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pharm > CNS DEPRESSANTS, PSYCHOTROPICS, NARCOTICS/NON NARCOTICS > Flashcards

CNS DEPRESSANTS, PSYCHOTROPICS, NARCOTICS/NON NARCOTICS Flashcards

1
Q

CNS DEPRESSANTS/SEDATIVE/HYPNOTIC

A
  • SEDATIVE: AN AGENT THAT PRODUCES A STATE OF CALMNESS WHEN GIVES IN DIVIDED DOSES. DOES NOT AFFECT LOC
  • HYPNOTIC:AN AGENT GIVEN AT BEDTIME TO INDUCE SLEEP, USUALLY IN A LARGER DOSE THAN A SEDATIVE.
  • DRUG TOLERANCE & DEPENDENCE
  • USED FOR SLEEP: SHORT ACTING-ALLOW PTS TO WAKE UP EARLY IN THE MORNING.
  • DO NOT ABRUPTLY WITHDRAW
  • TYPES: BARBITUATES, BENZODIAZEPINES
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2
Q

CNS DEPRESSANTS/BARBITUATES

A
  • PHENOBARBITAL, SECONBARBITAL
  • USED FOR INTERRUPTED SLEEP, PREOP, ANTICONVULSANT AGENT
  • MAJOR S/E: EXCESSIVE CNS DEPRESSION INCLUDING DROWSINESS, HANGOVER; RESTLESSNESS, DELIRIUM; REBOUND INSOMNIA, RESPIRATORY DEPRESSION
  • IMPLICATIONS/EDUCATION: HOLD IF RR LESS THAT 10; NOT FOR CHRONIC USE
  • OVERDOSE IS TREATED W/ROMAZICON
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3
Q

CNS DEPRESSANT/BENZODIAZEPINES

A
  • USED FOR INSOMNIA, SLEEP INDUCTION; SCHEDULE IV DRUGS
  • INCREASE THE ACTION OF GABA TO GABA RECEPTORS
  • HAVE SEDATIVE, HYPNOTIC & ANTICONVULSANT PROPERTIES
  • MAJOR S/E: CNS CHANGES=DROWSINESS, SLURRED SPEECH, MEMORY IMPAIRMENT, RESP DEPRESSION, HYPOTENSION
  • IMPLICATIONS/EDUCATION: SAFETY MEASURES
  • TYPES: FLORAZEPAM (DELMANE);TEMAZAPAM CHLORDIAZEPOXIDE (LIBRIUM)
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4
Q

SLEEPING MEDICATION

A
  • NON BENZODIAZEPINES
  • HELP TO FALL ASLEEP
  • AMBIEN: S/E OLDER PTS SLEEPWALK; SMALL DOSES
  • LUNESTA
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5
Q

STIMULANTS

A
  • AMPHETAMINES
  • USED TO TREAT NARCOLEPSY, ADHD
  • EX. PROVIGIL
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6
Q

PSYCHOTROPICS

A
  • ANTIPSYCHOTIC AGENTS (NEUROLEPTICS)
  • ANTIANXIETY
  • ANTIDEPRESSANTS
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7
Q

ANTIPSYCHOTICS

A
  • CHLORPROMAZINE (THORAZINE); PROCHLOPERAZINE (COMPAZINE); HALOPERIDOL (HALDOL)
  • USED FOR PSYCHIATRIC DISORDERS; ANTIEMETIC
  • ACT BY BLOCKING d2 DOPAMINE IN THE BRAIN
  • CONTROLS SYMPTOMS/NOT CURE
  • NEUROLEPTICS (ANTIPSYCHOTICS)
  • THORAZINE: FIRST ANTIPSYCHOTIC
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8
Q

SAFETY MEASURES/ANTIPSYCHOTICS

A
  • EPS SYMPTOMS ARE MAJOR S/E
  • STOOPED POSTURE, MASKLIKE FACE, TREMORS AT REST, SHUFFLING GAIT, PILL ROLLING
  • MAY GIVE ANTICHOLINERGICS TO PREVENT SOME SYMPTOMS
  • TARDIVE DYSKINESIA: SERIOUS-HAPPENS WHEN ANTIPSYCHOTICS ARE USE FOR OVER A YEAR - NOT REVERSABLE-PROTRUDING TONGUE, SMACKING OF LIPS, INVOLUNTARY MOVEMENTS
  • PHOTOSENSITIVITY
  • EX. CALDOL
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9
Q

