Leftover CNS

Question 1

drug for muscle spasm

Answer 1

cyclobenzaprine

Question 2

what is a muscle spasm?

Answer 2

involuntary contraction of muscle group

Question 3

non-pharmacological treatment for muscle spasms

Answer 3

heat pack, ice massage, whirlpool

Question 4

pharmacological treatment for muscle spasms

Answer 4

acetaminophen
NSAIDs
Muscle Relaxants

Question 5

prototype for muscle relaxant

Answer 5

cyclobenzaprine (Flexaril, Flexmid)

Question 6

1st drug of choice for muscle relaxant

Answer 6

cyclobenzaprine

Question 7

how does cyclobenzaprine work?

Answer 7

• works in brainstem to cause muscle relaxation W/O MUSCLE WEAKNESS
• decrease tonic motor activity

Question 8

side effects of cyclobenzaprine

Answer 8

CNS effects:

• drowsiness
• dizziness
• fatigue

Question 9

What should you avoid with cyclobenzaprine?

Answer 9

risk of additive effect:

• alcohol
• other CNS drugs

Question 10

Considerations for long term use with cyclobenzaprine?

Answer 10

• CNS effects decrease with continued use due to increase tolerance
• physical dependence –> wean off slowly

Question 11

Is cyclobenzaprine used postoperatively?

Answer 11

-used in multimodal pain protocol for ABD surgery

Question 12

what is spasticity?

Answer 12

heightened muscle tone

Question 13

causes of spasticity?

Answer 13

multiple sclerosis, cerebral palsy

Question 14

CNS drug for spasticity?

Answer 14

baclofen (Lioresal)

Question 15

How does Baclofen work?

Answer 15

decrease spasticity W/O MUSCLE WEAKNESS

Question 16

side effects of baclofen

Answer 16

CNS effects:

• drowsiness
• dizziness
• weakness
• fatigue

Question 17

what to avoid with baclofen?

Answer 17

risk of additive effects:

• alcohol
• other CNS drugs

Question 18

considerations with long term use of Baclofen?

Answer 18

• CNS effects decrease with continued use due to increase tolerance
• physical dependence –> wean off slowly

Question 19

initial dose of baclofen needs to be….. why?

Answer 19

start low and slow!

-too high of a dose initially can lead to RESP DEPRESSION, COMA

Question 20

what are characteristics of ADHD?

Answer 20

inattention, hyperactivity, impulsivity

Question 21

drug therapy goals for treating ADHD

Answer 21

• increase attention span
• improve focus/concentration
• ->does not get rid of negative behaviors but increase positive behaviors

Question 22

2 types of ADHD meds

Answer 22

stimulant

non-stimulant

Question 23

stimulant med for ADHD treatment

Answer 23

methylphenidate (concerta)

Question 24

which is 1st line of therapy for ADHD treatment- stimulant or non stimulant?

Answer 24

stimulant

Question 25

onset of action from stimulant ADHD meds?

Answer 25

immediate benefit

Question 26

Duration of action for stimulant ADHD drugs

Answer 26

only works 2-3 years

Question 27

how does methylphenidate (concerta) work?

Answer 27

promotes norepinephrine and dopamine release AND inhibits reuptake --> increase NE/Dopamine in synaptic cleft --> increase action of those neurotransmitters

Question 28

What schedule drug is methylphenidate? what does that result in?

Answer 28

Schedule II controlled substance | --> difficulty w/refills, potential for abuse

Question 29

what are side effects of methylphenidate?

Answer 29

- insomnia - decrease appetite - growth suppression - headache - abdominal pain

Question 30

what time of day do you need to take methylphenidate dose (s)?

Answer 30

1X daily = take in AM to prevent insomnia | BID = take 2nd dose before 4PM

Question 31

formulation options for methylphenidate?

Answer 31

- sustained release - immediate release - once daily dosing

Question 32

what is second line therapy for ADHD? stimulant or nonstimulant?

Answer 32

non stimulant : atomoxetine (strattera), alpha 2 adrenergic agonist

Question 33

How are non stimulant drugs more effective?

Answer 33

use in combination therapy with stimulant and other treatments

Question 34

non stimulant ADHD drug therapy:

Answer 34

atomoxetine (strattera) | alpha 2 adrenergic agonist

Question 35

how does Atomoxetine fxn?

Answer 35

inhibit norepinephrine reuptake | --> takes 1-3 weeks for full effect b/c adaptive change in brain needs to occur

Question 36

onset of action for atomoxetine:

Answer 36

takes 1-3 weeks for full effect b/c adaptive change in brain needs to occur

Question 37

is atomoxetine a controlled substance?

Answer 37

nope

Question 38

side effects of atomoxetine?

Answer 38

-gi* -decrease appetite* CNS: -dizziness -somnolence -modd swings -trouble sleeping

Question 39

which CNS non stimulant can cause suicidal thoughts in kids?

Answer 39

atomoxetine

Question 40

how do Alpha 2 Adrenergic Agonists work?

Answer 40

reduce sympathetic outflow from brain

Question 41

2 alpha 2 adrenergic drugs to know:

Answer 41

Guafacine (BP med) | Clonidine (treats drug abuse)

Question 42

what is Guafacine?

Answer 42

BP med used as ADHD non stimulant medication in class Alpha 2 Adrenergic Agonist

Question 43

What is clonidine?

Answer 43

Alpha 2 Adrenergic Agonist in ADHD Non stimulant category | -also used to treat drug abuse

Question 44

Side effects of Alpha 2 Adrenergic Agonist?

Answer 44

hypotension