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Neuro Flashcards

1
Q

Centrally acting muscle relaxants
Indication

A

Treat muscle spasms from spinal cord injury, MS, CP, or injury

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2
Q

Centrally acting muscle relaxants
Prototype

A

Baclofen (Lioresal)

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3
Q

Centrally acting muscle relaxants
MOA

A

Enhance inhibitory effects of GABA on spinal cord, which suppresses hyperactive reflexes

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4
Q

Centrally acting muscle relaxants
Major adverse effects

A

Drowsiness, dizziness, muscle weakness, constipation, withdrawal symptoms if stopped suddenly (anxiety, hallucinations, seizures)

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5
Q

Centrally acting muscle relaxants
administration

A

-PO with lowest effective dose and gradual increase
-Give with food or milk
-Can give via intrathecal infusion into spine too

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6
Q

Centrally acting muscle relaxants
Safety

A

-Rhabdomyolysis due to abrupt discontinuation from intense muscle contractions, kidney damage ensues
-avoid alcohol

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7
Q

Centrally acting muscle relaxants
Contraindications

A

Hypersensitivity
MAOIs within past 2 weeks = CNS depression
CVA or seizure disorder

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8
Q

Peripherally acting muscle relaxants
Indication

A

relax skeletal muscle spasms from CVA, spinal cord injury, MS, and CP
Prevent malignant hyperthermia

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9
Q

Peripherally acting muscle relaxants
Prototype

A

Dantrolene (Dantrium)

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10
Q

Peripherally acting muscle relaxants
MOA

A

Inhibit release of calcium from muscle cells, which inhibits muscle contraction
Reverses malignant hyperthermia in IV form

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11
Q

Peripherally acting muscle relaxants
Adverse effects

A

Drowsiness, dizziness, muscle weakness, diarrhea
Liver toxicity

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12
Q

Peripherally acting muscle relaxants
Admin

A

PO or IV
(IV for malignant hyperthermia)

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13
Q

Peripherally acting muscle relaxants
Contraindications

A

Liver disease

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14
Q

Peripherally acting muscle relaxants
Safety

A

-Use with alcohol and other CNS depressants = resp depression
-use with estrogen = liver toxicity

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15
Q

Hydantoins (AED)
Indication

A

Control tonic-clonic seizures

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16
Q

Hydantoins (AED)
Prototype

A

Phenytoin (Dilantin)

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17
Q

Hydantoins (AED)
MOA

A

Decrease neuron activity by inhibiting influx of sodium

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18
Q

Hydantoins (AED)
Adverse effects

A

Drowsiness, gingival hyperplasia among children and teens, skin rash can indicate Steven Johnson or become septic

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19
Q

Hydantoins (AED)
Safety

A

-abrupt discontinuation can cause status epilepticus
-narrow therapeutic range (ataxia, nystagmus, sedation)
-reduces BC effectiveness

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20
Q

Hydantoins (AED)
Admin

A

Give with food
-Inject IV slowly because phenytoin acts on heart too (abrupt reduction in sodium influx can cause dysrhythmias or arrest)

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21
Q

Hydantoins (AED)
Contraindications

A

Pregnancy
Skin rash
Bradycardia/heart block
Allergy to hydantoins

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22
Q

Traditional AED/Anticonvulsants
Indication

A

Treats tonic clonic and partial seizures
Mood stabilizer for bipolar
Helps trigeminal neuralgia pain

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23
Q

Traditional AED/Anticonvulsants
Prototype

A

Carbamazepine (Tegretol)

