Neurology Flashcards
generic name and class
aricept
generic: donepezil
class: acetylcholinesterase inhibitor
indication
donepezil
alzheimer’s disease
adverse effects
donepezil
Feeling dizzy, tired, or weak; Diarrhea, upset stomach, or throwing up; Trouble sleeping (vivid dreams); Muscle cramps; Not hungry; Weight loss, Headache
counseling points
donepezil
should not be used in patients with baseline bradycardia
generic name and class
namenda
generic: memantine
class: n-methyl-d-aspartate (NMDA) receptor antagonist
indication
memantine
alzheimers disease
use with caution
memantine
- history of seizure disorder
- cardiovascular disease
- renal impairment
- hepatic impairment
- alkalinizing medications, dietary changes or patient conditions that may increase urine pH
generic name and class
gralise or neurontin
generic: gabapentin
class: antiseizure, gaba analog
indication
gabapentin
neuropathic pain
warnings
gabapentin
- should not be discontinued abruptly b/c of possibility of seizure
- IR and ER products are not interchangeable
- may exacerbate myasthenia gravis
- use with caution in patients with renal impairment
- tolerance, psychological and physical dependence may occur in patients with history of substance misuse
common ADRs
gabapentin
drowsiness, dizziness
rare but serious ADRs
gabapentin
- respiratory depression
- CNS depression resulting in accidental injury
- DRESS
- SJS
- toxic epidermal necrolysis
- bullous pemphigoid
- erythema multiforme
- hypersensitivity angitis
- agitation
generic name and class
lyrica
generic: pregabalin
class: antiseizure agent, gaba analog
indication
pregabalin
neuropathic pain
warnings
pregabalin
- history of angioedema or concurrent use with meds known to cause angioedema (ACEI)
- renal impairment
- substance misuse
- don’t abruptly withdraw
common ADRs
pregabalin
- drowsiness
- dizziness
- edema
rare but serious ADRs
pregabalin
- respiratory depression
- accidental injury
- maculopapular rashes
- DRESS
- SJS
- toxic epidermal necrolysis
- peripheral edema
- blurred vision, decreased visual acuity, diplopia, visual field loss
- weight gain
generic name and class
skelexin
generic: metaxalone
class: skeletal muscle relaxant
indication
metaxalone
spasticity
common ADRs
metaxalone
dizziness, drowsiness, headache
rare but serious ADR
metaxalone
serotonin syndrome if used with SSRIs, SNRIs, TCAs, etc.
generic name and class
1.focalin 2. vyvanse 3. ritalin/concerta
- dexmethylphenidate
- lisdexamfetamine
- methylphenidate
class: CNS stimulant
black box warning
cns stimulants
- risks of misuse, abuse, substance use disorder, and overdose consistently across all medicines in the class, as well as advise health care professionals to monitor patients closely for signs and symptoms of misuse, abuse, and substance use disorder
- hypersensitivity or use during or within 14 days following MAOI therapy
- Methylphenidate ER capsules (generic Metadate CD): Patients with rare hereditary problems of fructose intolerance, glucose-galactose malabsorption, or sucrose-isomaltase insufficiency.
