neuro Flashcards
(279 cards)
1
Q
What is the brand name of Benztropine?
A
Cogentin
2
Q
What drug class is Benztropine in?
A
Antiparkinsonian, Anticholinergic
3
Q
What are the indications for Benztropine?
A
Extrapyramidal Disease
Parkinsonism
4
Q
What is the mechanism of action of Benztropine?
A
Possesses anticholinergic and antihistamine effects. May inhibit reuptake and storage of dopamine.
5
Q
What are the major contraindications for Benztropine?
A
Hypersensitivity, Use in patients <3 y of age
6
Q
What are the black box warnings for Benztropine?
A
None
7
Q
What are the common adverse drug reactions for Benztropine?
A
Constipation, Nausea
8
Q
What are the rare but serious adverse drug reactions for Benztropine?
A
Anhidrosis [inability to sweat], Drug-induced psychosis, Heat stroke, Increased body temperature, Tachycardia, Visual hallucinations
9
Q
What are the key counseling points for Benztropine?
A
Drug may impair heat regulation. Advise patient to use caution with activities leading to an increased core temperature, such as strenuous exercise, exposure to extreme heat, or dehydration. Patient should avoid activities requiring mental alertness or coordination until drug effects are realized. Instruct patient to report sudden muscle weakness or stiffness, and signs/symptoms of tardive dyskinesia (tongue thrusting, facial grimacing/tics, random movements of extremities). Patient should not drink alcohol while taking this drug.
10
Q
What is the brand name of Carbamazepine?
A
Tegretol
11
Q
What drug class is Carbamazepine in?
A
Anticonvulsant
12
Q
What are the indications for Carbamazepine?
A
Focal onset and generalized, onset of Seizures, Neuropathic pain
13
Q
What is the mechanism of action of Carbamazepine?
A
Acts presynaptically to block firing of action potentials, which decreases the release of excitatory neurotransmitters, and postsynaptically by blocking high-frequency repetitive discharge initiated at cell bodies.
14
Q
What are the major contraindications for Carbamazepine?
A
Hypersensitivity, History of bone marrow depression, MAOIs, Nefazodone
15
Q
What are the black box warnings for Carbamazepine?
A
Agranulocytosis, Aplastic anemia, Dermatologic reactions (especially in asians), Screen for HLA-B*15:02
16
Q
What are the common adverse drug reactions for Carbamazepine?
A
Hyponatremia, Dizziness, Nausea
17
Q
What are the rare but serious adverse drug reactions for Carbamazepine?
A
Cardiac dysrhythmia, Hepatitis, Nephrotoxicity, Pancreatitis, Pancytopenia, Stevens-Johnson syndrome, Syncope, Toxic epidermal necrolysis, Suicidal thoughts and behaviors
18
Q
What are the key counseling points for Carbamazepine?
A
May decrease effectiveness of oral contraceptives; use an alternative form of birth control. Avoid activities requiring mental alertness or coordination until drug effects are realized.
Take with food, but not alcohol, grapefruit, or grapefruit juice. Avoid abrupt discontinuation.
19
Q
What are the brand names of Carbidopa/Levodopa?
A
Rytary, Duopa, Sinemet
20
Q
What drug class is Carbidopa/Levodopa in?
A
Antiparkinsonian
21
Q
What is the indication for Carbidopa/Levodopa?
A
Parkinson disease
22
Q
What is the mechanism of action of Carbidopa/Levodopa?
A
When levodopa is administered orally, it is rapidly decarboxylated to dopamine in extracerebral
tissues so that only a small portion of a given dose is transported unchanged to the CNS. For this reason, when given along, large doses of levodopa are required for adequate therapeutic effect. However, these doses often result in nausea and other adverse reactions. Carbidopa inhibits decarboxylation of circulation levodopa, preventing nausea and allowing more levodopa to reach the CNS. Carbidopa does not cross the BBB and does not affect the metabolism of levodopa within the CNS.
23
Q
What are the major contraindications for Carbidopa/Levadopa?
A
Hypersensitivity, Narrow-angle glaucoma, Concurrent MAOI or linezolid
24
Q
What are the black box warnings for Carbidopa/Levodopa?
A
None
25
What are the common adverse drug reactions for Carbidopa/Levodopa?
Dyskinesia
26
What are the rare but serious adverse drug reactions for Carbidopa/Levodopa?
Orthostatic hypotension, Neuroleptic malignant, syndrome, Hallucinations, Sleep attacks, Compulsive behavior
27
What are the key counseling points for Carbidopa/Levodopa?
If you are using the oral disintegrating tablets, place on top of the tongue; does not require water or swallowing.
28
What is the brand name of Dexmethylphenidate?
Focalin
29
What drug class is Dexmethylphenidate in?
CNS Stimulant (C-II)
30
What is the indication for Dexmethylphenidate?
ADHD
31
What is the mechanism of action of Dexmethylphenidate?
Stimulant that increases CNS activity by **inhibiting reuptake of norepinephrine and dopamine**, increasing neuronal firing rate and stimulating the cerebral cortex and subcortical structures.
32
What are the major contraindications for Dexmethylphenidate?
Hypersensitivity to amphetamines, MAOI use, Drug dependence, Glaucoma, Tics or history of Tourette syndrome
33
What are the black box warnings for Dexmethylphenidate?
Abuse and dependence
34
What are the common adverse drug reactions for Dexmethylphenidate?
Weight loss, Loss of appetite, Headache, Insomnia, Restlessness
35
What are the rare but serious adverse drug reactions for
Dexmethylphenidate?
AMI, Seizures, Spasmodic movement, Anemia, Stroke, Thrombocytopenia, Psychosis, Mania, Drug dependence, *Priapism*
36
What are the key counseling points for Dexmethylphenidate?
