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PHARMACOLOGY > DRUGS ACTING ON CNS AND PNS > Flashcards

DRUGS ACTING ON CNS AND PNS Flashcards

1
Q
  • medicines that stimulate the brain, speeding up both mental and physical processes
  • increase energy, improve attention and alertness
A

CNS stimulants

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2
Q
  • elevates blood pressure, HR, and RR
  • decrease the need for sleep, reduce appetite, improve confidence and concentration, and lessen inhibitions
A

CNS stimulants

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3
Q
  • stimulates the release of neurotransmitters - norepinephrine and dopamine
  • for narcolepsy and ADHD
  • can develop dependence
A

amphetamines

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4
Q
  • short-term use (12 weeks)
  • avoid abrupt withdrawal
  • SE: restlessness, insomnia, tachycardia, HPN, palpitations, dry mouth, anorexia, weight loss, diarrhea, constipation, impotence
A

amphetamines

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5
Q

what is the half life of amphetamines?

A

9-13 hours

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6
Q

to increase child’s attention span, cognitive performance and to decrease impulsiveness, hyperactivity and restlessness

A

amphetamine-like drugs

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7
Q

this amphetamine-like drug causes insomnia. do not give 6 hours before bedtime

A

methylphenidate (ritalin)

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8
Q

amphetamine-like drug that is for treatment of narcolepsy

A

pemoline (cylert), modafinil (provigil) NEW!

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9
Q

ritalin and pemoline should be given ___ minutes before meals (bfast and lunch)

A

30-45

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10
Q

long term use of amphetamines may lead to ___

A

drug abuse

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11
Q

(amphetamines)

dry mouth = ___

A

sugarless gums

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12
Q
  • appetite suppressant
  • SE: nervousness, restlessness, irritability, insomnia, palpitations, HPN
A

anorexiants

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13
Q

anorexiants should not be given to ages ___ and below

A

12

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14
Q
  • stimulates respiration
  • used in newborns for respiratory distress
  • SE: nervousness, restlessness, tremors, twitching, palpitations, insomnia, diuresis, GI irritation, tinnitus
A

analeptics

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15
Q

(analeptics)

caffeine citrate + theophylline

A

methylxanthines

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16
Q
  • doxapram (dopram)
  • treat respiratory depression caused by drug overdose, pre-postanesthetic respiratory depression, and COPD
  • SE: HPN, tachycardia, trembling and convulsions
A

respiratory CNS stimulants

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17
Q

CNS depressant that has a sedating and hypnotic effect

A

sedative-hypnotics

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18
Q

diminish physical and mental response at a lower dosage of certain CNS depressants but does not affect consciousness

A

sedation

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19
Q

natural sleep

A

hypnotic

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20
Q

5 types of sedative-hyponotics

A

barbiturates
benzodiazepines
nonbenzodiazepines
piperidinediones
chloral hydrate

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21
Q

long acting barbiturates

A

phenobarbital and mephobarbital

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22
Q

intermediate acting barbituates

A
  • amobarbital (amytal)
  • aprobarbitals (alurate)
  • butabarbital (butisol)
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23
Q

short acting barbiturates

A
  • secobarbital (seconal)
  • pentobarbital (nembutal)
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24
Q

ultra short acting barbituarates

A
  • thiopental Na (pentothal)
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25
Q

barbituarates:

used to control seizures in epilepsy

A

long acting

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26
Q

barbituarates:

  • sleep sustainers for maintaining long period of sleep
  • causes drowsiness / hangover
A

intermediate acting

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27
Q

barbituarates:

induce sleep for those difficulty falling asleep

A

short acting

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28
Q

barbituarates:

general anesthetics

A

ultrashort acting

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29
Q

true or false: barbiturates can be utilized for long term use

A

false - only 2 weeks or less

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30
Q

administer IV pentobarbital at a rate of less than ___ mg/min

A

50

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31
Q

increase the action of inhibitory neurotransmitter GABA > neuron excitability is reduced

A

benzodiazepines

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32
Q

(benzodiazepines)

used to treat insomnia

A

flurazepam (dalmane)

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33
Q

(benzodiazepines)

AR: loss of memory
should not be taken longer than 7-10 days

A

triazolam (halcion)

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34
Q

before taking benzodiazepines, one should urinate because?