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24
Q

Traditional AED/Anticonvulsants MOA

A

Inhibit sodium influx into neurons, which decreases electric activity

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25
Traditional AED/Anticonvulsants Adverse effects
Nystagmus, headache, blurred vision, ataxia (CNS depression) Fluid retention Skin rash - Steven's Johnson Photosensitivity reaction Bone marrow suppression
26
Traditional AED/Anticonvulsants Admin
Give with meals Must be given consistently to avoid seizures (i.e., take with a sip of water if NPO for procedure) Interacts with grapefruit
27
Traditional AED/Anticonvulsants Safety
Monitor WBC prior to giving carbamezapine Monitor for skin rash Instruction: Driving Sunscreen Lowers BC effectiveness Report fever and easy bruising (bone marrow suppression)
28
Traditional AED/Anticonvulsants Contraindications
Absence or myoclonic seizures Pregnancy (weigh risks) Heart failure or hematologic disorder
29
Valproic acid/Valproate Indications
Anticonvulsant (Treats all types of seizures) Controls mania with bipolar Migraine treatment
30
Valproic acid/Valproate Prototype
Valproic acid (Depakote, Depacon, Depakene)
31
Valproic acid/Valproate MOA
Inhibits sodium influx into neurons and also may affect calcium influx and enhance GABA
32
Valproic acid/Valproate Adverse reactions
GI upset Bruising, bleeding due to bone marrow suppression Rash Liver toxicity (more common in first few months) Hyperammonemia (valproic acid alters fatty acid metabolism)
33
Valproic acid/Valproate Admin
PO or IV Enteric coated and take with food to avoid GI upset Can sprinkle on food
34
Valproic acid/Valproate Safety
Review lab results for ammonia, platelets, and bleeding time Monitor for pancreatitis (rise in serum amylase) Monitor for liver function, jaundice, abdominal pain
35
Valproic acid/Valproate Contraindications
Pregnancy Liver disorder Blood clotting disorders Use of other anticonvulsants
36
Cholinesterase inhibitors Indication
improve cognitive function in mild to moderate dementia
37
Cholinesterase inhibitors Prototype
Donepezil (Aricept)
38
Cholinesterase inhibitors MOA
Inhibits acetylcholinesterase from breaking down acetylcholine, causing an increase in acetylcholine
39
Cholinesterase inhibitors Adverse effects
GI effects: Nausea, GI bleed Neuro effects: insomnia, dizziness, headaches Cardiac effects: Bradycardia, syncope
40
Cholinesterase inhibitors Admin
Give at bedtime with or without food Tabs, orally disintegrating tabs, syrup
41
Cholinesterase inhibitors Safety
Monitor for GI bleeding Assist with ambulation
42
Cholinesterase inhibitors Contraindications
Children GI bleeding
43
NMDA Receptor Antagonist Indication
Slow physical functioning and cognitive decline in moderate to severe Alzheimer's
44
NMDA Receptor Antagonist Prototype
Memantine (Nementa)
45
NMDA Receptor Antagonist MOA
Blocks glutamate from stimulating NMDA receptors, which decreases calcium influx into neurons and restores normal impulse transmission
46
NMDA Receptor Antagonist Adverse effects
Dizziness, confusion Constipation
47
NMDA Receptor Antagonist Contraindications
Renal failure
48
Immunomodulators Indication
Multiple sclerosis
49
Immunomodulators Prototype
Interferon beta1-A (Avonex) Interferon beta1-B (Betaseron)
50
Immunomodulators MOA
Inhibits movement of leukocytes across BBB, which prevents myelin sheath damage
51
Immunomodulators adverse effects
flu symptoms decrease of all blood cell types liver toxicity
52
Immunomodulators Admin
IM or subq requires liver testing and intermittent thyroid testing
53
Serotonin agonists Indication
Pain relief for migraines and cluster headaches
54
Serotonin agonists Prototype
Sumatriptan (Imitrex)
55
Serotonin agonists MOA
Activate 5-HT (serotonin) receptors, which promotes vasoconstriction and supresses release of CGRP This prevents inflammatory response
56
Serotonin agonists Adverse effects
Chest heaviness (vasoconstriction in lungs) Vasospasm of coronary vessels Tingling vertigo
57
Serotonin agonists Admin
PO, nasal spray, or subq
58
Serotonin agonists Contraindications
MI, CAD, angina, peripheral vascular disease, CVA
59
Amphetamines Indication
ADHD narcolepsy
60
Amphetamines Prototype
Amphetamine/dextroamphetamine sulfate(adderall)
61
Amphetamines MOA
