CNS stimulants, CNS depressants, anticonvulsants, Neuromusc
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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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