Pharmacology-- CNS Flashcards
TOMS
Short-acting BDZs:
Triazolam
Onazelam
Midazolam
Butyrophenone
Derivatives include: Haloperidol & droperidol
Atypical D4
Clozapine-Thiroidazine-Olanzepine-Risperidone= Do not cause EPS
Flumazenil
BDZ antidote for OD
Methylphenidate
Tx for ADHD (trade name Ritalin)
mech: NE/DA reuptake inhibitor
Phenytoin
Antiepileptic, stabilizes the inactive state of voltage-gated Na-channels.
Causes aplastic anemia, gingival hyperplasia, cleft lip & palate
Zero order clearance
Thiopental
Short acting barbiturate
Carbamazepine
DOC for trigeminal neuralgia
Tx lennox gastaut syndrome in kids
tradename: tegretol (also used for BP)
Atypical DA antagonists
Thioridazine, Olanzapine, Clozapine
Pimozide
antipsychtoic, DA-antagonist
Tx Tourette’s, scz
Risperidone
Atypical antipsychotic, good for negative sx
Thioridazine
Most anticholinergic of the neuroleptics
atypical antipsychotic
Haloperidol
Typical antipsychotic
Neuroleptic malignant hyperthermia due to chronic DA-2R block. Give dantrolene and bromocriptine to tx
Imipramine
TCA
Tx: Enuresis
Clomipramine
TCA
Tx: OCD
See aggressive behavior w/ use
Trazodone
SARI – 5HT antagonist & reuptake inhibitor
May cause PRIAPISM
Buproprion
NE-DA reuptake inhibitor
Depression and smoking cessation**
SSRIS
MDE & OCD
Fluoxetine
SSRI
“good for negative sx”…the fuck does that mean?
Phenelzine
Irreversible MAO-I
Lithium
Tx: manic phase of BP
SEs:Causes goiter by inhibiting conversion of T4 to T3;Causes nephrogenic DI (thus can be used to tx SIADH);Low salf diet will lead to Li tox
Alprazolam
Short acting benzo
Tx: anxiety d/os (social phobia, PD, GAD, etc)
Propranolol
Nonselective beta-blocker
tx: performance anxiety
opioid kappa-receptor (κ-r)
Spinal analgesia. Euphoria. ++euphoria. ++sedation. Constipation.
Per wikipedia: analgesia, sedation, miosis, inhib. of ADH release, dysphoria
opioid mu-receptor (μ-r)
supraspinal analgesia?
μ1: analgesia,physical dependence
μ2: respiratory depression,miosis, euphoria, red.GI motilityphysical dependence
μ3: possible vasodilation
Morphine & O2
Admin. is contraindicated for pt.s on morphine.
Sedation: Dec. CO2 sensitivity, and O2 admin can lead to dec. resp drive–> stop breathing
Morphine
Opioid analgesic, acts predom. at mu-receptor
Inc ICP= do NOT give to pt w head trauma!
Morphine OD
Signs: pin-point pupils, Dec. respiration, coma
Tx: Naloxone
Meperidine
Mu receptor agonist, some kappa activity
Anesthetic used during labor
aka Demerol
Hydromorphone
mu-r agonist (morphine deriv)
used in renal failure…why? it’s cleared renally
Tramadol
Ambulatory tx for mod-severe pain
Mech:weak μ-r agonist, induces 5HT release, and inhibits the reuptake of NE
Naloxone
Tx for Opiod OD, opiate R antagonist
Reverses respiratory dep
Used in suboxone–> no oral availability
Pentazocine
“mixed agonist-antagonist narc”–>Part κ(+) & part μ(-)
Tx: pain
Butorphanol
Part κ(+) & part μ(-)
Intranasal for migraine, oral for pain
Nalbuphene
Part κ(+) & part μ(-)
Inc GABA
Decrease seizure focus = barbs and benzos
Decreased Fast Na Channel Activity
Dec electrical activity spread= phenytoin & carbamazepine
Methoxyflurane
Volatile inhaled anesthetic
Can be nephrotoxic. Needs low MAC (min. alveolar concen.) for anesthetic induction
Enflurane
Volatile inhaled anesthetic
Can be nephrotoxic
Can cause tonic/clonic muscle spasms
Isoflurane
Volatile inhaled anesthetic
can cause bronchospasm
Halothane
Volatile inhaled anesthetic
Can cause ventricular extrasystoles & Malignant hyperthermia & Hepatitis
Nitrous Oxide
Volatile inhaled anesthetic (N2O…NOT NO!!)
No effect on HR. Needs High MAC for anesthetic induction
Thiopental
Short acting barb
Ketamine
Dissociative anesthetic
Droperidol
Can be used in combo w fentanyl for neuroleptoanalgesic effect
Used transdermally for chronic pain
Anti-DA drug
Fentanyl
Can be used in combo w Droperidol for neuroleptoanalgesic effect. Neuroleptic tranq, has mild alpha block
Midazolam
pre-anesthetic. Induces amnesia
Primidone
Biotransformed to phenobarb
C& A delta fibers
first fibers to be blocked w anesthesia
Esters
Local anesthetics
Procaine, Tetracain, benzocaine. Break down and yield PABA (allergen)
“caines” are locals
Amides
Local anesthetics
Lidocaine, Mepivaciane, Bupivaciane, Etidocaine= i before caine always an amide
metabolized in the liver
Amphetamine
DA reuptake inhibitor. MAOI,
Parkinson’s Tx
Bromocriptine
D2 agonist. Used w L-Dope for “on-off” phenomenon in Parkinson’s
Benzotropine
Anti muscarinic w some Da reuptake inhibition. Tx: Parkinson’s
Amantadine
Dec Da reuptake centrally. Tx: Parkinson’s
Can cause livido reticularis = skin mottling
Diphenhydramine (DPH)
First gen anti-histamine,
Tx: early parkinson’s for antichoinergic effects
Rxed for sleep disturbance
Pergolide
More effective and longer acting than bromocriptine for Pd. DA and 5HT agonist
WITHDRAWN FROM US MARKET IN 2007
(no ergoline derivs on market)
Ethosuximide
DOC for absence seizures
Mech poorly understood
Tranylcypromine
MAOI
SSRI & MAOI
fatal combo, especially w Paroxetine or fluoxetine plus tranylcypromine
Labor opioids
Meperidine and nalbuphine
Desipramine
TCA
Causes sudden cardiac death in children!