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B - PHARMACOLOGY > Nervous System > Flashcards

Nervous System Flashcards

1
Q

Anxiety Medications: Benzodiazepines

+ alprazolam (Xanax)

A

OTHER BENZOS: Diazepam, lorazepam, (many end with -pam, except chlordiazepoxide)

INDICATIONS: Anxiety, seizures, muscle spasms, alcohol withdrawal, and induce/maintain anesthesia

MODE OF ACTION: Enhances GABA effect in the CNS.

SIDE EFFECTS: SEDATION, amnesia, dependency/withdrawal, RESPIRATORY DEPRESSION.

KEY POINTS: short-term use only! Do not discontinue abruptly. ANTIDOTE IS FLUMAZENIL.

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2
Q

Anxiety Medications: Atypical Anxiolytics

+ buspirone (BuSpar)

A

INDICATIONS: Anxiety, panic disorder, OCD, PTSD.

SIDE EFFECTS: Dizziness, nausea, headache.

KEY POINTS: NO SEDATION. Dependency not likely, LONG-TERM USE OK. Full effects not fat for several weeks. Take with meals to decrease GI upset.

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3
Q

Anxiety and Depression: SSRIs

+ paroxetine (Paxil)

A

OTHER SSRIs: Sertraline, fluoxetine (many end with -ine).

INDICATIONS: Anxiety, depression, OCD, PTSD.

MODE OF ACTION: Inhibits serotonin reuptake (i.e., increases serotonin).

SIDE EFFECTS: Sexual dysfunction, weight gain, INSOMNIA.

KEY POINTS: WATCH FOR SEROTONIN SYNDROME! Symptoms: agitation, hallucinations, fever, diaphoresis, tremors. Do not take with St. John’s wort, as this increases the risk for serotonin syndrome. Full effects not felt for up to a month.

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4
Q

Depression Medications: Atypical Antidepressants

+ bupropion (Wellbutrin)

A

INDICATIONS: Depressions AND as an aid to quit smoking.

SIDE EFFECTS: INSOMNIA, headache, GI dishes, weight loss, agitation, seizures.

OTHER ATYPICAL ANTIDEPRESSANT: Trazadone (MAJOR SIDE EFFECT IS SEDATION!).

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5
Q

Depression Medications: Tricyclic Antidepressants

+ amitriptyline (Elavil)

A

OTHER TRICYCLIC ANTIDEPRESSANT: Imipramine.

INDICATIONS: Depression, neuropathy, fibromyalgia, anxiety, insomnia.

SIDE EFFECTS: Sedation, orthostatic hypotension, ANTICHOLINERGIC SIDE EFFECTS (urinary retention, constipation, dry mouth, blurry vision, photophobia, tachycardia), sweating, seizures.

KEY POINTS: To counteract anticholinergic side effects - chew gum, wear sunglasses, high fiber diet, increase fluid intake.

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6
Q

Depression Medications: MAOIs

+ phenelzine (Nardil)

A

OTHER MAOI: Tranylcyrpomine

iNDICATIONS: Depression

SIDE EFFECTS: Agitation/anxiety, orthostatic hypotension, HYPERTENSIVE CRISIS.

KEY POINTS: Interactions with MANY other medications (including OTC cold medications, which can result in severe hypertension). DO NOT EAT WITH FOODS RICH IN TYRAMINE such as: aged cheese, avocados, bananas, red wine, salami/pepperoni, chocolate.

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7
Q

Bipolar Medications: Mood Stabilizers

+ Lithium

A

INDICATIONS: Bipolar disorder

SIDE EFFECTS: GI upset, FINE HAND TREMORS, polyuria, weight gain, nephrotoxicity, electrolyte imbalances.

KEY POINTS: Monitor plasma levels! TOXICITY OVER 1.5 mEg/L. Symptoms of toxicity: COARSE TREMORS, confusion, hypotension, seizures, tinnitus. No diuretics, anticholinergics, or NSAIDS. Contraindicated for patients with renal disease. Closely monitor sodium levels. Need adequate fluid intake (2-3 liters) and sodium intake!

