Neurological Drugs Flashcards
Non-benzodiazepines
Prototype drug is Ambien, Sonata, Lunesta.
Treats short-term insomnia.
It enhances inhibitory effects of GABA.
Side effects are daytime drowsiness, headache, anxiety, dizziness, Diplopia, and confusions in older adults.
Administer just before bedtime and on an empty stomach.
It is a scheduled 4 controlled substance. It is contraindicated for children learning the piano, people have suicidal ideation, and during labor and delivery.
Take precautions for dosages for older adults people who are prone to substance abuse, history of depression, chronic respiratory disorders, sleep apnea, and hepatic or renal dysfunction.
Benzodiazepine
Suffix: -pam
Prototype drug is temazepam. Other sleep disorder drugs are Triazolam, and flurazepam.
Used to treat sleep disorder. Take by mouth 30 minutes before bedtime.
Side/adverse effects: Drowsiness, dizziness, confusion, anxiety.
Signs of toxicity– Weakness, slurred speech, ataxia, I’m coordinating muscle movements, and respiratory depression.
Contraindicated for pregnancy and lactation, it is a scheduled four controlled substance, glaucoma, and children under 18 years of age.
Take precautions for patients with renal and hepatic impairment, suicidal ideation, alcohol dependence, neuromuscular disorders, chronic gustatory disorders, and sleep apnea.
Tolerance can develop over weeks.
Do not take With any other CNS depressant it can increase risk of severe sedation and respiratory depression, do not take With alcohol or any other antidepressants the risk of sedation, Kava kava and valerian increases the risk for sedation, and smoking decreases affects of benzodiazepine.
Withdrawals - paranoia, panic attacks, muscle twitching, hallucinations. To avoid withdrawal syndrome gradually decrease use of benzodiazepines.
Centrally acting muscle relaxants
Proto type of drug is baclofen. Other drugs are Carisoprodol, chlorzoxazone, and cyclobenzaprine.
Relieves muscle spasms due to spinal cord injury, multiple sclerosis, cerebral palsy, and musculoskeletal injury or other disorders. Enhances the effect of GABA.
Side effects are drowsiness and dizziness early in therapy, nausea and constipation. Withdrawals Symptoms when discontinued abruptly are anxiety, restlessness, Visual hallucinations and seizures.
Give With food, encourage fluid, and increase fiber.
Cyclobenzaprine is contra indicated for patients MAOI antidepressants within the past two weeks it is also contraindicated for people with Cerebral palsy. This may cause hypertensive crisis.
Patients with diabetes may require increased insulin or oral antidiabetic drug due to increase in blood sugar was taking baclofen.
Peripherally acting muscle relaxants
Proto type drug is dantrolene also known as Dantrium.
Relaxes Skeletal muscle spasms related to CVA, Spinal cord injury, multiple sclerosis, and cerebral palsy. It is also used to prevent and treat malignant hyperthermia a side effect of general anesthesia.
Inhibits release of calcium and blocks contraction of muscles.
Side effect arm muscle weakness, drowsiness dizziness, diarrhea, and liver toxicity.
Women older than 35 using estrogen has increased risk of liver toxicity. Calcium channel blockers increase the risk for severe cardiac dysrhythmias.
Hydantoins
Prototype drug is Dilantin, phenytoin.
Use for tonic clonic seizures and partial seizures. Inhibits influx of sodium reduced sodium channels which decreases discharge of neurons from areas with increased activity.
Side effects are mild drowsiness, other CNS effects, gingival hyperplasia, skin rash and also withdrawal symptoms.
Monitor vital signs, give with meals, Inject IV slowly no more than 50 mg per minute. Monitor plasma levels therapeutic levels between 10 to 20 mcg/mL. It can lead to nystagmus, ataxia, sedation, and blurred or double vision.
Contra indicated for pregnancy risk category D, skin rash, Bradycardia or heart block, previous allergies to hydantoins, and seizures Caused by blood sugar.
IV solution of phenytoin is incompatible and solutions with many other drugs and with dextrose solution.
Diazepam, Isoniazid and Valproic acid increases levels of phenytoin.
Phenobarbital and carbamazepine can decrease phenytoin levels.
Phenytoin can reduce the effectiveness of oral Contraceptives.
Iminostilbenes
Prototype drug is carbamazepine also known as Tegretol
Use to treat partial seizures, tonic clonic seizures, bipolar disorder, and trigeminal neuralgia. Inhibits the influx of sodium through sodium channels therefore decreasing the discharge of neurons around areas of increased activity.
Side or adverse effects are visual disturbances such as headaches, ataxia, Nystagmus, and blurred vision. Decreased excretion of water which would result in Fluid retention. Also skin rash which may be serious can be an adverse effect. Epidermal Necrolysis and Stevens-Johnson syndrome. Bone marrow suppression.
Give as much of the daily dose at bedtime as possible. Monitor WBC CBCs throughout therapy withhold the drug for lower levels. Monitor skin rash. Check patients of Asian descent tested for HLA-B*1502 gene which increased risk of severe skin reaction.
Administer with meals to reduce gastrointestinal symptoms, do not mix oral suspension with other oral drug to suspensions.
Contraindicated for absence and myoclonic seizures, hematologic disorders and heart failure. Precautions for cardiac or hepatic disease the Asian gene and alcoholism.
Grapefruit juice will increase the levels. Antifungal, erythromycin, isoniazid, some antiretroviral, valproic acid, verapamil, niacin, and. Loratadine may cause increased Plasma level. Phenytoin, barbiturates, rifampin, cisplatin, and theophylline decreased plasma levels.
Valproic acid
Also known as Depakote, Depacon, and Depakene.
It’s for all seizures type, mania associated with bipolar disorder and migraine headache prevention.
