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CNS flashcards

1
Q

What makes up the nervous system?

A

Brain
Spinal Cord
Nerve

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2
Q

What transports messages in the nervous system?

A

Neurons

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3
Q

What kind of cells support the function of the neurons?

A

Glial cells

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4
Q

What is anxiety?

A

A condition associated with tension, apprehension, fear or panic.

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5
Q

What are the four major types of anxiety disorders?

A
  1. Generalized anxiety disorder
  2. Panic disorder
  3. Obsessive-compulsive disorder
  4. Post traumatic stress disorder
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6
Q

Treatment of anxiety is done by medications that effect which three neurotransmitters?

A

GABA
Serotonin
Norepinephrine

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7
Q

What are some symptoms of a panic attack?

A 
Dyspnea 
Chest pain 
Dizziness
Sweating
Hot flashes
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8
Q

What four classes of medications are used to treat anxiety?

A

Benzodiazepines
Azapirones
Anxiolytics
Antidepressants

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9
Q

How do benzo’s work to reduce anxiety?

A

Reduce neuronal excitability

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10
Q

What are some side effects of benzo’s

A

Drowsiness
Impaired reflexes
Muscle relaxation
Dependence

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11
Q

What are some examples of benzo’s used to treat anxiety?

A 
diazepam 
alprazolam 
temazepam 
lorazepam 
oxazepam
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12
Q

How do azapriones work to decrease anxiety?

A

They bind to dopamine and serotonin receptors and decrease neuron firing.

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13
Q

What is the most common severe psychiatric disorder?

A

Clinical depression

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14
Q

Are men or women more likely to have depression?

A

Women

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15
Q

What are the peak years that people get depression?

A

35-45

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16
Q

What are the four classes of antidepressants?

A

SSRI
SNRI
TCA
MAOI

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17
Q

How do SSRIs work?

A

Block the reuptake of serotonin

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18
Q

What are some common SSRI’s?

A

Prozac - fluoxetine
Paxil - paroxetine
Zoloft - sertraline
Celexa - citalopram

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19
Q

What two disorders is Prozac/fluoxetine used to treat?

A

Major depression and OCD

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20
Q

What are some side effects of Prozac/fluoxetine?

A

Drowsiness
Insomnia
Nausea
Loss of appetite

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21
Q

What three disorders is Paxil/paroxetine indicated for?

A

Depression
OCD
Panic disorder

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22
Q

What are some side effects of paxil/paroxetine?

A

Nausea
Headache
Sweating

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23
Q

What is a common SNRI used to treat depression?

A

Effexor / venlafaxine

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24
Q

How does effexor / venlafaxine work to treat depression?

A

Blocks the reuptake of both serotonin and norepinephrine.

