Neurology Flashcards
Atropine
anticholinergic
inhibits Ash and muscarinic receptors–> increased heart contraction strength and heart rate, relaxed GI and respiratory and GU systems, decreased gland secretions
Use for bradycardia
se: 6 A M
Agitated brain Anhidrosis Airway relax Accelerated heart beat Avid thirst with dry mouth Atonic bowel and bladder
Mydriasis with increased ocular pressure
ci: glaucoma, MG, obstructive GI/GU
Tolterodine
Anticholinergic/muscarinic
Overactive bladder
similar side effects: dry mouth, diarrhea, dyspepsia, constipation, anxiety, abnormal vision, dry eye, urinary retention
Do not take with AZITHROMYCIN, AZOLE ANTIFUNGALS, CYCLOSPORINE, other anticholinergics/antimuscarinics
ci: UC, toxic megacolon, BPH, glaucoma, MG, pregnancy
Dextroamphetamine
noncatecholamine amphetamine
Narcolepsy and ADHD
leads to anorexia, insomnia, high bp, low libido, palpitations
Antacids increase absorption
ci: hyperthyroid, glaucoma, hypertension, arteriosclerosis, agitates states, MAOI
Methyphenidate
ritalin
catecholamine norepinephrine release
ADHD, narcolepsy
se: anxiety, insomnia, tremor, euphoria, hypertension, angina, arrhythmias, anorexia, diarrhea, emesis, tolerance, abuse, dependence
Ci: anxiety, glaucoma, tourettes, serious heart issues, within 2 weeks of MAOI– severe hypertensive reaction
Oxymetazoline
direct acting sympathomimetic
vasocontricts mucosal blood vessels when applied topically
nasal congestion
local irritation, rebound congestion
ci: glaucoma, hyperthyroid, heart disease, less than 6yo
Pseudoephedrine
alpha adrenergic agonist
(alpha-vasoconstriction, B- bronchial relaxation and increased heart rate/contractility)
nasal congestion
rebound congestion, insominia anxiety, anorexia, GI upset, heart issues
Increased risk of hypertension and arrhythmias with cardiac glycosides and TCA, vasoconstriction with trots
do not give with MAOI
ci: severe hypertension, pheochromocytoma
Phenylephrine
nasal spray
alpha adrenergic agonist (sympathomimetic)
vasoconstriction of nasal mucosa
can be used for mydriasis in an eye dropper
se: anxiety, heart stuff, corneal clouding, tissue necrosis
increase beta blockers, MAOI hypertension possible
ci: hypertension, ventricular tachycardia, glaucoma
Phentermine
indirect alpha and beta adrenergic
weight loss drug
decreases appetite
se: hives, GI upset, heart issues, anxiety, low libido
decrease excretion with antacids, risk of arrhythmias with TCA
ci: pulmonary hypertension, arteriosclerosis, glaucoma
Nicotine
smoking cessation
cholinergic
ganglionic and CNS stimulant, stimulates respiratory system and then paralyses all autonomic ganglia
se: headache, flu like, skin reactions with patch
Varenicline
chantix
nicotinic acetylcholine receptor partial agonist
acts on mesolimbic dopamine system, stimulates nicotine activity but less
se: nausea, insomnia
Donepezil
anti alzheimers
cholinesterase inhibitor: decreases the break down of acetylcholine
slows cognitive decline in alzheimers
se: GI irritation, dizzy, headache, bradycardia, broncho constriction
give atropine if Mrs G gets into the bottle and takes too much and overdoses!
relative ci: arrhythmia, abnormal heart rate, asthma, COPD
Rivastigmine
antialzheimers
cholinergic
basically same as donepezil
Alprazolam
xanax
short acting benzodiazepine
increases effect of GABA- anxiolytic, mm relaxant, antidepressant, anticonvulsant
se: drowsy, fucked up
don’t take with alcohol or opiates
ci: glaucoma, sleep apnea, preexisting CNS/Respiratory depression, pregnancy and lactation
abrupt stop can cause seizures
Diazepam
long acting benzodiazepine
enhances effects of GABA
se: DIASepam
Drowsy Dependence Impaired judgement Anterograde Amnesia Suppression of respiration and circulation, even death
may decrease effectiveness of levodopa, hypothermia with lithium
ci: MG, less than 6months, pregnancy and lactation
Buspirone
anxiolytic
Azaspirodecanedione
high affinity for 5HT1, 5HT2, moderate affinity for dopamine d2
GAD
much lower side effect and risk profile than benzos
MAOI hypertension
ci: under 18, MAOI, epilepsy, severe renal or liver disease
Zolpidem
ambien
hypnotic
increased sedation and incoordination with TCA
ci: severe hepatic insufficiency
Carbamazepine
Neuronal Na+ channel blocker
slows down neuronal firing
MZP: Mania, seiZures, Pain (nerve)
se: ataxia, hyponatremia
Caution with OCP efficacy and shortens half life of doxycycline, decreases warfarin
ci: bone marrow depression, pregnancy, MAOI within 14 days
Phenytoin
neuronal na+ channel blocker
anticonvulsant
use: GPS
Generalized tonic clonic seizures
Partial seizures
Status epileptic
SE: F PHENyTOIN Folate antagonist Peripheral neuropathy Hyperplasia of gingiva, Hirsutism Enlarged LN Nystagmus Teratogen Osteomalacia Inhibits insulin Nausea vomiting
ci: sinus bradycardia, heart block, pregnancy
Gabapentin
structurally similar to GABA but neither an agonist nor antagonist
use for epilepsy and neuropathic pain
se: DASH Dizzy, drowsy Ataxia Somnolesence Headache
Ci: lactation
Pregabalin
Gaba analogue, reduces pain signal going from the brain to the periphery
ci; pregnancy, lactation
Modafinil
nonamphetamine CNS stimulant
Improves EDS in narcolepsy
se: headache, rhinitis, insomnia, personality disorders
Interactions: careful with OCP, increase metabolism of cyclosporin,
ci: hypertension, arrhtyhmias, chest pain, mitral valve prolapse
Carisoprodol
mm relaxant
carbamate derivative, blocks interneuronal synaptic activity in the descending reticular formation and spinal cord
se: dizzy, drowsy
ci: opiods, intermittent porphyria, lactation
Ketamine
NMDA receptor antagonist
direct action on the cortex and limbic system, dissociative
anesthesia
se: hypertension, increased CO, increased intracranial pressure, hallucinations,
ci: psychotic disorders, eye injury, raised IOP, cerebrovascular event history
Cyclobenzaprine
mm relaxant
similar to TCAs
se: drowsy, dry mouth
ci: recent MI