**Avoid late evening doses due to resulting insomnia**. If you cannot swallow the extended-release capsule, you may open it and pour the medicine into a small amount of soft food such as applesauce. **Stir this mixture well and swallow it without chewing. Seek medical attention if chest pain, seizures, heart palpitations, change in behavior or personality, or hostility.**
37
What is the brand name of Divalproex?
Depakote
38
What drug class is Divalproex in?
Anticonvulsant
39
What are the indications for Divalproex?
Absence seizure,Complex partial epileptic seizure, Manic bipolar disorder, Migrane prophylaxis
40
What is the mechanism of action of Divalproex?
Composed of sodium valproate and valproic acid. Valproic acid is a carboxylic acid compound whose anticonvulsant activity might be mediated by an inhibitory neurotransmitter, GABA. Valproic acid might **increase GABA levels by inhibiting GABA metabolism or enhancing postsynaptic GABA activity**. Valproic acid also limits repetitive neuronal firing through voltage- and usage-dependent sodium channels.
41
What are the major contraindications for Divalproex?
Hypersensitivity, Hepaticdiseasen
Urea cycle disorders
42
43
What are the black box warnings for Divalproex?
Hepatotoxicity, Patients with mitochondrial disease, Teratogenicity, Pancreatitis
44
What are the rare but serious adverse drug reactions for Divalproex?
Hepatitis, Palpitation, Pancreatitis, Tachycardia, Thrombocytopenia, Suicidal ideation or behavior
45
What are the key counseling points for Divalproex?
Avoid activities requiring mental alertness until drug effects are realized; drug may cause somnolence or dizziness. Seek medical attention for **signs and symptoms of liver dysfunction (e.g., dark-colored urine, light-colored stools, yellowing of skin or eyes, etc.), especially during the first 6 mo of therapy**. Take with food to avoid GI irritation. **Do not discontinue drug abruptly, as this may precipitate seizures**. Avoid alcohol. Sprinkle capsules can be swallowed whole or opened and sprinkled onto soft food; do not chew.
46
What is the brand name of Donepezil?
Aricept
47
What drug class is Donepezil in?
Central Cholinesterase Inhibitor
48
What are the indications for Donepezil?
Alzheimer disease Dementia
49
What is the mechanism of action of Donepezil?
Enhances the action of acetylcholine by **reversibly inhibiting acetylcholinesterase (AChE)**, the enzyme responsible for its hydrolysis. It has a high degree of selectivity for AChE in the CNS, which might explain the relative lack of peripheral side effects.
50
What are the major contraindications for Donepezil?
Hypersensitivity to the
drug or piperidine derivatives
51
What are the black box warnings for Donepezil?
None
52
What are the common adverse drug reactions for Donepezil?
Asthenia
53
What are the rare but serious adverse drug reactions for Donepezil?
Atrioventricular block, GI bleeding, Torsades de Pointes (Fatal Heart Rhythm)
54
What are the key counseling points for Donepezil?
Take at bedtime, with or without food. **Allow disintegrating tablet to dissolved on tongue and follow with a glass of water**. Adverse effects may be more frequent at dose escalation and tend to resolve with continued use. **Report signs/symptoms of GI bleeding.**
55
What is the brand name for Eletriptan?
Relpax
56
What drug class is Eletriptan in?
Antimigraine Serotonin Receptor Agonist
57
What is the indication for Eletriptan?
Migraine
58
What is the mechanism of action of Eletriptan?
**Binds with high affinity to serotonin (5-HT) subtypes 1B, 1D, and 1F receptors**. It has no significant affinity or pharmacological activity at adrenergic z1, z2, or ²; dopaminergic D1 or D2; muscarinic; or opioid receptors. **Serotonin receptor agonists are believed to be effective in migraine, either through vasoconstriction** (via activation of 5-HT1 receptors located on intracranial blood vessels) or through activation of 5-HT1 receptors on sensory nerve endings in the trigeminal system, resulting in the inhibition of proinflammatory neuropeptide release.
59
What are the major contraindications for Eletriptan?
Hypersensitivity, Cerebrovascular syndromes, Hemiplegic or basilar migraine, Ischemic bowel disease, Ischemic heart disease, Peripheral vascular disease, Severe hepatic impairment, Uncontrolled hypertension
60
What are the black box warnings for Eletriptan?
None
61
What are the common adverse drug reactions for Eletriptan?
Weakness
62
What are the rare but serious adverse drug reactions for Eletriptan?
Angina, Cardiac dysrhythmia, Coronary arteriosclerosis, Heart block, Hypertension, AMI, Aphasia, Cerebral ischemia, Stroke, Dystonia, Hemiplegia, Neuropathy, Transient ischemic attack, Oculogyric crisis
63
What are the key counseling points for Eletriptan?
Should avoid activities requiring mental alertness or coordination until drug effects are realized, as this drug may cause **dizziness or somnolence.**
64
What is the brand name of Eszopiclone?
Lunesta
65
What drug class is Eszopiclone in?
Nonbarbiturate Hypnotic (C-IV)
66
What is the indication for Eszopiclone?
Insomnia
67
What is the mechanism of action of Eszopiclone?
It is believed to bind to or interact allosterically at the GABA-receptor complex domain.
68
What are the major contraindications of Eszopiclone?
Hypersensitivity, History of complex sleep behavior
69
What are the black box warnings for Eszopiclone?
Risk of complex sleep
behaviors (sleepwalking, sleep driving, etc.)
70
What are the common adverse drug reactions for Eszopiclone?
Headache
71
What are the rare but serious adverse drug reactions for Eszopiclone?
Anaphylaxis, Angioedema
72
What are the key counseling points for Eszopiclone?
