Nervous system drugs Flashcards
1
Q
Epinephrine
A
- IM/SubQ indication: allergic reaction (analphylaxis)
- IV: cardiogenic shock (cardiac arrest) NOT USED UNLESS NEEDED
- aerosol: airway obstruction (bronchspasm)
side effects: high risk for extravasation
- see table for other s/s
2
Q
Atropine (anticholinergic)
A
- IV: for symptomatic bradycardia
- PO drop: reduce saliva
- ophthalmic drop: produce mydriasis and cycloplegia
- IM: for reversal for cholinergic OD (OD with MG drugs)
- Side effects/adverse reactions: bear side effects
- contraindications: glaucoma, BPH, MG
3
Q
methylphenidate (amphetamine-like)
A
- PO, transdermal patch, schedule 2
- MOA: increase dopamine, norepinephrine, increase attention span and cognitive performance
- indication: ADHD, narcolepsy
4
Q
modafinil and armodafinil (amphetamine-like)
A
- schedule 4
- indication: narcolepsy, jet lag, ADHD, sleep apnea
5
Q
theophylline (analeptics)
A
- respiratory stimulant and bronchodilator
- MOA: stimulation of brain stem, reverse corticosteroid resistance
- IV: neonatal apnea, emergency respiratory depression (anesthetic recovery)
- IV/PO: bronchodilator (asthma, COPD, severe asthma)
- side effects: diuresis (diuretic effect), restlessness, tremors, twitching, insomnia, seizure, tinnitus, tachycardia, palpitations, dysrhythmia, dependence, withdrawal, hyperglycemia, GIB
6
Q
barbiturates (sleepy chicken)
A
- schedule 4
- MOA: GABA stimulation (inhibitory neurotransmitter)
- indication: anti-epileptic, sedative, hypnotic
NO REVERSAL AGENT - respiratory depression, bradycardia, ataxia, dependence and tolerance, vivid dreams, hangover effect, skin abrasion, constipation, paradoxical effects, decreases effect of oral contraceptives
- contraindications: pregnancy, with other sedatives-hypnotics (alcohol and opiods)
- short term use (2 weeks)
7
Q
benzodiazepines (sleepy chicken)
A
- -pams and -lams (schedule 4)
- MOA: GABA stimulation
- indications: sedative (prevent DTs), epilepsy, spasms, insomnia, anesthesia induction
- PO/IM/IV
- chlordiazepoxide is exception to pam lams*
- IV: given for desired response and dose adjustments need to be made due to cross-tolerance
8
Q
zolpidem (nonbenzodiazepine hypnotic)
A
schedule 4
- MOA: GABA enhancer
- PO/SL
- indication: short term use (less than 10 days) only PRN for insomnia
- duration: at least 8 hours (give early)
- side effects: hypotension, hangover effect, lightheadedness, fall
- contraindication: sleep-apnea, chronic respiratory disorders, children, pregnancy, breastfeeding, concurrent use with other CNS depressant
9
Q
Inhalation anesthetics
A
Nitrous oxide - inhaled gas flurane - inhaled volatile liquids Adverse effects: anesthesia awareness overdose, HA, confusion, N/V, shivering, chills, malignant hyperthermia
10
Q
IV Anesthetics
A
- etomidate
- propofol
high risk of infection (use vial within 6 hours)
contraindication: allergy to egg/soybean - ketamine
side effects: paradoxical effects
11
Q
caine
A
MOA: prevent conduction of nerve impulses at injection site
12
Q
carbidopa-levodopa (dopaminergic)
A
- MOA: dopamine replacement, gradual lower effectiveness after 5 years of treatment
- short duration (4-5 hr 1/2: 50 min)
- for parkinson’s
- side effects: dystonia, dyskinesia, akathisia, psychosis, anticholinergic effects, harmless brown urine and sweat
13
Q
amantadine (bear)
A
- MOA: improve dopamine action (also for flu A)
- side effects: livedo reticularis, anticholinergic effects
- drug tolerance develops
14
Q
benztropine (anticholinergic)
A
- centrally acting (for brain)
- MOA: inhibit release of acetylcholine in CNS
- side effect: may affect PNS, dystonia, contraction, twisting, distortions, spasms
- contraindications: alzheimer or MG
15
Q
donepezil and memantine (alzheimer’s)
A
- MOA: cholinesterase inhibitors, improve cognitive function
- side effects: dizziness, insomnia, HA, anorexia, muscle cramps
16
Q
edrophoium
A
- for diagnosing MG
- MOA: preventing destruction of ACh
17
Q
neostigmine
A
- for acute treatment of myasthenic crisis, reversal for non depolarizing anti paralytics
- preventing destruction of ACh
18
Q
pyridostigmine
A
- maintenance of MG
- preventing destruction of ACh
19
Q
succinylcholine (paralytic agent-depolarizing)
A
- MOA: ACh agonist, binds to nicotinic receptor at neuromuscular junction
- contraindication: pregnancy, MG
- side effects: hyperkalemia
- adverse effect: respiratory depression, apnea, malignant hyperthermia
20
Q
vecuronium (paralytic agent-nondepolarizing)
A
- MOA: competitive antagonist (binds without inducing ACh), paralysis
- side effect: histamine release = rash, hives, angioedema, bronchospasm, low BP, tachycardia
21
Q
cyclobenzaprine, carisoprodol (spasm)
A
- CNS sedation
- side effects: lightheadedness, fatigue, fall, physical dependence
22
Q
interferon (MS drugs)
A
- side effects: flu symptoms, myalgia, arthralgia, muscle spasm, depression, suicidal ideation, dizziness, fatigue
23
Q
phenytoin (suppress Na+ influx)
hydantoins (sleepy chicken)
A
- PO/IV
- side effect: pink-red urine, HA, dizziness, sedation, diplopia, nystagmus, dysrhythmia, brady, hypotension, syncope, gingival hyperplasia, hirsutism, hyperglycemia
- contraindication: pregnancy
24
Q
valproic acid (suppress Ca++ influx) - anticonvulsant
A
- side effect: pancreatitis, thrombocytopenia, dizziness, ataxia, diplopia, impaired cognition
- contraindication: pregnancy, children < 2
- narrow therapeutic range: dose adjustment required
25
gabapentin (promote GABA release-sleepy chicken)
- indications: neuropathic pain, restless leg syndrome, fibromyalgia, phantom pain, paresthesia
- side effects: monitor drowsiness/dizziness, confusion, depression, suicidal thoughts, ataxia, angioedema, GI distress
26
CBD oil (sleepy chicken)
schedule 5 (schedule 1 in clinical setting and not used)
- indication: rare and severe epilepsy in patients 2 or older
side effect: liver failure, decreased appetite, diarrhea, rash, weakness, no euphoria, no psychoactive, sleepy, sedation, lethargy
