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my-linh's review > Central Nervous System Agents > Flashcards

Central Nervous System Agents Flashcards

1
Q

Phenytoin

A
  • Anti-seizure (partial, generalized, tonic-clonic).
  • Decreases sodium and calcium ion flow.
  • SE: Nystagmus, gingival hyperplasia, drug-induced lupus, fetal hydantoin.
  • Induces cytochrome P-450.
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2
Q

Lamotrigine

A
  • Anti-seizure, mood disorders, and depression.
  • Blocks fast VG Na+ channels at the presynaptic neuron.
  • SE: Steven Johnson Syndrome.
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3
Q

Valproic Acid

A
  • Anti-seizure and Bipolar Disorder (Mania)
  • Increase GABA and reduce Na+ and K+ conduction (hyperpolarization)
  • Hepatoxicity and NTD (teratogen)
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4
Q

Ethosuximide

A

-Absence seizures

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5
Q

Carbamazipine

A
  • Partial seizures, trigeminal neuralgia
  • Inhibits flow of Na+
  • SE: hepatotoxicity, agranulocytosis, and aplastic anemia.
  • Induce CYP450
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6
Q

Buspirone

A
  • Generalized anxiety disorder
  • 5’HT presynaptic partial agonist
  • Slow onset of action
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7
Q

Smoking Cessation Agents (Bupropion and Varenicline)

A
  • Bupropion: Smoking cessation and depression. Inhibit the reuptake of NE and DA (together inhibits reward loop), nicotinic agonist. Psychosis, reduces threshold for seizures, dry mouth.
  • Varenicline: Smoking cessation. Partial agonist and antagonist at nicotinic acetylcholine receptors.
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8
Q

Sumatriptan

A
  • Migraine and cluster headaches
  • Stimulates the 5’HT receptors; vasoconstiction of intracranial vessels.
  • SE: Coronary vasospasm; contraindicated in patients with CAD
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9
Q

Memantine

A
  • Severe Alzheimer
  • NMDA receptor antagonist; reduce glutamate (neuronal excitation)
  • SE: CNS effects
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10
Q

Tramadol

A
  • Pain
  • Weak mu receptor agonist
  • SE: Seizures; respiratory depression.
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11
Q

Butorphanol

A
  • Pain and migraines (intranasal)
  • Agonist at kappa, mixed agonist and antagonist at the mu receptor.
  • SE: withdrawal with sudden cessation.
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12
Q

Opiods (General)

A
  • Morphine, codeine, dexmethorphan, hydrocodone, oxycodone, heroin, fentanyl.
  • Pain
  • Binds to opiod receptors -> hyperpolarization and decreased activity of neural cells.
  • SE: Cardiac and respiratory depression, constipation.
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13
Q

Opiod Overdose or Withdrawal Treatment

A
  • Overdose: Naloxone or Naltrexone.

- Withdrawal: Methadone, Butorphanol+ Naltrexone

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14
Q

General Intravenous Anesthetic Agents (List them out).

A

-Propofol (GABA), Etomodate (GABA), Ketamine (NMDA antagonist), Benzos, Barbs, and Opiods.

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15
Q

Halothane and the “-Fluranes”

A
  • General Inhaled Anesthetics; decrease neuronal activity
  • SE: myocardial and respiratory depression. Halothane fulminant hepatic necrosis, cardiac arrhythmias. Methoxyflurane and enflurane: nephrotoxicity.
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16
Q

Local Anesthetics Agents (Two “I’s” = Amides, and Esters)

A
  • Prociaine, Cocaine, Tetracaine, Benzocaine.
  • Bupivicaine and Lidocaine. (AMIDES)
  • Block sodium channels. For minor surgical procedures.
  • SE: Seizures. Cocaine (HTN and cardiac arrhythmias).
  • Other: Give with Epinephrine to constrict vessels (a1 agonist) to keep drug localized the the region.
17
Q

Pancuronium and “urium, nium, ium”

A
  • Adjunct to general anesthesia induction.
  • Non-depolarizing nicotinic NMJ blocker.
  • SE: Hypotension; Effects can be reversed with administration of cholinesterase inhibitor (Neostigmine to increase ACh at the junction).
18
Q

Levetiracetam

A
  • Partial seizures, myoclonic seizures, and tonic-clonic seizures.
  • Binds to synaptic vesicles to interrupt nerve conduction.
  • SE: Drowsiness and depression.
19
Q

Vigabatrin

A
  • Infantile spasms in children and adjunct for refractory complex partial seizures.
  • Irreversibly inhibits GABA transaminase.
  • SE: Visual field constriction and visual loss.
20
Q

Tiagabine

A
  • Partial seizures

- Inhibit the reuptake of GABA

21
Q

Topiramate

A
  • Epilepsy, migraines, and mood disorders.