ATYPICAL ANTIPSYCHOTICS

A
  • EX. SEROQUEL, RESPERIDOL

* CAUSE LESS EPS SYMPTOMS BUT MAY CAUSE SEDATION

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10
Q

ANTIANXIETY MEDICATIONS

A
  • DIAZEPAM (VALIUM), ALPRAZOLAM (XANAX)
  • USED FOR ANXIETY, MUSCLE RELAXANT, PREOP
  • DEPRESS THE CNS & INDUCE RELAXATION & THEY INCREASE NEUROTRANSMITTER CONCENTRATION LEVELS OF NOREPINEPHRINE & SEROTONIN
  • MAJOR S/E: ABUSE, RESP. DEPRESSION, HYPOTENSION, DEPENDANCE, TOLERANCE,SEDATION
  • IMPLICATIONS/EDUCATION: SAFETY MEASURES, AGENTS TREAT SYMPTOMS/DOES NOT CURE ANXIETY
  • TREATS OCD, POST TRAMATIC STRESS DISORDER,
  • TELLS THE BRAIN TO RELAX
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11
Q

PSYCHOTROPICS

A
  • ANTIDEPRESSANTS: SSRI, TCA, MAOI
  • THERE IS NO DIFFERENCE IN EFFICIENCY
  • DEPRESSION CRITERIA
  • CAUSES OF DEPRESSION
  • DRUG SELECTION
  • ONSET OF ACTION: SIX WEEKS ARE NEEDED TO EVALUATE ANY ONE DRUG AN ANY ONE DOSAGE
  • ARD’S ARE A MAJOR REASON FOR NON-COMPLIANCE
  • HERBAL REMEDIES: ST. JOHN’S WART
  • SSRI: SAFTER, TAKE UP TO 6 WEEKS TO WORK,DO NOT STOP ABRUPTLY, WEIGHT GAIN, SEXUAL DISFUNCTION
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12
Q

PSYCHOTROPICS/SSRI

A

*PROZAC, PAXIL, LEXAPRO
*INCREASE THE LEVEL OF SEROTONIN; TREAT OCD & DEPRESSION
*S/E: GI, INSOMNIA, WEIGHT LOSS, HEADACHE, ADR, SEIZURE
*TCA’S AMITRYPTILINE (ELAVIL), IMIPRAMINE ( TOFRANIL)
*BLOCK THE UPTAKE OF NOREPINEPHRINE & SEROTONIN; TREAT DEPRESSION & SOMETIMES CHRONIC HEADACHE
S/E: ANTICHOLINERGIC EFFECTS (S.E. GREATER IN TCA’S THAN IN SSRI); EPS EFFECTS; SEDATION & WEIGHT GAIN

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13
Q

PSYCHOTROPICS/MAOI

A
  • PHENALAZINE SULFATE (NARDIL)
  • INACTIVATE NOREPINEPHRINE, DOPAMINE, EPINEPHRINE & SEROTONIN
  • USED AS A LAST CHOICE TO TREAT DEPRESSION
  • ADR: HYPERTENSIVE CRISIS WHEN TAKEN W/FOODS CONTAINING TYRAMINE(AGED CHEESE, WINE, BEER, AVACADOS, BANANAS, YOGURT, PEPPERONI
  • S/E: CNS STIMULATION; ORTHOSTATIC HYPOTENSION, INSOMNIA AND ANTICHOLINERGI EFFECTS
  • MANY FOOD AND DRUG INTERACTIONS
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14
Q

ATYPICAL ANTIDEPRESSANTS

A
  • SIMILAR TO SSRI; BLOCK SEROTONIN REUPTAKE BUT HAVE LESS SIDE EFFECTS
    *USED TO TREAT DEPRESSION, ANXIETY AND SMOKING
    *EX. BUPROPION (WILLBUTRIN, ZYBAN)
    S/E: HEADACHE, DROWSINESS, DECREASED BP; SEIZURES
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15
Q

MOOD STABILIZERS

A
  • LITHIUM, TEGRETOL
  • MUST CHECK RENAL FUNCTION
  • MUST MONITOR DRUG LEVELS
  • HIGH LEVELS ARE LIFE THREATENING
  • LITHIUM TOXICITY: AFFECTS HEART
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16
Q

DRUGS TO TREAT MIGRAINE & CLUSTER HEADACHES

A
  • BETA ADRENERGIC BLOCKERS (INDERAL OR TENORMIN)
  • ANTICONVULSANTS (DEPAKOTE, NEURONTIN,
  • TCA’S (ELAVIL)
  • ERGOTAMINE: A NON SPECIFIC SEROTONIN AGONIST
  • 5-HT RECEPTOR AGONISTS (IMITREX)-A SLECTIVE SEROTONIN RECEPTOR AGONIST-DO NOT GIVE IF PT HAS HTN(TREATS MIGRAINE)
  • MONITOR DRUG LEVELS
17
Q

ANALGESICS

A
  • NARCOTICS
  • MIXED NARCOTIC AGONIST-ANTAGONIST
  • NARCOTIC ANTAGONIST
  • NON-NARCOTIC ANALGESICS
  • NONSTEROIDAL ANTI-INLAMMATORIES
  • RELIEVE PAIN
  • RESP. DEPRESSION-IV ROUTE
  • DEPRESSES COUGH REFLEX-PNEUMONIA
18
Q