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8
Q

Bipolar Medications: Antiepiletic Drugs
+ carbamazepine (Tegretol)
+ valproic acid (Depakote)

A

INDICATIONS: Bipolar disorder AND use as an anticonvulsant/antiepileptic.

CARBAMAZEPINE SIDE EFFECTS: BLOOD DYSCRASIAS (anemia, leukopenia, thrombocytopenia); vision issues (nystagmus, double vision), hypo-osmolarity, rash.

VALPROIC ACID SIDE EFFECTS: GI upset, HEPATOTOXICITY, pancreatitis, thrombocytopenia.

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9
Q

Antipsychotic Medications: Conventional
+ chlorpromazine (Thorazine)
+ haloperidol (Haldol)

A

INDICATIONS: Schizophrenia, psychotic disorders. Mainly controls positive symptoms (i.e. delusions, hallucinations).

SIDE EFFECTS: (MANY!)
+ EXTRAPYRAMIDAL SIDE EFFECTS (EPS): Dystonia, Parkinson’s symptoms (shuffling gait, rigidity), tardive dyskinesia (lip smacking, tongue rolling), akathisia.

+NEUROLEPTIC MALIGNANT SYNDROME (NMS): Fever, BP fluctuations, dysrhythmias, muscle rigidity.

+ OTHERS: Agranulocytosis, anticholinergic effects, orthostatic hypotension, sedation, seizures.

KEY POINTS: Monitor vital signs every 1-2 hours. Anticholinergics (ex: benztropine) can be used to control EPS symptoms. Muscle relaxant (ex: dantrolene) can be used to treat NMS.

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10
Q

Antipsychotic Medications: Atypical

resperidone (Risperdal)

A

OTHER ATYPICAL ANTIPSYCHOTICS: Clozapine, olanzapine (many end in -done or -pine.

INDICATIONS: Schizophrenia. Controls positive and negative symptoms (anergia, anhedonia, social withdrawal).

SIDE EFFECTS: DIABETES, WEIGHT GAIN, INCREASED CHOLESTEROL, sedation, orthostatic hypotension, anticholinergic effects, menorrhagia, decreased libido. CLOZAPINE CARRIES RISK FOR AGRANULOCYTOSIS!

KEY POINTS: Risperdone can be administered by IM injections q 2 weeks (for non-compliant patients). Avoid alcohol.

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11
Q

ADHD Medications

+ methylphenidate (Ritalin, Methylin)

A

OTHER ADHD MEDICATIONS: Amphetamine mixture (Adderall)

INDICATIONS: ADHD and conduct disorders

SIDE EFFECTS: Insomnia, dysrhythmias, DECREASED APPETITE, WEIGHT LOSS.

KEY POINTS: Do not administer at night, give medication immediately before or after meals, MONITOR CHILD’S WEIGHT DURING THERAPY.

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12
Q

Alcohol Abuse: Medications during Withdrawal

A

****NOTE: WITHDRAWAL STARTS WITHIN 4-12 HOURS OF LAST DRINK, PEAKS AT 24-48 HOURS.

BENZODIAZEPINES (chlordiazepoxide, diazepam, lorazepam): Used to stabilize vital signs, decrease risk of seizures, decrease withdrawal manifestations.

CARBAMAZEPINE; Decreases risk of seizures.

CLONIDINE: Decreases autonomic response (decreases BP, HR).

BETA BLOCKERS (propranolol, atenolol): Decreases autonomic response (decreases BP, HR) and cravings.

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13
Q

Alcohol Abuse: Medications to promote Abstinence

A

DISULFIRAM (Antabuse): If patient ingests alcohol, they will get many unpleasant side effects, including nausea, vomiting, sweating, palpitations, and hypotension.

NALTREXONE (Vivitrol): Suppresses craving for alcohol (also available as monthly IM injections).

ACAMPROSATE (Campral): Decreases abstinence symptoms (anxiety, restlessness).

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14
Q

Medications for Opioid and Nicotine Withdrawal

A

OPIOID WITHDRAWAL:
+ Methadone: Used for withdrawal and long-term maintenance.