A

it causes urinary retention

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35
Q

antidote for benzodiazepines

A

flumazenil

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36
Q
  • zoldipem (ambien)
  • short term treatment of insomnia (< 10 days)
  • DOA: 6-8 hours
  • metabolized in liver and excreted in urine
A

nonbenzodiazepines

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37
Q

induces sleep and decrease nocturnal awakenings

A

chloral hydrate

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38
Q

first anesthetic, aka laughing gas

A

nitrous oxide

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39
Q
  • a hypnotic - given at night before surgery
  • premedication and anticholinergic given 1 hour before surgery to decrease secretions
A

balanced anesthesia

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40
Q

4 stages of general anesthesia

A
  • analgesia / induction
  • excitement / delirium
  • surgical stage
  • medullary paralysis
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41
Q

stages of general anes:

decreased pain awareness, sometimes with amnesia, impaired consciousness but not lost

A

analgesia / induction

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42
Q

stages of general anes:

excitation, amnesia, enhance reflexes, uncontrolled movement, irregular respiration, urinary incontinence

A

excitement or delirium

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43
Q

stages of general anes:

unconscious, no pain reflex, regular respiration, maintain BP

A

surgical stage

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44
Q

stages of general anes:

too deep > overdosage > cardiorespiratory collapse > death

A

medullary paralysis

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45
Q

surgical stage:

light anesthesia

A

plane 1

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46
Q

surgical stage:

loss of blink reflex, regular respiration, surgical procedures can be performed

A

plane 2

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47
Q

surgical stage:

deep anesthesia, shallow breathing, assisted by ventilator

A

plane 3

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48
Q

surgical stage:

diaphragmatic breathing only, ventilator is required, causes cardiovascular impairment

A

plane 4

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49
Q
  • gas or volatile liquids administered as gas
  • AR: respi depression, HPN, dysrhythmias, hepatic dysfunction
A

inhalation anesthetics

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50
Q

what should you watch out for when administering inhalation anesthetics?

A

malignant hyperthermia

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51
Q

management for malignant hyperthermia caused by inhalation anes?

A

dantrolene

52
Q
  • as general anesthesia
  • AR: respiratory and cardio vascular effects
A

IV anesthetics

53
Q

IV anes used for intubation or minor surgeries

A

midazolam / propofol

54
Q

what should you watch out for when administering propofol?

A

infections - propofol support microbial growth

55
Q
  • type of anesthesia used on mucous membranes, broken / unbroken skin, and burns
  • forms: solution, liquid spray, ointment, cream, and gel
A

topical anesthetics

56
Q

most common local anesthetic used for dental procedures, sutures, and diagnostics such as lumbar punctures and tohracentesis

57
Q

where is spinal anesthesis injected into?

A

the subarachnoid space on the 3rd - 4th lumbar space (children) / 1st lumbar space (adult)

58
Q

classification of seizures:

muscle stiffening

59
Q

classification of seizures:

rhythmic, repetitive jerking of muscles

60
Q

classification of seizures:

stiffening, then jerking of muscles

A

tonic-clonic

61
Q

classification of seizures:

brief and sudden lapse in awareness, usually less than 15 secs, most common in children

A

absence (petit mal)

62
Q

classification of seizures:

sudden, brief twitching of a muscle

62
Q
  • also called antiepileptics
  • suppress the abnormal electrical impulses from the seizure focus to other cortical areas, preventing seizures
A

anticonvulsants

63
Q

anticonvulsant actions (3)

A
  • suppress Na influx
  • suppress Ca influx
  • increase GABA action
64
Q

drugs that suppress Na influx

A

phenytoin
fosphenytoin
carbamazepine
oxcarbazepine
valproic acid

65
Q

drugs that suppress Ca influx

A

valproic acid
ethosuximide

66
Q

drugs that enhance the action of GABA

A

barbiturates
benzodiazepines

67
Q
  • first anticonvulsant
  • discovered in 1938
  • teratogenic
  • IV and PO only

SE: gingival hyperplasia, slurred speech, confusion, depression, thrombocytopenia, leukopenia, hyperglycemia, NV, constipation

68
Q

therapeutic range of phenytoin

A

10-20 mcg / ml

69
Q
  • used for partial, grand mal, and status epilepticus
  • teratogenic
  • gradual discontinuance
A

phenobarbital

70
Q

used for absence or petit mal

A

succinimides

71
Q

succinimide of choice

A

ethosuxinimide

72
Q
  • used to treat petit-mal seizure
  • trimethadione
  • paramethadione
A

oxazolidone / oxazolinedinedione

73
Q

(benziodiazepines)

used for petit mal seizure

A

clonazepam

74
Q

(benziodiazepines)

used for partial seizure

A

clorazepate
dipotassium

75
Q

(benziodiazepines)

used for acute status epilepticus / severe seizure, IV only

76
Q

(iminostilbenes)

  • used for grand mal and partial seizures
  • bipolar disease, trigeminal neuralgia, alcohol withdrawal
  • PO
A

carbamazepine

77
Q

(valproate)

  • used for petit-mal, grand mal, mixed types of seizures
  • hepatotoxic
A

valproic acid

78
Q

common SE of phenytoin that you should inform the patient

A

pinkish red / brown urine

79
Q

drugs for parkinson’s

A

anticholinergic
dopaminergic
dopamine agonists
mao-b inhibitor
comt inhibitor

80
Q
  • inhibit the release of acetylcholine
  • benztropine, biperiden, trihexyphenidyl, diphenhydramine HCl
A

anticholinergic

81
Q
  • dopaminergic that doesnt cross the BBB
  • converted to dopamine
  • diminishes the symptoms of parkinson’s
  • SE: NV, dyskinesia, HPN, psychosis, cardia dysrhythmias
82
Q

dopaminergic that is an alternative drug combines with levodopa

83
Q

diet for patients on carbidopa-levodopa

A

low protein

84
Q

stimulate the dopamine receptors

A

dopamine agonists

85
Q

(dopamine agonists)

