Central Nervous System Agents Flashcards
1
Q
Phenytoin
A
- Anti-seizure (partial, generalized, tonic-clonic).
- Decreases sodium and calcium ion flow.
- SE: Nystagmus, gingival hyperplasia, drug-induced lupus, fetal hydantoin.
- Induces cytochrome P-450.
2
Q
Lamotrigine
A
- Anti-seizure, mood disorders, and depression.
- Blocks fast VG Na+ channels at the presynaptic neuron.
- SE: Steven Johnson Syndrome.
3
Q
Valproic Acid
A
- Anti-seizure and Bipolar Disorder (Mania)
- Increase GABA and reduce Na+ and K+ conduction (hyperpolarization)
- Hepatoxicity and NTD (teratogen)
4
Q
Ethosuximide
A
-Absence seizures
5
Q
Carbamazipine
A
- Partial seizures, trigeminal neuralgia
- Inhibits flow of Na+
- SE: hepatotoxicity, agranulocytosis, and aplastic anemia.
- Induce CYP450
6
Q
Buspirone
A
- Generalized anxiety disorder
- 5’HT presynaptic partial agonist
- Slow onset of action
7
Q
Smoking Cessation Agents (Bupropion and Varenicline)
A
- Bupropion: Smoking cessation and depression. Inhibit the reuptake of NE and DA (together inhibits reward loop), nicotinic agonist. Psychosis, reduces threshold for seizures, dry mouth.
- Varenicline: Smoking cessation. Partial agonist and antagonist at nicotinic acetylcholine receptors.
8
Q
Sumatriptan
A
- Migraine and cluster headaches
- Stimulates the 5’HT receptors; vasoconstiction of intracranial vessels.
- SE: Coronary vasospasm; contraindicated in patients with CAD
9
Q
Memantine
A
- Severe Alzheimer
- NMDA receptor antagonist; reduce glutamate (neuronal excitation)
- SE: CNS effects
10
Q
Tramadol
A
- Pain
- Weak mu receptor agonist
- SE: Seizures; respiratory depression.
11
Q
Butorphanol
A
- Pain and migraines (intranasal)
- Agonist at kappa, mixed agonist and antagonist at the mu receptor.
- SE: withdrawal with sudden cessation.
12
Q
Opiods (General)
A
- Morphine, codeine, dexmethorphan, hydrocodone, oxycodone, heroin, fentanyl.
- Pain
- Binds to opiod receptors -> hyperpolarization and decreased activity of neural cells.
- SE: Cardiac and respiratory depression, constipation.
13
Q
Opiod Overdose or Withdrawal Treatment
A
- Overdose: Naloxone or Naltrexone.
- Withdrawal: Methadone, Butorphanol+ Naltrexone
14
Q
General Intravenous Anesthetic Agents (List them out).
A
-Propofol (GABA), Etomodate (GABA), Ketamine (NMDA antagonist), Benzos, Barbs, and Opiods.
15
Q
Halothane and the “-Fluranes”
A
- General Inhaled Anesthetics; decrease neuronal activity
- SE: myocardial and respiratory depression. Halothane fulminant hepatic necrosis, cardiac arrhythmias. Methoxyflurane and enflurane: nephrotoxicity.
16
Q
Local Anesthetics Agents (Two “I’s” = Amides, and Esters)
A
- Prociaine, Cocaine, Tetracaine, Benzocaine.
- Bupivicaine and Lidocaine. (AMIDES)
- Block sodium channels. For minor surgical procedures.
- SE: Seizures. Cocaine (HTN and cardiac arrhythmias).
- Other: Give with Epinephrine to constrict vessels (a1 agonist) to keep drug localized the the region.
17
Q
Pancuronium and “urium, nium, ium”
A
- Adjunct to general anesthesia induction.
- Non-depolarizing nicotinic NMJ blocker.
- SE: Hypotension; Effects can be reversed with administration of cholinesterase inhibitor (Neostigmine to increase ACh at the junction).
18
Q
Levetiracetam
A
- Partial seizures, myoclonic seizures, and tonic-clonic seizures.
- Binds to synaptic vesicles to interrupt nerve conduction.
- SE: Drowsiness and depression.
19
Q
Vigabatrin
A
- Infantile spasms in children and adjunct for refractory complex partial seizures.