NICOTINE WITHDRAWAL:
+ Guproprion (Wellbutrin): See atypical antidepressants for more information.
+ Nicotine replacements: Gum, patch, nasal spray.
+ Varenicline (Chantix): Reduces cravings and withdrawal symptoms; monitor patient closely for depression/suicidal thoughts.

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15
Q

Cholinergics

+ neostigmine (Prostigmin)

A

OTHER CHOLINERGICS: Pyridostigmine, edrophonium.

INDICATIONS: Myasthenia Gravis; improves strength/mobility. Reversal of neuromuscular blocking agents.

MODE OF ACTION: Increases ACh at receptor sites (by inhibiting cholinesterase).

SIDE EFFECTS: Excess ACh, causing increased salivation, diarrhea, nausea/vomiting, sweating, bradycardia.

KEY POINTS: EDROPHONIUM GIVEN TO PATIENTS TO DIAGNOSE MYASTHENIA GRAVIS (VS. CHOLINERGIC CRISIS). ANTIDOTE IS ATROPINE!

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16
Q

Anti-Parkinson’s Agent: Dopamine agonist

+ levodopa/carbidopa (Sinemet)

A

INDICATIONS: Parkinson’s; decreases tremors and muscle rigidity.

MODE OF ACTION: Increases dopamine in CNS (levodopa converted to dopamine in CNS, and carbidopa prevents breakdown of levodopa).

SIDE EFFECTS: Nausea/vomiting, drowsiness, dyskinesias (such as tics), orthostatic hypotension, darkening of urine and sweat, psychosis.

KEY POINTS: High-protein meals DECREASE the effectiveness of Levadopa/carbidopa.

17
Q

Anti-Parkinson’s Agent: Anticholinergic Agent

+ benztropine (Cogentin)

A

INDICATIONS: Parkinson’s; decreases tremors and muscle rigidity.

MODE OF ACTION: Decreases Each in CNS.

SIDE EFFECTS: ANTICHOLINERGIC EFFECTS (dry mouth, dry eyes, blurry vision, urinary retention, constipation).

KEY POINTS: To counteract anticholinergic side effects - chew gum, wear sunglasses, high fiber diet, increase fluid intake.

18
Q

Antiepileptics

+ phenytoin (Dilantin)

A

OTHER ANTIEPILEPTICS: Lamotrigine, carbamazepine, valproic acid (See Bipolar Medications/Antiepileptics drugs for information on carbamazepine, valproic acid).

INDICATIONS: Seizures.

SIDE EFFECTS: GINGIVAL HYPERPLASIA, diplopia, nystagmus, rash, ataxia, hypotension.

KEY POINTS: SERUM PHENYTOIN LEVELS NEED TO BE MONITORED ROUTINELY (NARROW THERAPEUTIC RANGE)! Decreases effectiveness of oral contraceptives.

19
Q 
Antiglaucoma agent (topical beta blocker)
\+ timolol
A

INDICATIONS: Glaucoma (primarily open angle)

MODE OF ACTION: Non-selective beta blocker, decreases aqueous humor production, which increases IOP.

SIDE EFFECTS: Temporary stinging of eye.

KEY POINTS: Do not touch eye w/applicator, hold gentle pressure on the nasalacrimal duct fo 30-6- seconds after application. Overdose can cause systemic effects.

20
Q 
Antiglaucoma Agent (Carbonic Anhydrase Inhibitor)
\+ acetazolamide (Diamox Sequels)
A

INDICATIONS: Glaucoma, heart failure, altitude sickness.

MODE OF ACTION: Causes diuresis and lowers IOP by decreasing queues humor secretion.

SIDE EFFECTS: Flulike symptoms, GI upset, electrolyte imbalances (Na and K).

KEY POINTS: Administer with food to minimize GI upset. Monitor electrolytes.

21
Q

Ear drops to treat Otitis Externa

+ ciprofloxacin with hydrocortisone (pro HC)

A

INDICATIONS: Otitis exert (Swimmer’s ear).

