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

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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
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3
Q

methylphenidate (amphetamine-like)

A
  • PO, transdermal patch, schedule 2
  • MOA: increase dopamine, norepinephrine, increase attention span and cognitive performance
  • indication: ADHD, narcolepsy
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4
Q

modafinil and armodafinil (amphetamine-like)

A
  • schedule 4

- indication: narcolepsy, jet lag, ADHD, sleep apnea

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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
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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)
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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
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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
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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
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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
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11
Q

caine

A

MOA: prevent conduction of nerve impulses at injection site

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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
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13
Q

amantadine (bear)

A
  • MOA: improve dopamine action (also for flu A)
  • side effects: livedo reticularis, anticholinergic effects
  • drug tolerance develops
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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
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15
Q

donepezil and memantine (alzheimer’s)

A
  • MOA: cholinesterase inhibitors, improve cognitive function

- side effects: dizziness, insomnia, HA, anorexia, muscle cramps

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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
Q

gabapentin (promote GABA release-sleepy chicken)

A
  • indications: neuropathic pain, restless leg syndrome, fibromyalgia, phantom pain, paresthesia
  • side effects: monitor drowsiness/dizziness, confusion, depression, suicidal thoughts, ataxia, angioedema, GI distress
26
Q

CBD oil (sleepy chicken)

A

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