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25
What are some side effects of Effexor / venlafaxine?
``` Nausea Somnolence Dry mouth blurred vision headache ```
26
What drug class can be used for children with bed wetting problems?
TCA's
27
What are some side effects of TCAs?
Sedation dry mouth constipation Urinary retention
28
What auxiliary label is used for TCAs?
Patients should avoid prolonged sun exposure.
29
What are some common TCA's used?
Elavil - amitriptyline Anafranil - clomipramine Sinequan - doxepin
30
What does MAOI stand for?
Monoamine Oxidase Inhibitor
31
Are MAOIs a first or second line treatment?
Second because their is many interactions with food and other drugs.
32
What are some foods to be avoided when the patient is taking MAOIs?
Cheese Pickled fish Sauerkraut
33
What are some drugs when the patient is taking MAOIs?
Meperidine Methyphenidate Levodopa Amphetamine
34
What are some drugs considered to be MAOI's?
Nardil Eldepryl Parnate
35
What antidepressants do not fall into the 4 categories of antidepressants? (2)
Desyrel - trazadone | Zyban, wellbutrin - bupropion
36
What drugs cause serious interactions with trazodone?
Xanax - alprazolam | Halcion - triazolam
37
What are some side effects of bupropion?
Dry mouth Nausea and vomiting Seizures Impotence
38
What is bipolar disorder?
Cycling mood changes: severe highs (mania) and lows (depression)
39
What are some symptoms of mania?
``` Overactive Overtalkative Lots of energy Disorganized thoughts Short attention span Easily distracted ```
40
What are some symptoms of depression?
Low mood Lack of energy Changes in eating and sleeping Sadness
41
What is the most commonly used compound for bipolar?
Lithium compounds
42
What is the usual dose of lithium?
300mg two-three times a day
43
What are some common drugs for bipolar?
Tegretol - carbamazepine Depakene - valproic acid Depakote - divalproex
44
What is schizophrenia?
A chronic phsychotic disorder
45
What are some symptoms of schizophrenia?
Delusions Hallucinations Withdrawal bizarre or regressive behavior
46
What are some common drugs used to treat schizophrenia?
``` Zyprexa Clozaril Seroquel Risperdal Haldol ```
47
What is epilepsy?
A recurrent seizure disorder characterized by a sudden, excessive, disorderly discharge from cerebral neurons.
48
How do seizures happen?
A sudden, excessive firing of a small number of neurons
49
What are some causes of seizures?
``` Alcohol Epilepsy High fever Toxic substances Infection (meningitis) ```
50
What are the two major types of seizure?
Partial | General
51
What is a partial seizure?
Effects only one hemisphere of the brain
52
What causes a partial seizure?
Injury to the cerebral cortex
53
What are the two types of partial seizures?
Simple | Complex
54
What is the most common type of seizures?
Partial Seizure
55
What happens during a simple partial seizure?
Stiffening or jerking in one extremity followed by a tingling sensation
56
Is consciousness lost during simple partial seizures?
No
57
What happens in a complex partial seizure?
Purposeless behavior | aura immediately before seizure
58
How long do complex partial seizures last?
up to 20 minutes
59
What is a generalized seizure?
Involves both hemispheres simultaneously.
60
What are the four main categories of general seizures?
Grand mal (tonic-clonic seizure) Petit mal (absence seizure) Myoclonic (blateral massive epileptic myoclonus) Atonic or Akinetic (drop attacks)
61
What happens during a Grand Mal seizure?
Body becomes rigid for a minute or two. The muscle jerks, shallow breathing ad loss of bladder control occurs. After the attack the patient is usually drowsy and confused for some hours.
62
What are some first line therapies for Grand Mal seizures
Tegretol Dilantin Valproic acid
63
What is a second line therapy used for the treatment of Grand Mal seizures
phenibarbital
64
What happens during a Petit Mal seizure?
Inturruption of the patients activities, blank stare, rotating eyes, No convulsions. After the attack the patient continues normally.
65
What are two medications used in the treatment of Petit Mal seizures?
Valproic Acid | Clonazepam
66
What is a myoclonic seizure?
Sudden massive muscle jerks which throw the patient down.
67
What is the first line therapy for myoclonic seizures?
Valproic acid
68
What is the second line therapy for myoclonic seizures?
Lamotrigine | Clonazepam
69
What is an atonic seizure?
Sudden loss of both muscle tone and consciousness. The patient may collapse, the head may drop and the jaw may slacken.
70
What is the first line therapy for atonic seizures?
Valproic acid
71
What is the second line therapy for Atonic seizures?