Increase release of norepinephrine and dopamine, which causes alertness, improved mood, better concentration, reduced hyperactivity, and sympathetic NS effects
62
Amphetamines Adverse effects
Hypertension Anxiety Appetite suppression Abuse/tolerance/withdrawal Toxicity - looks like paranoid schizophrenia
63
Amphetamines Admin
PO, DO NOT CRUSH Give in the morning to avoid insomnia Drug holidays for children to prevent growth suppression
64
Amphetamines Contraindications
Hyperthyroidism Severe hypertension cardiovascular disease
65
Methylphenidate indication
CNS Stimulant: ADHD Narcolepsy
66
Methylphenidate Prototype
Methylphenidate (Ritalin, Concerta)
67
Methylphenidate MOA
Increase release of norepinephrine and dopamine in brain and PNS
68
Methylphenidate Adverse effects
Same as amphetamines (toxicity, appetite suppression, sympathetic effects)
69
Methylphenidate admin
PO or patch Some capsules can be opened and sprinkled in applesauce
70
Local anesthetic Indication
When small areas of the body require anesthesia or client cannot have general anesthesia
71
Local anesthetic Prototype
Lidocaine (xylocaine) also procaine (Novocain) -this is the ester type
72
Local anesthetic MOA
Prevents depolarization by inhibiting influx of sodium into neurons through sodium channels
73
Local anesthetic Adverse effects
CNS stimulation - restlessness, tremors, confusion, irritability After CNS stimulation wears off, CNS depression can occur: respiratory depression Hypotension and headaches with spinal admin Bradycardia or heart block
74
Local anesthetic Admin
Topical Epidural Spinal IM Nerve block IV for regional anesthesia
75
General anesthesia/short-acting barbiturates Indication
Rapid induction of anesthesia and hypnosis for brief procedures or an adjunct to other drugs for longer procedures
76
General anesthesia/short-acting barbiturates Prototype
Methohexital sodium (Brevital White) Propofol (Diprivan) - most widely used IV
77
General anesthesia/short-acting barbiturates MOA
Enhance inhibitory effects of GABA and cause significant CNS depression
78
General anesthesia/short-acting barbiturates Adverse effects
therapeutic doses- bradycardia and hypotension Higher doses - tachycardia due to compensation and respiratory depression
79
General anesthesia/Benzodiazepines Indication
Sedation prior to general anesthesia, moderate or conscious sedation with amnesia, and adjunct to inhaled anesthesia for surgery
80
General anesthesia/Benzodiazepines Prototype
midazolam (Versed) also, diazepam (Valium)
81
General anesthesia/Benzodiazepines MOA
CNS depressant and hypnotic - enhance inhibitory effects of GABA
82
General anesthesia/Benzodiazepines Adverse effects
Amnesia is normal side effect Cardiac or respiratory arrest possible
83
General anesthesia/Benzodiazepines Admin
Inject IV bolus slowly over at least 2 minutes and monitor VS IM admin before procedure PO for children Used with opioids for conscious sedation
84
General anesthesia/Benzodiazepines Contraindications
Pregnancy
85
General anesthesia/Opioids Indication
Adjunct to anesthesia for their sedative and pain relief effects
86
General anesthesia/Opioids Prototype
fentanyl (Duragesic)
87
General anesthesia/Opioids MOA
narcotic agonist - bind to mu receptors and inhibits pain impulses similarly to natural opioids
88
General anesthesia/Opioids Adverse effects
Resp. depression Constipation Circulatory collapse Nausea
89
Dopaminergic agents Indication
Parkinsons symptom relief
90
Dopaminergic agents prototype
levadopa/carbadopa (Simenet)
91
Dopaminergic agents MOA
crosses BBB and is taken up by dopaminergic neurons in the substantia nigra, where it is converted to dopamine
92
Dopaminergic agents Adverse effects
Dyskinesias Orthostatic hypotension Nausea Inappropriate behaviors
93
Dopaminergic agents Admin
Give with food Avoid high-protein foods because they reduce absorption may cause dark urine and sweat
94
Dopaminergic agents Contraindications
Melanoma Hx of suicidal or psychosis glaucoma
95
Dopamine agonists Indication
Parkinson's relief restless leg syndrome
96
Dopamine agonists Prototype
Pramipexole (Mirapex)
97
Dopamine agonists MOA
Bind to dopamine receptors and mimic natural dopamine
98
Dopamine agonists Adverse effects
Sleep attacks Orthostatic hypotension Dyskinesias Nausea (stimulates chemoreceptor trigger zone)

Pharmacology ATI (19 decks)

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