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NSG 155 Pharmacology > Neuro 1 > Flashcards

Neuro 1 Flashcards

1
Q

Name main groups of antidepressants and their prototype drugs (for this class)

A

Antidepressants

  • trycyclic antidepressants (TCAs)
    • imipramine (Tofranil)
  • selective serotonin reuptake inhibitors (SSRI)
    • sertraline (Zoloft)
  • serotonin norepinephrine reuptake inhibitor (SNR)
    • duloxetine (Cymbalta)
  • monoamine oxidase inhibtors (MAOIs)
    • phenelzine (Nardil)
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2
Q

sumatriptan

therapeutic class

pharmacologic class

general action

some of the alerts

A

sumatriptan (Imitrex)

Therapeutic Class: antimigraine

Pharmacologic Class: triptans

Actions:

  • vasoconstrictor of cranial arteries
  • selectively reduces carotid arterial blood flow

Alert:

  • may cause cardiac ischemia in susceptible person w/o previous cardiac event
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3
Q

benztropine

A

benztropine (Cogentin)

  • Therapeutic Class: antiparkinson drug
    • ​relieves symptoms
  • Pharmacologic class: centrally acting cholinergic receptor blocker (anticholinergic)
    • blocks excess cholinergic stimulation
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4
Q

NSAIDs

A

ibuprofen; ketorolac (Toradol)

  • Pharmacologic Class: NSAID
    • Inhibits COX1 and COX2 (non-specific)
      • NSAIDs inhibit cyclooxygenase (COX), an enzyme responsible for formation of prostaglandins. When COX is inhibited, inflammation and pain are reduced.
  • Increased risk of b leeding with ginkgo and garlic
  • Take with food
  • ketorolac can be given IV (among other routes)
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5
Q

nalaxone

therapeutic class

pharmacologic class

action

contraindication

A

nalaxone (Narcan)

  • Therapeutic Class: drug for treatment of acute opioid overdose
  • Pharmacologic Class: opioid receptor ANTAGONIST
    • Action: blocks both MU and Kappa receptors
  • Contraindication: should NOT be used for respiratory depression caused by nonopioid medications
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6
Q

migraine

A
  • throbbing or pulsating pain
  • thought to be vasodilation of the cranial arteries
  • treatment includes
    • beta blockers
    • trycyclic antidepressants
    • calcium channel blockers
    • ergot alkaloids
    • triptans
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7
Q

Parkinson’s Disease

A
  • (2nd) most common degenerative CNS disease
  • progressive loss of dopamine
    • dopaminergic drugs (dopamine agonists and related drugs)
      • dopaminergic adjunct agents
      • levodopa/carbidopa
      • catechol-methyl transferase (COMT) inhibitors
    • anticholinergics
      • benztropine
  • Symptoms:
    • resting tremors
    • rigidity - rigid body structure
    • slowlness of movement (bradykinesia)
    • loss of balance
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8
Q

seizure and convulsion are not synonymous

convulsions - specifically refer to involuntary, violent spasms of the large skeleltal muscles. Some types of seizures involve vonulsions, other seizures do not.

all convulsions are seizures, but not all seizures are convulsions.

antiseizure, anticonvulsant, antiepileptic drugs

A

*

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9
Q

causes of seizures

A

Causes:

  • fever
    • febrile seizures
  • infectious diseases
    • acute infections such as meningitis and encephalitis can cause inflammation in the brain
  • trauma
    • physical head trauma may cause increase intracranial pressure
    • chemical trauma, such as presence of toxic substances or ingestion of poisonso may cause brain injury
  • withdrawal symptoms
  • other causes
    • metabolic disorders - changes in fluid and electrolyte levels such as hypoglycemia, hyponatremia, water intoxication
    • others
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10
Q

tonic-clonic seizures

A

tonic-clonic seizures

  • preceded by aura
  • intense muscle contraction (tonic phase)
    • followed by alternating contraction and relaxation of muscles (clonic phase)
  • disorientation and deep sleep after seizure (postictal state)
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11
Q

status epilepticus

A
  • medical emergency
  • continuous seizure activity, which can lead to coma and death
  • usually tx with benzodiazpine (e.g., diazepam)
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12
Q

benzodiazepines

common trade name

uses

black box warning

IV administration

overdose

A

lorazepam (Ativan)

diazepam (Valium)

  • Uses:
    • sedation
    • antianxiety
    • anticonvulsant effect (for antiseizure therapy, primary indication is status epilepticus)
  • Black Box Warning:
    • concomittant use of benzodiazpines and opioids may result in profound sedation, respiratory depression, coma, and death
  • parenteral diazepam and lorazepam are used to terminate status epilepticus
    • in IV administration monitor respirations every 15 minutes
  • Overdose: flumazenil (Romazicon) used for overdose of benzodiazepine
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13
Q

phenytoin

A

phenytoin (Dilantin, Phenytek)

Black Box Warning:

  • rate of administration should not exceed 50 mg/min in adults and 1 to 3 mg/kg/min (or 50 mg/min, whichever is slower) in pediatric pts becuas of risk of severe hypotension and cardiac arrhythmias. Careful cardiac monitoring needed during and after administering IV dDilantin
  • abrupt discontinuation can cause status epilepticus
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14
Q

gabapentin

A
  • used for partial seizures and neuropathic pain
  • taper dose; do not stop abruptly
  • Adverse Effects:
    • CNS depression, somnolence
    • dizziness, ataxia
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15
Q

valproic acid (Depakene)

A
  • used for many types of epilepsy
  • do not mix with carbonated beverages
  • Black Box Warning:
    • hepatic failure esp. in children under age 2 y.o.
    • can produce life-threatening pancreatitis
    • teratogenic effects including spina bifida
      • ​pregnancy D
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16
Q

barbiturate

A

phenobarbital

Pharmacologic Class: barbiturate; GABA-a receptor agonist

Uses:

  • primarily used as an anticonvulsant
  • sedative
  • may be used as preanesthetic agent

Alert:

  • high abuse potential - schedule IV controlled substance
  • Should NOT be combined with other CNS depressants
  • when therapy is d/c, dose should be tapered and not stopped abruptly
17
Q

cyclooxygenase

A
  • cyclooxygenase-1 (COX-1)
    • present in all tissues
    • reduces gastric acid secretion, promotes renal blood flow, promotes platelet aggregation
    • inhibition of COX-1 results in bleeding, gastric upset, reduced renal function
  • cyclooxygenase-2 (COX-2)
    • formed only after tissue injury
      • promotes inflammation, sensitizes pain receptors, mediates fever in brain
    • inhibition of COX-2 results in supression of inflammation

NSG 155 Pharmacology (10 decks)

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