CNS Medications Flashcards by Lauren Cooper

What is Diazepam used for?

Seizures, anxiety, muscle spasms (Trade: Valium)

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What class is Diazepam in?

Benzodiazepine; GABA enhancer

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What is Lorazepam used for?

Status epilepticus, anxiety (Trade: Ativan)

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How do benzodiazepines work?

Bind GABA receptors → enhance inhibition in CNS

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What is the difference between a seizure and a convulsion?

Seizure = abnormal brain activity; convulsion = muscle spasms

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What is Phenytoin (Dilantin) used for?

Seizure control (Anti-epileptic drug - AED)

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What is Carbamazepine (Tegretol) used for?

Partial & generalized seizures, bipolar disorder

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What is Gabapentin (Neurontin) also used for besides seizures?

Neuropathic pain

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What’s the mechanism of Valproic acid (Depakene)?

Increases GABA, reduces neuron firing

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Patient with epilepsy hasn’t taken meds and has a seizure lasting 3 mins. What med?

Give Lorazepam IV for status epilepticus

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What is Carbidopa-Levodopa (Sinemet) used for?

Parkinson’s disease

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How does Levodopa work?

Converts to dopamine in brain to improve movement

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Why is carbidopa combined with levodopa?

Prevents peripheral metabolism → ↑ brain delivery

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What are signs of Parkinson’s?

Tremors, rigidity, bradykinesia

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Which med is most effective for Parkinson’s?

Levodopa (with carbidopa)

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What is TPA used for?

Acute ischemic stroke → dissolves clots

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What is a major contraindication for TPA?

Active bleeding or recent hemorrhagic stroke

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How is TPA administered?

IV, within 3–4.5 hours of stroke onset

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What is the goal of anticoagulant therapy?

Prevent clot formation (DVT, stroke)

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A patient had a stroke 1 hour ago. BP stable. What is the ideal treatment?

Administer TPA if no contraindications

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What’s the difference between sedatives and hypnotics?

Sedatives calm; hypnotics induce sleep

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Which drug class includes Barbiturates and Benzodiazepines?

CNS Depressants

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What are barbiturates used for?

Seizures, anesthesia, sedation

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What is a risk of barbiturate overdose?

Respiratory depression → coma or death

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Name a commonly used barbiturate.

Phenobarbital

What are long-acting benzodiazepines?

Diazepam (Valium), Clonazepam (Klonopin)

What’s the use of Alprazolam (Xanax)?

Anxiety, panic disorders

What are side effects of benzodiazepines?

Drowsiness, confusion, hypotension

What’s a short-acting benzodiazepine?

Midazolam (Versed)

Patient is panicking before surgery. What sedative can you give?

Midazolam for anxiolysis and amnesia

Name a Tricyclic Antidepressant (TCA).

Amitriptyline

What do TCAs do?

Inhibit serotonin and norepinephrine reuptake

What are adverse effects of TCAs?

Sedation, anticholinergic effects, orthostatic hypotension

What’s a serious risk of TCA overdose?

Cardiac dysrhythmias

What’s the action of MAOIs?

Inhibit breakdown of serotonin, dopamine, NE

Name an MAOI drug.

Phenelzine (Nardil)

What food interactions must be avoided with MAOIs?

Tyramine (e.g., cheese, wine) → hypertensive crisis

What is Fluoxetine (Prozac)?

SSRI (selective serotonin reuptake inhibitor)

What’s the main benefit of SSRIs over TCAs?

Fewer side effects

Patient on MAOIs eats aged cheese and has high BP and headache. What’s happening?

Hypertensive crisis from tyramine interaction

What is Sertraline (Zoloft)?

SSRI

What is Duloxetine (Cymbalta)?

SNRI

What do SNRIs do?

Block reuptake of serotonin & norepinephrine

What’s serotonin syndrome?

Overstimulation → agitation, sweating, confusion, ↑ HR/BP

What is a symptom of serotonin syndrome?

Hyperreflexia, myoclonus, high fever

What is Citalopram (Celexa)?

SSRI for depression

What are common SSRI side effects?

Nausea, insomnia, sexual dysfunction

What’s a severe risk of combining SSRIs and MAOIs?

Serotonin syndrome

What’s the mechanism of Venlafaxine (Effexor)?

SNRI – ↑ serotonin & NE

A patient taking both St. John’s Wort and fluoxetine reports confusion and tremors. What do you suspect?

