Pharm: Drugs Acting on the Central and PNS: Antiseizure, Antiparkinsonism, Muscle Relaxants, Opioids/Analgesic Agents, General/Local Anesthetic Agents

Question 1

Drugs used to depress the CNS - prevents/reduces S & S of anxiety?

Answer 1

Anxiolytics

Question 2

Former mainstay class for treatment of anxiety/for sedation/sleep induction (has many severe adverse effects and drug-drug interactions)?

Answer 2

Barbiturates

Question 3

Class of drug acts on limbic system and reticular activating system to make GABA or gamma-aminobutyric acid (inhibitory neurotransmitter), more effective -> causing interference with neuron firing? (Depresses CNS block S&S of anxiety/cause sedation and hypnosis in higher doses)

Answer 3

Benzodiazepines

Question 4

Ends in -LAM or -PAM?

Answer 4

Benzodiazepines used as anxiolytics-hypnotics

Question 5

alprazolam, chlordiazepoxide, clonazepam, clorazepate, diazepam, estazolam, flurazepam, lorazepam, midazolam, oxazepam, quazepam, temazepam, and triazolam?

Answer 5

Benzodiazepines used as anxiolytics-hypnotics

Question 6

pentobarbital, phenobarbital, secobarbital?

Answer 6

Barbiturates used as anxiolytics-hypnotics

Question 7

Ends in -BARBITAL?

Answer 7

Barbiturates

Question 8

AKA Xanax?

Answer 8

Alprazolam - anxiety, panic attacks -> make sure to taper

Question 9

AKA Librium? Calms nervous system -> reduce risk of seizures, manages agitation, sootes anxiety

Answer 9

Chlordiazepoxide - anxiety, alcohol withdrawal, preop- anxiolytic

Question 10

AKA Klonopin?

Answer 10

Clonazepam - panic disorders, restless leg syndrome, seizure disorders

Monitor for SI, liver function, taper after long term therapy

Question 11

Different indication for clonazepam?

Answer 11

Restless leg syndrome

Question 12

AKA Gen-Xene, Tranxene?

Answer 12

Clorazepate: Anxiety, alcohol withdrawal

Make sure to taper

Question 13

AKA Valium?

Answer 13

Diazepam - anxiety, alcohol withdrawal, muscle relaxant, preoperative anxiolytic

Question 14

Hypnotic, treatment for insomnia?

Answer 14

Estazolam, flurazepam

monitor liver/renal function, CBC if used long-term

Question 15

AKA Ativan?

Answer 15

Lorazepam - anxiety, preanesthesia anxiolytic, insomnia d/t stress

Watch for sedation

Question 16

AKA Midazolam?

Answer 16

Midazolam - sedation, anxiety, conscious sedation for short procedures ; continous sedation of intubated or mechanically ventilated patients

Keep resuscitation equipment close to help patient breathe PRN

Question 17

Treatment for Anxiety disorders, alcohol withdrawal, hyperexcitability and agitation, and preoperative relief of anxiety and tension to aid in balanced anesthesia?

Answer 17

Benzodiazepines

Question 18

Some adverse effects of benzos on the CNS/Peripheral?

Answer 18

Sedation, drowsiness, depression, lethargy, blurred vision, headaches, confusion, light-headedness

Question 19

Monitor for dry mouth, N/V, constipation, inc liver enzymes; hypo/hypertension, arrhytmias, palpitations, urinary retention?

Answer 19

Adverse effects of benzos on GI, CV, and urinary systems

Question 20

what to avoid when taking benzos?

Answer 20

CNS depressants - opioids and alcohol

DO NOT take with cimetidine, oral contraceptives, or disulfiram inc ben

Decreased when given with theophyllines

Question 21

AKA Butisol?

Answer 21

Butabarbital - short term sedative/hypnotic

Can produce aggressiveness/excitability

Question 22

AKA phenobarbital?

Answer 22

Phenobarbital - sedative-hypnotic, control of seizures, preanesthetic

Taper after long use; monitor injection sitess

Question 23

CNS depressants - inhibit neuronal impulse conduction in ascending RAS, depress cerebral cortex/alter cerebellar function; causes sedation, hypnosis, anesthesia?

Answer 23

Barbiturates

Question 24

What to watch out for in barbiturates?

Answer 24

CNS depression - drowsiness, solmnolence, lethargy, ataxia, vertigo

Question 25

Buspirone?

Answer 25

Treats anxiety - Causes dry mouth, headache -> caution in hepatic/renal impairment

Question 26

SEDATIVE: Dexmedetomidine?

Answer 26

Precedex - sedation for intubation/mechanically ventilated patients in ICU | 1 mcg/kg IV over 10 min -> 0.2-0.7 mcg/kg/h w/ infusion device

Question 27

Diphenhydramine?

Answer 27

Benadryl: Sleep aid, motion sickness, allergies -> SHORT TERM treatment for insomnia | Monitor for drying effects -> thickened respiratory secretions ## Footnote Breathing difficulties

Question 28

Eszopiclone?

Answer 28

Lunesta - Insomnia, 1 mg PO before bed

Question 29

Ramelteon?

Answer 29

Rozerem - treatment of insomnia characterized by difficulty falling asleep | Monitor for depression and SI

Question 30

Suvorexant?

Answer 30

Belsomra - treatment of insomnia w/ difficulty in sleep onset, and/or sleep maintenance

Question 31

Tasimelteon?

Answer 31

Hetlioz - treatment of non-24 hour sleep-wake disorder

Question 32

Zaleplon?

Answer 32

Sonata- short term treatment of insomnia

Question 33

Zolpidem?

Answer 33

Ambien, intermezzo, zolpimist - short term treatment of insomnia

Question 34

Can be sedating - used as preoperative medicines and postop to decrease need for narcotics?

Answer 34

Antihistamines: Promethazine (Promethegan), Diphenhydramine

Question 35

Buspirone?

Answer 35

Antianxiety, anticonvulsant, muscle-relaxant ## Footnote Can reduce S&S of of anxiety w/o severe effects

Question 36

Amantadine, apomorphine, bromocriptine, carbidopa-levodopa, levodopa, pramipexole, rasgiline, ropinirole, rotigotine?

Answer 36

Dopaminergic agents

Question 37

Benztropine, diphenhydramine, trihexphenidyl?

Answer 37

Anticholinergic agents

Question 38

Entacapone, safinamide, selegline, tolcapone?

Answer 38

Adjunctive agents

Question 39

Includes lack of coordination, rhythmic tremors, rigidity/weakness, bradykinesia (extreme slowness)?

Answer 39

Characteristics of parkinsons

Question 40

Hallmark symptoms of parkinsonism?

Answer 40

Shuffling gait, drool, mask-like expression, difficulty swallowing

Question 41

What causes parkinsonism?

Answer 41

Loss of dopamine-secreting cells -> results in loss of inhibitory dopamine effect

Question 42

Amantadine?

Answer 42

Amantadine - Antiviral, treatment of idiopathic/drug-induced parkinsonism in adults

Question 43

Apomorphine?

Answer 43

Apokyn - intermittent treatment of hypomobility "off" episodes of parkinsonism

Question 44

Bromocriptine?

Answer 44

Parlodel - treatment of idiopathic parkinson dx -> beneficial after response to levodopa decreases

Question 45

Carbidopa-levodopa?

Answer 45

Sinemet - treatment of idiopathic Parkinson dx

Question 46

Levodopa?

Answer 46

Dopar - treatment of idiopathic Parkinson dx