Leftover CNS Flashcards
drug for muscle spasm
cyclobenzaprine
what is a muscle spasm?
involuntary contraction of muscle group
non-pharmacological treatment for muscle spasms
heat pack, ice massage, whirlpool
pharmacological treatment for muscle spasms
acetaminophen
NSAIDs
Muscle Relaxants
prototype for muscle relaxant
cyclobenzaprine (Flexaril, Flexmid)
1st drug of choice for muscle relaxant
cyclobenzaprine
how does cyclobenzaprine work?
- works in brainstem to cause muscle relaxation W/O MUSCLE WEAKNESS
- decrease tonic motor activity
side effects of cyclobenzaprine
CNS effects:
- drowsiness
- dizziness
- fatigue
What should you avoid with cyclobenzaprine?
risk of additive effect:
- alcohol
- other CNS drugs
Considerations for long term use with cyclobenzaprine?
- CNS effects decrease with continued use due to increase tolerance
- physical dependence –> wean off slowly
Is cyclobenzaprine used postoperatively?
-used in multimodal pain protocol for ABD surgery
what is spasticity?
heightened muscle tone
causes of spasticity?
multiple sclerosis, cerebral palsy
CNS drug for spasticity?
baclofen (Lioresal)
How does Baclofen work?
decrease spasticity W/O MUSCLE WEAKNESS
side effects of baclofen
CNS effects:
- drowsiness
- dizziness
- weakness
- fatigue
what to avoid with baclofen?
risk of additive effects:
- alcohol
- other CNS drugs
considerations with long term use of Baclofen?
- CNS effects decrease with continued use due to increase tolerance
- physical dependence –> wean off slowly
initial dose of baclofen needs to be….. why?
start low and slow!
-too high of a dose initially can lead to RESP DEPRESSION, COMA
what are characteristics of ADHD?
inattention, hyperactivity, impulsivity
drug therapy goals for treating ADHD
- increase attention span
- improve focus/concentration
- ->does not get rid of negative behaviors but increase positive behaviors
2 types of ADHD meds
stimulant
non-stimulant
stimulant med for ADHD treatment
methylphenidate (concerta)
which is 1st line of therapy for ADHD treatment- stimulant or non stimulant?
stimulant
onset of action from stimulant ADHD meds?
immediate benefit
Duration of action for stimulant ADHD drugs
only works 2-3 years
how does methylphenidate (concerta) work?
promotes norepinephrine and dopamine release AND inhibits reuptake
–> increase NE/Dopamine in synaptic cleft –> increase action of those neurotransmitters
What schedule drug is methylphenidate? what does that result in?
Schedule II controlled substance
–> difficulty w/refills, potential for abuse
what are side effects of methylphenidate?
- insomnia
- decrease appetite
- growth suppression
- headache
- abdominal pain
what time of day do you need to take methylphenidate dose (s)?
1X daily = take in AM to prevent insomnia
BID = take 2nd dose before 4PM
formulation options for methylphenidate?
- sustained release
- immediate release
- once daily dosing
what is second line therapy for ADHD? stimulant or nonstimulant?
non stimulant : atomoxetine (strattera), alpha 2 adrenergic agonist
How are non stimulant drugs more effective?
use in combination therapy with stimulant and other treatments
non stimulant ADHD drug therapy:
atomoxetine (strattera)
alpha 2 adrenergic agonist
how does Atomoxetine fxn?
inhibit norepinephrine reuptake
–> takes 1-3 weeks for full effect b/c adaptive change in brain needs to occur
onset of action for atomoxetine:
takes 1-3 weeks for full effect b/c adaptive change in brain needs to occur
is atomoxetine a controlled substance?
nope
side effects of atomoxetine?
-gi*
-decrease appetite*
CNS:
-dizziness
-somnolence
-modd swings
-trouble sleeping
which CNS non stimulant can cause suicidal thoughts in kids?
atomoxetine
how do Alpha 2 Adrenergic Agonists work?
reduce sympathetic outflow from brain
2 alpha 2 adrenergic drugs to know:
Guafacine (BP med)
Clonidine (treats drug abuse)
what is Guafacine?
BP med used as ADHD non stimulant medication in class Alpha 2 Adrenergic Agonist
What is clonidine?
Alpha 2 Adrenergic Agonist in ADHD Non stimulant category
-also used to treat drug abuse
Side effects of Alpha 2 Adrenergic Agonist?
hypotension