- Irreversibly inhibits GABA transaminase.
- SE: Visual field constriction and visual loss.
20
Q
Tiagabine
A
- Partial seizures
- Inhibit the reuptake of GABA
21
Q
Topiramate
A
- Epilepsy, migraines, and mood disorders.
- Blocks Na+ and agonist at the GABA receptors.
22
Q
Typical Anti-Psychotic Agents
A
- Haloperidol and Fluphenazine
- Positive symptoms of schizo, Tourette, and Delirium and Agitation.
- Blocks D2 receptors mainly.
- SE: Sedation, anti-cholinergic side effects, EPS (due to DA blockade). Increase prolactin -> galactorrhea and amenorhea. Neuroleptic malignant syndrome.
23
Q
Heterocyclic Anti-Depressants
A
- Nefazodone, mirtazapine, venlafaxine, and maprotiline.
- Depression and generalized anxiety.
- Blocks NE and 5’HT reuptake.
- SE: sedation
24
Q
Tricyclic Anti-Depressants
A
- Despiramine, nortriptyline, imipramine, amytriptyline, and Doxepin, Amoxapine.
- Depression, enuresis (involuntary urination by children) and chronic pain syndromes.
- Blocks reuptake of NE and 5’HT.
- SE: Sedation (blocks H1), postural hypotension (adrenergic receptor blockade), anti-cholinergic effects (urinary retention, blurred vision, constipation, and dry mouth), Trazo”bone” -> priapism.
- Dont use with MAOI. Overdose can widened QRS complex).
25
SSRIs
- Fluoxetine, Paroxetine, Sertraline, Fluvoxamine, Escitalopram, and Citalopram.
- Depression, anxiety, OCD, eating disorders, PTSD.
- Sexual dysfunction, loss of appetite and weight loss. Serotonin Syndrome. Fluoxetine inhibits CYP450.
26
Pregabalin
- Neuropathic pain and fibromyalgia.
| - Dizziness.
27
Gabapentin
- Postherprtic neuralgia, neuropathic pain, and partial seizures.
- Peripheral Edema.
28
Atypical Anti-Psychotics
- Clozapine, Risperidone, Olanzapine, and Quetiapine
- Positive and negative Sx of Schizo. Delirium.
- Block both 5'HT and DA receptors.
- SE: Clozapine: agranulocytosis.
- Fewer EPS and anti-cholinergic side effects.
29
Benzodiazepines
- "-zolams and zopams". Lorazepam and Ozazepam for the OLd.
- Anxiety, seizures, status epilepticus, muscle spasms, alcohol withdrawal, and anesthetics.
- SE: sedation
- Experience withdrawal symptoms. Overdose: tx with flumazenil.
30
Barbiturates
- "-barbitals" and Thiopental.
- Sedative for anxiety and insomnia, thiopental for induction of anesthesia, and management of seizures.
- SE: Induce cytochrome 450; experience withdrawal symptoms; overdose of barbiturates.
31
Succinylcholine
- Muscle paralysis for endotracheal intubation
- Competes with ACh to reversibly bind to nicotinic receptors.
- SE: Malignant hyperthermia, tx with Dantrolene.
32
Levodopa
- Parkinsonism (loss of DA neurons in basal ganglia)
- Converted to dopamine in brain by DOPA-decarboxylase.
- SE: dyskinesia, cardiac arrhythmias (peripheral conversion of levodopa to dopamine).
Bromocriptine (partial dopamine agonist).
Amantadine (DA agonist), MAO B Inhibitor- Selegiline.
33
MAOI
- Tranylcypromine, Phenelzine, and Isocarboxazid.
- Atypical depression. Selegiline for Parkinsons.
- MAO A I (block NE and 5' HT), MAO B I (blocks DA)
- SE: Hypertensive crisis with tyramine-containing foods.
34
Lithium
- Bipolar disorder; mood disorders.
- Inhibit phosphoinositol second messenger cascade.
- SE: LMNOP- Movements, nephrogenic insipidus, and hypOthyroidism, ebstein anomaly.
35
Zolpidem
- Short term tx of insomnia
- GABA receptor agonist and decreased activity of CNS neurons.
- Mild anterograde amnesia. Hallucinations.
