Shelf: Lippincot's CNS

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amantadine: tx Parkinson's
antiviral drug for influenza -> who would have thought?
enhances synthesis, release and re-uptake of DA unless DA release is already at a maximum
less efficacious than levodopa
tolerance develops faster
good for rigidity and bradykinesia
antimuscarinic agents benztropine trihexyphenidyl biperiden: tx Parkinson's
blocking cholinergic transmission -> effects similar to augmentation of DA transmission (creates an imbalance in DA/ACh ratio)
bromocriptine: tx Parkinson's
DA agonist
used w/ levodopa
must be built up slowly over 2-3 mo, serious side effects include:
hallucinations, confusion, delirium, nausea, orthostatic hypotension, worsens MI and ulcers
carbidopa: tx Parkinson's
DOPA decarboxylase inhibitor that doesn't cross BBB
it increases the action of levodopa and diminishes its side effects
deprenyl (selegiline): tx Parkinson's
inhibits MAOB -> dec metabolism of DA -> inc levels

may prolong the period before severe symptoms set in
levodopa: tx Parkinson's
DA precursor that enters CNS and is decarboxylated to DA
also greatly decarboxylated in periphery unless co-administered w/ carbidopa
side effects -> nausea, vomiting, arrhythmias, hypotension
pramipexole: tx Parkinson's
non-ergot DA agonists
alleviate the motor deficitis in levodopa-naive patients and patients taking levodopa
less side effects
ropinirole: tx Parkinson's
non-ergot DA agonist
alleviate the motor deficits in levodopa-naive patients and patietns taking levodopa
less side effects
tolcapone: tx Parkinson's
nitrocatechol derivative-
selectively and reversibly inhibits both peripheral and central COMT
reduces the on-off phenomenon
excitatory pathways: excitatory neuron releases NE or ACh ->
bind to receptor on post-synaptic membrane ->
transient inc in Na permeability ->
Na influx ->
slight depolarization or EPSP
inhibitory pathways: inhibitory neuron releases GABA or glycine ->
binds to receptor on post-synaptic membrane ->
transient inc in K and Cl permeability ->
Cl influx and K efflux ->
slight hyperpolarization or IPSP
pyridoxine: B6
increases peripheral breakdown of levodopa
MAOIs and levodopa: hypertensive crisis
levodopa and glaucoma: can make glaucoma worse
levodopa and anti-psychotics: have opposing actions -> don't give them to the same patient
aprazolam: benzo anxiolytic-
when GABA binds its receptor -> opens Cl channel -> Cl influx -> hyperpolarization

the benzos bind a separate receptor that enhances GABA's affinity for its receptor
chlordiazepoxide: benzo anxiolytic
tx alcohol withdrawal
long acting
clonazepam: anti-epileptic

myoclonic
clorazepate: benzo anxiolytic
tx alcohol withdrawal
long acting
diazepam: anti-epileptic

status epilepticus
lorazepam: benzo anxiolytic
quazepam: benzo hypnotic
long acting
midazolam: benzo hypnotic
estazolam: benzo hypnotic
flurazopam: benzo hypnotic
tx sleep disorder- long acting
temazepam: benzo hypnotic
tx sleep disorder- int acting- inability to stay asleep
triazolam: benzo hypnotic
tx sleep disorder- short acting- difficulty in getting to sleep
buspirone: anxiolytic
tx GAD
affinity for D2 and serotonin receptors
no anticonvulsant or muscle relaxant properties
hydroxyzine: anxiolytic
anti-histamine w/ antiemetic activity
great for drug addicts and for sedation before dental work or surgery
zolpidem: anxiolytic
acts on bezo receptors
- has no muscle relaxing or anticonvulsant properties

side effects include nightmares
flumazenil: benzo antagonist
GABA receptor antagonist
admin may precipitate withdrawal in dependent patients
amobarbital: barbituate
short acting
phenobarital: barbituate
long term management of tonic-clonic seizures
long acting
pentobarbital: barbituate
short acting
secobarbital: barbituate
short acting
thiopental: barbituate
short acting- good to induce anesthesia
antihistamines diphenhydramine doxylamine: sedatives
good for very mild insomnia
chloral hydrate: sedative
derivative of acetaldehyde -> converted to trichloroethanol
induces sleep in 30 minutes and lasts about 6 hours
ethanol: sedative
disulfiram: inhibit aldehyde dehydrogenase
(antabuse)
amphetamine: psychomotor stimulant
riases intracellular stores of catecholamines and blocks MAO
major actions due to release of DA, not NE
tx ADD