- Blocks Na+ and agonist at the GABA receptors.

22
Q

Typical Anti-Psychotic Agents

A
  • Haloperidol and Fluphenazine
  • Positive symptoms of schizo, Tourette, and Delirium and Agitation.
  • Blocks D2 receptors mainly.
  • SE: Sedation, anti-cholinergic side effects, EPS (due to DA blockade). Increase prolactin -> galactorrhea and amenorhea. Neuroleptic malignant syndrome.
23
Q

Heterocyclic Anti-Depressants

A
  • Nefazodone, mirtazapine, venlafaxine, and maprotiline.
  • Depression and generalized anxiety.
  • Blocks NE and 5’HT reuptake.
  • SE: sedation
24
Q

Tricyclic Anti-Depressants

A
  • Despiramine, nortriptyline, imipramine, amytriptyline, and Doxepin, Amoxapine.
  • Depression, enuresis (involuntary urination by children) and chronic pain syndromes.
  • Blocks reuptake of NE and 5’HT.
  • SE: Sedation (blocks H1), postural hypotension (adrenergic receptor blockade), anti-cholinergic effects (urinary retention, blurred vision, constipation, and dry mouth), Trazo”bone” -> priapism.
  • Dont use with MAOI. Overdose can widened QRS complex).
25
Q

SSRIs

A
  • Fluoxetine, Paroxetine, Sertraline, Fluvoxamine, Escitalopram, and Citalopram.
  • Depression, anxiety, OCD, eating disorders, PTSD.
  • Sexual dysfunction, loss of appetite and weight loss. Serotonin Syndrome. Fluoxetine inhibits CYP450.
26
Q

Pregabalin

A
  • Neuropathic pain and fibromyalgia.

- Dizziness.

27
Q

Gabapentin

A
  • Postherprtic neuralgia, neuropathic pain, and partial seizures.
  • Peripheral Edema.
28
Q

Atypical Anti-Psychotics

A
  • Clozapine, Risperidone, Olanzapine, and Quetiapine
  • Positive and negative Sx of Schizo. Delirium.
  • Block both 5’HT and DA receptors.
  • SE: Clozapine: agranulocytosis.
  • Fewer EPS and anti-cholinergic side effects.
29
Q

Benzodiazepines

A
  • “-zolams and zopams”. Lorazepam and Ozazepam for the OLd.
  • Anxiety, seizures, status epilepticus, muscle spasms, alcohol withdrawal, and anesthetics.
  • SE: sedation
  • Experience withdrawal symptoms. Overdose: tx with flumazenil.
30
Q

Barbiturates

A
  • “-barbitals” and Thiopental.
  • Sedative for anxiety and insomnia, thiopental for induction of anesthesia, and management of seizures.
  • SE: Induce cytochrome 450; experience withdrawal symptoms; overdose of barbiturates.
31
Q

Succinylcholine

A
  • Muscle paralysis for endotracheal intubation
  • Competes with ACh to reversibly bind to nicotinic receptors.
  • SE: Malignant hyperthermia, tx with Dantrolene.
32
Q

Levodopa

A
  • Parkinsonism (loss of DA neurons in basal ganglia)
  • Converted to dopamine in brain by DOPA-decarboxylase.
  • SE: dyskinesia, cardiac arrhythmias (peripheral conversion of levodopa to dopamine).

Bromocriptine (partial dopamine agonist).
Amantadine (DA agonist), MAO B Inhibitor- Selegiline.

33
Q

MAOI

A
  • Tranylcypromine, Phenelzine, and Isocarboxazid.
  • Atypical depression. Selegiline for Parkinsons.
  • MAO A I (block NE and 5’ HT), MAO B I (blocks DA)
  • SE: Hypertensive crisis with tyramine-containing foods.
34
Q

Lithium

A
  • Bipolar disorder; mood disorders.
  • Inhibit phosphoinositol second messenger cascade.
  • SE: LMNOP- Movements, nephrogenic insipidus, and hypOthyroidism, ebstein anomaly.
35
Q

Zolpidem

A
  • Short term tx of insomnia
  • GABA receptor agonist and decreased activity of CNS neurons.
  • Mild anterograde amnesia. Hallucinations.

my-linh's review (4 decks)

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