Lamotrigine | clonazepam
72
What is status epilepticus?
A medical emergency brought on by repeated generalized seizures that can deprive the brain of oxygen.
73
How is antiseizure medication delivered to patients with status epilepticus?
Intravenously
74
What are the who goals of therapy with anticonvulsants?
1. Control or reduce frequency of seizures | 2. Prevent emotional or behavioral changes
75
What are some examples of Hydrantoins used to treat seizures?
Dilantin - phenytoin | Cerebyx - fosphenytoin
76
What are some examples of valproates used to treat seizures?
Divalproex | valproic acid
77
What are some examples of iminostilbenes?
Carbamazepine | Trileptil - oxcarbazepine
78
What are some examples of y-aminobutyric acid analogs used to treat seizures?
Gabapentin pregabalin Sabril - vigabatrin
79
What are some examples of Barbiturates used to treat seizures?
Phenobarbital
80
What are some benzodiazepines used in the treatment of seizures?
Clonazepam clorazepate diazepam
81
What is Phenytoin / Dilantin used to treat?
Manage generalized, grand mal, simple and complex partial
82
What are some side effects of Phenytoin?
``` Dizziness Drowsiness Hirsutism Ataxia Slowed thinking ```
83
What is a major alert that comes with Phenytoin / Dilantin?
It is a known teratogen and are classified as a risk category D
84
What are some interactions with Phenytoin / Dilantin?
``` Alcohol Carbamazepine Clonazepam Fluoxetine Oral contraceptives Warfarin Corticosteroids ```
85
What is Parkinsons Disease?
A progressive disorder of the nervous system involving the degeneration of neurons causing impaired muscle movement.
86
What causes the symptoms of parkinsons disease?
An imbalance between dopamine and acetylcholine
87
What are some characteristics of Parkinson's Disease?
``` Resting tremor and rigidity Bradykinesia Akinesia Short steps Forward tilt of trunk ```
88
What are some drugs used to treat Parkinson's?
Levodopa - Carbidopa Ropinirole Selegeline Pramipraxole
89
What is Huntington's Disease?
A hereditary progressive and degenerative disease of neurons that affects muscle movement, cognitive function, and emotions
90
What are some symptoms of Huntington's Disease?
``` Tremors Rhythmic oscillations Sudden abnormal movements Speech impairment Difficulty swallowing ```
91
What is a drug that depletes dopamine stores in Huntington's Disease?
Nitoman - tetrabenazine
92
What is a drug that blocks dopamine receptors in Huntington's Treatment?
Haloperidal
93
What is Alzehimer's Disease?
A neurodegenerative disease that causes memory loss and behavioural changes
94
What neurotransmitter is lacking in Alzheimer's disease?
Acetylcholine
95
What are 4 examples of drugs approved to treat Alzheimer's?
Donepezil galantamine rivastigmine memantine
96
What does ALS stand for?
Amyotrophic Lateral Sclerosis (ALS)
97
What is another name for ALS?
Lou Gehrig's disease
98
What is ALS?
A progressive degenerative disease of nerves that leads to muscle weakness, paralysis, and eventual death.
99
What is insomnia?
A condition characterized by difficulty falling asleep, staying asleep, or both.
100
What is narcolepsy?
Inappropriate episodes of falling asleep suddenly and without warning.
101
How long do narcolepsy attacks last?
a few seconds to 30 minutes
102
What is an example of a barbiturates used in the treatment of insomnia?
pentobarbital
103
What are some examples of benzo's used in the treatment of insomnia?
temazepam | lorazepam
104
What are some miscellaneous drugs used in the treatment of insomnia?
Zopiclone
105
What class of drug is the preferred choice of hypnotics for insomnia? Why?
Benzos for their long duration of effectiveness and low rate of fatal overdose
106
What are some natural / non-prescription remedies for insomnia?
diphenhydramine doxylamine Melatonin Valerian
107
What class of drug is the primary treatment for narcolepsy? Give examples
Stimulants - methylphenidate - dextroamphetamine - modanafil
108
What are the three characteristics of ADHD?
Hyperactivity Impulsivity Distractibility
109
Is ADHD and ADD more common in men or women?
Men
110
What is a drug used to treat ADHD and narcolepsy?
Methylphenidate
111
What are some other drugs used to treat ADHD?
Adderall XR Dexedrine Vyvanse
112
How does a headache happen?
Dilation of the cerebral surface vessels
113
What are some common side effects of a headache?
Nausea, vomiting, anorexia
114
Sensitivity to light and sound are common in headaches. What are the technical names for this?
Photophobia | Phonophobia
115
What are the 5 components of a classic migraine?
``` Prodrome Aura Headache Headache relief Postdrome ```
