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Pharmacology ATI > Neuro > Flashcards

Neuro Flashcards

1
Q

Centrally acting muscle relaxants
Indication

A

Treat muscle spasms from spinal cord injury, MS, CP, or injury

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2
Q

Centrally acting muscle relaxants
Prototype

A

Baclofen (Lioresal)

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3
Q

Centrally acting muscle relaxants
MOA

A

Enhance inhibitory effects of GABA on spinal cord, which suppresses hyperactive reflexes

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4
Q

Centrally acting muscle relaxants
Major adverse effects

A

Drowsiness, dizziness, muscle weakness, constipation, withdrawal symptoms if stopped suddenly (anxiety, hallucinations, seizures)

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5
Q

Centrally acting muscle relaxants
administration

A

-PO with lowest effective dose and gradual increase
-Give with food or milk
-Can give via intrathecal infusion into spine too

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6
Q

Centrally acting muscle relaxants
Safety

A

-Rhabdomyolysis due to abrupt discontinuation from intense muscle contractions, kidney damage ensues
-avoid alcohol

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7
Q

Centrally acting muscle relaxants
Contraindications

A

Hypersensitivity
MAOIs within past 2 weeks = CNS depression
CVA or seizure disorder

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8
Q

Peripherally acting muscle relaxants
Indication

A

relax skeletal muscle spasms from CVA, spinal cord injury, MS, and CP
Prevent malignant hyperthermia

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9
Q

Peripherally acting muscle relaxants
Prototype

A

Dantrolene (Dantrium)

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10
Q

Peripherally acting muscle relaxants
MOA

A

Inhibit release of calcium from muscle cells, which inhibits muscle contraction
Reverses malignant hyperthermia in IV form

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11
Q

Peripherally acting muscle relaxants
Adverse effects

A

Drowsiness, dizziness, muscle weakness, diarrhea
Liver toxicity

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12
Q

Peripherally acting muscle relaxants
Admin

A

PO or IV
(IV for malignant hyperthermia)

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13
Q

Peripherally acting muscle relaxants
Contraindications

A

Liver disease

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14
Q

Peripherally acting muscle relaxants
Safety

A

-Use with alcohol and other CNS depressants = resp depression
-use with estrogen = liver toxicity

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15
Q

Hydantoins (AED)
Indication

A

Control tonic-clonic seizures

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16
Q

Hydantoins (AED)
Prototype

A

Phenytoin (Dilantin)

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17
Q

Hydantoins (AED)
MOA

A

Decrease neuron activity by inhibiting influx of sodium

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18
Q

Hydantoins (AED)
Adverse effects

A

Drowsiness, gingival hyperplasia among children and teens, skin rash can indicate Steven Johnson or become septic

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19
Q

Hydantoins (AED)
Safety

A

-abrupt discontinuation can cause status epilepticus
-narrow therapeutic range (ataxia, nystagmus, sedation)
-reduces BC effectiveness

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20
Q

Hydantoins (AED)
Admin

A

Give with food
-Inject IV slowly because phenytoin acts on heart too (abrupt reduction in sodium influx can cause dysrhythmias or arrest)

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21
Q

Hydantoins (AED)
Contraindications

A

Pregnancy
Skin rash
Bradycardia/heart block
Allergy to hydantoins

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22
Q

Traditional AED/Anticonvulsants
Indication

A

Treats tonic clonic and partial seizures
Mood stabilizer for bipolar
Helps trigeminal neuralgia pain

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23
Q

Traditional AED/Anticonvulsants
Prototype

A

Carbamazepine (Tegretol)

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24
Q

Traditional AED/Anticonvulsants MOA

A

Inhibit sodium influx into neurons, which decreases electric activity

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25
Q

Traditional AED/Anticonvulsants
Adverse effects

A

Nystagmus, headache, blurred vision, ataxia (CNS depression)
Fluid retention
Skin rash - Steven’s Johnson
Photosensitivity reaction
Bone marrow suppression

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26
Q

Traditional AED/Anticonvulsants
Admin

A

Give with meals
Must be given consistently to avoid seizures (i.e., take with a sip of water if NPO for procedure)
Interacts with grapefruit

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27
Q

Traditional AED/Anticonvulsants
Safety

A

Monitor WBC prior to giving carbamezapine
Monitor for skin rash
Instruction:
Driving
Sunscreen
Lowers BC effectiveness
Report fever and easy bruising (bone marrow suppression)

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28
Q

Traditional AED/Anticonvulsants
Contraindications

A

Absence or myoclonic seizures
Pregnancy (weigh risks)
Heart failure or hematologic disorder

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29
Q

Valproic acid/Valproate
Indications

A

Anticonvulsant (Treats all types of seizures)
Controls mania with bipolar
Migraine treatment

