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Gen Pharm > Medications Acting on the CNS > Flashcards

Medications Acting on the CNS Flashcards

1
Q

CYCLOBENZAPRINE - Non-opiate

  1. Indications
  2. MOA
  3. SEs and contraindications
  4. Other
A
  1. Muscle spasms
  2. Decreases somatic motor activity by inhibiting tonic activity of alpha and gamma neurons
  3. Anti-cholinergic effects
    Drowsiness
    Loss of coordination
    *Caution in patients with narrow angles
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2
Q

ACETOMINOPHEN (Tylenol) - Non-opiate

  1. Indications
  2. MOA
  3. SEs and contraindications
  4. Other
A
  1. Analgesia
    Antipyresis
  2. Not well understood
  3. Hepatotoxicity
  4. No anti-inflammatory properties
    Safe in pregnancy and infants
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3
Q

TRAMADOL - Non-opiate

  1. Indications
  2. MOA
  3. SEs and contraindications
  4. Other
A
  1. Analgesic
  2. Acts as an agonist at Mu opiate receptors (not true opiate)
  3. Dry mouth
    Sedation
    Dizziness
    Nausea
  4. Causes miosis less than true opiates
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4
Q

MEPERIDINE, OXYCODONE, METHADONE, HYDROCODONE - opiate

  1. Indications
  2. MOA
  3. SEs and contraindications
  4. Other
A
  1. Analgesic
  2. Agonist at Mu, Kappa, and Delta opiate receptors
  3. Miosis
    Respiratory depression
    Drowsiness
    Sedation
    Nausea
    Papilledema
  4. NALOXONE: opioid antagonist - reverses opiate effects
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5
Q

SUMATRIPTAN, ZOLMITRIPTAN

  1. Indications
  2. MOA
  3. SEs and contraindications
  4. Other
A
  1. Migraines
  2. 5-HT1B and 1D receptor agonist: causes vasoconstriction due to increase in serotonin and reduces inflammation in the CNS
  3. *All related to systemic vasoconstriction:
    NAION
    MI
    Stroke
    CRAO and retinal venous thromboses
  4. “Trip up migraines”
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6
Q

PHENOTHIAZINES, CHLORPROMAZINE, THIORIDAZINE

  1. Indications
  2. MOA
  3. SEs and contraindications
  4. Other
A
  1. Anti-psychotics
  2. Dopamine receptor antagonists
  3. Parkinson-like SEs
    Pigmentation of corneal endothelium
    Anterior stellate cataracts
    hyperpigmentation of the RPE
    Anti-cholinergic effects
    Oculogyric crisis
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7
Q

AMANTADINE

  1. Indications
  2. MOA
  3. SEs and contraindications
  4. Other
A
  1. Parkinson’s disease
  2. Potentiates dopamine effects by blocking reuptake or augmenting its release in the brain
  3. N/A
  4. Great at crossing the BBB
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8
Q

Parkinson’s diseases is due to a ________ deficiency

A

Dopamine

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9
Q

Parkinson’s symptoms

A

Parkinson’s is a TRAP
Tremor at rest
Rigidity
Akinesia
loss of Postural reflexes

Causes exposure keratopathy and MGD

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10
Q

BROMOCRIPTINE

  1. Indications
  2. MOA
  3. SEs and contraindications
  4. Other
A
  1. Prolactin-secreting pituitary adenomas, Parkinson’s disease
  2. Dopamine agonist
  3. N/A
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11
Q

METHYLPHENIDATE, DEXTROAMPHETAMINE

  1. Indications
  2. MOA
  3. SEs and contraindications
  4. Other
A
  1. ADHD, narcolepsy, depression
  2. Increases release of dopamine
  3. Chronic therapy can cause mydriasis and dry eye
    *Caution in patients with narrow angles
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12
Q

All dopamine agonists have ______________ SEs which may cause ________ that can precipitate _____________

A

adrenergic agonist, mydriasis, angle closure

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13
Q

DONEPEZIL

  1. Indications
  2. MOA
  3. SEs and contraindications
  4. Other
A
  1. Dementia
  2. CHS acetylcholinesterase inhibitor
  3. Cataracts
    Blurry vision
    Ocular irritation
    Decreased IOP due to muscarinic agonist effects
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14
Q

