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CNS stimulants, CNS depressants, anticonvulsants, Neuromusc

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Question
Answer
show Brain and spinal cord  
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show stimulate the release of neurotransmitters (norepinephrine and dopamine); Adderall controls ADHD; causes euphoria and alertness  
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Amphetamines (side effects and adverse effects)   show
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show amphetamine-like drug (CNS stimulant) Trade Name: Ritalin/Ritalin SR Pregnancy Category: C Contraindications: hypersensitivity, hyper thyroidism, anxiety, history of seizures, motor tics, Tourette syndrome, glaucoma NOT to be used in children under 6  
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show Kinetics: Well absorbed from GI Half life: 1-3 hours Excretion: 40% unchanged in urine Dynamics: PO: onset = .5-1 hr; peak = 1-3 hours; duration = 4-6 hr  
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show ADHD: PO, 5 mg before breakfast and lunch Narcolepsy: PO, 10 mg, BID/TID before meals Drug interactions: may increase effects of decongestants, antiHTN, barbiturates; alter insulin Food: caffeine may increase effects  
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Methylphenidate (prototype; uses)   show
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show appetite suppressants; treat obesity; rarely prescribed; Didrex, Dexedrine, Dospan; do NOT give to children younger than 12 y.o.; nervousness, restlessness, irritability, insomnia, heart palpitations, HTN  
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Analeptics (definition, use, side effects)   show
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Doxapram (Dopram)   show
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Migraine headaches   show
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show characterized by a severe unilateral NONthrobbing pain located around EYE; NO aura, NO nausea, NO vomiting  
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Migraine treatment   show
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show 5-HT receptor agonist (antimigraine) Trade: Imitrex Pregnancy Category: C Contraindications: hypersenstivity, coronary artery disease, HTN, obesity, diabetes mel., smoking Dosage: SubQ, PO, intranasal  
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REM rebound   show
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show sedative-hypnotic; long-acting = control of seizures in epilepsy (Phenobarbital and mephobarbital) intermediate-acting = sleep sustainers for maintaining sleep (butabarbital AKA Butisol) - ASSESS VITALS  
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show short-acting = induce sleep (secobarbital AKA Seconal, pentobarbital AKA Nembutal - ASSESS VITALS ultrashort-acting = general anesthetic; thiopental sodium AKA Pentothal  
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Secobarbital sodium (prototype; drug class, contraindications, dose)   show
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Secobarbital sodium (prototype; Drug interactions, Pharmacokinetics/dynamics)   show
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Secobarbital sodium (prototype; use, side effects)   show
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Sumatriptan (prototype; pharmacokinetics/dynamics, use)   show
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Sumatriptan (prototype; side effects)   show
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Benzodiazepines (Xanax, Ativan, Restoril)   show
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Nonbenzodiazepines   show
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show benzodiazepine antagonist; reversal of sedative effects; management of benzo OD  
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show Sedative-hypnotic; non-benzodiazepine Trade: Ambien Pregnancy Category: B Contraind: allergy, lactation Dosage: PO - at bedtime Interactions: drug - decrease CNS function with alcohol, CNS depress, anticonvuls, phenothiazines; food - decreases absorp  
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Zolpidem tartrate (prototype; pharmacokinetics/dynamics, uses)   show
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Zolpidem tartrate (prototype; side effects and adverse reactions)   show
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Methylphenidate (prototype; mode of action)   show
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show causes vasoconstriction of cranial carotid arteries to relieve migraine attacks  
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show depression of the CNS, including the motor and sensory activities  
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Zolpidem tartrate (prototype; mode of action)   show
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show depress CNS, alleviate pain, and cause LOC 4 stages: analgesia, excitement/delirium, surgical, medullary paralysis (ventilation NEEDED) IV MED  
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Balanced anesthesia   show
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show block pain at the site where drug is administered; allows consciousness to be maintained Ethers or amides(low allergy incid) Synthetic cocaine = Novocain Short - .5-1 hr duration Mod - 1-3 hr Long - 3-10 hr  
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show requires local to be injected in the subarachnoid space at the 3rd or 4th lumbar space headaches may result - leaking hypotension - leaking  
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show Nerve: prevents pain at nerve ending Spinal: subarachnoid membrane (2nd layer) Epidural: outer covering (dura mater) Caudal: near sacrum Saddle: lower end to block perineal area (childbirth)  
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show lack of oxygen to brain  
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show most common; tonic - skeletal muscles contract in a spasm lasting 3-5 seconds; clonic - dysrhythmic muscular contraction, or jerkiness of legs and arms lasting 2-4 minutes; GENERALIZED  
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show brief LOC lasting less than 10 sec; usually occurs in children; fewer than 3 spike waves on EEG; GENERALIZED  
