CNS Stimulants - Lichtblau Flashcards Preview

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Flashcards in CNS Stimulants - Lichtblau Deck (20):
1

CNS effects of sympathomimetics?

Increased alertness/wakefulness
Initiative, confidence, and alertness
Increased motor and speech
Decreased food consumption
Stimulate respiration (rate and depth)

*Greatest effect seen if fatigue or lack of sleep is present

2

What kind of toxicity do you get with acute and chronic sympathomimetics use?

Acute: exaggerated therapy effects
- Cardio - headaches, arrythmia, palpitations, anginal pain, hyperthermia
- CNS - dizziness, agitation, confusion, insomnia, seizures, coma
- Treatment - Antipsychotic & Acidify patient urine

Chronic: Amphetamine psychosis
-hallucinations, delusions, and compulsions
-marked weight loss
-drug screen
-symptoms will resolve in 7-10 days

3

Do Sympathomimetics work for weight loss?

Yes, sort of. BUT very high abuse potential

4

What are a couple really good therapeutic uses for sympathomimetics?

ADHD
Narcolepsy

5

What are the three main mechanisms of action of cocaine?

Blocked reuptake of norepinephrine - motor
Blocked reuptake of dopamine - euphoria
Local anesthetic properties

6

Cocaine toxicity?

Cardiac arrythmia
Thombosis (coronary and cerebral)
In-utero brain development damaged

7

Ecstasy (MDMA) is derived from methamphetamine. How is it altered to change its effects?

A methyl group is added to increase lipophilicity and allow it to rapidly enter the brain

8

How does ecstasy(MDMA) act differently than amphetamines in its mechanism?

Stimulates the release and inhibits the reuptake of serotonin

9

Besides acting on serotonin, what does ecstasy affect?

Stimulates release and inhibits reuptake of epinephrine, noreprinephrine, and dopamine

10

What are bath salts and how are they abused?

They often contain various amphetamine-like chemicals: Methylenedioxypyrovalerone, Mephedrone

ACt as stimulants on brain. High abuse and addiction liability. (cocaine substitute?)

11

Toxicity with bath salts?

Chest pains, increased heart rate and BP, agitation, hallucinations, paranoia, delusions

12

Most commonly used xanthine?

Caffeine

13

Caffeine effects on CNS?

Stimulates cerebral cortex: (1st affected)
-clearer thoughts, less fatigue, mental dexterity

Medullary centers: (2nd affected)
-respiration and vasomotor center

Spinal cord (very large dose)
-hyperreflexia

14

Apart from acting on the CNS, what kind of crazy stuff could that starbucks be doing to you?

Increased cardiac output
Possible arrythmias
Skeletal Muscle stimulation
Diuretic
Relax Smooth muscle

15

Proposed mechanisms?

Removes intracellular Ca from sarcoplasmic reticulum
Inhibits phosphodiesterase and leads to elevated levels of cAMP
Nonselective adenosine receptor antagonist, which stops sleepiness-inducing adenosine

16

Toxicity of doses of caffeine, starting at about 1gm:

CNS - Insomnia, excitement, mild delirium, sensory disturbances, convulsions
Cardio - Increased HR and respiration, decreased clotting
Gastric - secretions increased

17

Therapeutic uses of caffeine?

Cardiac stimulation in congestive heart failure...Controversial

Analeptic - stimulates CNS
Bronchial asthma
Add to ergot alkaloids for migraines

18

What is modafinil used for?

Treating narcolepsy, shift-sleep disorder, excessive sleepiness from sleep apnea
ADHD

19

Modafinil mechanism of action:

Increases dopamine release, blocks its reuptake
Increase NE release
Increase 5HT release

Elevates hypothalamic histamine levels
Activates glutamtergic circuits
Inhibits GABA-ergic transmission

20

Adverse effects of modafinil?

Headache
Nausea
Insomnia
Lack of appetite
Dizziness
Agitation
Anxiety
High blood pressure

Severe skin rash