**Take immediately before bedtime and do not take with heavy/high-fat meal**. Severe anaphylactic/anaphylactoid reactions, some fatal, have been reported. Be aware of the risk of "sleep-driving" and other complex behaviors (e.g., preparing and eating food, making phone calls) when the patient is not fully awake. Risk is increased when drug is combined with alcohol or other CNS depressants/ Avoid activities requiring mental alertness or coordination until drug effects are realized. **Report insomnia that worsens or persists longer than 7-10 d**. Report abnormal thoughts or behavior (confusion, agitation, hallucinations, suicidal thoughts, new or worsening depression), memory loss, or anxiety. **Take drug only when experiencing insomnia.** This drug should not be taken on a regular schedule when insomnia is not present. Do not drink alcohol while taking this drug.
73
What is the brand name of Gabapentin?
Neurontin, Gralise
74
What drug class is Gabapentin in?
Gamma Aminobutyric Acid Analog, Anticonvulsant
75
What are the indications for Gabapentin?
Partial Seizure, Postherpetic neuralgia
76
What is the mechanism of action of Gabapentin?
Cyclohexane compound that is structurally related to GABA; its mechanism of action if not known. **Gabapentin does not interact with GABA receptors or alter the formation, release, degradation, or reuptake of GABA.**
77
What are the major contraindications for Gabapentin?
Hypersensitivity
78
What are the black box warnings for Gabapentin?
None
79
What are the common adverse drug reactions for Gabapentin?
Dizziness, Somnolence
80
What are the rare but serious adverse drug reactions for Gabapentin?
Stevens-Johnson syndrome, Suicidal thoughts
81
What are the key counseling points for Gabapentin?
**First dose on 1st day should be taken at bedtime.** ER formulation should be taken with the **evening meal.** Patient should avoid activities requiring mental alertness or coordination until drug effects are realized, as drug may cause dizziness and somnolence. Report worsening depression, suicidal ideation, or unusual changes in behavior. Avoid sudden discontinuation of drug, as this may precipitate status epilepticus. **Wait 2 h after antacid before taking gabapentin.**
82
What are the brand names for Guanfacine?
Estulic, Tenex
83
What drug class is Guanfacine in?
z2-Adrenergic Agonist
84
What are the indications for Guanfacine?
Attention-deficit hyperactivity disorder (ADHD), Hypertension (HTN)
85
What is the mechanism of action of Guanfacine?
Stimulates postsynaptic
z2-adrenergic receptors in the CNS by activating inhibitory neurons to decrease
sympathetic outflow.
86
What are the major contraindications for Guanfacine?
Hypersenstivity
87
What are the black box warnings for Guanfacine?
None
88
What are the common adverse drug reactions for Guanfacine?
Drowsiness, Headache, Dizziness, Insomnia, Anorexia
89
What are the rare but serious adverse drug reactions for Guanfacine?
Seizure, Chest pain,
Rebound hypertension
90
What are the key counseling points for Guanfacine?
Avoid alcohol, CNS depressants. Caution with driving and other tasks requiring alertness. Swallow extended-release tablet whole, may be taken with or without food. Report signs/symptoms of hypotension, exacerbation of angina peripheral edema, fatigue, hypotension, or hepatic dysfunction with initial dosing and dose changes. Avoid abrupt discontinuation to reduce risk of rebound hypertension.
91
What is the brand name of Lacosamide?
Vimpat
92
What drug class is Lacosamide in?
Anticonvulsant (C-V)
93
What is the indication for Lacosamide?
Partial onset seizure
94
What is the mechanism of action of Lacosamide?
Stabilizes hyperexcitable
neuronal membranes and inhibits neuronal firing.
95
What are the major contraindications for Lacosamide?
Hypersensitivity
96
What are the black box warnings for Lacosamide?
None
97
What are the common adverse drug reactions for Lacosamide?
Dizziness, Fatigue, Ataxia, Nausea, Tremor, Diplopia
98
What are the rare but serious adverse drug reactions for Lacosamide?
Acute psychosis, Bradycardia,
Hepatotoxicity, Agranulocytosis, Suicidality
99
What are the key counseling points for Lacosamide?
May be taken without
regard to food but at same time of day. Take with food if GI distress. For the oral
solution, measure carefully with oral syringe. Seek medical attention if seizure
frequency increases or seizures worsen, abnormal heartbeat, or extreme dizziness.
100
What is the brand name for Lamotrigine?
Lamictal
101
What drug class is Lamotrigine in?
Phenyltriazine Anticonvulsant
102
What are the indications for Lamotrigine?
Bipolar I disorder, Partial seizure
103
What is the mechanism of action of Lamotrigine?
Phenyltriazine derivative
unrelated to other marketed antiepileptic drugs (AEDs). Inhibits voltage-dependent
sodium channels, thereby stabilizing neuronal membranes and reducing the release of excitatory neurotransmitters such as glutamate and aspartate.
104
What are the major contraindications for Lamotrigine?
Hypersensitivity
105
What are the black box warnings for Lamotrigine?
Serious skin reactions
106
What are the common adverse drug reactions for Lamotrigine?
Rash, Ataxia, Somnolence, Headache, Diplopia, Rhinitis, Nausea, Vomiting, Insomnia
107
What are the rare but serious adverse drug reactions for Lamotrigine?
Stevens-Johnson syndrome, Anemia, Leukopenia, Disseminated intravascular coagulation, Thrombocytopenia, Liver failure, Aseptic meningitis, Suicidal thoughts
108
What are the key counseling points for Lamotrigine?
Seek medical attention if blistering rash develops or if yellowing of skin or eyes, unusual bruising or bleeding, shortness of breath, or suicidal thoughts occur. Slow titration necessary to minimize side effect. Avoid alcohol. Consult HCP if become or planing to become pregnant. Review driving restriction for patients with seizures. Place oral disintegrating tablet formulation on tongue and allow to dissolve.