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Psychomotor seizure   show
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show Jacksonian Seizure; involves spontaneous movement that spreads, can develop into generalized seizure; PARTIAL - SIMPLE  
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Anticonvulsants   show
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show anticonvulsant, hydantoin Trade: Dilantin Preg Category: D Contraindications: allergy, heart block, psychiatric disorders, pregnancy Dosage: PO and IV (loading dose) Theraputic range: 10-20 mcg/ml Toxic: 30-50 mcg/ml  
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Phentoin (prototype; pharmacokinetics/dynamincs)   show
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show Drug: decreased with folic acid, calcium, antacids Decreases effects of: anticoag, oral contra, antihist, corticoster, dopamine Food: decreased adsorption  
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Phentoin (prototype; uses; side effects and adverse effects)   show
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show reduces motor cortex activity by altering transport of ions  
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Status epilepticus   show
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Succinimides   show
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show treat petit mal seizures; Trimethadione was first drug developed; many severe side effects  
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show treatment of manic episodes in bipolar disorders  
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Benzodiazepines (as an anticonvulsant)   show
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Anticholinergics   show
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show antiparkinson: dopaminergic Trade: Sinemet Pregnancy Category: C Contraindications: narrow-angle glaucoma, severe cardiac, renal or hepatic disease Dosage: PO - ratio of 10 carb/100 levo; extended release - 5 carb/200 levo  
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Carbidopa-levodopa (prototype; interactions, use)   show
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show Pharmacokinetics: PO - well absorbed; carbidopa 36% protein bound, levodopa is unknown; t1/2 = 1-2 hrs; excreted in urine as metabolites Pharmacodynamics: PO - onset = 15 min; peak = 1-3 hrs; duration = 5-12 hrs  
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Carbodopa-levodopa (prototype; side effects, adverse effects)   show
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show transmission of levodopa to brain cells for conversion to dopamine; carbidopa blocks the conversion of levodopa to dopamine in the peripheral nervous system  
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show stimulate the dopamine receptors ex: Amantadine (high tolerance); can be used for drug induced parkinsonism  
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show the enzyme monoamine oxidase-B (MAO-B) causes catabolism of dopamine; selegILINE inhibits MAO-B - prolongs action of levodopa ex: RasagILINE (Azilect)  
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show enzyme catechol-O-methyltransferase (COMT) inactivates dopamine; when taken c levodopa - increase amount of levodopa concentration in the brain  
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show tacrine (Cognex); donepezil (Aricept); rivastigmine (Exelon); permits more acetylcholine in the neuron receptors; used for Alzheimer's disease  
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show acetylcholinesterase inhibitor Trade: Cognex Contra: liver/renal diseases Dosage: PO qid Interactions: increse ALT, AST  
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show Pharmacokinetics: PO - food decreases absorb rate; 50% pro bnd; t1/2 = 3 hrs; excreted in urine Pharmacodynamics: onset = .5 hr; peak = 2 hrs; duration = 24-36 hrs Use: improves memory loss  
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Tacrine (prototype; side effects, mode of action)   show
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Myasthenia gravis (MG)   show
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Multiple sclerosis (MS)   show
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show severe generalized muscle weakness and may involve the muscles of respiration; stress or inadequate dosing of AChE inhibitors can trigger  
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show overdoing AChE inhibitors Symptoms: miosis (pupil constriction; abnormal), pallor, sweating, vertigo, excess salivation, naus, vomit, ab crmping,diarrhea, bradycardia, involun muscle twitching  
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AChE inhibitors for MG   show
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Pyridostigmine bromide (prototype; drug class, contraindications, interactions)   show
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show PO, sustained-release PO, IM/IV, adults and children Use: control and treat myasthenia gravis Mode of action: transmission of neuromuscular impulses by preventing destruction of acetylcholine  
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show Pharmacokinetics: PO - poorly absorbed, Sustained-release - 50%; t1/2 = PO - 3.5-4 hrs, IV - 2 hrs; excreted in urine by liver Pharmacodynamics: IV, IM, PO, PO - SR (quickest to slowest onset); PO SR has longest duration; all peaks are unknown  
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show Side effects: naus, vomit, diarrhea, hdache, dizzi, ab cramps, excess saliva, sweating, rash, miosis Adverse effects: hypotension, bradycardia, urticaria  
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show histamine blockers, idomethacin (an NSAID) and beta-blockers  
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show Centrally acting muscle relaxants Trade: Soma, Sopropol Pregnancy category: C Contraindications: severe liver or renal disease Dosage: PO bedtime Interactions: increase CNS depression c alcohol, narcotics, sedative-hypnotics, antihistamines, antidepr  
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show Pharmacokinetics: PO - absorbs well; t1/2 = 8 hrs; excreted in urine Pharmacodynamics: PO, onset = 30 mins, Peak = 3-4 hrs, duration = 4-6 hrs  
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Carisoprodol (prototype; mode of action; side effects; adverse effects)   show
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