Pharm: Drugs Acting on the Central and PNS: Antiseizure, Antiparkinsonism, Muscle Relaxants, Opioids/Analgesic Agents, General/Local Anesthetic Agents Flashcards
Drugs used to depress the CNS - prevents/reduces S & S of anxiety?
Anxiolytics
Former mainstay class for treatment of anxiety/for sedation/sleep induction (has many severe adverse effects and drug-drug interactions)?
Barbiturates
Class of drug acts on limbic system and reticular activating system to make GABA or gamma-aminobutyric acid (inhibitory neurotransmitter), more effective -> causing interference with neuron firing? (Depresses CNS block S&S of anxiety/cause sedation and hypnosis in higher doses)
Benzodiazepines
Ends in -LAM or -PAM?
Benzodiazepines used as anxiolytics-hypnotics
alprazolam, chlordiazepoxide, clonazepam, clorazepate, diazepam, estazolam, flurazepam, lorazepam, midazolam, oxazepam, quazepam, temazepam, and triazolam?
Benzodiazepines used as anxiolytics-hypnotics
pentobarbital, phenobarbital, secobarbital?
Barbiturates used as anxiolytics-hypnotics
Ends in -BARBITAL?
Barbiturates
AKA Xanax?
Alprazolam - anxiety, panic attacks -> make sure to taper
AKA Librium? Calms nervous system -> reduce risk of seizures, manages agitation, sootes anxiety
Chlordiazepoxide - anxiety, alcohol withdrawal, preop- anxiolytic
AKA Klonopin?
Clonazepam - panic disorders, restless leg syndrome, seizure disorders
Monitor for SI, liver function, taper after long term therapy
Different indication for clonazepam?
Restless leg syndrome
AKA Gen-Xene, Tranxene?
Clorazepate: Anxiety, alcohol withdrawal
Make sure to taper
AKA Valium?
Diazepam - anxiety, alcohol withdrawal, muscle relaxant, preoperative anxiolytic
Hypnotic, treatment for insomnia?
Estazolam, flurazepam
monitor liver/renal function, CBC if used long-term
AKA Ativan?
Lorazepam - anxiety, preanesthesia anxiolytic, insomnia d/t stress
Watch for sedation
AKA Midazolam?
Midazolam - sedation, anxiety, conscious sedation for short procedures ; continous sedation of intubated or mechanically ventilated patients
Keep resuscitation equipment close to help patient breathe PRN
Treatment for Anxiety disorders, alcohol withdrawal, hyperexcitability and agitation, and preoperative relief of anxiety and tension to aid in balanced anesthesia?
Benzodiazepines
Some adverse effects of benzos on the CNS/Peripheral?
Sedation, drowsiness, depression, lethargy, blurred vision, headaches, confusion, light-headedness
Monitor for dry mouth, N/V, constipation, inc liver enzymes; hypo/hypertension, arrhytmias, palpitations, urinary retention?
Adverse effects of benzos on GI, CV, and urinary systems
what to avoid when taking benzos?
CNS depressants - opioids and alcohol
DO NOT take with cimetidine, oral contraceptives, or disulfiram inc ben
Decreased when given with theophyllines
AKA Butisol?
Butabarbital - short term sedative/hypnotic
Can produce aggressiveness/excitability
AKA phenobarbital?
Phenobarbital - sedative-hypnotic, control of seizures, preanesthetic
Taper after long use; monitor injection sitess
CNS depressants - inhibit neuronal impulse conduction in ascending RAS, depress cerebral cortex/alter cerebellar function; causes sedation, hypnosis, anesthesia?
Barbiturates
What to watch out for in barbiturates?
CNS depression - drowsiness, solmnolence, lethargy, ataxia, vertigo
Buspirone?
Treats anxiety - Causes dry mouth, headache -> caution in hepatic/renal impairment
SEDATIVE: Dexmedetomidine?
Precedex - sedation for intubation/mechanically ventilated patients in ICU
1 mcg/kg IV over 10 min -> 0.2-0.7 mcg/kg/h w/ infusion device
Diphenhydramine?
Benadryl: Sleep aid, motion sickness, allergies -> SHORT TERM treatment for insomnia
Monitor for drying effects -> thickened respiratory secretions
Breathing difficulties
Eszopiclone?
Lunesta - Insomnia, 1 mg PO before bed
Ramelteon?
Rozerem - treatment of insomnia characterized by difficulty falling asleep
Monitor for depression and SI
Suvorexant?
Belsomra - treatment of insomnia w/ difficulty in sleep onset, and/or sleep maintenance
Tasimelteon?
Hetlioz - treatment of non-24 hour sleep-wake disorder
Zaleplon?
Sonata- short term treatment of insomnia
Zolpidem?
Ambien, intermezzo, zolpimist - short term treatment of insomnia
Can be sedating - used as preoperative medicines and postop to decrease need for narcotics?
Antihistamines: Promethazine (Promethegan), Diphenhydramine
Buspirone?
Antianxiety, anticonvulsant, muscle-relaxant
Can reduce S&S of of anxiety w/o severe effects
Amantadine, apomorphine, bromocriptine, carbidopa-levodopa, levodopa, pramipexole, rasgiline, ropinirole, rotigotine?
Dopaminergic agents
Benztropine, diphenhydramine, trihexphenidyl?
Anticholinergic agents
Entacapone, safinamide, selegline, tolcapone?
Adjunctive agents
Includes lack of coordination, rhythmic tremors, rigidity/weakness, bradykinesia (extreme slowness)?
Characteristics of parkinsons
Hallmark symptoms of parkinsonism?
Shuffling gait, drool, mask-like expression, difficulty swallowing
What causes parkinsonism?
Loss of dopamine-secreting cells -> results in loss of inhibitory dopamine effect
Amantadine?
Amantadine - Antiviral, treatment of idiopathic/drug-induced parkinsonism in adults
Apomorphine?
Apokyn - intermittent treatment of hypomobility “off” episodes of parkinsonism
Bromocriptine?
Parlodel - treatment of idiopathic parkinson dx -> beneficial after response to levodopa decreases
Carbidopa-levodopa?
Sinemet - treatment of idiopathic Parkinson dx
Levodopa?
Dopar - treatment of idiopathic Parkinson dx