109
What are the brand names of Levetiracetam?
Keppra, Keppra XR, Spritam
110
What drug class is Levetiracetam in?
Anticonvulsant
111
What are the indications for Levetiracetam?
Myoclonic seizure, Partial seizure, Tonic-clonic seizure
112
What is the mechanism of action of Levetiracetam?
Pyrrolidine derivative
that is structurally unrelated to other AEDs. MOA is unclear and does not relate to
any known mechanisms of neuronal excitation or inhibition.
113
What are the major contraindications for Levetiracetam?
Hypersensitivity
114
What are the black box warnings for Levetiracetam?
None
115
What are the common adverse drug reactions for Levetiracetam?
Asthenia, Fatigue, Headache
Somnolence, Vomiting, Increased BP
116
What are the rare but serious adverse drug reactions for Levetiracetam?
Pancytopenia, Hepatotoxicity, Suicidal thoughts, Suicide,
Stevens-Johnson Syndrome
117
What are the key counseling points for Levetiracetam?
Swallow extended-release tablet whole; do not chew, break, or crush. Avoid activities requiring mental alertness or coordination until drug effects are realized. Report mood swings, agitation, hostile behavior, suicidal ideation, or unusual changes in behavior. Avoid sudden discontinuation of drug; may increase seizure activity.
118
What is the brand name of Lisdexamfetamine?
Vyvanse
119
What drug class is Lisdexamfetamine in?
Amphetamine, CNS Stimulant
(C-II)
120
What are the indications for Lisdexamfetamine?
Attention-deficit hyperactivity disorder (ADHD), Binge eating disorder
121
What is the mechanism of action of Lisdexamfetamine?
Prodrug converted to dextroamphetamine. Amphetamines cause the release of dopamine and
norepinephrine at presynaptic nerve terminals and may block the reuptake of norepinephrine and dopamine by competitive inhibition.
122
What are the major contraindications for Lisdexamfetamine?
Hypersensitivity/idiosyncrasy to sympathomimetic amines,
MAOIs, Symptomatic cardiovascular disease or Advanced arteriosclerosis,
Moderate-severe hypertension, Hyperthyroidism, Glaucoma, Agitated states, History of drug dependence
123
What are the black box warnings for Lisdexamfetamine?
Risk of abuse, misuse, diversion
124
What are the common adverse drug reactions for Lisdexamfetamine?
Insomnia, Irritability, Loss of appetite, Upper abdominal pain, Xerostomia
125
What are the rare but serious adverse drug reactions for Lisdexamfetamine?
Chest pain, New worsening existing psychotic disorders, AMI, Stroke, Sudden cardiac death, Tachycardia, Anaphylaxis, Peripheral vasculopathy (including
Raynaud's), Serotonin syndrome
126
What are the key counselling points for Lisdexamfetamine?
Take dose in the morning with or without food. If capsule opened for administration, drug should be dissolved in water, yogurt, or orange juice and consumed problems (behavior and thought problems, bipolar illness, aggressive behavior or hostility). Also report
chest pain, palpitations, dyspnea, or signs/symptoms of cardiac dysrhythmia, AMI,
or cerebrovascular accident
127
What is the brand name of Memantine?
Namenda
128
What are the major contraindications for Memantine?
Hypersensitivity
129
What is the mechanism of action of Memantine?
Activation of NMDA
receptors by glutamate is believed to contribute to the symptomatology of Alzheimer
disease. Memantine is believed to act as an uncompetitive (open-channel) NMDA receptor antagonist that binds preferentially to the NDMA receptor-operated cation channels. There is no evidence that memantine prevents or slows neurodegeneration in patients with Alzheimer disease.
130
What is the indication for Memantine?:
Alzheimer disease
131
What drug class is Memantine in?
N-Methyl-D-Aspartate (NMDA) Receptor Antagonist
132
What are the black box warnings for Memantine?
None
133
What are the common adverse drug reactions for Memantine?
None known
134
What are the rare but serious adverse drug reactions for Memantine?
Stevens-Johnson syndrome, DVT, Hepatitis, Liver failure, Cerebrovascular accident,
Grand mal seizure, Transient ischemic attack, Acute renal failure
135
What are the key counseling points for Memantine?
May be taken with or
without food. The oral solution is packaged with a dosing device that should be used
to administer the medication.
136
What is the brand name for Metaxalone?
Skelaxin
137
What drug class is Metaxalone in?
Centrally Acting Skeletal Muscle Relaxant
138
What is the indication for Metaxalone?
Musculoskeletal pain or spasm
139
What is the mechanism of action of Metaxalone?
MOA in humans has not
been established by may be due to general CNS depression. It has no direct action on the contractile mechanism of striated muscle, the motor end plate, or the nerve fiber.
140
What are the major contraindications for Metaxalone?
Hypersensitivity, Significantly impaired renal or hepatic function
141
What are the black box warnings for Metaxalone?
None
142
What are the common adverse drug reactions for Metaxalone?
Dizziness
143
What are the rare but serious adverse drug reactions for Metaxalone?
Hemolytic anemia, Leukopenia, Jaundice, Immune hypersensitivity reaction, Maculopapular rash, Slowed or difficult breathing when used in combination with opioids
144
What are the key counseling points for Metaxalone?
Patients should avoid
activities requiring mental alertness or coordination until drug effects are known, as
drug may cause dizziness or sedative effects.
145
What are the brand names of Methylphenidate?
Ritalin, Concerta
146
What drug class is Methylphenidate in?
CNS Stimulant (C-II)
147
What are the indications for Methylphenidate?
