Headaches?

    <p>Muscle tension and sensitization of peripheral and central nociceptive pathways</p> Signup and view all the answers

    Which of the following is NOT a general measure for all types of headaches?

    <p>Trigger diary</p> Signup and view all the answers

    What are the first-line treatments for acute migraine headaches?

    <p>Triptans and NSAIDs</p> Signup and view all the answers

    Which of the following is a first-line treatment option for Tension-Type Headaches?

    <p>NSAIDs</p> Signup and view all the answers

    Which of the following is NOT a first-line treatment option for Cluster Headaches?

    <p>Verapamil</p> Signup and view all the answers

    Rebound headaches are a common side effect of overusing acute headache treatments.

    <p>True</p> Signup and view all the answers

    What is the primary goal of treatment for Multiple Sclerosis (MS)?

    <p>Reduce relapse rate, slow progression, and decrease CNS lesions</p> Signup and view all the answers

    Which of the following is a first-line injectable DMT for MS?

    <p>All of the above</p> Signup and view all the answers

    Which of the following is a first-line oral DMT for MS?

    <p>All of the above</p> Signup and view all the answers

    Natalizumab, a monoclonal antibody, is used to block lymphocyte migration into the CNS and is effective for both relapsing-remitting and primary progressive MS.

    <p>True</p> Signup and view all the answers

    Which of the following is NOT a common side effect of interferon beta treatment?

    <p>Weight gain</p> Signup and view all the answers

    What is the primary treatment for acute exacerbations in MS?

    <p>High-dose corticosteroids</p> Signup and view all the answers

    Which of the following is a common side effect of ocrelizumab?

    <p>All of the above</p> Signup and view all the answers

    Alemtuzumab, a monoclonal antibody, is used to deplete CD52+ T and B cells, and it is associated with a high risk of autoimmune conditions, including thyroid and kidney problems.

    <p>True</p> Signup and view all the answers

    Cladribine, a chemotherapeutic agent, works by killing lymphocytes and it is associated with a high risk of opportunistic infections and lymphopenia.

    <p>True</p> Signup and view all the answers

    What is the main goal of monitoring for MS treatment?

    <p>Assess patient's response to treatment, assess for side effects, and monitor for progression of the disease</p> Signup and view all the answers

    What is the most common type of MS?

    <p>Relapsing-Remitting MS</p> Signup and view all the answers

    What is the primary symptom of Alzheimer's Disease?

    <p>Cognitive decline</p> Signup and view all the answers

    Which of the following is a major risk factor for Alzheimer's Disease?

    <p>All of the above</p> Signup and view all the answers

    Donepezil, Rivastigmine, and Galantamine are all examples of cholinesterase inhibitors used to treat Alzheimer's Disease.

    <p>True</p> Signup and view all the answers

    Which of the following is a common side effect of cholinesterase inhibitors?

    <p>All of the above</p> Signup and view all the answers

    What is the primary indication for Memantine?

    <p>Moderate to severe Alzheimer's Disease</p> Signup and view all the answers

    Lecanemab is a disease-modifying therapy for Alzheimer's Disease that targets amyloid-beta aggregates.

    <p>True</p> Signup and view all the answers

    Aducanumab is a disease-modifying therapy for Alzheimer's Disease that is currently available in Canada.

    <p>False</p> Signup and view all the answers

    Antipsychotics, like Risperidone, are FDA-approved for aggression in dementia.

    <p>True</p> Signup and view all the answers

    Which of the following is NOT recommended for treating Behavioral and Psychological Symptoms of Dementia (BPSD)?

    <p>Benzodiazepines</p> Signup and view all the answers

    It is crucial to monitor patients taking cholinesterase inhibitors for their heart rate, GI symptoms, and weight loss.

    <p>True</p> Signup and view all the answers

    Which of the following is a common side effect of Memantine?

