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Pharmacology > CNS flashcards > Flashcards

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
Q

What are some side effects of Effexor / venlafaxine?

A 
Nausea
Somnolence 
Dry mouth 
blurred vision 
headache
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26
Q

What drug class can be used for children with bed wetting problems?

A

TCA’s

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27
Q

What are some side effects of TCAs?

A

Sedation
dry mouth
constipation
Urinary retention

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28
Q

What auxiliary label is used for TCAs?

A

Patients should avoid prolonged sun exposure.

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29
Q

What are some common TCA’s used?

A

Elavil - amitriptyline
Anafranil - clomipramine
Sinequan - doxepin

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30
Q

What does MAOI stand for?

A

Monoamine Oxidase Inhibitor

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31
Q

Are MAOIs a first or second line treatment?

A

Second because their is many interactions with food and other drugs.

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32
Q

What are some foods to be avoided when the patient is taking MAOIs?

A

Cheese
Pickled fish
Sauerkraut

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33
Q

What are some drugs when the patient is taking MAOIs?

A

Meperidine
Methyphenidate
Levodopa
Amphetamine

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34
Q

What are some drugs considered to be MAOI’s?

A

Nardil
Eldepryl
Parnate

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35
Q

What antidepressants do not fall into the 4 categories of antidepressants? (2)

A

Desyrel - trazadone

Zyban, wellbutrin - bupropion

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36
Q

What drugs cause serious interactions with trazodone?

A

Xanax - alprazolam

Halcion - triazolam

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37
Q

What are some side effects of bupropion?

A

Dry mouth
Nausea and vomiting
Seizures
Impotence

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38
Q

What is bipolar disorder?

A

Cycling mood changes: severe highs (mania) and lows (depression)

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39
Q

What are some symptoms of mania?

A 
Overactive 
Overtalkative 
Lots of energy 
Disorganized thoughts 
Short attention span 
Easily distracted
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40
Q

What are some symptoms of depression?

A

Low mood
Lack of energy
Changes in eating and sleeping
Sadness

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41
Q

What is the most commonly used compound for bipolar?

A

Lithium compounds

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42
Q

What is the usual dose of lithium?

A

300mg two-three times a day

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43
Q

What are some common drugs for bipolar?

A

Tegretol - carbamazepine
Depakene - valproic acid
Depakote - divalproex

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44
Q

What is schizophrenia?

A

A chronic phsychotic disorder

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45
Q

What are some symptoms of schizophrenia?

A

Delusions
Hallucinations
Withdrawal
bizarre or regressive behavior

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46
Q

What are some common drugs used to treat schizophrenia?

A 
Zyprexa
Clozaril 
Seroquel 
Risperdal 
Haldol
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47
Q

What is epilepsy?

A

A recurrent seizure disorder characterized by a sudden, excessive, disorderly discharge from cerebral neurons.

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48
Q

How do seizures happen?

A

A sudden, excessive firing of a small number of neurons

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49
Q

What are some causes of seizures?

A 
Alcohol 
Epilepsy 
High fever 
Toxic substances 
Infection (meningitis)
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50
Q

What are the two major types of seizure?

A

Partial

General

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51
Q

What is a partial seizure?

A

Effects only one hemisphere of the brain

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52
Q

What causes a partial seizure?

A

Injury to the cerebral cortex

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53
Q

What are the two types of partial seizures?

A

Simple

Complex

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54
Q

What is the most common type of seizures?

A

Partial Seizure

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55
Q

What happens during a simple partial seizure?

A

Stiffening or jerking in one extremity followed by a tingling sensation

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56
Q

Is consciousness lost during simple partial seizures?

A

No

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57
Q

What happens in a complex partial seizure?

A

Purposeless behavior

aura immediately before seizure

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58
Q

How long do complex partial seizures last?

A

up to 20 minutes

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59
Q

What is a generalized seizure?

A

Involves both hemispheres simultaneously.

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60
Q

What are the four main categories of general seizures?