MODE OF ACTION: Ciprofloxacin is an antibiotic, hydrocortisone is a steroid that decreases inflammation.

KEY POINTS: Roll container gently prior to administration (or gently shake for suspension form), position patient on unaffected side, keep patient on side for 5 minutes after installation (lightly pack ear w/cotton), dry ear canal after swimming, bathing.

22
Q

Neuromuscular Blocking Agent

+ succinylcholine (Anectine)

A

OTHER NEUROMUSCULAR BLOCKING AGENT: Pancuronium

INDICATIONS: Used as an adjunct to anesthesia in surgery or intubation procedures.

MODE OF ACTION: Blocks ACh at neuromuscular junction, causing skeletal muscle paralysis.

SIDE EFFECTS: Respiratory arrest, apnea, MALIGNANT HYPERTHERMIA (sx: muscle rigidity, fever), muscle pain following surgery.

KEY POINTS: Treatment of malignant hyperthermia includes administering 100% oxygen, cooling measures, and administration of dantrolene (skeletal muscle relaxation).

23
Q

Muscle Relaxants: Direct acting on skeletal muscle

+dantrolene (Dantrium)

A

INDICATIONS: Muscle spasticity r/t spinal cord injury, cerebral palsy, multiple sclerosis. Also used to treat and prevent malignant hyperthermia.

MODE OF ACTION: Prevents release of calcium in skeletal muscles (inhibiting muscle contraction) to reduce muscle spasticity.

SIDE EFFECTS: Drowsiness, muscle weakness, GI upset, hepatic toxicity.

KEY POINTS: Monitor for signs of liver damage.

24
Q

Muscle Relaxants: Centrally Acting

+ baclofen (Lioresal)

A

INDICATIONS: Spasticity r/t spinal cord injury, cerebral palsy, multiple sclerosis. Also used to treat malignant hyperthermia.

MODE OF ACTON: Enhances GABA in CNS to reduce muscle spasticity.

SIDE EFFECTS: Drowsiness, GI upset (nausea), constipation.

KEY POINTS: Increase fiber consumption.

25
Q

Urinary Tract Stimulant

+ bethanechol (Urecholine)

A

INDICATIONS: Non-obstructive urinary retention.

MODE OF ACTION: Stimulates cholinergic receptors n GU tract, allowing for bladder emptying.

SIDE EFFECTS: CHOLINERGIC SYMPTOMS (flushing, sweating, urinary urgency, bradycardia, hypotension).

KEY POINTS: Administer 1 hour before or 2 hours after meals to minimize nausea and vomiting.

26
Q

Urinary Tract Antispasmodic

+ oxybutynin (Ditropan)

A

INDICATIONS: Overactive bladder symptoms (frequency, urgency, nocturia).

MODE OF ACTION: Inhibits ACh in the bladder, therefore reducing urinary urgency and frequency.

SIDE EFFECTS: ANTICHOLINERGIC SYMPTOMS (dry mouth, urinary retention, constipation, blurred vision).

KEY POINTS: Increase fiber and fluid intake.

27
Q

Insomnia Medication

+ zolpidem (Ambien)

A

INDICATIONS: Insomnia.

MODE OF ACTION: Increases GABA in the CNS, promoting sedation/sleep.

SIDE EFFECTS: DAYTIME SLEEPINESS, dizziness.

KEY POINTS: Allow for at least 8 hours of sleep.

28
Q

Sedative/Hypnotic

+ pentobarbital (Nembutal)

A

OTHER SEDEATIVE/HYPNOTIC MEDS: PROPOFOL, MIDAZOLAM

INDICATIONS: Induction and maintenance of anesthesia, conscious sedation, intubation.

MODE OF ACTION: CNS depression and loss of consciousness.

SIDE EFFECTS: Respiratory and cardiovascular depression. Propofol side effects: pain at IV site, high risk of bacterial contamination.

KEY POINTS: Have resuscitation equipment available, monitor ECG and vital signs. Vials of propofol should be used within 6 hours. Monitor for signs of infection.

B - PHARMACOLOGY (11 decks)

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