neuro drugs Flashcards by Bree Smouse

opioid analgesics MOA

mu agonists (open K, close Ca) to decrease transmission
- inhibit release of ACh, NE, 5-HT, substance P, glutamate

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opioid analgesics ADR

addiction, respiratory depression, miosis, additive CNS depression with other drugs
- tx with naloxone

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butorphanol

MOA: partial mu agonist, produces analgesia
USES: extreme pain (migraine, labor, etc.)
ADR: less respiratory depression than full agonist, overdose not easily reversed with naloxone

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tramadol

MOA: weak opioid agonist, works on lots of NTs (“tram it all”)
USE: chronic pain
ADR: decrease sz threshold, serotonin sydrome

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2 non opioids for neuropathic pain

duloxetine

gabapentin

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ethosuximide

MOA: blocks T-type Ca channels
USE: absence
ADR: SJS

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benzos for sz

MOA: increase freq Cl channel opening to increase GABA
USE: status elipticus

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phenytoin

MOA: increase Na channel inactivation
USE: status elipticus, tonic-clonic
ADR: SJS

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carbamazepine

MOA: Na channel inactivation
USE: partial/generalized sz
ADR: SJS, agranulocytosis, aplastic anemia, SIADH, teratogenesis (neural tube)

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valproic acid

MOA: Na channel inactivation and increase GABA
USE: tonic clonic (also all others), bipolar
ADR: hepatotoxicity, contra in pregnancy (neural tube)

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gabapentin

MOA: GABA analog, inhibits Ca channels
USE: partial/generalized sz, peripheral neuropathic pain

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phenobarbital

MOA: increase GABA
USE: partial/generalized sz, great in neonates

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topiramate

MOA: blocks Na channels, increase GABA
USE: partial/generalized sz, migraine prevention, EtOH and cocaine addiction
ADR: mental dulling

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lamotrigine

MOA: blocks Na channels
USE: all sz
ADR: SJS

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3 meds for absence sz

ethosuximide, valproic acid, lamotrigine

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barbituates

“-barbital”
MOA: increase duration of Cl channel opening to decrease neuron firing and increase GABA
USE: sedative, anesthesia
ADR: resp/CV depression, CYP-450, dependence

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benzos

MOA: increase freq of Cl channel opening to increase GABA
USE: anxiety, status epileptics, EtOH detox, anesthesia
ADR: additive CNS effects, dependence
- tx overdose with flumazenil

insomnia agents

zolpidem, zaleplon, eszopiclone, temazepam, trazodone

MOA: BZ1 GABA receptor

anesthetics for maintenance

inhaled: halothane, enflurane, isoflurane, NO
ADR: malignant hyperthermia, hepatotoxicity (halothane), nephhrotoxicity (methoxyflurane), proconvulsant (enflurane)

induction anesthetics

propofol, ketamine (PCP analog), thiopental (barbituate), benzos

local anesthetics

lidocaine, procaine, bupivacaine, etc.

MOA: preferentially blocks activated Na channels

depolarizing neuromuscular blocking drugs

USE: mm. paralysis in surgery or ventilation

- succinylcholine: ACh agonist produces sustained depolarization and prevents contraction

nondepolarizing neuromuscular blocking drugs

“-curium”

MOA: ACh competitive antagonist (reverse with neostigmine)

Parkinson drugs

DA agonists: bromocriptine
increase DA: amantadine, L-DOPA/carbidopa
prevent breakdown: selegiline
curb excess cholinergic activity: benztropine

Alzheimer drugs

memantine: NMDA antagonist | donepezil, rivastigmine: AChE inhibitors

sumatriptan

MOA: 5-HT agonist (inhibits trigeminal nerve activation, prevents vasoactive peptide release, vasoconstriction) USE: migrane, cluster ADR: coronary vasospasm (contra in CAD, angina)

ADHD drugs

CNS stimulants: amphetamine salts, methylphenidate, phentermine MOA: increase NE and DA USE: ADHD, appetite control, narcolepsy ADR: growth restriction

high potency antipsychotics

haloperidol, trifluoperazine, fluphenazine MOA: block D2 USE: schizophrenia positive symptoms, tourettes ADR: EPS symptoms

low potency antipsychotics

``` chlorpromazine, thioridazine MOA: block D2 ADR: anticholinergic, antihistamine effects, sedation - chlorpromazine: corneal deposits - thioridazine: retinal deposits ```

2 serious ADR of typical antipsychotics

tardive dyskinesia | neuroleptic malignant syndrome

atypical antipsychotics

clozapine, risperidone, olanzapine, quetiapine MOA: ? USE: schizo (positive and negative symptoms), bipolar, OCD, tourettes ADR: fewer than typicals - clozapine: agranulocytosis

lithium

MOA: ? USE: mood stabilizer for bipolar, SIADH ADR: HORNET

buspirone

MOA: stimulates 5-HT receptors USE: anxiety PROS: less abuse potential, minimal hypnotic effects, doesn't interact with alcohol

SSRIs

fluoxetine, paroxetine, sertraline, citalopram USE: depression, anxiety, panic, OCD, bulemia, PTSD ADR: serotonin syndrome, sexual dysfunction - tx with cyproheptadine

SNRI

venlafaxine, duloxetine

TCAs

"-ipramine", "-iptyline" MOA: block repute of NE and 5-HT ADR: convulsions, coma, cardiotoxicity (arrhythmias), resp depression, anticholinergic - NaHCO3 for cardio toxicity

wide QRS and overdose

TCA overdose

MAOIs

PITS: phenelzine, isocarboxazid, tranylcypromine, selegiline USE: atypical depression ADR: hypertensive crisis, contra with SSRI, TCA, St. John's

mood stabilizers

lithium, valproic acid, carbamazepine, lamotrigine | MOA: Na inhibition (anticonvulsant), GABA agonist (mood stabilizer)

bupropion

MOA: NE, DA uptake inhibitor USE: smoking, depression ADR: sz in bulemia pts PRO: no sexual side effects

mirtazapine

MOA: alpha 2 antagonist (increase NE, 5-HT release) USE: depression ADR: weight gain, sedation

trazodone

MOA: blocks 5-HT2 and alpha 1 USE: insomnia ADR: priapism ("trazobone")