ADHD, Narcolepsy
148
What is the mechanism of action of Methylphenidate?
Stimulant that increases CNS activity by inhibiting reuptake of norepinephrine and dopamine, increasing neuronal firing rate and stimulating the cerebral cortex and subcortical
structures
149
What are the major contraindications for Methylphenidate?
Hypersensitivity to amphetamines, Anxiety, Agitation, Concurrent MAOIs, Drug dependence, Glaucoma, Tics or history of Tourette syndrome, Hypertension, Angina, Heart failure, Concurrent halogenated anestheitcs
150
What are the black box warnings for Methylphenidate?
Abuse and dependence potential
151
What are the common adverse drug reactions for Methylphenidate?
Weight loss, Loss of appetite, Headache, Insomnia, Irritability
152
What are the rare but serious adverse drug reactions for
Methylphenidate?
Seizures, Spasmodic movement, Anemia, Thrombocytopenia,
Psychosis, Mania, Drug dependence, Suicidal thoughts, Priapism, Peripheral vasculopathy
153
What are the key counseling points for Methylphenidate?
Avoid late evening doses due to resulting insomnia. Swallow the extended-release capsule
whole. Do not crush, break, or chew it. If you cannot swallow the extended-release
capsule, you may open it and pour the medicine into a small amount of soft food such
as pudding, yogurt, or applesauce. Stir in this mixture well and swallow it without
chewing. Avoid abrupt discontinuation. For the patch, apply same time each day,
alternating hips. Remove after 9 hrs.
154
What is the brand name for Modafinil?
Provigil
155
What drug class is Modafinil in?
CNS Stimulant (C-IV)
156
What are the indications for Modafinil?
Narcolepsy, Obstructive sleep apnea, Shift work-sleep disorder
157
What is the mechanism of action of Modafinil?
Wakefulness-promoting
agent acting as a CNS stimulant. It is chemically and pharmicalogically unrelated
to other CNS stimulants, such as methylphenidate, amphetamine, or permoline.
158
What are the major contraindications for Modafinil?
Hypersensitivity
159
What are the black box warnings for Modafinil?
None
160
What are the common adverse drug reactions for Modafinil?
Anxiety, Headache, Insomnia, Nausea
161
What are the rare but serious adverse drug reactions for Modafinil?
Cardiac dysrhythmia, Stevens-Johnson syndrome
162
What are the key counseling points for Modafinil?
This drug may decrease effectiveness of hormonal or IUD contraception. Recommended additional form of birth control during therapy and 1 mo after last dose. Avoid activities requiring mental alertness or coordination until drug effects are realized. If using drug for daytime wakefulness, take in the morning; if using to maintain wakefulness during shift work, take drug 1 hr prior to working. Do not drink alcohol while taking this drug. Practice good sleep hygiene. Does not replace need for CPAP machines in patients with obstructive sleep apnea.
163
What is the brand name of Oxcarbazepine?
Trileptal
164
What drug class is Oxcarbazepine?
Dibenzazepine Carboxamide, Anticonvulsant
165
What is the indication for Oxcarbazepine?
Focal onset (partial seizure)
166
What is the mechanism of action of Oxcarbazepine?
10-keto analogue of
carbamazepine that exerts its anticonvulsant effect through an active 1--monohydroxy metabolite (MHD). MOA unknown but likely involves blockade of voltage-dependent sodium channel and inhibition of repetitive firing.
167
What are the major contraindications for Oxcarbazepine?
Hypersensitivity
168
What are the black box warnings for Oxcarbazepine?
None
169
What are the common adverse drug reactions for Oxcarbazepine?
Somnolence, Headache, Diplopia, Dizziness
170
What are the rare but serious adverse drug reactions for Oxcarbazepine?
Anaphylaxis, Angioedema, Stevens-Johnson syndrome, Suicidal thoughts, Pancytopenia
171
What are the key counseling points for Oxcarbazepine?
Suspension should be shaken well and dose prepared immediately using oral dosing syringe.
Suspension can be mixed in a small glass of water just prior to administration or may be swallowed directly from the syringe. Avoid activities requiring mental alertness or coordination until drug effects are realized. Report signs/symptoms of serious
dermatologic reactions, myelosuppression, or hepatotoxicity. Take with food, but not alcohol, grapefruit, or grapefruit juice. Avoid abrupt discontinuation to avoid risk of seizure.
172
What is the brand name of Phenobarbital?
Luminal
173
What drug class is Phenobarbital in?
Long-Acting Barbiturate (C-IV)
174
What are the indications for Phenobarbital?
Seizure, Sedation
175
What is the mechanism of action of Phenobarbital?
Produces different degrees of depression within the CNS, from sedation to general anesthesia. It has
been demonstrated to depress monosynaptic responses in the CNS only transiently, but synaptic recovery is delayed and a decrease in postsynaptic resistance is observed at some synapses.
176
What are the major contraindications for Phenobarbital?
Hypersensitivity to barbiturates, Marked liver function impairment, Respiratory disease with evidence of dyspnea or obstruction, History of sedative or hypnotic addiction, Personal or gamily history of acute intermittent porphyria
177
What are the black box warnings for Phenobarbital?
Concomitant use with
opioids, Dependence and withdrawal, Abuse (IV only)
178
What are the common adverse drug reactions for Phenobarbital?
None known
179
What are the rare but serious adverse drug reactions for Phenobarbital?
Barbiturate withdrawal, Bradyarrhythmia, Megaloblastic anemia,
Respiratory depression, Stevens-Johnson syndrome
180
What are the key counseling points for Phenobarbital?