    <p>All of the above</p> Signup and view all the answers

    What are the major risk factors for developing Traumatic Brain Injury (TBI)?

    <p>All of the above</p> Signup and view all the answers

    The Glasgow Coma Scale (GCS) is used to assess the severity level of TBI.

    <p>True</p> Signup and view all the answers

    Which of the following is a common symptom of TBI?

    <p>All of the above</p> Signup and view all the answers

    What are the major goals of non-pharmacological management for TBI?

    <p>Both A and B</p> Signup and view all the answers

    Which of the following is NOT a first-line treatment for ICP control in TBI?

    <p>Corticosteroids</p> Signup and view all the answers

    High-dose corticosteroids are generally recommended for treating TBI due to their effectiveness.

    <p>False</p> Signup and view all the answers

    The use of phenytoin or levetiracetam is recommended as a 7-day prophylaxis for seizure prevention in TBI patients with GCS < 10 or those who have experienced a penetrating injury.

    <p>True</p> Signup and view all the answers

    Mechanical methods of DVT prophylaxis are initially recommended, and LMWH or heparin can be used later when there is no contraindication.

    <p>True</p> Signup and view all the answers

    It is recommended to maintain normothermia (normal body temperature) and a blood glucose level of 6–10 mmol/L in TBI patients.

    <p>True</p> Signup and view all the answers

    Monitoring for ICP and cerebral perfusion pressure (CPP) is crucial in TBI patients to ensure proper brain function.

    <p>True</p> Signup and view all the answers

    Pharmacists' role in TBI management includes ensuring appropriate medication therapy and monitoring for drug-related problems.

    <p>True</p> Signup and view all the answers

    Essential Tremor is a rare condition.

    <p>False</p> Signup and view all the answers

    What are the risk factors for early seizures after a traumatic brain injury (TBI)? (Select all that apply)

    <p>Depressed skull fracture</p> Signup and view all the answers

    What are the common symptoms of traumatic brain injury (TBI)? (Select all that apply)

    <p>Nausea</p> Signup and view all the answers

    What are the two main types of seizures?

    <p>Focal and generalized</p> Signup and view all the answers

    What are the three phases of status epilepticus management?

    <p>Phase 1: IV midazolam/lorazepam. Phase 2: IV phenytoin, valproic acid, or levetiracetam. Phase 3: Intubation and drugs like midazolam, propofol, phenobarbital.</p> Signup and view all the answers

    Which antiepileptic drug is contraindicated in pregnancy?

    <p>Valproic acid</p> Signup and view all the answers

    What are the two main pharmacological treatment goals in Parkinson's Disease?

    <p>To manage motor symptoms (tremor, bradykinesia, rigidity) and improve quality of life.</p> Signup and view all the answers

    Which of these is NOT a common side effect of beta-blockers?

    <p>Drowsiness</p> Signup and view all the answers

    What are the types of headache?

    <p>All of the above</p> Signup and view all the answers

    Triptans are contraindicated in patients with cardiovascular disease.

    <p>True</p> Signup and view all the answers

    NSAIDs can be used to treat severe migraine attacks.

    <p>False</p> Signup and view all the answers

    What are the two main types of pharmacological therapies for Multiple Sclerosis (MS)?

    <p>Disease-modifying therapies (DMTs) and relapse management.</p> Signup and view all the answers

    What are the three main subtypes of Multiple Sclerosis (MS)?

    <p>Relapsing-remitting MS (RRMS), secondary progressive MS (SPMS), and primary progressive MS (PPMS).</p> Signup and view all the answers

    What are the common side effects of interferon beta-la therapy?

    <p>All of the above</p> Signup and view all the answers

    Glatiramer acetate is safe to use during pregnancy and breastfeeding.

    <p>True</p> Signup and view all the answers

    What is the main goal of disease-modifying therapies (DMTs) for Multiple Sclerosis (MS)?