FLUXETINE, ESCITALOPRAM (Lexapro), PAROXETINE, SERTALINE

  1. Indications
  2. MOA
  3. SEs and contraindications
  4. Other
A
  1. Antidepressants (SSRIs)
  2. Inhibits serotonin reuptake from synaptic cleft of the CNS
  3. Mydriasis
    *Caution in patients with narrow angles
    Serotonin syndrome if prescribed with TCAs and MAOIs
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15
Q

Serotonin syndrome

A

Excess serotonin activity in the CNS - marked by a change in mental status

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16
Q

VENLAFAXINE (Effexor), DULOXETINE

  1. Indications
  2. MOA
  3. SEs and contraindications
  4. Other
A
  1. Depression, GAD, panic disorder, and social anxiety disorder (SNRIs)
  2. Inhibits serotonin and norepinephrine reuptake
  3. Risk of suicide
    Serotonin syndrome if prescribed with TCAs and MAOIs
    Mydriasis
    *Caution in patients with narrow angles
17
Q

BUPROPION

  1. Indications
  2. MOA
  3. SEs and contraindications
  4. Other
A
  1. Smoking cessation
  2. Inhibits the reuptake of dopamine and norepinephrine
  3. N/A
18
Q

AMITRIPYLINE, IMIPRAMINE

  1. Indications
  2. MOA
  3. SEs and contraindications
  4. Other
A
  1. Depression (TCAs)
  2. Inhibits norepinephrine and serotonin reuptake
  3. Anticholinergic effects (dry eye, increased IOP, blurry vision, mydriasis)
    TCA OVERDOSE IS LIFE THREATNINGL DO NOT PRESCRIBE TO A SUICIDAL PATIENT
    Can exacerbate systemic effects of topical phenylephrine
19
Q

PHENELZINE

  1. Indications
  2. MOA
  3. SEs and contraindications
  4. Other
A
  1. Depression (MAOI)
  2. Inhibits MAO, the enzyme responsible for breaking down NE and serotonin
  3. Glaucoma
    Nystagmus
    Interacts with food with tyramine: can cause lethal HTN crisis
    Serotonin syndrome if taken with SSRIs or TCAs
    *Caution in patients with narrow angles
    Can exacerbate systemic effects of topical phenylephrine
20
Q

DIAZEPAM, LORAZEPAM, CLONAZEPAM, ALPRAZOLAM

  1. Indications
  2. MOA
  3. SEs and contraindications
  4. Other
A
  1. Anxiety, panic attacks, sedative and alcohol withdrawal
  2. Benzodiazepines that opens Cl channels by binding to GABA receptors, resulting in hyperpolarization of neurons in the CNS (^ GABA = decreased anxiety)
  3. Sedation
    Depression
    Confusion
    Bradycardia
    Dyspnea
    DONT USE WITH ALCOHOL
    Mydriasis and nystagmus

CI: narrow angle glaucoma

21
Q

PHENYTOIN

  1. Indications
  2. MOA
  3. SEs and contraindications
  4. Other
A
  1. Seizures
  2. Acts on NE, acetylcholine, and GABA
  3. Nystagmus
    Diplopia
    EOM palsies
    Ataxia
    Gingival hyperplasia
22
Q

PHENOBARBITAL

  1. Indications
  2. MOA
  3. SEs and contraindications
  4. Other
A
  1. Seizures, sedation
  2. Reduces glutamatergic excitatory transmissions by blocking AMPA receptors
  3. Sedation
    Respiratory depression
    Mydriasis
    Increased IOP
    Cycloplegia
23
Q

TOPIRAMATE

  1. Indications
  2. MOA
  3. SEs and contraindications
  4. Other
A
  1. Seizures, Alcoholism,
  2. Multiples CNS effects
  3. Blurry vision
    Diplopia
    Nystagmus

*May cause choroidal swelling which can lead to secondary angle closure glaucoma

Gen Pharm (17 decks)

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