overdose tx w/ chlorpromazine
caffeine: psychomotor stimulant
a methylxanthine
cocaine: psychomotor stimulant
prolongation of DA action produces intense euphoria
used therapeutically as topical anesthetic (blocks voltage gated Na channels)
vasoconstriction causes necrosis and perforation of nasal septum
methylphenidate: psychomotor stimulant
tx narcolepsy (an amphetamine)
nicotine: psychomotor stimulant
2nd to caffeine as most widely used stimulant
2nd to alcohol as most widely abused drug
theobromine: psychomotor stimulant
a methylxanthine found in coco
theophylline: psychomotor stimulant
a methylxanthine found in tea
Lysergic acid diethylamide (LSD): psychotomimetic
acts at presynaptic 5-HT receptors
haloperidol can shorten its action
phencyclidine (PCP): psychotomimetic
inhibits reuptake of DA, serotonin and NE
also anticholinergic (yet it causes salivation)
an analog of ketamine
produces dissociative anesthesia (insensitivity to pain, without loss of consciousness) and analgesia
tetrahydrocannabinol (THC) dronabinol: psychotomimetic
high dose may lead to psychosis
tx severe emesis in cancer patients
anticholinergics scopolamine: preanesthetic medication
prevent bradycardia and secretion of fluids into respiratory tract
antiemetics dropendol: preanesthetic medication
antihistamines: preanesthetic medication
prevention of allergic reactions (diphenhydramine)
or to decrease gastric acidity (cimetidine)
barbituates phenobarbital: preanesthetic medication
for sedation

thiopental (fast acting short lived barbituate) helps avoid stage II of anesthesia
benzodiazepines diazepam: preanesthetic medication
relieves anxiety and facilitates amnesia
opiods fentanyl: preanesthetic medication
for analgesia
atracurium: mm relaxant
succinylcholine: mm relaxant
vecuronium: mm relaxant
enflurane: inhaled anesthetic
halothane: inhaled anesthetic
best agent in pediatrics, bronchial sm mm relaxation good for patients w/ asthma
reduces hepatic and renal blood flow, lowers BP, sensitizes myocardium to actions of catecholamines, hepatic toxicity and arrhythmias
isoflurane: inhaled anesthetic
good mm relaxant, rapid recovery, stability of CO, does no raise intracranial pressure, no sensitization of myocardium
methoxyflurone: inhaled anesthetic
nitrous oxide: inhaled anesthetic
good analgesia, rapid onset/recovery, safe, nonirritating
incomplete anesthesia, no mm relaxation
sevoflurane: inhaled anesthetic
amitriptyline: TCA
amoxapine: TCA- 2nd gen
desipramine: TCA
doxepine: TCA
imipramine: TCA
maprotiline: TCA- 2nd gen
nortriptyline: TCA
protriptyline: TCA
trimipramine: TCA
fluoxetine: SSRI
fluvoxamine: SSRI
nefazodone: SSRI
paroxetine: SSRI
sertraline: SSRI
trazodone: SSRI
venlafaxine: SSRI
isocarboxazid: MAOI
phenelzine: MAOI
tranylcypromine: MAOI
lithium salts: drugs used to treat mania
chlorpromazine: phenothiazine (neuroleptic) lots of adverse effects

tx hiccups
fluphenazine: phenothiazine (neuroleptic)
available as slow release
prochlorperazine: phenothiazine (neuroleptic)
promethazine: phenothiazine (neuroleptic)
thioridazine: phenothiazine (neuroleptic) strong muscarinic antagonist

good anti-emetic
risperidone: benzisoxazole (neuroleptic)
clozapine: dibenzodiazepine (neuroleptic)
agranulocytosis
haloperidol: butyrophernone (neuroleptic)
little adrenergic or muscarinic activity; available as slow release
thiothixene: thioxanthene (neuroleptic)
fentanyl: opiod agonist
80x analgesic potential of morphine, short duration of action
(anesthesiologists get addicted to this stuff)
heroin: opiod agonist
meperidine: opiod agonist
tx acute pain
methadone: opiod agonist
morphine: opiod agonist miosis via Edinger-Westphal emesis via trigger zone not for asthmatics (releases histamine)
morphine-6-glucoronide = potent
morphine-3-glucoronide = not potent
sufentanil: opiod agonist
even more potent than fentanyl
codeine: opiod agonist (moderate)
(** in most new cough medicines, codeine has been replaced w/ detromethorphan)
propoxyphene: opiod agonist (moderate)
dextro-isomer -> for pain
levo isomer -> antitussive
(VERY bad when taken w/ alcohol and even naloxone can't overcome the cardiotoxicity)
buprenorphine: mixed opiod agonist/antagonist
pentazocine: mixed opiod agonist/antagonist

can induce withdrawal in morphine addicts
naloxone: opiod antagonist
tx overdose (works within 30 seconds! to relieve respiratory depression and coma)
may produce withdrawal sx in morphine or heroin abusers
naltrexone: opiod antagonist
blocks the effect of injected heroin for up to 48 hours
-> used to tx opiate-dependence
carbamazepine: anti-epileptic partial simple partial complex tonic clonic

can cause bone marrow suppression
corazepate: anti-epileptic
ethosuximide: anti-epileptic absence

can cause Stevens-Johnson
gabapentin: anti-epileptic
lamotrigine: anti-epileptic (new)
inhibits glutamate and aspartate release
bloks Na channels
phenobarbital: anti-epileptic febrile seizures in children

causes sedation
phenytoin: anti-epileptic
partial simple
partial complex
grand mal
status epilepticus
primidone: anti-epileptic

phenobarbital is its metabolite
tiagabine: anti-epileptic
topiramate: anti-epileptic
valproic acid: anti-epileptic

myoclonic
viagabatrin: anti-epileptic

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Deck Info

Number of cards 118