Neural System 1 Flashcards
what is ADHD?
a series of behavioral disorders
what are the subtypes of ADHD?
1) . inattentive
2) . hyperactive-impulsive
3) . combined
what is the etiology of ADHD?
multi-factorial:
environmental, genetic and biological factors
what increases the risk of developing ADHD?
pre/perinatal expsoure to cigarettes/alcohol
TX options of ADHD?
1) . stimulants
2) . Atomoxetine (Strattera)
3) . Other
How do stimulants work?
block NE and dopamine reuptake
boxed warnings with stimulants?
1) . increase CV risk
2) . abuse potential
common AE for stimulants?
1) . decreased appetite/weight loss
2) . stomach ache
3) . insomnia
4) . HA
5) . irritability/jitteriness
Rare/uncommon AE for stimulants?
1) . dysphoria
2) . “spacey”/zombie-like state
3) . tics/abnormal movements
4) . HTN, HR fluctuations
5) . hallucinations
6) . discolorations from patch
Atomoxetine (strattera) MOA
selective NE re-uptake inhibitor (SNRI)
Pro/Con of Atomoxetine (Strattera)?
less effective than stimulants but also less abuse potential
AE of Atomoxetine (Strattera)
more fatigue, sedation and dizziness than stimulants
boxed warnings for Atomoxetine (Strattera)
increased risk of suicide
Other ADHD drugs
1) . alpha-2 adrenergic agonists
2) . Bupropion
3) . Lithium
4) . Anti-psychotics
What is epilespy?
a chronic condition characterized by recurrent seizures
what is a seizure?
a finite event resulting from excessive discharge of cerebral neurons causing transient impairments or loss of consciousness
what can cause a seizure?
1) . too little GABA
2) . too much Glutamate
3) . CNS inflammation
what is GABA?
main CNS inhibitory neurotransmitter > normally inhibits depolarization
what is Glutamate?
an excitatory neurotransmitter
What are the types of seizures?
1) . partial
2) . generalized
what occurs in a partial seizure?
one cerebral hemisphere with no loss of consciousness
what is a a generalized seizure?
effects both hemispheres and results in loss of consciousness
Types of generalized seizures?
1) . Tonic/Clonic
2) . only Tonic
3) . only Clonic
What is the most common type of generalized seizure?
Tonic/Clonic
how long does an only tonic seizure last?
a few seconds
how long does an only clonic seizure last?
a few seconds
What occurs during a tonic/clonic seizure?
1) . rigid extensor spasm 1st 10-30 seconds
2) . rhythmic flexor spasm 2-4 minutes
during the rigid extensor spasm what can happen?
stopped respiration, poop, pee and salivate
during the rhythmic flexor spasm what can happen?
continued loss of consciousness»_space; alertness will slowly return after
what are the two types of epilepsy?
1) . Primary
2) . Seconday
What causes primary epilepsy?
it is idiopathic and accounts of 50% of cases
what causes secondary epilepsy?
1) . in children: injury @ birth or metabolic disease
2) . in adults: TBI
TX for epilepsy
excitatory or inhibitory:
1) . antiepileptic drug (AED)
2) . antiseizure drug (SD)
3) . anti-convulsant
drug TX for epilepsy depends on ____
1) . patient specific factors
2) . type of seizure
3) . response to previous meds
goals for epilepsy TX
1) . eliminate seizures
2) . experience no AEs
3) . improve QOL
AE of Epileptic drugs
1) . rash (Steven Johnson’s Syndrome)
2) . neurotoxicity
3) . hypothyroidism
At risk populations for Epilepsy
1) . Women
2) . pregnant women
3) . children
4) . elderly
Therapeutic considerations for Epilepsy
1) . some drugs are NTI
2) . watch for sedation, dizziness and ataxia
3) . rashes
4) . bone marrow depression
5) . vitamin K deficiency
6) . ask about seizure activity
7) . know how to respond appropriately to a seizure
therapeutic considerations for women and AEDs
1) . decreased ovarian function
2) . infertility
3) . PCOD
4) . weight gain
what is PCOD?
polycystic ovarian disease
