Nervous system meds; meds for pain

Question 2

G: levodopa/carbidopa

B: Sinemet

Answer 2

Classification/Action

Anti-parkinson agent; acts to replace dopamine levels in CNS

Notes

SE: Nausea and vomiting; orthostatic decrease in BP; dark urine, psycho S/S (hallucinations, paranoid ideation); dysrhythmias

Question 3

G: benztropine

B: Cogentin

Answer 3

Classification/Action

Antiparkinson; for tx of Parkinson’s EPS, including drug induced EPS

Notes

SE: anticholinergic S/S as dry mouth, blurred vision, urinary retention, constipation; confusion

Question 4

G: donepezil

B: Aricept

Answer 4

Classification/Action

Anti-Alzheimer’s agent; cholinesterase inhibitor (so works to increase Ach)

Notes

SE: cholinergic S/S as N&V, diarrhea, dyspepsia, bronchoconstriction (caution with asthma, COPD pt)

Question 5

G: phenobarbital

B:

Answer 5

Classification/Action

Barbiturate anticonvulsant; sedative/hypnotic

Notes

Schedule IV; Tx of partial and generalized T-C seizures (check blood levels: 15-40mcg/mL); more often used w/children than adults

SE: lethargy

Question 6

G: phenytoin

B: Dilantin

Answer 6

Classification/Action

anticonvulsant, especially for tonic-clonic & partial seizures; also a cardiac antidysrhythmic

Notes

check blood levels; 10-20 mcg/mL; do not abruptly D/C

SE: pink urine; gingivial hyperplasia; ataxia, nystagmus, diplopia; agranulocytosis, decreased blood count

Question 7

G: diazepam

B: Valium

Answer 7

Classification/Action

Benzodiazepine anticonvulsant (also skeletal muscle relaxant, sedative, antianxiety agent)

Notes

Schedule IV; especially for tx of status epilepticus

SE: sedation, dizziness; nausea, dry mouth, urinary retention, constipation; rash; do not abruptly D/C

Question 8

G: baclofen

B: Lioresal

Answer 8

Classification/Action

Skeletal muscle relaxant; antispasticity agent

Notes

SE: drowsiness, urinary retention, constipation; decreased BP; rash; do not abruptly D/C

Question 9

G: prednisone

B: Deltasone

Answer 9

Classification/Action

anti-inflammatory; immunosuppressant in large doses

Notes

SE: increased risk of infections; osteoporosis, skin thinning, hyperglycemia, GI ulcer; adrenal gland suppression; slow wound healing; taper to D/C

Question 10

G: ASA; aspirin

B:

Answer 10

Classification/Action

NSAID; Cox1 &Cox2 enzyme inhibitor; platelet aggregate inhibitor

Notes

Some protection against MI

SE: N&V, GI upset & bleeding; tinnitus (toxicity sign); not recommended for use in children (risk of Reyes)

Question 11

G: ibuprofen

B: Motrin, Advil

Answer 11

Classification/Action

NSAID; Cox1 &Cox2 enzyme inhibitor

Notes

Causes less GI bleeding than ASA, but less platelet aggregation inhibition so no MI protection

**SE: **

Question 12

G: celecoxib

B: Celebrex

Answer 12

Classification/Action

2nd generation NSAID, Cox2 inhibitor

Notes

SE: GI upset but less risk of GI bleeding than Cox1 inhibitors; rash; possible increased risk of MI, stroke

Question 13

G: ketorolac

B: Toradol

Answer 13

Classification/Action

NSAID, Cox1 & Cox2 enzyme inhibitor

Notes

PO, IM, IV; low-inflammatory effects; for short-term acute pain tx, especially post-op

SE: GI bleeding

Question 14

G: etanercept

B: Enbrel

Answer 14

Classification/Action

immunosuppresant, DMARD (TNF blocker); tx of RA, Crohn’s, UC, psoriasis

Notes

SE: bone marrow suppression, increases risk of infection (especially URI), neoplasm, HF; avoid if pt has MS

Question 15

G: acetaminophen

B: Tylenol, APAP

Answer 15

Classification/Action

analgesic for mild pain; antipyretic

Notes

SE: rash; hepatotoxicity w/prolonged large doses or w/overdose

Question 16

G: morphine

B:

Answer 16

Classification/Action

opioid analgesic; tx of moderate to severe pain

Notes

Schedule II

SE: N&V, constipation; rash; decreased respiratory rate (hold if R <12), decreased BP; sedation; opioid OD triad; pinpoint pupils, respiratory depression, coma

Question 17

G: meperidine

B: Demerol

Answer 17

Classification/Action

opioid for moderate top severe pain; esp for biliary pain as does not cause spasm at sphincter of Oddj; in L&D

Notes

Schedule II

SE: see morphine; only use short term (48 hrs) as its metabolite can cause neurotoxicity & seizures in longer term use

Question 18

G: fentanyl

B: Duragesic, Sublimaze

Answer 18

Classification/Action

opioid analgesic; tx for severe pain

Notes

Schedule II; parenteral; transdermal patch, transmucosal forms

SE: see morphine

Question 19

G: oxycodone

B: OxyContin

Answer 19

Classification/Action

opioid analgesic; slow release (q 12 hr PO dosing)

Notes

Schedule II

SE: constipation, respiratory depression (if R < 12/min, assess level of sedation)

Question 20

G: hydrocodone/acetaminophen

B: Lortab; Vicodin

Answer 20

Classification/Action

Opioid analgesic w/acetaminophen; tx of moderate pain; also antitussive effects

Notes

Schedule III

SE: respiratory depression, decreased B/P; sedation, constipation

Question 21

G: nalbuphine

B: Nubain

Answer 21

Classification/Action

Opoid agonist/antagonist; tx of moderate to severe pain

Notes

Schedule IV; less risk of addiction due to opioid antagonist effect

SE: dizziness, drowsiness, dry mouth

Question 22

G: gabapentin

B: Neurontin

Answer 22

Classification/Action

Analgesic adjuvant; anticonvulsant; also used as mood stabilizer

Notes

Especially used for neuropathic pain & migraine prophylaxis

SE: drowsiness, lethargy

Question 23

G: amitriptyline

B: Elavil

Answer 23

Classification/Action

Analgesic adjuvant; especially for prevention of migraine headache

Notes

antidepressant in large doses

SE: drowsiness, orthostatic decrease B/P, dry mouth, constipation, urinary retention

Question 24

G: sumatriptan

B: Imitrex

Answer 24

Classification/Action

Vascular headache suppressant, tx of migraine headache; also cluster headache tx

Notes

For tx of migraine, not prevention

SE: dizziness, transient “chest heaviness”