A

Grand mal (tonic-clonic seizure)
Petit mal (absence seizure)
Myoclonic (blateral massive epileptic myoclonus)
Atonic or Akinetic (drop attacks)

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61
Q

What happens during a Grand Mal seizure?

A

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.

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62
Q

What are some first line therapies for Grand Mal seizures

A

Tegretol
Dilantin
Valproic acid

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63
Q

What is a second line therapy used for the treatment of Grand Mal seizures

A

phenibarbital

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64
Q

What happens during a Petit Mal seizure?

A

Inturruption of the patients activities, blank stare, rotating eyes, No convulsions. After the attack the patient continues normally.

65
Q

What are two medications used in the treatment of Petit Mal seizures?

A

Valproic Acid

Clonazepam

66
Q

What is a myoclonic seizure?

A

Sudden massive muscle jerks which throw the patient down.

67
Q

What is the first line therapy for myoclonic seizures?

A

Valproic acid

68
Q

What is the second line therapy for myoclonic seizures?

A

Lamotrigine

Clonazepam

69
Q

What is an atonic seizure?

A

Sudden loss of both muscle tone and consciousness. The patient may collapse, the head may drop and the jaw may slacken.

70
Q

What is the first line therapy for atonic seizures?

A

Valproic acid

71
Q

What is the second line therapy for Atonic seizures?

A

Lamotrigine

clonazepam

72
Q

What is status epilepticus?

A

A medical emergency brought on by repeated generalized seizures that can deprive the brain of oxygen.

73
Q

How is antiseizure medication delivered to patients with status epilepticus?

A

Intravenously

74
Q

What are the who goals of therapy with anticonvulsants?

A
  1. Control or reduce frequency of seizures

2. Prevent emotional or behavioral changes

75
Q

What are some examples of Hydrantoins used to treat seizures?

A

Dilantin - phenytoin

Cerebyx - fosphenytoin

76
Q

What are some examples of valproates used to treat seizures?

A

Divalproex

valproic acid

77
Q

What are some examples of iminostilbenes?

A

Carbamazepine

Trileptil - oxcarbazepine

78
Q

What are some examples of y-aminobutyric acid analogs used to treat seizures?

A

Gabapentin
pregabalin
Sabril - vigabatrin

79
Q

What are some examples of Barbiturates used to treat seizures?

A

Phenobarbital

80
Q

What are some benzodiazepines used in the treatment of seizures?

A

Clonazepam
clorazepate
diazepam

81
Q

What is Phenytoin / Dilantin used to treat?

A

Manage generalized, grand mal, simple and complex partial

82
Q

What are some side effects of Phenytoin?

A 
Dizziness 
Drowsiness 
Hirsutism 
Ataxia 
Slowed thinking
83
Q

What is a major alert that comes with Phenytoin / Dilantin?

A

It is a known teratogen and are classified as a risk category D

84
Q

What are some interactions with Phenytoin / Dilantin?

A 
Alcohol 
Carbamazepine 
Clonazepam 
Fluoxetine 
Oral contraceptives 
Warfarin
Corticosteroids
85
Q

What is Parkinsons Disease?

A

A progressive disorder of the nervous system involving the degeneration of neurons causing impaired muscle movement.

86
Q

What causes the symptoms of parkinsons disease?

A

An imbalance between dopamine and acetylcholine

87
Q

What are some characteristics of Parkinson’s Disease?

A 
Resting tremor and rigidity 
Bradykinesia 
Akinesia 
Short steps 
Forward tilt of trunk
88
Q

What are some drugs used to treat Parkinson’s?

A

Levodopa - Carbidopa
Ropinirole
Selegeline
Pramipraxole

89
Q

What is Huntington’s Disease?

A

A hereditary progressive and degenerative disease of neurons that affects muscle movement, cognitive function, and emotions

90
Q

What are some symptoms of Huntington’s Disease?