Avoid activities requiring mental alertness or coordination until drug effects are realized, as drug
may cause dizziness, light-headedness, or somnolence. Advise patient against sudden discontinuation of drug. Do not drink alcohol or use other CNS depressant drugs while taking phenobarbital. Many drug interactions; check with HCP when starting new medications or OTC products.
181
What is the brand name for Phentermine?
Adipex-P, Lomaira
182
What drug class is Phentermine in?
Centrally Acting Appetite Suppressant (C-IV)
183
What is the indication for Phentermine?
Obesity
184
What is the mechanism of action of Phentermine?
Sympathomimetic
amine with pharmacologic activity similar to amphetamines. Actions include CNS stimulation and elevation of BP. Weight loss is due to anorectic effect, primarily one of appetite suppression, but may also have other CNS or metabolic effects.
185
What are the major contraindications for Phentermine?
Hypersensitivity to the drug or other sympathomimetic amines, Use in agitated states, Cardiovascular disease, History of drug abuse, Glaucoma, Moderate to severe hypertension,
Hyperthyroidism
186
What are the black box warnings for Phentermine?
None
187
What are the common adverse drug reactions for Phentermine?
None known
188
What are the rare but serious adverse drug reactions for Phentermine?
Heart valve disorder, Psychotic disorder, Primary pulmonary hypertension
189
What are the key counseling points for Phentermine?
Phentermine may
impair ability to engage in potentially hazardous activities such as operating machinery or driving a motor vehicle; avoid. Take during day time to avoid insomnia.
190
What is the brand name for Phenytoin?
Dilantin
191
What drug class is Phenytoin in?
Hydantoin Anticonvulsant
192
What are the indications for Phenytoin?
Seizure, Generalized tonic-clonic, Complex partial, Following neurosurgery treatment, Prophylaxis
193
What is the mechanism of action of Phenytoin?
Hydantoin that suppresses
the spread of seizure activity mainly by inhibiting synaptic posttetanic potentiation
and blocking the propagation of electric discharge. Might decrease sodium transport
and block calcium channels at the cellular level to produce these actions.
194
What are the major contraindications for Phenytoin?
Hypersensitivity, Sinus bradycardia, AV block
195
What are the black box warnings for Phenytoin?
Hypotension and arrhythmias with IV administration
196
What are the common adverse drug reactions for Phenytoin?
Gingival hyperplasia
197
What are the rare but serious adverse drug reactions for Phenyotin?
Hepatotoxicity, Pancytopenia, Systemic lupus erythematosus, Stevens-Johnson syndrome, Suicidal behavior, Withdrawal seizures
198
What are the key counseling points for Phenytoin?
Suspension requires
extensive shaking before administration. Do not crush extended-release capsules. Avoid activities requiring mental alertness or coordination until drug effects are realized. Report signs/symptoms of pancytopenia, hepatotoxicity, systemic lupus erythematosus, or severe skin reaction. Do not drink alcohol while taking this drug. Many drug interactions; check with HCP when starting new medications or OTC
products.
199
What are the brand names for Pramipexole?
Mirapex, Mirapex ER
200
What drug class is Pramipexole in?
Dopamine Agonist, Antiparkinson
201
What are the indications for Pramipexole?
Parkinson disease, Restless leg syndrome
202
What is the mechanism of action of Pramipexole?
Nonergot-derived
dopamine subtype selective agonist that exerts activity in the CNS at D2 and D3
receptors but has no activity at the D1 receptor. D2 receptors are thought to play an important role in improving the akinesia, bradykinesia, rigidity, and gait disturbances of Parkinson disease.
203
What are the major contraindications for Pramipexole?
Hypersensitivity
204
What are the black box warnings for Pramipexole?
None
205
What are the common adverse drug reactions for Pramipexole?
Asthenia, Dream disorder, Dyskinesia, Extrapyramidal movements, Nausea, Somnolence
206
What are the rare but serious adverse drug reactions for Pramipexole?
Blackouts, Heart failure, Impulsive behavior, Melanoma
207
What are the key counseling points for Pramipexole?
Take with food if
nausea occurs. Avoid activities requiring mental alertness or coordination until drug effects are realized. Rise slowly from siting/lying-down position. Report new or increased gambling urges, sexual urges, compulsive eating or buying, as well as
new-onset or worsening dyskinesia. Do not discontinue abruptly, as this may cause emergent hyperpyrexia and confusion. Do not drink alcohol, and avoid concomitant
use of other CNS depressants.
208
What is the brand name for Pregabalin?
Lyrica
209
What drug class is Pregabalin in?
Analgesic, Anticonvulsant (C-IV in NY, C-V federal)
210
What are the indications for Pregabalin?
Neuropathic pain, Diabetes associated or spinal cord injury associated, Fibromyalgia, Postherpetic neuralgia
211
What is the mechanism of action of Pregabalin?
GABA analogue that
strongly binds to the z2-delta site *a subunit of voltage-gated calcium channels) in
CNS tissues. Binding to the z2-delta subunit may be involved in pregabalin's effects on neuropathic pain and seizure control. Pregabalin reduces the calcium-dependent
release of several neurotransmitters.
212
What are the major contraindications for Pregabalin?
Hypersensitivity
213
What are the black box warnings for Pregabalin?
None
214
What are the common adverse drug reactions for Pregabalin?
Dizziness, Somnolence, Ataxia, Headache, Peripheral edema
215
What are the rare but serious adverse drug reactions for Pregabalin?
Angioedema
216
What are the key counseling points for Pregabalin?
Solution must be used
within 45 d of first opening the bottle. Avoid activities requiring mental alertness or coordination until drug effects are realized. Avoid sudden discontinuation of drug due to risk of withdrawal, including increased seizure frequency. Avoid concurrent
use of CNS depressants, such as alcohol.
217
What is the brand name for Rizatriptan?
