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CNS stimulants, CNS depressants, anticonvulsants, Neuromusc

Quiz yourself by thinking what should be in each of the black spaces below before clicking on it to display the answer.
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Question
Answer
show Brain and spinal cord  
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Amphetamines   show
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show restlessness, insomnia, tachycardia, HTN, heart palpitations, dry mouth, anorexia, weight loss, diarrhea, constipation, impotence  
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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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show correct hyperactivity caused by ADHD, increase attention span, treat fatigue, and control narcolepsy  
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Anorexiants (definition, use, side effects)   show
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Analeptics (definition, use, side effects)   show
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Doxapram (Dopram)   show
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show characterized by a unilateral throbbing HEAD pain c nausea, vomiting, photophobia; caused by inflammation and dilation of blood vessels in cranium; etiology unknown; classic = aura, common = no aura  
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Cluster headaches   show
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show analgesics, opioid analgesics, ergot alkaloids, selective serotonin (5-HT) receptor agonists; MILD - aspirin, acetaminophen or NSAIDs; Demerol or Stadol NS  
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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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show results in vivid dreams and nightmares; frequently occurs after taking a hypnotic for a prolonged period then abruptly stopping; it MAY occur after one hypnotic dosage  
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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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show sedative-hypnotic: barbiturate Trade: Seconal Sodium Pregnancy Category: D Contraindications: resp depression, severe hepatic disease, pregnancy, nephrosis, hypersensitivity Dosage: Sed - PO, Hyp - PO at bedtime, preop - PO 1-2 hr before  
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Secobarbital sodium (prototype; Drug interactions, Pharmacokinetics/dynamics)   show
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show treats insomnia; used for sedation, preop medication Side effects: lethargy, drowsiness, hangover, dizziness, paradoxical excitement in elderly  
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show Pharmacokinetics: rapid absorp following subQ; 10-20% protein bound; t1/2 = 2 hrs; excretion in urine and feces Pharmacodynamics: onset quicker with subQ than PO peak 2-4 hrs c both; duration unknown treat migraine and cluster headaches  
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show dizziness, fainting, tingling, numbness, warm sensation, drowsiness, muscle cramps, nausea, vomiting, diarrhea, abdom cramping Adverse reactions: hypotension, HTN, heart block, angina, dysrhythmias, thromboembolism, seizures, CNS hemorrhage, stroke  
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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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Zolpidem tartrate (prototype; drug class, contraindications, dosage, interactions)   show
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show pharmacokinetics: PO, 79-96% protein bound; t1/2 = 2-2.5 hrs; excreted in bile, urine, feces pharmacodynamics: PO; onset = 7-27 min; peak = .5-2.3 hrs; duration = 6-8 hrs uses: treat insomnia  
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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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Secobarbital sodium (prototype; mode of action)   show
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show depression of CNS, neurotransmitter inhibition  
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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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show a hypnotic given the night before, premed c narcotic analgeic or benzodiazepine + anticholinergic, short acting barb, inhaled gas, muscle relaxant * minimizes CV problems, decreases amount of gen anesth. needed, decreases pain; QUICKER RECOVERY  
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Anesthetics (local)   show
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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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Blocks (nerve, spinal, epidural, caudal, saddle)   show
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show lack of oxygen to brain  
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Grand mal (tonic-clonic) seizure   show
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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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show complex symptoms - automatisms (repetitive behaviors), behavioral changes, motor seizures; PARTIAL - COMPLEX  
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Motor seizure   show
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show used for epileptic seizures; AKA Antiepileptic drugs (AEDs); suppress the abnormal electric impulses from the seizure focus to other cortical areas - prevents seizure but does not eliminate cause; CNS depressant  
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Phenytoin (prototype; drug class, contraindications, dose)   show
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show pharmacokinetics: PO - slow; IM - erratic; 85-95% protein bound; t1/2 = 6-45 hrs (22); excreted in urine (small), bile/feces (mod) Pharmacodyamics: PO - onset = .5-2 hr, peak = 1.5-3 hr, duration = 6-12 hr; IM - onset = 1 min-1 hr  
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Phentoin (prototype; interactions)   show
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show prevent tonic-clonic (grand mal) and complex partial seizures (psychomotor) Side fx: headache, diplopia, confus, dizzi, sluggishness, decreased coord, slurred spch, rash, anorexia, naus, vomit, red-brwn colored urine Adverse: depress, gingival hyrplasia  
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Phentoin (prototype; mode of action)   show
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show rapid succession of epileptic seizures; treated c phenobarbital, a long-acting barbiturate  
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show used to treat absence or petit mal seizures; acts by decreasing calcium influx thru the t-type Ca channels Ethosuximide (Zarontin)  
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show treat petit mal seizures; Trimethadione was first drug developed; many severe side effects  
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Divalproex sodium (Depakote)   show
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Benzodiazepines (as an anticonvulsant)   show
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show reduce rigidity in Parkinsonism; inhibit the release of acetylcholine; contraindicated if pt has glaucoma DRY YOU UP  
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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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show Drug: increase HTN crisis c MAOIs; decrease levodopa effect c anticholinergics Lab: may increase BUN, AST, ALT, ALP, LDH Food: avoid foods c vitamin B6 Use: treat parksinsonism; relieve tremors and rigidity  
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Carbodopa-levodopa (prototype; pharmacokinetics/dynamics)   show
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Carbodopa-levodopa (prototype; side effects, adverse effects)   show
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Carbidopa-levodopa (prototype; mode of action)   show
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show stimulate the dopamine receptors ex: Amantadine (high tolerance); can be used for drug induced parkinsonism  
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MAO-B inhibitor (-ILINE)   show
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COMT inhibitors (-CAPONE)   show
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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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Tacrine (prototype; pharmacokinectics/dynamics, use)   show
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Tacrine (prototype; side effects, mode of action)   show
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show lack of nerve impulses and muscle responses at the myoneural junction Causes: fatigue and muscular weakness of the resp system, facial muscles and extremities Etiology: inadequate secretion of ACh or loss of ACh  
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show attacks myelin sheath of nerve fiberws, causing lesions (plaques)  
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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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Cholinergic crisis   show
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show neostigmate (Prostigmin): short-acting; t1/2 = .5-1 hr; PO q2-4hr pyridostigmine bromide (Mestinon): intermed action; PO q3-6 hrs ambenonium chloride (Mytelase): long-acting; only given if above don't work  
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show cholinesterase inhibitor Trade: Mestinon Preg Category: C Contra: GI and GU obstruction, severe renal disease Interactions: decreased effect c atropine, muscle relaxants, antidysrhythmics, magnesium  
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Pyridostigmine bromide (prototype; dosage, use, mode of action)   show
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Pyridostigmine bromide (prototype; pharmacokinetics/dynamics)   show
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Pyridostigmine bromide (prototype; side effects and adverse reactions)   show
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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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Carisoprodol (prototype; pharmacokinetics/dynamics)   show
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show Mode of action: blocks interneuronal activity Side effects: naus, vomit, dizziness, weakness, insomnia Adverse reactions: asthmatic attack, tachycardia, hypotension, diplopia  
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