116
Describe the vascular theory of migraines
Migraines are caused by vasodilation and naturally occurring mechanical stimulation of sensory nerve endings.
117
The medications used in migraine therapy can be divided into what two classes?
Abortive therapy | Prophylactic therapy
118
What is abortive therapy for migraines?
Treats acute migraines after they occur, and are taken at the first sign of a headache.
119
What do triptans do, and what are they used to treat?
They bind to serotonin receptors during vasoconstriction of blood vessels in the dura - used to treat migraines
120
What are some examples of Triptans used to treat migraines?
``` Axert Zomig Amerge Maxalt Frova ```
121
What is prophylactic therapy for migraines?
Attempts to prevent or reduce occurrence
122
What are some drug classes used in prophylactic therapy of migraines?
Beta blockers Valprates Estrogen TCAs
123
What are the four common effects of Narcotics?
Analgesia Sedation Euphoria Dysphoria
124
What is neuropathic pain?
Nerve injury caused by trauma, infection, or chronic diseases
125
What are some examples of different types of neuropathic pain?
Diabetic neuropathy Phantom Limb Shingles
126
What are some classes of drugs used to treat neuropathic pain?
Antidepressants Antiseizure drugs Anesthetics Topical medications
127
How long does pain have to last to be considered chronic?
Over three months
128
What are the three primary classes of analgesics?
Narcotics NSAIDs Acetaminophen
129
What are the two types of narcotic analgesics
Opioids | Opiates
130
What are Opiates?
Alkaloids found in opium
131
What are opioids?
Derivatives of opiates
132
What are some side effects of opioids?
``` Nausea Vomiting Drowsiness Dry mouth urinary retention Constipation ```
133
What are two more severe side effects of narcotic analgesics?
Respiratory depression and fatal overdose
134
What are three non-narcotic analgesics?
NSAIDs Salicylates Acetaminophen
135
What is the major problems with NSAIDs?
Can cause ulcers
136
What is an example of an NSAID that blocks Cox-2, but has little effect on Cox-1?
celecoxib - Celebrex
137
What is special about Aspirin?
The only NSAID that is able to inhibit the clotting of blood for a prolonged period.
138
What are some common side effects of NSAIDs?
``` Nausea Vomiting Diarrhea Constipation Dizziness Headache Drowsiness ```
139
What is the recommended dose for ibuprofen?
400mg every 8 hours.
140
What is the most commonly used OTC non-narcotic analgesic?
Acetaminophen
141
What is the most important trait of anesthesia?
Controllability
142
What are the physiological effects of anesthesia on the nervous system?
Nerve tissue function in the PNS is depressed
143
What are the physiological effects of anesthesia on the respiratory system?
Lung function is depressed
144
What are the physiological effects of anesthesia on the Hepatic system?
Some anesthetics can cause liver changes
145
What are the physiological effects of anesthesia on the Endocrine system?
Some anesthetics can cause ADH to be released causing urinary retention.
146
What are the physiological effects of anesthesia on the cardiovascular system?
Cardiac muscle activity reduced | Blood pressure reduced
147
What are the physiological effects of anesthesia on the Skeletal Muscular system?
Muscle relaxation occurs
148
What are the physiological effects of anesthesia on the GI system?
Vomiting and nausea can occur
149
What are the four reversible actions of General Anesthesia?
Unconsciousness Analgesia Skeletal Muscle relaxation Amnesia on recovery
150
What drugs are sometimes given before anesthesia and why?
Narcotics for pain relief | Benzo's for amnesia
151
What is a common inhaled anesthesia?
Nitrous oxide - also called laughing gas
152
What is an antagonist used for? Give an example.
To reverse benzo and narcotic overdoses. An example is naloxone
153
When using local anesthetics, loss of sensory action occurs in what order? (5 steps)
1. Pain perception 2. Temperature 3. Touch sensation 4. Proprioception 5. Skeletal muscle tone
154
What are the two categories of local anesthetics?
Esters | Amides
155
What are esters? (local anesthesia)
Short acting and metabolized mainly in plasma and issue fluids and excreted in urine.
156
What are two examples of esters used in local anesthesia?
Benzocaine | Procaine
157
What are amides? (Local anesthesia)
Amides are longer acting and are metabolized by liver enzymes and excreted in the urine
158
What are two examples of amides used in local anesthesia?
Marcaine | Xylocaine

Pharmacology (18 decks)

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