Dementia, ADHD, Narcolepsy, Neuromuscular Disorders Flashcards
Cognitive enhancers
enhance cognition in persons suffering from dementia
symptomatic treatment only
cognitive impairment results from
loss of cholinergic neurons and other neurodegeneration
cholinesterase inhibitors
cognitive nehancer
may also release ACh
tacrine (no longer available due to hepatotoxicity)
donepezil (causes muscle cramps)
rivastigmine
galantamine
side effects of cholinesterase inh
GI symptoms depression headache anxiety anorexia donepezil- muscle cramps
Memantine
cognitive enhancer
noncompetitive NMDA antagonist
usually coprescribed with AchE inhibitor
dissociative anesthetic at higher dose (like ketamine)
side ffects of memantine
agitation
urinary incontinence
insomnia
diarrhea
adhd
involves deficits in executivce fxn resulting from dysregulation of cns dopamine and/or noradrenergic systems projecting to frontosubcortical brain regions
narcolepsy
excessive sleepiness and frequent daytime sleepiness
may include dream like hallucinations, sleep paralysis, cataplexy
decreased orexin (hypocretin) expression in brain
methylphenidate
stimulant used for adhd
dexmethylphenidate
more active, d-isomer of methylphenidate
ADHD stimulant
d-amphetamine
ADHD and narcolepsy
lisdexamfetamine
adhd
-pro drug of d-amphetamine
stimulants for adhd/narcolepsy
releases and/or blocks reuptake of norepinephrine and dopamine
causes insomnia, anorexia, weight loss
modafinil
narcolepsy
specific for
(armodafinil- active R isomer)
reuptake inhibitors of norepinephrine and dopamine
inc glutametergic activity, decreases GABAergic activity
similar side effect to other stimulants- insomnia, anorexia, weight loss
atomoxetine
non stimulant for adhd
NE reuptake inhibitor
suicidal ideation in children and adolescents
guanfacine
adhd non stimulants
a2 agonist- binds receptors in prefrontal cortex
side effects: sleepiness, lethargy, GI symptoms, hypotension, impotence
spasticity
violent, painful, muscle contractions resulting from dysfunction of descending motor input
caused by trauma, inflammation, MS, cerebral palsy
Diazepam
anti spastic drugs
spinal and supraspinal site of action
muscle relaxation through central mechanism- enhances GABAergic transmission
causes sedation and ataxia
Baclofen
works at spinal cord
GABAb agonist- metabotropic receptors- G protein
decreases reflexes
causes drowsiness which can be decreased with intrathecal administration
used for spinal cord injury and MS
Tizanidine
spinal cord
a2 agonist- reinforces pre and post synaptic inhibition in spinal cord
inhibits nociception
used for when relief of spasticity is most important due to short DOA
side effect drowsiness
dantrolene
muscle is site of action
reduces muscle contraction by decreasing Ca release from sarcoplasmic reticulum
causes generalized muscle weakness, hepatotoxicity
antispastic for paralysis, cerebral palsy, MS
botulinum toxin
works at muscle
inhibits Ach release from vesicles
injected into muscle
used for local muscle spasm or more general spastic disorders such as cerebral palsy
muscle spasm
acute muscle spasm caused by trauma or strain
sedative and/or at level of brain stem or spinal cord
cyclobenzaprine
carisoprodol
orphenadrine
cyclobenzaprine
used for muscle spasms
related to TCAs
not for spasm due to cerebral palsy or spinal cord injury
carisoprodol
metabolized into meprobamate, a barbiturate like sedative hypnotic with abuse potential