    <p>To reduce relapse rate, slow progression, and decrease CNS lesions.</p> Signup and view all the answers

    What are the main risk factors for Alzheimer's Disease (AD)? (Select all that apply)

    <p>Smoking</p> Signup and view all the answers

    What are the two main pharmacological therapies used to manage symptoms of Alzheimer's Disease (AD)?

    <p>Cholinesterase inhibitors and memantine.</p> Signup and view all the answers

    Donepezil is a type of NMDA receptor antagonist.

    <p>False</p> Signup and view all the answers

    What is the main goal of non-pharmacological management of Alzheimer's Disease (AD)?

    <p>To maintain cognitive function and improve quality of life</p> Signup and view all the answers

    Risperidone is FDA approved for aggression in dementia.

    <p>True</p> Signup and view all the answers

    Which of these is NOT a common side effect of antipsychotics?

    <p>Drowsiness</p> Signup and view all the answers

    Benzodiazepines are recommended for the management of behavioral and psychological symptoms of dementia (BPSD).

    <p>False</p> Signup and view all the answers

    What are the two main goals of the pharmacist's role in managing patients with dementia?

    <p>Optimizing therapy and preventing polypharmacy issues.</p> Signup and view all the answers

    The pharmacist should educate caregivers about the benefits of non-drug interventions.

    <p>True</p> Signup and view all the answers

    Study Notes

    Dizziness Pharmacotherapy Overview

    • Dizziness is a symptom with various causes, including vertigo, disequilibrium, presyncope, and lightheadedness.
    • Dizziness can be classified as peripheral or central in origin.
    • Peripheral causes include BPPV (most common), Meniere's disease, vestibular neuritis/labyrinthitis.
    • Central causes include stroke/TIA, multiple sclerosis, and migrainous vertigo.
    • Risk factors for dizziness include age, head trauma, neurological disorders, cardiovascular conditions, diabetes, and medication use.

    Non-Pharmacological Therapy

    • Vestibular rehabilitation helps retrain the brain for balance problems, often used for BPPV and vestibular neuritis.
    • The Epley maneuver is a physical therapy technique for repositioning otoliths in BPPV.
    • Dietary changes (low-salt diet for Meniere's) can reduce fluid retention in the inner ear.
    • Hydration and avoiding triggers (like dehydration, and orthostatic hypotension) are important for dizziness management.

    Pharmacological Therapy (Page 2)

    • First-line treatments for BPPV typically involve non-pharmacological interventions like Epley maneuver.
    • Corticosteroids may be used in acute vestibular neuritis to reduce inflammation.
    • Antiemetics (e.g., meclizine, dimenhydrinate) can help relieve symptoms.
    • Diuretics are used for Meniere's disease to reduce fluid buildup.
    • Antihistamines and benzodiazepines can help with vertigo attacks (acute).
    • Triptans are used for acute migrainous vertigo.
    • Beta-blockers or anticonvulsants can be used for prevention of migraines associated with vertigo.

    Side Effects of Common Medications (Page 2)

    • Antihistamines can cause drowsiness, dry mouth, and blurred vision.
    • Benzodiazepines can cause dependence and withdrawal if used long-term.
    • Corticosteroids may lead to weight gain, hyperglycemia, and osteoporosis.
    • Diuretics can cause dehydration and orthostatic hypotension.

    Important Points for Pharmacists (Page 3, and more)

    • Accurate diagnosis is crucial for appropriate treatment.
    • Counsel patients on potential side effects of vertigo treatments (especially sedation).
    • Monitor for drug interactions, particularly in older adults.
    • Lifestyle modifications, such as fall prevention strategies, can be helpful.

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    Description

    This quiz explores the pharmacotherapy and non-pharmacological approaches to managing dizziness. It covers the causes, classifications, and risk factors of dizziness, along with effective therapeutic interventions like vestibular rehabilitation and dietary modifications. Test your knowledge on the various treatments available for this multifaceted symptom.

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