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30
Q

Valproic acid/Valproate
Prototype

A

Valproic acid (Depakote, Depacon, Depakene)

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31
Q

Valproic acid/Valproate
MOA

A

Inhibits sodium influx into neurons and also may affect calcium influx and enhance GABA

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32
Q

Valproic acid/Valproate
Adverse reactions

A

GI upset
Bruising, bleeding due to bone marrow suppression
Rash
Liver toxicity (more common in first few months)
Hyperammonemia (valproic acid alters fatty acid metabolism)

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33
Q

Valproic acid/Valproate
Admin

A

PO or IV
Enteric coated and take with food to avoid GI upset
Can sprinkle on food

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34
Q

Valproic acid/Valproate
Safety

A

Review lab results for ammonia, platelets, and bleeding time
Monitor for pancreatitis (rise in serum amylase)
Monitor for liver function, jaundice, abdominal pain

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35
Q

Valproic acid/Valproate
Contraindications

A

Pregnancy
Liver disorder
Blood clotting disorders
Use of other anticonvulsants

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36
Q

Cholinesterase inhibitors
Indication

A

improve cognitive function in mild to moderate dementia

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37
Q

Cholinesterase inhibitors
Prototype

A

Donepezil (Aricept)

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38
Q

Cholinesterase inhibitors
MOA

A

Inhibits acetylcholinesterase from breaking down acetylcholine, causing an increase in acetylcholine

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39
Q

Cholinesterase inhibitors
Adverse effects

A

GI effects: Nausea, GI bleed
Neuro effects: insomnia, dizziness, headaches
Cardiac effects: Bradycardia, syncope

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40
Q

Cholinesterase inhibitors
Admin

A

Give at bedtime with or without food
Tabs, orally disintegrating tabs, syrup

41
Q

Cholinesterase inhibitors
Safety

A

Monitor for GI bleeding
Assist with ambulation

42
Q

Cholinesterase inhibitors
Contraindications

A

Children
GI bleeding

43
Q

NMDA Receptor Antagonist
Indication

A

Slow physical functioning and cognitive decline in moderate to severe Alzheimer’s

44
Q

NMDA Receptor Antagonist
Prototype

A

Memantine (Nementa)

45
Q

NMDA Receptor Antagonist
MOA

A

Blocks glutamate from stimulating NMDA receptors, which decreases calcium influx into neurons and restores normal impulse transmission

46
Q

NMDA Receptor Antagonist
Adverse effects

A

Dizziness, confusion
Constipation

47
Q

NMDA Receptor Antagonist
Contraindications

A

Renal failure

48
Q

Immunomodulators
Indication

A

Multiple sclerosis

49
Q

Immunomodulators
Prototype

A

Interferon beta1-A (Avonex)
Interferon beta1-B (Betaseron)

50
Q

Immunomodulators
MOA

A

Inhibits movement of leukocytes across BBB, which prevents myelin sheath damage

51
Q

Immunomodulators
adverse effects

A

flu symptoms
decrease of all blood cell types
liver toxicity

52
Q

Immunomodulators
Admin

A

IM or subq
requires liver testing and intermittent thyroid testing

53
Q

Serotonin agonists
Indication

A

Pain relief for migraines and cluster headaches

54
Q

Serotonin agonists
Prototype

A

Sumatriptan (Imitrex)

55
Q

Serotonin agonists
MOA

A

Activate 5-HT (serotonin) receptors, which promotes vasoconstriction and supresses release of CGRP
This prevents inflammatory response

56
Q

Serotonin agonists
Adverse effects

A

Chest heaviness (vasoconstriction in lungs)
Vasospasm of coronary vessels
Tingling
vertigo

57
Q

Serotonin agonists
Admin

A

PO, nasal spray, or subq

58
Q

Serotonin agonists
Contraindications

A

MI, CAD, angina, peripheral vascular disease, CVA

59
Q

Amphetamines
Indication

A

ADHD
narcolepsy

60
Q

Amphetamines
Prototype

A

Amphetamine/dextroamphetamine sulfate(adderall)

61
Q

Amphetamines
MOA

A

Increase release of norepinephrine and dopamine, which causes alertness, improved mood, better concentration, reduced hyperactivity, and sympathetic NS effects

62
Q

Amphetamines
Adverse effects

A

Hypertension
Anxiety
Appetite suppression
Abuse/tolerance/withdrawal
Toxicity - looks like paranoid schizophrenia

63
Q

Amphetamines
Admin

A

PO, DO NOT CRUSH
Give in the morning to avoid insomnia
Drug holidays for children to prevent growth suppression

