CNS stimulants, CNS depressants, anticonvulsants, Neuromusc
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| 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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