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Pharmacotherapy > Central Nervous System Drugs > Flashcards

Central Nervous System Drugs Flashcards

Drug, indication, class, side effects

1
Q

Klasifikasi kelas serta cara kerja Diazepam, lorazepam, midazolam

A

kelas : Benzodiazepin
cara kerja: Agonis receptor GABA (menenangkan)

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2
Q

6 Indikasi diazepam, lorazepam, midazolam

A

Phobia
anti-anxiety (pre-anesthesia)
insomnia
Muscle spasm
Epilepsi
Sedatif

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3
Q

Apa 2 efek samping dari diazepam, lorazepam, dan midazolam?

A

ketergantungan dan CNS depression (dose dependent)

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4
Q

ketergantungan kelas benzodiazepin (cth: diazepam,, lorazepam, midazolam) dapat diatasi dengan?

A

Flumazenil

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5
Q

Kelas terratogen benzodiazepin

A

D atau X

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6
Q

M & E diazepam, lorazepam, midazolam

A

M : @ liver become glucoronide
E: @ kidneys

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7
Q

If a patient is tolerant against diazepam (benzodiazepines), drug should be discontinued immediately. T/F?

A

F. Discontinue gradually.

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8
Q

3 indications for barbiturates

A

Antianxiety
Anesthesia
Anti-convulsion

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9
Q

common anti-seizure barbiturate

A

phenobarbital

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10
Q

common short acting barbiturate (induce anesthesia)

A

sodium thiopental

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11
Q

3 withdrawal symptom of phenobarbital dependent patient

A

cerebral seizure
psychosis
rem-rebound with nightmare

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12
Q

5 phenobarbital and sodium thiopental side effect

A

Dose-dependent anterograde amnesia (short term memory loss)
enzyme induction
sleep phase changes
CNS depression
severe withdrawal side effects

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13
Q

4 general withdrawal symptom of phenobarbital and sodium thiopental

A

tremor
weakness
hypersensitivity
fear

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14
Q

4 drug classes indicated for insomnia, from safest to most risky

A
  1. melatonin receptor agonist
    low abuse, no rebound insomnia, no significant withdrawal symptom, no dependence, not teratogenic
  2. newer hypnotics
    less potential for withdrawal and dependence, teratogen C (human risk cannot be ruled out)
  3. trichloethanol forming structures
    no impact on sleep cycle but fast tolerance
  4. Benzodiazepine
    dependence, tolerance, teratogen D or X (evidence of risk to human fetus or contraindicated in pregnancy)
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15
Q

Diazepam, lorazepam, midazolam can be used for anesthesia. T/F?

A

F. Benzodiazepines does not exhibit anesthetic effect even at high doses

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16
Q

2 drugs indicated for insomnia in the class of new hypnotics

A

zolpidem
zopiclone

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17
Q

drug for insomnia in the class of melatonin receptor agonist

A

ramelteon

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18
Q

ramelteon A&M

A

A : rapid oral absorption
M : first pass metabolism result in active metabolite with longer half life

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19
Q

Drug for insomnia that forms trichloethanol

A

chloral hydrate

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20
Q

4 chloral hydrate side effects

A

confusion
hepatotoxicity
allergy
nausea

21
Q

disadvantage of chloral hydrate as insomnia drug, aside from its side effects

A

fast tolerance

22
Q

Drug classes indicated to treat anxiety

A
  1. Benzodiazepine (enhance GABA)
  2. Barbiturates (enhance GABA)
  3. 5-HT receptor agonist
23
Q

Drug indicated for chronic anxiety that works by enhancing 5-HT receptor

A

buspirone

24
Q

Buspirone is an anxiolytic with no sedation. T/F?

A

T

25
Q

1 disadvantage of buspirone as an anxiolytic compared to benzodiazepine and barbiturates

A

needs 1 week to become effective

26
Q

3 advantages of buspirone (5-ht receptor agonist) compared to barbiturate and benzodiazepine as anxiolytics

A

no memory loss (vs barbiturate)
no withdrawal symptom (vs barbiturate and benzodiazepine)
no impact on motor skills (vs barbiturate)

27
Q

4 advantages of Ramelteon (melatonin receptor agonist) as anti insomnia vs zolpidem and diazepam

A

low potential for abuse
no rebound insomnia (diazepam>zolpidem)
no significant withdrawal symptom (diazepam)
no dependence (diazepam > zolpidem)

28
Q

Teratogenicity category of zolpidem and zopiclone (new hypnotics)

A

C

29
Q

1 advantage of chloral hydrate vs diazepam and zolpidem for insomnia

A

no impact on sleep cycle

30
Q

General drug interaction of hypnotics-sedative drugs

A

additive effect with other CNS-depressant drugs

31
Q

3 antiepileptic that work as GABA receptor agonist

A

benzodiazepine
barbiturate
vigabatrin

32
Q

phenytoin, carbamazepine indication and MOA

A

antiepileptic, enhance Na+ channel inhibition, therefore delaying action potential

33
Q

Gabapentin, valproic acid, ethosuximide, pregabalin indication and MOA

A

antiepileptic, inhibit Ca+, therefore inhibit action potential

34
Q

Felbamate and rufinamide indication and MOA

A

antiepileptic, inhibit glutamate receptor, an excitatory neurotransmitter

35
Q

2 general side effects of antiepileptic

A

enzyme induction
CNS side effects

36
Q

general side effect of gabapentin, valproic acid, ethosuximide, phenytoin, felbamate, and vigabatrin

A

enzyme induction
CNS side effects

37
Q

Antiepileptic indicated for partial seizures and MOA

A

gabapentin, inhibit Ca+

38
Q

the antiepileptic valproic acid is contraindicated in pregnancy (especially during first trimester) because?

A

it causes fetal malformation (birth defects)

39
Q

hormonal birth control might not work if taken with phenobarbital. T/F?

A

T

40
Q

According to EMA (European medicines agency), valproic acid can be used to treat epilepsy in pregnant women under what conditions?

A

form of epilepsy is unresponsive to other anti-epileptic drugs

41
Q

Which anticonvulsant is also used to treat neuropathy (nerve pain) in diabetic patients? which class is it?

A

Gabapentin, Ca+ channel inhibitor

42
Q

One function of benzodiazepine is an anxiolytic. Does it has antipsychotic effect?

A

no, but it does have neurotic effects that help reduce phobias.

43
Q

Haloperidol and chlorpromazine indication?

A

Schizophrenia

44
Q

Haloperidol and chlorpromazine classification and MOA

A

Typical antipsychotic, block D2 receptor

45
Q

Risperidone, clozapine, and ziprasidone classification and MOA

A

atypical antipsychotic, block D2 and other receptors

46
Q

difference in disadvantages of haloperidol and chlorpromazine compared to risperidone, clozapine, and ziprasidone

A

Haloperidol and chlorpromazine (typical) : higher risk for movement disorder

risperidone, clozapine, ziprasidone (atypical) : higher risk of metabolic side effect

47
Q

Major tranquilizers are neuroleptics (depress nerve functions). What is neurolepsis?

A

Psychomotor slowing
emotional quieting
affective indifference

48
Q

haloperidol and chlorpromazine could have parkinsons syndrome side effects (involuntary actions). T/F?

A

T

49
Q

Side effect of chlorpromazine, haloperidol, risperidone, and clozapine?

A

Hormonal disorder
Allergy
Vegetative disorder
Epileptic seizure
Hypothermia
Depression
Photosensitization
Impotence
Loss of concentration
Jaundice

Pharmacotherapy (6 decks)

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