64
Q

Amphetamines
Contraindications

A

Hyperthyroidism
Severe hypertension
cardiovascular disease

65
Q

Methylphenidate
indication

A

CNS Stimulant:
ADHD
Narcolepsy

66
Q

Methylphenidate
Prototype

A

Methylphenidate (Ritalin, Concerta)

67
Q

Methylphenidate
MOA

A

Increase release of norepinephrine and dopamine in brain and PNS

68
Q

Methylphenidate
Adverse effects

A

Same as amphetamines (toxicity, appetite suppression, sympathetic effects)

69
Q

Methylphenidate
admin

A

PO or patch
Some capsules can be opened and sprinkled in applesauce

70
Q

Local anesthetic
Indication

A

When small areas of the body require anesthesia or client cannot have general anesthesia

71
Q

Local anesthetic
Prototype

A

Lidocaine (xylocaine)
also procaine (Novocain) -this is the ester type

72
Q

Local anesthetic
MOA

A

Prevents depolarization by inhibiting influx of sodium into neurons through sodium channels

73
Q

Local anesthetic
Adverse effects

A

CNS stimulation - restlessness, tremors, confusion, irritability

After CNS stimulation wears off, CNS depression can occur: respiratory depression

Hypotension and headaches with spinal admin

Bradycardia or heart block

74
Q

Local anesthetic
Admin

A

Topical
Epidural
Spinal
IM
Nerve block
IV for regional anesthesia

75
Q

General anesthesia/short-acting barbiturates
Indication

A

Rapid induction of anesthesia and hypnosis for brief procedures or an adjunct to other drugs for longer procedures

76
Q

General anesthesia/short-acting barbiturates
Prototype

A

Methohexital sodium (Brevital White)
Propofol (Diprivan) - most widely used IV

77
Q

General anesthesia/short-acting barbiturates
MOA

A

Enhance inhibitory effects of GABA and cause significant CNS depression

78
Q

General anesthesia/short-acting barbiturates
Adverse effects

A

therapeutic doses- bradycardia and hypotension
Higher doses - tachycardia due to compensation and respiratory depression

79
Q

General anesthesia/Benzodiazepines
Indication

A

Sedation prior to general anesthesia, moderate or conscious sedation with amnesia, and adjunct to inhaled anesthesia for surgery

80
Q

General anesthesia/Benzodiazepines
Prototype

A

midazolam (Versed)
also, diazepam (Valium)

81
Q

General anesthesia/Benzodiazepines
MOA

A

CNS depressant and hypnotic - enhance inhibitory effects of GABA

82
Q

General anesthesia/Benzodiazepines
Adverse effects

A

Amnesia is normal side effect
Cardiac or respiratory arrest possible

83
Q

General anesthesia/Benzodiazepines
Admin

A

Inject IV bolus slowly over at least 2 minutes and monitor VS
IM admin before procedure
PO for children
Used with opioids for conscious sedation

84
Q

General anesthesia/Benzodiazepines
Contraindications

A

Pregnancy

85
Q

General anesthesia/Opioids
Indication

A

Adjunct to anesthesia for their sedative and pain relief effects

86
Q

General anesthesia/Opioids
Prototype

A

fentanyl (Duragesic)

87
Q

General anesthesia/Opioids
MOA

A

narcotic agonist - bind to mu receptors and inhibits pain impulses similarly to natural opioids

88
Q

General anesthesia/Opioids
Adverse effects

A

Resp. depression
Constipation
Circulatory collapse
Nausea

89
Q

Dopaminergic agents
Indication

A

Parkinsons symptom relief

90
Q

Dopaminergic agents
prototype

A

levadopa/carbadopa (Simenet)

91
Q

Dopaminergic agents
MOA

A

crosses BBB and is taken up by dopaminergic neurons in the substantia nigra, where it is converted to dopamine

92
Q

Dopaminergic agents
Adverse effects

A

Dyskinesias
Orthostatic hypotension
Nausea
Inappropriate behaviors

93
Q

Dopaminergic agents
Admin

A

Give with food
Avoid high-protein foods because they reduce absorption
may cause dark urine and sweat

94
Q

Dopaminergic agents
Contraindications

A

Melanoma
Hx of suicidal or psychosis
glaucoma

95
Q

Dopamine agonists
Indication

A

Parkinson’s relief
restless leg syndrome

96
Q

Dopamine agonists
Prototype

A

Pramipexole (Mirapex)

97
Q

Dopamine agonists
MOA

A

Bind to dopamine receptors and mimic natural dopamine

98
Q

Dopamine agonists
Adverse effects

A

Sleep attacks
Orthostatic hypotension
Dyskinesias
Nausea (stimulates chemoreceptor trigger zone)

Pharmacology ATI (19 decks)

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