A 
Tremors 
Rhythmic oscillations 
Sudden abnormal movements 
Speech impairment 
Difficulty swallowing
91
Q

What is a drug that depletes dopamine stores in Huntington’s Disease?

A

Nitoman - tetrabenazine

92
Q

What is a drug that blocks dopamine receptors in Huntington’s Treatment?

A

Haloperidal

93
Q

What is Alzehimer’s Disease?

A

A neurodegenerative disease that causes memory loss and behavioural changes

94
Q

What neurotransmitter is lacking in Alzheimer’s disease?

A

Acetylcholine

95
Q

What are 4 examples of drugs approved to treat Alzheimer’s?

A

Donepezil
galantamine
rivastigmine
memantine

96
Q

What does ALS stand for?

A

Amyotrophic Lateral Sclerosis (ALS)

97
Q

What is another name for ALS?

A

Lou Gehrig’s disease

98
Q

What is ALS?

A

A progressive degenerative disease of nerves that leads to muscle weakness, paralysis, and eventual death.

99
Q

What is insomnia?

A

A condition characterized by difficulty falling asleep, staying asleep, or both.

100
Q

What is narcolepsy?

A

Inappropriate episodes of falling asleep suddenly and without warning.

101
Q

How long do narcolepsy attacks last?

A

a few seconds to 30 minutes

102
Q

What is an example of a barbiturates used in the treatment of insomnia?

A

pentobarbital

103
Q

What are some examples of benzo’s used in the treatment of insomnia?

A

temazepam

lorazepam

104
Q

What are some miscellaneous drugs used in the treatment of insomnia?

105
Q

What class of drug is the preferred choice of hypnotics for insomnia? Why?

A

Benzos for their long duration of effectiveness and low rate of fatal overdose

106
Q

What are some natural / non-prescription remedies for insomnia?

A

diphenhydramine
doxylamine
Melatonin
Valerian

107
Q

What class of drug is the primary treatment for narcolepsy? Give examples

A

Stimulants

  • methylphenidate
  • dextroamphetamine
  • modanafil
108
Q

What are the three characteristics of ADHD?

A

Hyperactivity
Impulsivity
Distractibility

109
Q

Is ADHD and ADD more common in men or women?

110
Q

What is a drug used to treat ADHD and narcolepsy?

A

Methylphenidate

111
Q

What are some other drugs used to treat ADHD?

A

Adderall XR
Dexedrine
Vyvanse

112
Q

How does a headache happen?

A

Dilation of the cerebral surface vessels

113
Q

What are some common side effects of a headache?

A

Nausea, vomiting, anorexia

114
Q

Sensitivity to light and sound are common in headaches. What are the technical names for this?

A

Photophobia

Phonophobia

115
Q

What are the 5 components of a classic migraine?

A 
Prodrome 
Aura 
Headache 
Headache relief 
Postdrome
116
Q

Describe the vascular theory of migraines

A

Migraines are caused by vasodilation and naturally occurring mechanical stimulation of sensory nerve endings.

117
Q

The medications used in migraine therapy can be divided into what two classes?

A

Abortive therapy

Prophylactic therapy

118
Q

What is abortive therapy for migraines?

A

Treats acute migraines after they occur, and are taken at the first sign of a headache.

119
Q

What do triptans do, and what are they used to treat?

A

They bind to serotonin receptors during vasoconstriction of blood vessels in the dura - used to treat migraines

120
Q

What are some examples of Triptans used to treat migraines?

A 
Axert 
Zomig 
Amerge 
Maxalt 
Frova
121
Q

What is prophylactic therapy for migraines?

A

Attempts to prevent or reduce occurrence

122
Q

What are some drug classes used in prophylactic therapy of migraines?

A

Beta blockers
Valprates
Estrogen
TCAs

123
Q

What are the four common effects of Narcotics?

A

Analgesia
Sedation
Euphoria
Dysphoria

124
Q

What is neuropathic pain?