  • antiviral that acts on the dopamine receptors
  • SE: orthostatic HPN, confusion, urinary retention, constipation
A

amantadine HCl (symmetrel)

86
Q

(dopamine agonists)

  • act directly on CNS, CVS, and GIT
  • SE: orthostatic HPN, palpitations, chest pain, edema, nightmares, delusions, confusion
A

bromocriptine (parlodel)

87
Q
  • prolongs the action of levodopa
  • selegiline HCl (eldepryl)
A

mao-b inhibitor

88
Q
  • inactivates dopamine
  • tolcapone (tasmar) - can cause liver damage
  • entacapone (comtan)
A

comt inhibitors

89
Q

improves the cognitive function of clients with mild to moderate alzheimer’s

A

acetylcholinesterase / cholinesterase inhibitors

90
Q

1st drug of choice for alzheimer’s

A

tacrine (cognex)

91
Q

(drugs for myasthenia gravis)

1st drug / drug of choice

A

neostigmine (prostigmin)

92
Q

(drugs for myasthenia gravis)

increases muscle strength

A

pyridostigmine bromide (mestinon)

93
Q

(drugs for myasthenia gravis)

used to distinguish myasthenia crisis from cholinergic crisis

A

edrophonium chloride (tensilon)

94
Q

antidote for cholinergic crisis when administering drugs for myasthenia gravis

A

atropine sulfate

95
Q

why should you avoid baclofen (lioresal) when taking drugs for myasthenia gravis?

A

may lead to paralysis

96
Q
  • spasmolytics
  • suppress hyperactive reflexes
  • decrease pain and increase range of motion
  • have a sedative effect
A

skeletal muscle relaxants

97
Q

drugs for skeletal muscle spasticity

A
  • baclofen (lioresal)
  • dantrolene (dantrium)
  • diazepam (valium)
98
Q

drugs for muscle spasms

A
  • carisoprodol (soma)
  • methocarbamol (robaxin)
  • orphenadrine citrate (norflex)
99
Q

what should you monitor when administering muscle relaxants?

A

serum liver enzyme levels

100
Q
  • aka major tranquilizers
  • blocks dopamine
  • SE: blurred vision, dry mouth, photosensitivity, orthostatic HPN

haloperidol (haldol), chlorpromazine (thorazine)

A

antipsychotics

101
Q

extrapyramidal symptoms include (3)

A
  • pseudoparkinsonism
  • akathisia
  • dystonia
102
Q

pill rolling tremors, mask-like face, propulsive gait

A

pseudoparkinsonism

103
Q

restless leg syndrome

104
Q

poor muscle tone

105
Q

adverse effects of antipsychotics

A
  • tardive dyskinesia (irreversible)
  • aggranulocytosis (low wbc)
  • hepatotoxicity
106
Q
  • aka minor tranquilizers, antianxiety
  • decrease RAS
  • stimulates action of GABA

diazepam (valium), oxazepam (serax), chlorodiazepoxide (librium), alprazolam (xanax)

A

anxiolytics

107
Q

(antidepressant)

prolongs norepinephrine’s action

A

tricyclics

108
Q

(antidepressant)

prevents destruction of norepinephrine

A

mao inhibitors

109
Q

(antidepressant)

most sensitive and least used

A

mao inhibitors

110
Q

(antidepressant)

prolongs serotonin action

A

SSRI - selective serotonin reuptake inhibitor

111
Q

1st antidepressant

A

imipramine (tofranil)

112
Q

therapeutic effect of tricyclics

113
Q

side effect of mao inhibitors

A

hypertensive crisis

114
Q

what should you avoid when taking mao inhibitors?

A

tyramine containing foods

115
Q

the safest antidepressant, should avoid bedtime doses because it causes insomnia

116
Q
  • idiopathic, reduces the release of norepinephrine
  • SE: NAVDA. excessive tears and urination, fine hand tremors
A

mood stabilizer / antimanic agents

117
Q

what should you watch out for when administering mood stabilizers?

A

lithium toxicity (vomiting, diarrhea, lethargy)

118
Q

therapeutic range of mood stabilizers

A

0.5-1.5 meq/L

119
Q

toxic range of mood stabilizers

A

1.5-2.0 meq/L

120
Q

therapeutic effect of mood stabilizers

A

10-14 days

121
Q

how much fluid should one consume when taking mood stabilizers?

A

3 liters per day

122
Q

administered when mood stabilizer toxicity occurs

A

mannitol (osmotic diuretic)

123
Q

mood stabilizer - used in bipolar disorders

A

carbamazepine (tegretol)

124
Q

what should you watch out for when administering carbamazepine?

A

aggranulocytosis

PHARMACOLOGY (9 decks)

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