Maxalt
218
What drug class is Rizatriptan in?
Antimigraine, Serotonin Receptor Agonist
219
What is the indication for Rizatriptan?
Migraine
220
What is the mechanism of action of Rizatriptan?
Binds with high affinity
to serotonin (5HT) receptor subtypes 1B and 1D. Serotonin receptor agonists are believed to be effective in migraine either through vasoconstriction (via activation of 5-HT1 receptors located on intracranial blood vessels) or through activation of 5-HT1
receptors on sensory nerve endings in trigeminal system resulting in the inhibition
of proinflammatory neuropeptide release.
221
What are the major contraindications for Rizatriptan?
Cerebrovascular syndromes, Hemiplegic or basilar migraine, Ischemic bowel disease, Ischemic heart disease, Peripheral vascular disease, Severe hepatic impairment, Uncontrolled Hypertension, MAOI, Ergot alkaloids
222
What are the black box warnings for Rizatriptan?
None
223
What are the common adverse drug reactions for Rizatriptan?
None known
224
What are the rare but serious adverse drug reactions for Rizatriptan?
Angina, Cardiac dysrhythmia, Coronary Arteriosclerosis, Heart block, Hypertension,
Acute myocardial infarction, Aphasia, Cerebral ischemia, Stroke, Dystonia, Hemiplegia, Neuropathy, Transient ischemic attack, Oculogyric crisis
225
What are the key counseling points for Rizatriptan?
Avoid alcohol, CNS
depressants. Caution with driving and other tasks requiring alertness. Allow disintegrating tablet to dissolve on tongue and then swallow, do not chew.
226
What are the brand names of Ropinirole?
Requip, Requip XL
227
What drug class is Ropinirole in?
Dopamine Agnoist
228
What are the indications for Ropinirole?
Parkinson disease, Restless leg syndrome
229
What is the mechanism of action of Ropinirole?
Non-ergoline dopamine
agonist that has a higher specificity to D3 than to D2 and D4 subtypes of dopamine receptors. The drug has a moderate affinity for opioid receptors and has insignificant effects on D1, 5-hydroxytryptamine 1 (5-HT1), 5-HT2, benzodiazepine, GABA, muscarinic, z1-, z2-, and ²-adrenoreceptors. It is suggested that ropinirole stimulates the postsynaptic D2-type receptor found in the brain's caudate putamen in Parkinson disease.
230
What are the major contraindications for Ropinirole?
Hypersensitivity
231
What are the black box warnings for Ropinirole?
None
232
What are the common adverse drug reactions for Ropinirole?
Drowsiness, Dyskinesia, Nausea, Orthostatic hypotension, Somnolence, Vomiting, Hallucinations
233
What are the rare but serious adverse drug reactions for Ropinirole?
Sinus node dysfunction, Neuroleptic malignancy syndrome, Impulse control/compulsive behaviors
234
What are the key counseling points for Ropinirole?
Take with food to reduce nausea. Avoid driving and other activities requiring mental alertness or
coordination until drug effects are realized. Rise slowly from sitting/lying-down position. Report new onset of exacerbation of dyskinesia, changes in BP, fainting, or unusual urges. Avoid sudden discontinuation of drug; it increases risk of neuroleptic malignancy syndrome. Do not drink alcohol or take other CNS depressants while
using this drug.
235
What is the brand name for Sumatriptan?
Imitrex
236
What drug class is Sumatriptan in?
Antimigraine Serotonin Receptor Agonist
237
What are the indications for Sumatriptan?
Migraine, Cluster headaches
238
What is the mechanism of action of Sumatriptan?
Binds with high affinity to serotonin (5-HT) subtypes 1B, 1D, and 1F receptors. It has no significant affinity
or pharmacologic activity at adrenergic ±1, ±2, or²; dopaminergic D1 or D2; muscarinic; or opioid receptors. Serotonin receptor agonists are believed to be effective in migraine either through vasoconstriction (via activation of 5-HT1 receptors located on intracranial blood vessels) or through activation of 5-HT1 receptors on sensory nerve endings in the trigeminal system resulting in the inhibition of proinflammatory neuropeptide release.
239
What are the major contraindications for Sumatriptan?
Hypersensitivity, Cerebrovascular syndromes, Hemiplegic or basilar migraine, Ischemic bowel disease, Ischemic heart disease, Peripheral vascular disease, Severe hepatic impairment, Uncontrolled hypertension, MAOIs, Ergot alkaloids
240
What are the black box warnings for Sumatriptan?
None
241
What are the common adverse drug reactions for Sumatriptan?
None known
242
What are the rare but serious adverse drug reactions for Sumatriptan?
Angina, Cardiac dysrhythmia, Coronary arteriosclerosis, Heart block, Hypertension,
AMI, Aphasia, Cerebral ischemia, Stroke, Dystonia, Hemiplegia, Neuropathy, Transient ischemic attack, Oculogyric crisis
243
What are the key counseling points for Sumatriptan?
Avoid activities requiring mental alertness or coordination until drug effects are realized, as this drug may cause dizziness or somnolence.
244
What is the brand name for Topiramate?
Topamax
245
What drug class is Topiramate in?
Anticonvulsant
246
What are the indications for Topiramate?
Focal or generalized tonic-clonic, seizures, Migraine prevention
247
What is the mechanism of action of Topiramate?
Electrophysiologic and biochemical evidence suggests that topiramate blocks voltage-dependent sodium channels, augments the activity of the neurotransmitter gamma-aminobutyrate at
some subtypes of the GABA-A receptor, antagonizes the AMPA/kainate subtype of the glutamate receptor, and inhibits the carbonic anhydrase enzyme, particularly isozymes II and IV
248
What are the major contraindications for Topiramate?