A

Nerve injury caused by trauma, infection, or chronic diseases

125
Q

What are some examples of different types of neuropathic pain?

A

Diabetic neuropathy
Phantom Limb
Shingles

126
Q

What are some classes of drugs used to treat neuropathic pain?

A

Antidepressants
Antiseizure drugs
Anesthetics
Topical medications

127
Q

How long does pain have to last to be considered chronic?

A

Over three months

128
Q

What are the three primary classes of analgesics?

A

Narcotics
NSAIDs
Acetaminophen

129
Q

What are the two types of narcotic analgesics

A

Opioids

Opiates

130
Q

What are Opiates?

A

Alkaloids found in opium

131
Q

What are opioids?

A

Derivatives of opiates

132
Q

What are some side effects of opioids?

A 
Nausea 
Vomiting 
Drowsiness 
Dry mouth 
urinary retention 
Constipation
133
Q

What are two more severe side effects of narcotic analgesics?

A

Respiratory depression and fatal overdose

134
Q

What are three non-narcotic analgesics?

A

NSAIDs
Salicylates
Acetaminophen

135
Q

What is the major problems with NSAIDs?

A

Can cause ulcers

136
Q

What is an example of an NSAID that blocks Cox-2, but has little effect on Cox-1?

A

celecoxib - Celebrex

137
Q

What is special about Aspirin?

A

The only NSAID that is able to inhibit the clotting of blood for a prolonged period.

138
Q

What are some common side effects of NSAIDs?

A 
Nausea 
Vomiting 
Diarrhea 
Constipation 
Dizziness 
Headache 
Drowsiness
139
Q

What is the recommended dose for ibuprofen?

A

400mg every 8 hours.

140
Q

What is the most commonly used OTC non-narcotic analgesic?

A

Acetaminophen

141
Q

What is the most important trait of anesthesia?

A

Controllability

142
Q

What are the physiological effects of anesthesia on the nervous system?

A

Nerve tissue function in the PNS is depressed

143
Q

What are the physiological effects of anesthesia on the respiratory system?

A

Lung function is depressed

144
Q

What are the physiological effects of anesthesia on the Hepatic system?

A

Some anesthetics can cause liver changes

145
Q

What are the physiological effects of anesthesia on the Endocrine system?

A

Some anesthetics can cause ADH to be released causing urinary retention.

146
Q

What are the physiological effects of anesthesia on the cardiovascular system?

A

Cardiac muscle activity reduced

Blood pressure reduced

147
Q

What are the physiological effects of anesthesia on the Skeletal Muscular system?

A

Muscle relaxation occurs

148
Q

What are the physiological effects of anesthesia on the GI system?

A

Vomiting and nausea can occur

149
Q

What are the four reversible actions of General Anesthesia?

A

Unconsciousness
Analgesia
Skeletal Muscle relaxation
Amnesia on recovery

150
Q

What drugs are sometimes given before anesthesia and why?

A

Narcotics for pain relief

Benzo’s for amnesia

151
Q

What is a common inhaled anesthesia?

A

Nitrous oxide - also called laughing gas

152
Q

What is an antagonist used for? Give an example.

A

To reverse benzo and narcotic overdoses. An example is naloxone

153
Q

When using local anesthetics, loss of sensory action occurs in what order? (5 steps)

A
  1. Pain perception
  2. Temperature
  3. Touch sensation
  4. Proprioception
  5. Skeletal muscle tone
154
Q

What are the two categories of local anesthetics?

A

Esters

Amides

155
Q

What are esters? (local anesthesia)

A

Short acting and metabolized mainly in plasma and issue fluids and excreted in urine.

156
Q

What are two examples of esters used in local anesthesia?

A

Benzocaine

Procaine

157
Q

What are amides? (Local anesthesia)

A

Amides are longer acting and are metabolized by liver enzymes and excreted in the urine

158
Q

What are two examples of amides used in local anesthesia?

A

Marcaine

Xylocaine

Pharmacology (18 decks)

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