NARCOTICS

A
  • PRESCRIBED FOR MODERATE TO SEVERE PAIN
  • CONSIDERED CD CLASS II-CLASS IV
  • ACT ON THE CNS TO SUPPRESS PAIN SO THAT PAIN IS NO LONGER PERCEIVED
  • MAY ALSO SUPPRESS RESPIR. & COUGHING
  • DEPENDING ON THE TYPE, CAN BE GIVEN PO, IM, SQ, IVP, TRANDERMAL OR VIA PCA
19
Q

ANALGESICS

A
  • NARCOTICS: MEPERIDINE, MORPHINE SULFATE
  • S/E: DECREASED RR (HOLD IF LESS THAN 10) AND BP, CONSTIPATION, URINARY RETENTION, HYPOTENSION
  • IMPLICATIONS: PAIN SCALE, SAFETY MEASURES, PCA PUMPS, DO NOT ADMINISTER TO PT W/HEAD INJURIES
  • MIXED NARCOTIC AGONIST/ANTAGONIST: BUTORPHANOL, TARTRATE (STADOL); NALBUPHINE (NUBAIN)
  • S/E AND IMPLICATIONS: SAME AS NARCOTICS
  • LESS POTENTIAL FOR ABUSE THAN W/NARCOTICS
  • USED FOR MILD OR MODERATE PAIN;NARCOTICS ARE FOR MORE SEVERE TYPE OF PAIN
20
Q

ANALGESICS

A
  • NARCOTIC ANTAGONISTS: NALAXONE (NARCAN)
  • USED FOR REVERSAL OF NARCOTIC EFFECT-RESP DEPRESSION
  • S/E: GI N/V, RETURN OF PAIN
  • RELAPSE OF RESP. DEPRESSION CAN OCCUR WITHIN 15-20 MIN
  • NARCAN IV PUSH: REVERSES NARCOTIC IN SYSTEM
21
Q

ANALGESICS

A
  • NONSTEROIDAL ANTI-INFLAMMATORIES (NSAIDS)
  • MILD TO MODERATE PAIN/POST OP PAIN
  • ARTHRITIS/DECREASES INFLAMMATION
  • DYSMENORRHEA (MENSTRAL CRAMPS)
  • FEVER REDUCTION
  • ASA CAN ALSO BE CLASSIFIED AS NSAIDS
  • MAJOR S/E: SIMILAR TO ASPIRIN PRODUCTS
  • IMPLICATIONS: MONITOR CBC COUNT (HGH, HCT, PLT) TAKE W/FOOD TO AVOID GI DISTRESS; DISCONTINUE USE 24-48 HRS PREOP
  • AVOID W/LIVER DISEASE
22
Q

ANALGESICS

A
  • NSAIDS: TYPES:
  • IBUPROFEN: ADVIL, MOTRIN
  • NAPROXEN: ALEVE
  • KETOROLAC: TORADOL
  • COX 2 INHIBITORS: CELECOXIB (CELEBREX) ARTHRITIS
23
Q

ANTICONVULSANTS

A
  • AGENTS USED TO PREVENT OR TREAT THE SEVERITY OF EPILEPSY OR OTHER CONVULSIVE SEIZURES.
  • SUPPRESS ABNORMAL ELECTRIC IMPULSES FROM THE SEIZURE FOCUS TO OTHER AREAS
  • SEIZURES ARE CLASSIFIED AS PARTIAL, GENERALIZED, OR STATUS EPILECTICUS
  • STATUS EPILECTICUS: CONTINUOUS SEIZURE ACTIVITY LASTING MORE THAN 30 MIN; LIFE THREATENING
  • TREATMENT GOAL IS TO CONTROL SEIZURES ACTIVITY W/O INTERFERING W/DAILY LIFE
  • STATUS EPILECTICUS: SEIZURE ONE AFTER ANOTHER
24
Q

ANTICONVULSANTS

A
  • TREATMENT; FIRST LINE THERAPY = PHENYTOIN (DILANTIN)
  • MAY BE GIVEN PO OR IV
  • MAJOR S/E ARE MINIMAL AT THERAPEUTIC LEVELS
  • COMMON S/E: GINGIVAL HYPERPLASIA, N/V
  • NEURO: SEDATION
  • DERM: RASH
  • CV: DYSRRYTHMIAS, HYPOTENSION
25
Q

ANTICONVULSANTS

A
  • IMPLICATIONS:
  • HIGHLY PROTEIN BOUND
  • GIVE IV VERY SLOWLY=OVER 10 MIN
  • DO NOT MIX W/ OTHER IV DRUGS; CAUSES EXTRAVASATION AND TISSUE DEATH
  • SAFETY MEASURES (SEDATION)
  • DOSING MAY NEED TO BE TITRATED MANY TIMES
  • ASSESS ORAL CAVITY AND DEGREE OF GUM TENDERNESS
  • COMPLIANCE IS A MAJOR FACTOR FOR CONTROL OF DISEASE
  • MONITOR FOR THERAPEUTIC SERUM LEVELS

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