indication
CNS stimulants
ADHD
rare but serious ADRs
CNS stimulants
- MI
- tachycardia
- hypertension
- growth retardation in peds
- priapism
- psychosis or mania
generic name and class
estulic/tenex
generic: guanfacine
class: alpha 2 adrenergic agonist; antihypertensive (ADHD)
common ADRs
guanfacine
- dizziness
- drowsiness
- headache
- constipation
- xerostomia
- impotence
- fatigue
- insomnia
serious ADRs
guanfacine
- AV block
- bradycardia
- hypotension
- orthostatic hypotension
- sinoatrial nodal rhythm disorder
- syncope
- anxiety
- rebound hypertension
generic name and class
tegretol
generic: carbamazepine
class: sodium channel blocker
indication
sodium channel blockers
epilepsy
major contraindications
carbamazepine
- hypersensitivity
- history of bone marrow depression
- co-treatment w/ MAOIs, nefazodone, other NNRTIs that are CYP3A4 substrates
black box warning
carbamazepine
agranuloccytosis; aplastic anemia; SJS/TEN (especially in Asians-screen for HLA-B*15:02)
generic name and class
trileptal
generic: oxcarbazepine
class: sodium channel blocker
ADRs
oxcarbazepine
Rare but Serious: Agranulocytosis,
Dermatological reactions (less
common than with carbamazepine)
Common: CNS depression, dizziness,
diplopia, nausea, ataxia, hyponatremia, weight gain, alopecia
generic name and class
lamictal
generic: lamotrigine
class: sodium channel blocker
black box warning
lamotrigine
serious skin reactions including SJS
concimitant use with divalproex increases lamotrigine levels, which can increase the risk of serious skin reactions
generic name and class
generic: dilantin
generic: phenytoin
class: sodium channel blocker
major contraindications
phenytoin
- hypersensitivity
- sinus bradycardia
- AV block
black box warning
phenytoin
hypotension and arrhythmias with IV admin
generic name and class
depakote
generic: divalproex
class: gaba modulator
indication
divalproex
epilepsy
major contraindications
divalproex
- hypersensitivity
- hepatic disease
- urea cycle disorders
black box warnings
divalproex
- hepatoxicity
- patients with mitochondrial disease
- teratogenicity
- pancreatitis
generic name and class
luminal
generic: phenobarbital
class: gaba receptor agonist (barbiturates, antiepileptic)
major contraindication
phenobarbital
- hypersensitivity
- marked liver function impairment
- respiratory disease with evidence of dyspnea or obstruction
- personal or family history of acute intermittent prophyria
black box warning
phenobarbital
- concomitant use with opioids
- dependence and withdrawal
- abuse
generic name and class
topamax
generic: topiramate
class: glutamate blocker (antiepileptic)
major contraindications
topiramate
- hypersensitivity
- alcohol use for ER formulation 6 hrs before and after admin
generic name and class
keppra, spritam
generic: levetiracetam
class: glutamate blocker (antiepileptic)
generic name and class
sinemet/rytary
generic: carbidopa/levodopa
class: dopa decarboxylase inhibitor (antiparkinsonian)
major contraindication
carbidopa/levodopa
hypersensitivity and concurrent use with non-selective MAOIs
generic name and class
1. mirapex 2. requip
- pramipexole
- ropinirole
class: dopamine agonist (antiparkinsonian)
key counseling points
pramipexole and ropinirole
do not stop suddenly
generic name and class
cogentin
generic: benztropine
class: anticholinergic (antiparksonian)
major contraindications
benztropine
hypersensitivity and angle-closure glaucoma
generic name and class
1.relpax 2.maxalt 3.imitrex
1.eletriptan
2.rizatriptan
3.sumatriptan
class: acute migraine treatment
major contraindications
triptans
- history of stroke or transient ischemic attack
- peripheral vascular disease
- uncontrolled hypertension
generic name and class
provigil
generic: modafinil
class: CNS stimulant
indication
modafinil
narcolepsy, obstructive sleep apnea, shift work sleep disorder
major warnings
modafinil
- SJS
- TEN
- DRESS
- cardiovascular disease
- psychiatric disorders
generic name and class
1.lunesta 2.ambien/intermezzo
- eszopiclone
- zolpidem
class: nonbenzodiazepine benzodiazepine-receptor agonist hypnotic
for insomnia
black box warnings
z drugs
complex sleep behaviors (sleep walking or driving, engaging in other activites while not fully awake)
Discontinue immediately if patient experiences complex sleep behavior
generic name and class
chantix
generic: varenicline
class: partial nicotine agonist
smoking cessation aid
rare but serious ADR
CHANTIX
neuropsychiatric events (depression, suicidal thoughts)
generic name and class
adipex-p, lomaira
generic: phentermine
class: sympathomimetic; CNS stimulant
anorexiant (reduces appetite)
major contraindications
phentermine
cardiovascular disease (arrhythmias, heart failure, CAD, stroke, uncontrolled hypertension)
