ANS, Neuro, and Psych Drugs Flashcards
Succinylcholine
Depolarizing neuromuscular blocking agent. Keeps nACh channel opens. Giving ache during first phase (fasiculations) potentiates effect AChE during second phase (paralysis) attenuated effect
Pralidoxime
Ach esterase regenerator Used for AchE overdose (eg pesticides) Needs to be given immediately
Carbamates
AChE inhibitors (-stigmines)
Ipatropine
Bronchi relaxation (IPA try to breathe now)
Bethenchol
mAChR agonist Used for postoperative illeus (Beth needs to shit)
Pilocarpine
mAChR agonist Used to induce myosis(pupillary contraction) and for glaucoma (allowing for movement if vit hum out canal of schlem)
Carbachol
mAChR agonist Used for glaucoma (“need to squeeze the eye (constraction) to get rid of extra aqueous humor”) Carborator on pipe to smoke weed another txt for glaucoma
Scopolamine
mAChR antagonist Used as antiemetic (scope to clean out mouth after puking)
Tolterodine
mAChR antagonist Used for urinary incontinence (toltery can hold it man)
Tropicamide
Anticholinergic used to induce mydriasis Tropico is used topically
Tubocurarine Pancuronium
Nondepolarizing paralytic (neuromuscular blocking agent) nAChR antagonist Look for cur as in curare in them
Benzotropine
Anticholinergic fir Parkinson’s Park the Benz (the Benz penetrates the cns)
Atropine
Anticholinergic Antiparkinsonian
Cholomimetic effects?
Cardiac slowing, decreased CO, vasodilation, decreased artery pressure GI peristalsis, contraction of bladder, contraction of bronchial smooth muscle Stim of glands: sweat, lacrimation, salivation and bronchial secretions
Acetylcholinesterase inhibitor overdose?
Overdose= dumbbells Diarrhea urination mitosis bronchochonstriction bradycardia, excitation (of cns-Parkinson’s like; skeletal muscle) lacrimation, salivation, sweating
Anticholinergic effects?
Inhibition of sweat, secretions, tachycardia, mydriasis, cycloplegia, decrease gi motility, relaxation of bronchi biliary and uriniary smooth muscle With kids have to be careful of over activity with hyperthermia and no sweating
Local anesthetics–two classes what are they and how do you know which one is which?
Esters— take away Caine and there won’t be another I in the name Degraded by PABA Amides—take the Caine out and there will be another i These are degraded by cyps
Morphine
Opiate High first pass metabolism, why administered IV
Methadone
Synthetic mu agonist, weaker than morphine and used to help with withdrawal symptoms Cross tolerance exhibited with heroin
Hydromorphone (dilaudid)
Synthetic mu agonist, weaker than morphine and used as alternative Has antitussive effects
Hydrocodone
Oral antitussive and analgesic
Meperidine (Demerol)
Opiate Metabolized to convulsant (therefore renal and hepatic considerations) Tx in hospital until you start seeing fasiculations and then take ptn off of it
Dextromethorphan
Antitussive opiate “Purple drank” robotussin
Diphenoxylate
Antidiarhea formulated with atropine
Loperamide
Antidiarrhea opiate
Naloxone Naltrexone Nalmefene
Opiate antagonists (Tx for OD)
Levodopa
Antiparkinsons DA precursor, passes thru BBB
Carbidopa (sinemet)
Antiparkinsons Decarboxylase inhibitor, given in combo to prevent peripheral breakdown of L dopa. Does not pass into brain Side effects are less than with l dopa alone
Bromocriptine
Antiparkinsons DA agonist Ergot- thus causes fibrosis
Rotigone
Antiparkinsons DA agonist (non ergot) Hits DA R 1,2,3 “Roti does all three”
Ropinirole
Antiparkinsons DA agonist Non ergot If it makes you uncontrollably sleepy then needs to be stopped
Pramiplexole
Antiparkinsons non ergot DA agonist Also used for restless leg syndrome
Apomorphine
Antiparkinsons D4 agonist Need to give antiemetic first
Selegiline Resagiline
Antiparkinsons MAO B inhibitor (B specific for dopamine breakdown) Selegiline has side effects, htn crisis Resagiline does not have side effects
CAN BE USED TO INCREASE DA IN PD
Tolcapone Entacapone
Antiparkinsons COMT inhibitors (Capone!!) Tolcapone has hepatotoxicity Entcapone does not–cuz ents are awesome
CAN BE USED TO INCREASE DA IN PD***** (only effect when used in combo with Levodopa/carbidopa) THESE WORK PERIPHERALLY INCREASING AMOUNT OF LEVODOPA AVAILIBLE FOR BRAIN
Amantadine
Antiviral Antiparkinsons
Antipsychotics
Both work similiarly, you pick drug based on SEs; long half lives; concerned with tardive dyskinesias as SEs—irreversible and immediate stoppage required. Toxicity—parkinsonian effects, SNS effects from muscarinic blockade; also an Alpha adrenergic blockade=postural hypotension and failure to ejaculate, cardiac=prolonged QT Typical (first generation)–D2 antagonists: most have “-zine” cuz the make you zzzzzz -SEs: Extrapyramidal neuro effects (neuroleptic drugs–tranquilizers, bradykinesia, mild rigidity, tremor, akathisia–subjective restlessness) -Also increased release of prolactin–>lacrimation; Dystonias caused by typcals can be relieved via diphenhydramine (benadril) or benzotropine -NB: Haloperidol (haldol), chlorpromazine (thorazine), thioridazine (mellarlil) Atypical (2nd generation): 5-Ht2 antagonists > D2 antagonists; most have “-pine” -SEs: less extrapyramidal symtoms. Do have hypotension, seizures, weight gain, increased risk of type II db, ad hyperlipidemia -NB: Clozapine (clozaril), risperidone (risperdal), paliperidone (invega), olanzapine (zyprexa), quetiapine (seroquel) short half life , ziprasidone short half life, aripiprazole (abilify) Neuroleptic Malignant syndrome: Bromocriptine (ergot DA agonist) and stop antipyshcotic
Chlorpromazine
Typical Antipsychotics–D2 Antagonist; originally called neuroleptic drugs=tranquilizers SEs-Extrapyramidal effects: bradykinesia, mild rigidity, tremor, subjective restlessness (akathisia), reduced initiative and interest, emotional manifestations.
Thioridazine
Typical Antipsychotics–D2 Antagonist; Also has mACh activity which might explain less extrapyramidal effects. Orthostatic hypotension and urinary retention originally called neuroleptic drugs=tranquilizers SEs-Extrapyramidal effects: bradykinesia, mild rigidity, tremor, subjective restlessness (akathisia), reduced initiative and interest, emotional manifestations.
Haloperidol
Typical Antipsychotics–D2 Antagonist; Increased risk for extrapyramidal effect originally called neuroleptic drugs=tranquilizers SEs-Extrapyramidal effects: bradykinesia, mild rigidity, tremor, subjective restlessness (akathisia), reduced initiative and interest, emotional manifestations.