Serotonin syndrome

What are neuroleptics used for?

Treat psychosis (e.g., schizophrenia, bipolar)

How do neuroleptics work?

Block dopamine receptors in brain

What is Risperidone (Risperdal)?

Atypical antipsychotic

What are extrapyramidal symptoms (EPS)?

Dystonia, akathisia, parkinsonism

What is Neuroleptic Malignant Syndrome (NMS)?

Rare, life-threatening reaction to antipsychotics

What’s a sign of NMS?

Hyperthermia, rigidity, altered mental status

Name an antipsychotic that may cause weight gain.

Olanzapine (Zyprexa)

What’s the brand name of Aripiprazole?

Abilify

What are side effects of Clozapine (Clozaril)?

Agranulocytosis, seizures, weight gain

Patient with schizophrenia is drooling, febrile, and has muscle rigidity. What is this?

Likely NMS – medical emergency

What neurotransmitter does the sympathetic nervous system primarily use?

Norepinephrine

What neurotransmitter does the parasympathetic nervous system use?

Acetylcholine

What does stimulation of Alpha-1 receptors cause?

Vasoconstriction, ↑ BP, pupil dilation

What’s a drug that activates Beta-2 receptors?

Salbutamol (Ventolin) → bronchodilation

What does Beta-1 receptor stimulation do?

Increases heart rate and contractility

What’s an example of a Beta-1 blocker?

Metoprolol

What are anticholinergic medications also called?

Parasympatholytics

What do cholinergic agonists do?

Mimic the parasympathetic system → ↓ HR, ↑ secretions

What’s a major side effect of anticholinergics?

Dry mouth, constipation, urinary retention, blurred vision

A patient has asthma. What kind of SNS drug might help?

Beta-2 agonist (e.g., salbutamol)

What does 'positive inotropic' mean?

Increases the force of cardiac contraction

What does 'positive chronotropic' mean?

Increases heart rate

What does 'positive dromotropic' mean?

Increases AV node conduction

What is a sympathomimetic drug?

Mimics the sympathetic nervous system (e.g., epinephrine)

What is a sympatholytic drug?

Inhibits the sympathetic nervous system

What are muscarinic receptors responsible for?

Heart rate, glandular secretions, smooth muscle activity

What are nicotinic receptors responsible for?

Muscle contraction, autonomic ganglia stimulation

What is the antidote for a cholinergic overdose?

Atropine

What effect do Alpha-2 receptors have?

Decrease norepinephrine release (negative feedback)

A patient has urinary retention due to anticholinergics. What med can reverse this?

Bethanechol (muscarinic agonist)

What class is Diphenhydramine also a part of?

Anticholinergic (besides antihistamine)

What is an example of a neuromuscular blocking agent?

Succinylcholine

What does Botox do in the nervous system?

Blocks acetylcholine release at neuromuscular junctions

What’s a common side effect of SSRIs in young adults?

Increased risk of suicidal thoughts

Why are MAOIs rarely used today?

High risk of food and drug interactions

What are early signs of TCA overdose?

Tachycardia, agitation, arrhythmia

A Parkinson’s patient stops taking Sinemet and develops muscle rigidity and high fever. What is this?

Neuroleptic Malignant Syndrome

Why must clozapine patients have regular blood tests?

Risk of agranulocytosis

What’s an example of a miscellaneous CNS depressant?

Zopiclone

A patient on antipsychotics develops lip smacking and involuntary facial movements. Diagnosis?

Tardive dyskinesia

Which class causes the most respiratory depression?

Barbiturates (and high-dose benzodiazepines with other depressants)

What are the 'SHIVERS' signs related to?

Serotonin Syndrome

Why is serotonin syndrome dangerous?

Risk of hyperthermia, seizures, organ failure

Which class of antidepressants is safest in overdose?

SSRIs

Which Parkinson’s drug crosses the blood-brain barrier?

Levodopa

Why do SNRIs help with fibromyalgia?

Boost serotonin and norepinephrine in pain pathways

What is the main action of antipsychotics?

Block dopamine receptors

What type of med is atropine?

Anticholinergic (muscarinic antagonist)

What drug would you use for benzodiazepine overdose?

Flumazenil

A patient has pinpoint pupils, respiratory depression, and unconsciousness. Suspected drug class?

Opioids