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Drugs affecting CNS Flashcards

1
Q

appetite suppressant medications education

A

short term use only- 8-12 weeks
-monitor thyroid and hormone levels
only for those with BMI 30 or greater
-works by stimulating satiety centers of the hypothalamus

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2
Q

monitoring of appetite suppresants

A
  • thyroid levels

- controlled substance d/t its abuse and dependence levels

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3
Q

anorexiants ADRs:

A

CNS overtstimulation: agitation, confusion, palpitations, arrythmias, sudden withdrawal can cause withdrawal symptoms, inc glucose in pts with diabetes

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4
Q

avoid anorexiants in patients with

A

heart problems, drug history, eldcerly

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5
Q

lipase inhibitors: ex of drug and facts

A

-Orlistat: taken orally with meals
works by preventing absorption of fats in the intestine; therefore, fat gets excreted quick out into feces

side effect: fatty oily stools, fecal urgency

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6
Q

epilepsy vs seizure

A

epilepsy- 2 or more unprovoked seizures

seizures- may be provoked (stressor, dehydration, chock, etc), if provoked, doesn’t count as the one tally for epilepsy

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7
Q

Anticonvulsant medications also being used in the treatment of mood disorders

A

gabapentin and Lamotrigine

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8
Q

drug choices for anticonvulsants

A

Hydantoins
Carbamazepines (Tegretol)
Succinimides
Drugs that affect GABA (Neurontin

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9
Q

hydantoin drug example

A

dilantin:

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10
Q

special dilantin consideration

A

unlike phenobarbitals, where doubling dose where you double dose, it doubles serum level), Dilantin does not work that way. Dilantin as its doubled, you can sometimes triple serum level , or slightly inc therapeutic effect. Does and therap effects are not 1:1 relationship like phenobarb
-can interact with antacid, valium use

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11
Q

First-line treatment for tonic-clonic and partial complex seizures

A

hydantoins

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12
Q

MoA of hydantoins

A

increasing influx of sodium ions across cell membranes in the motor cortex

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13
Q

anti-seizure meds consideration and talk to PCP when takin

A

birth control meds

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14
Q

common side effects of dilantin

A

itching, paresthesias, gingival hyperplasia, urinary retention,

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15
Q

monitoring of hydantoins

A

monitor liver labs, thyroid tests, kidney fx, OTC meds (antacids and nsaids)

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16
Q

driving and seizures

A

cannot drive if had seizure within a year

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17
Q

carbamezapine class drug

A

tegretol: black box warning: Steven Johnson syndrome (esp in asian ppl)

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18
Q

teaching for pt taking carbamezapine (tegretol)

A

teach about S/S of bone marrow suppression

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19
Q

Succinimide drug class:

A

Used for treatment of absence seizures in children and adults
Ethosuximide (Zarontin)

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20
Q

Ethosuximide (zarontin)-

A

Suppresses seizures by delaying calcium influx into neuron

Side effects: GI most common; somnolence

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21
Q

Lamictal (lamotrigine)

A

tonic clonic seizures, mood disorders, and absence disorders

can be used with valproic acid and phenytoin

22
Q

Levateracitam (keppra)

A

few drug interactions (cleaner drug for seizure)

23
Q

Gabapentin (Neurontin)

A

gaba working in body; suicidal thinking; can be used for neuropathic pain assoc with diabetic neuropathy, herpes zoster

24
Q

gabapentin lab monitoring

A

renal fx:

if GFR too low, renal dosing may be required

25
Q

Inhibits excitatory neurotransmitter release in the CNS
Used in treatment of focal onset seizures, diabetic peripheral neuropathy, post herpetic neuralgia, and fbromyalgia
Excreted unchanged by kidneys – reduced dosing in renal disease required

A

lyrica

26
Q

TCA’s (first ones in the market)

A

Slavic, tofranil; overdose can lead to death, EKG changes, ortho hypotension, and anticholinergic effects

pt education: report chest pain, suicidal thinking, don’t drive, no alchohol

27
Q

Most commonly prescribed antidepressant and well tolerated

A

ssri’s; inc levels of serotonin in body;