Hypersensitivity, Alcohol use for the ER formulation (within 6 h prior to and 6 h after administration)
249
What are the black box warnings for Topiramate?
None
250
What are the common adverse drug reactions for Topiramate?
Ataxia, Loss of appetite, Dizziness, Impaired psychomotor performance, Somnolence, Fatigue, Nystagmus, Low serum bicarbonate
251
What are the rare but serious adverse drug reactions for Topiramate?
Erythema multiforme, Stevens-Johnson syndrome, Hypohidrosis, Increased body temperature, Metabolic acidosis, Liver failure, Glaucoma, Myopia, Suicidal ideation, Visual field defects
252
What are the key counseling points for Topiramate?
Avoid activities requiring mental alertness and coordination until drug effects are realized. Drug may cause dizziness and somnolence, especially if taken with alcohol or other CNS depressants. May cause diplopia, nervousness, confusion, and many other CNS effects. Do not discontinue drug abruptly, as this may cause increased seizure activity. Seek medical attention for new eye problems or high body temperature. May decrease sweating; avoid hot temperatures (including hot tubs and saunas).
Maintain adequate fluid intake to minimize the risk of kidney stones. Instruct females on estrogen-progestin contraceptives to use an additional form of contraception due to decreased effectiveness of oral contraceptives. Take a missed dose as soon as
possible, if >1 dose is missed, consult HCP.
253
What is the brand name for Trazodone?
Desyrel
254
What drug class is Trazodone in?
Antidepressant
255
What is the indication for Trazodone?
Major depressive disorder
256
What is the mechanism of action of Trazodone?
Suspected to be related to its potentiation of serotonergic activity in the CNS by inhibiting reuptake of serotonin. Trazodone also significantly blocks histamine (H1) and ±1-adrenergic receptors.
257
What are the major contraindications for Trazodone?
Hypersensitivity, Use of MAOI
258
What are the black box warnings for Trazodone?
Suicidal ideation, Not for use in children
259
What are the common adverse drug reactions for Trazodone?
Dizziness, Sedation, Headache, Nausea, Somnolence, Xerostomia
260
What are the rare but serious adverse drug reactions for Trazadone?
Bleeding risk, Cardiac dysrhythmia, Fractures, Priapism, Prolonged QTc, Serotonin
syndrome, Suicidal thoughts, Torsade de Pointes (Fatal Heart Rhythm)
261
What are the key counseling points for Trazadone?
Avoid driving and other activities requiring mental alertness or coordination until drug effects are realized, as this medicine may cause dizziness or somnolence. Report signs/symptoms of priapism immediately. Avoid use of MAOI within the past 14 d. Avoid sudden discontinuation of drug. Do not drink alcohol, or use barbiturates or other CNS depressants while taking this drug.
262
What is the brand name for Varenicline?
Chantix
263
What drug class is Varenicline in?
Smoking Cessation Agent
264
What is the mechanism of action of Varenicline?
Binds with high affinity and
selectivity at ±4²2 neuronal nicotinic acetylcholine receptors. Its efficacy in smoking cessation is believed to be the result of activity at ±4²2 subtype of the nicotinic receptor
where its binding produces agonist activity, while simultaneously preventing nicotine binding to these receptors.
265
What is the indication for Varenicline?
Smoking cessation
266
What are the major contraindications for Varenicline?
Hypersensitivity
267
What are the black box warnings for Varenicline?
None
268
What are the common adverse drug reactions for Varenicline?
Dream disorder, Nausea, Headache, Insomnia, Irritability
269
What are the rare but serious adverse drug reactions for Varenicline?
Abnormal behavior, Suicidal thoughts, Angioedema, Hypersensitivity reactions,
Increased risk of accidents, Increased risk of cardiovascular related events, Sleepwalking, Seizures
270
What are the key counseling points for Varenicline?
Take drug after eating
and with a full glass (240 mL) of water. If you experience sleepwalking, seizures signs of hypersensitivity (shortness of breath), mental status changes or suicidal
ideation, stop taking and contact HCP. May be used with other nicotine replacement products to help alleviate withdrawal from nicotine. Limit alcohol use.
271
What are the brand names for Zolpidem?
Ambien, Intermezzo
272
What drug class is Zolpidem in?
Nonbarbiturate Hypnotic (C-IV)
273
What is the indication for Zolpidem?
Insomnia
274
What is the mechanism of action of Zolpidem?
Binds the benzodiazepine
receptor but is structurally different from a benzodiazepine. Sedative and hypnotic effects are due to increased chloride conductance, neuronal hyperpolarization,
inhibition of action potential, and decrease in neuronal excitability.
275
What are the major contraindications for Zolpidem?
Hypersensitivity, History of complex sleep behavior
276
What are the black box warnings for Zolpidem?
Risk of complex sleep
behaviors (sleep walking, sleep driving, etc)
277
What are the common adverse drug reactions for Zolpidem?
Dizziness, Drowsiness, Headache
278
What are the rare but serious adverse drug reactions for Zolpidem?
Tachycardia, Complex behavior, Abnormal thinking, Behavior changes, Anaphylaxis, Worsening of depression, Angioedema, Drug dependence, Slowed or difficult breathing when used in combination with opioids, Falls leading to severe injuries associated with decreased level of consciousness, Hallucinations
279
What are the key counseling points for Zolpidem?
Take on an empty stomach. May cause daytime drowsiness; avoid driving or other tasks requiring motor coordination. Avoid alcohol. Take immediately prior to bedtime. There is risk of "sleep-driving" and other complex behaviors (eg, preparing and eating food, making phone calls) when not fully awake, zolpidem should be discontinued if this occurs. Risk is increased when drug is combined with alcohol or other CNS depressants.Bed partner should monitor for irregular respiration.
