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Pharmacology > CNS part 2 > Flashcards

CNS part 2 Flashcards

1
Q
  • Minor tranquilizers, anti-anxiety
  • Mechanism of action - stimulation
    the action of GABA
A

Anxiolytic and Hypnotic Agents

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2
Q

Anxiolytic and Hypnotic Agents

A

Benzodiazepines (-pam)
1. Diazepam (valium)
2. Oxazepam (Serax)
3. Alprazolam (Xanax)

Side effects: Dizziness, Drowsiness, Dry
mouth, Sedation

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3
Q

Benzodiazepines Nursing considerations:

A
  1. Give before meals
  2. Ask patient to avoid caffeine and
    alcohol
  3. Administer separately
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4
Q

Conditions characterized by an
abnormal range of moods or
international emotional states and
loss of control over them

A

Mood disorders

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5
Q

Antidepressant Classifications

A
  1. Selective serotonin reuptake
    inhibitors (SSRI)
  2. Serotonin-Norepinephrine Reuptake
    Inhibitors (SNRI)
  3. Tricyclic Antidepressants (TCA)
    Inhibits the reuptake of NE & 5-HT
  4. Monoamine Oxidase Inhibitors
    (MAOI)
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6
Q

Decrease in norepinephrine and serotonin =

A

symptoms of mood disorder

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6
Q
  • breaks down NE & 5-HT
A

MAO

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7
Q

MAO inhibitor - prevents the breakdown =

A

more NE & 5HT

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8
Q
  • Inhibits 5-HT reuptake
  • Normally takes 4-8 weeks for
    antidepressants to show appreciable
    effect
A

Selective serotonin reuptake inhibitors
(SSRI)

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9
Q

a product of biosynthesis of tryptophan

A

Serotonin

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10
Q

Selective serotonin reuptake inhibitors
(SSRI) Clinical use:

A

Depression
Generalized Anxiety
OCD
Bulimia
Binge Eating Disorder

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11
Q

Serotonin Syndrome clinical Manifestation

A

~ Increase Activity
~ Autonomic Instability
~ Altered mental status

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11
Q

SSRI Adverse Effects

A

Serotonin Syndrome

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12
Q

Serotonin-Norepinephrine Reuptake
Inhibitors (SNRI)

A

Venlafaxine
Desvenlafaxine
Duloxetine,
levomilnacipran
Milnacipran

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12
Q
  • Inhibits 5-HT and NE uptake
  • Clinical Use: Depression and GAD
  • Adverse effect: inc. BP. stimulant
    effects, sedation, sexual dysfunction,
    nausea
A

Serotonin-Norepinephrine Reuptake
Inhibitors (SNRI)

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13
Q

Selective serotonin reuptake inhibitors
(SSRI)

A

Fluoxetine
Fuvoxamine
Paroxetine,
sertraline
Escitalopram
Citalopram

14
Q

Erection in males =
Ejaculation =

A

stimulation of parasympathetic

stimulation of sympathetic

15
Q
  • Inhibits 5-HT and NE reuptake
  • Clinical use: MDD, peripheral neuropathy, chronic neuropathic pain, migraine prophylaxis, OCD
  • Adverse effects (3C’s)
    1. Convulsion
    2. Coma
    3. Cardiotoxicity
A

Tricyclic Antidepressants (TCA)

15
Q

Tricyclic Antidepressants (TCA)

A

Amitriptyline
Nortriptyline
Imipramine,
Desipramine
Clomipramine
Doxepin
Amoxapine

16
Q

Monoamine Oxidase Inhibitors
(MAOI)

Nonselective -

Selective -

A

Nonselective :
Tranycyclopomine
phenelzine
Isocarboxazid

Selective:
Selegiline

17
Q
  • Increase level of amine
    neurotransmitter (norepinephrine, 5-HT,
    dopamine)
  • Clinical use: Atypical depression,
    anxiety, parkinson’s dse (selegiline)
    -
    Adverse effect:
    1. CNS stimulation
    2. Hypertensive crisis
    3. Serotonin Syndrome
A

Monoamine Oxidase Inhibitors
(MAOI)

17
Q

Monoamine Oxidase Inhibitors
(MAOI) nursing responsibilities

A

Do not give MAOI with SSRI’s, TCA’s

2 week washout period

Avoid Tyramine rich foods

18
Q

Mechanism not established, possibly related to inhibition of phosphoinositol cascade

teratogenic

Mood stabilizer bipolar disorder;
treats acute manic episodes and
prevents relapse

A

Lithium

19
Q

Lithium Side effects & ranges

A
  1. Low thyroid
  2. Ebstein anomaly - 2 cusps of tricuspid cusp is misplaced
  3. Insipidus
  4. Unwanted movements (tremor)

Therapeutic range: 0.5-1.5 meq/L
Toxic range: 1.5-2.0 mEq/L

20
Q

Lithium NR

A
  1. Best taken after meals
  2. Therapeutic effect 0-14 days
  3. Increase fluid intake
21
Q

Chronic Illness causing profound functional impairment

A

Schizophrenia

22
Q

Schizophrenia symptoms

Excessive or distorted functioning =
Diminished functioning =
Reduced ability to understand or make plans, diminished working memory =

A

Positive
Negative
Cognitive

23
Q

Types of antipsychotics

A

Typical (1st generational)
Atypical (2nd generation)

23
Q

Typical (1st generational)

A

Haloperidol
Pimozide
Fluphenazine
Thioridazine
Chlorpromazine

24
Q

Atypical 2nd generation

A

Asenapine
Clozapine
Olanzapine
risperidone
lurasidone
Ziprasidone

25
Q

Block D2 receptor also blocks 5-HT2 receptor

A

antipsychotics

26
Q

Antipsychotic side effects

A

EXTRAPYRAMIDAL SYNDROME

ADAPT:
Acute Dystonia
Akathisia
Parkinsonism
Tardive Dyskinesia

27
Q

NE -

5-HT -

A

Noradrenergic -

Serotonergic -

Pharmacology (9 decks)

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