ADRs: CNS, GI, sexual dysfunction , weight gain

  • can’t take up to 3-4 weeks to start working
  • taper between 2-3 weeks
28
Q

sari warnings

A

Suicide ideation and increased suicide risk- especially with children early in treatment

29
Q

serotonin syndrome

A

diarrhea, tremor, sweating, restlessness, hyperreflexia - if untreated leads to disorientation, fever, rigidity, coma, seizures, and death – 10% mortality rate

30
Q

SNRI’s examples

A

duloxetine (Cymbalta) and vanlafaxine (Effexor)

31
Q

sari’s and children

A

NOT approved

32
Q

SNRI’s monitoring

A

watch with antibiotic : quinolones

33
Q

Decreased alertness and low energy and depressed-

A

snri’s

34
Q

depression with pain or fibromyalgia ->

A

Cymbalta

35
Q

Inhibits reuptake of both norepinephrine and dopamine

A

bupropion (Wellbutrin): dec attention span, dec motivation,

-few sexual side effects
-contrindicated in siezure disorders
can be used with smoking cessation too; decide when they want to quit, then start wellbutrin 10-15 days before

36
Q

thorazine and haldol side efects

A

Parkinsonism, eps syndrome,

inc mortality with old people

monitor: prolactin levels and aim scale

37
Q

These drugs attempt to restore the functional balance of dopamine and acetylcholine (ACh) in the corpus striatum of the brain.

A 
dopaminergic: good for parkinson's
Amantadine (Symmetrel)
Bromocriptine (Parlodel)
Levodopa (L-Dopa, Larodopa)
Carbidopa-levodopa (Sinemet)
Pramipexole (Mirapex) – also used for RLS
Ropinirole (Requip) – also used for RLS
38
Q

Must better to treat anxiety with ssri’s than anxiolytics and hypnotics d/t

A

phys/psych dependence and abuse potential

39
Q

anxiety drugs : short acting

A

lorazepam (Ativan) and alprazolam (xanax)

40
Q

anxiety drugs: long acting

A

clonazepam (klonipin) and diazepam (valium)

41
Q

Long term treatment of general anxiety disorder
Exerts effect by enhancing serotonin; no CNS depression
Little risk of dependence and few drug interactions
Pharmacokinetics: reduced first-pass affect, has many metabolites, one has noradrenergic effects, NOT used with panic attacks
Takes up to 2 weeks for onset to occur and up to 6 weeks for maximum effect
Needs to be taken daily – not prn

A

busperone (buspar)

42
Q

3rd class of anxiolytics: barbiturates

A

Used today for pre-anesthesia sedation; seizure disorders; status epilepticus (phenobarbitals)

43
Q

sedative hypnotics:

Benzos and nonbenzos

A

Benzos: high tolerance

nonbenzos: take immediately before bed and sleep for 6-7 hrs of sleep

44
Q

High incidence of drug-drug and drug-food interactions, especially with foods containing tyramine with this drug

A

maoi’s (Nardil marplan)

low safety margin

45
Q

lithium (mood stablizer)

A

bipolar disorder, very low therapy index

at toxic levels: neuro changes (ataxia, tremors, confusion)

46
Q

2 types of muscle relaxants/antispasmodics

A

centrally-acting and direct acting

47
Q

centrally acting muscle relaxant

A

CNS depression likely; flexeril take at night;

48
Q

direct acting antispasmodics:

A

dantrolene treats spasticity in upper neurons

-pt education: titration schedule

49
Q

amphetamines vs strattera

A

schedules vs nonscheduled substance; no amphetamine side effects for Strattera;

ampetamines can take drug holidays, not straterra, as it takes forever to start working

50
Q

Modafinil (Provigil)

Amodafinil (Nuvigil)

A

used to treat narcolepsy and SWCD (sleep wake cycle disorder)

51
Q

xanthine

A

coffee

advanced pharm exam 1 (3 decks)

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