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Intro To Drugs > CNS agents > Flashcards

CNS agents Flashcards

1
Q

Enzyme inducers

A 
Rifampin
Phenytoin
Phenobarbital
Carbamazepine
Nafcillin
Alcohol
St. John’s wort
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2
Q

Enzyme inhibitors

A 
Erythromycin
Cimetidine
Ciprofloxacin 
Fluconazole 
Ketoconazole
Itraconazole
Clarithromycin
Amiodarone
Grapefruit juice
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3
Q

Antidepressants BB warning

A

Increased risk of suicidal thoughts and behavior

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4
Q 
Desipramine
Nortriptyline
Amitriptyline
Imipramine
Doxepin
Tri-cyclic Antidepressants
A

Medications take weeks to work!

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5
Q

Amitriptyline

A

Dosing:

Elderly patients: start at half the dose

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6
Q 
Monoamine Oxidase Inhibitors
Phenelzine
Isocarboxazid
Tranylcypromine
Selegiline
A

Avoid OTC decongestants

Wash out period

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7
Q

Paroxetine

A

Pregnancy Category D

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8
Q

Venlafaxine

A

Monitor BP

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9
Q

Bupropion

A

Smoking cessation, Alternative if experiencing sexual side effects from other agents

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10
Q

Nefazodone

A

Priapism

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11
Q

Trazodone

A

Often used as a hypnotic

Take with food

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12
Q

Butalbital with Caffeine and Acetaminophen

A

Report HA that persists for more than 3-4 days

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13
Q

5-HT Receptor Agonists “Triptans”

A

“Standard of care” in the treatment of acute migraine

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14
Q

Sumatriptan

A

injection

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15
Q

GABA

A

inhibitory neuro excitory transmitter

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16
Q

phenytoin dosing considerations

A

Hypo-albuminemia

ALBUMIN- Low albumin will increase phenytoin (higher free levels= more adverse effects)

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17
Q

phenytoin reactions

A

nystagmus (involuntary eye movement)

Decreases efficacy of oral contraceptives

18
Q

carbamazepine

A

diplopia
Auto-inducer (induces its own metabolism)
Stevens Johnson Syndrome (SJS)

19
Q

Valproic acid

A

weight gain, alopecia, blurry vision

avoid in young women

20
Q

oxcarbazepine

A

Consider alternative/additional BC

Is not an auto-inducer

21
Q

lamotrigine

A

Black box warning – risk of life threatening rash

22
Q

lithium

A

mood stabilizer

Caution use of diuretics, NSAIDs, ACE-I’s, ARBs

23
Q

Atypical Anti-psychotic agents

A

Have become 1st line or standard of therapy

24
Q

Atypical agents BBW

A

Tight glycemic control for all agents- hyperglycemia (diabetes)

25
Q

Aripiprazole

A

Hyperglycemia, drug induced diabetes mellitus

26
Q

olanzapine

A

weight gain

Weight gain can lead to diabetes mellitus

27
Q

quetiapine- seroquel

A

Hyperglycemia, drug-induced diabetes mellitus, EPRs

28
Q

risperidone

A

Hyperglycemia

May prolong QT interval- Associated with Arrhythmias

29
Q

Benzodiazepines

A

CNS effects
Avoid alcohol consumption
Schedule IV medication

30
Q

Buspirone

A

Non-benzodiazepine anti-anxiety agent
Eldery patience to use half the dose
Effects of drug may take time (> 1 week)
Do not abruptly stop the drug

31
Q

Alzheimer’s Disease

A 
Causes:
Deficiency in acetylcholine (neurotransmitter
Poor prognosis
Degeneration of brain tissue
Atrophy occurs
Medications are not curative
32
Q

Donepezil

A

Bedtime dosing

33
Q

Memantine

A

hallucinations)

34
Q

Parkinson’s Disease

A

A deficiency of dopamine in the basal ganglia

35
Q

Carbidopa/Levodopa

A

Levodopa circulates in plasma to the blood brain barrier then converted to dopamine
Carbidopa inhibits breakdown of levodopa which increases the amount of levodopa at the BBB

36
Q

Ropinirole

A

Monitor blood pressure (orthostatic)

37
Q

Sleep Inducing Agents

A

Gradual taper upon discontinuation to prevent rebound, relapse or withdrawal symptoms

38
Q

Temazepam

A

Elderly patients should be started on lower doses

39
Q

Varenicline

A

Black box warning: depression, suicidal thoughts
Pharmacist counseling points:
Family members should be aware of mood/suicide thoughts

40
Q

Amphetamine/Dextroamphetamine

A

Cardiac effects, drug abuse/dependency
Growth suppression, psychiatric imbalance
Aggression, seizures, visual disturbances
Avoid doses close to bedtime
Drug holidays – children
For catch up growth

41
Q

Methylphenidate

A 
Avoid doses close to bedtime
Drug holiday (children)

Intro To Drugs (13 decks)

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