CNS Pharmacology and Psychotropic Medications Flashcards

Vocabulary practice flashcards generated from lecture notes covering central nervous system medications, anesthesia, neurodegenerative conditions, autoimmune neurological disorders, and psychotropic therapy.

Attention-Deficit/Hyperactivity Disorder (ADHD)

A disorder characterized by inattentiveness, inability to concentrate, restlessness, hyperactivity, inability to complete tasks, and impulsivity, involving serotonin, norepinephrine, and dopamine.

Narcolepsy

A condition characterized by falling asleep during normal waking activities, such as driving or talking with someone.

Amphetamines

CNS stimulants with a half-life of $9-15$ hours that stimulate the release of norepinephrine and dopamine from the brain and sympathetic nervous system and block their reuptake.

Modafinil

An amphetamine-like drug with an incomplete known mechanism of action that increases wakefulness in clients with sleep disorders such as narcolepsy.

Methylphenidate

An amphetamine-like CNS stimulant well absorbed from GI mucosa, generally more effective for ADHD than amphetamines, that should be administered $30-45$ minutes before meals or upon awakening and at least $6$ hours before sleep.

Anorexiants

CNS stimulants that produce a stimulant effect on the hypothalamic and limbic regions of the brain to suppress appetite.

Analeptics

CNS stimulants whose primary use is to stimulate respiration; includes the subgroup xanthines (methylxanthines) which have a half-life of approximately $4$ hours.

Insomnia

The inability to fall asleep or remain asleep, occurring more frequently in women with an incidence that increases with age.

Ramelteon

The newest category/melatonin agonist sedative-hypnotic and the only major sedative-hypnotic approved for long-term use in chronic insomnia; acts selectively on melatonin receptors with a maximum dose of $8$ mg/d taken within $30$ minutes of bedtime.

Barbiturates

CNS depressant sedative-hypnotics restricted to short-term use ($2$ weeks or less) due to numerous side effects including tolerance; grouped into long-acting, intermediate-acting, and short-acting.

Flumazenil

A benzodiazepine antagonist used as an antagonist for benzodiazepine overdose.

Triazolam

A short-acting benzodiazepine hypnotic with a $2-5$ hour half-life that does not produce metabolites and carries an increased risk of anterograde amnesia or memory impairment.

Zolpidem tartrate

A nonbenzodiazepine (CSS IV) used for short-term treatment ($<10$ days) of insomnia with a duration of $6-8$ hours and a half-life of $1.4-8.4$ hours.

Nitrous oxide

Known as 'laughing gas', it was the first anesthetic introduced.

Spinal anesthetic

A local anesthetic injected into the subarachnoid space below the first lumbar space in adults or the third lumbar space in children.

4 Stages of Anesthesia

1. Analgesia, 2. Excitement or Delirium, 3. Surgical, 4. Medullary Paralysis.

Spinal block

Penetration of the anesthetic into the subarachnoid space.

Epidural block

Placement of the anesthetic into the epidural space.

Phenytoin

A hydantoin anticonvulsant used for tonic-clonic seizures, partial seizures, and status epilepticus with a narrow therapeutic range of $10-20$ mcg/mL.

Ethosuximide

A succinimide anticonvulsant used to treat absence seizures with a therapeutic range of $40-100$ mcg/mL that decreases calcium influx through T-type calcium channels.

Carbamazepine

An iminostilbene anticonvulsant used to control tonic-clonic and partial seizures with a therapeutic range of $4-12$ mcg/mL, which has a toxic interaction with grapefruit juice.

Valproate

An anticonvulsant with a therapeutic serum range of $50-100$ mcg/mL prescribed for tonic-clonic, absence, and mixed seizures; carries a risk of hepatotoxicity requiring liver enzyme monitoring.

Parkinson's Disease

Also called 'shaking palsy', a neurodegenerative disorder resulting from a loss of neurons in the substansia nigra causing a deficiency in dopamine.

Carbidopa-Levodopa

A combination dopaminergic medication combined in a ratio of 1:10, where carbidopa inhibits the enzyme dopa decarboxylase to allow smaller levodopa doses.

Seligline

An MAO-B inhibitor that can delay the use of carbidopa-levodopa by $1$ year in Parkinson's patients; contraindicated with tyramine-rich foods.

Entacapone

A COMT inhibitor that does not affect liver function, used in Parkinson's disease, which may cause a brownish orange discoloration of urine.

Pimavanserin

An atypical antipsychotic used specifically to treat hallucinations and delusions associated with Parkinson's disease psychosis.

Alzheimer's Disease

An irreversible neurodegenerative disorder characterized by a decline in activities of daily living, cognitive abilities, and changes in behavior.

Rivastigmine

An acetylcholinesterase/cholinesterase inhibitor that increases ACh at cholinergic synapses to increase cognitive functions and slow disease progression in mild to moderate Alzheimer's disease.

Aducanunab

An IV-administered IgG1 amyloid beta-directed monoclonal antibody initiated in patients with mild cognitive impairment or mild dementia to reduce amyloid plaques in the brain.

Myasthenia Gravis

A chronic autoimmune neuromuscular disease in which antibodies attack ACh receptors, leading to ineffective muscle contraction and weakness.

Pyridostigmine

An acetylcholinesterase inhibitor used to increase muscle strength in Myasthenia Gravis, having an oral half-life of $3$ hours and an IV half-life of $1.5$ hours, with atropine as its antidote.

Multiple Sclerosis

An autoimmune disorder attacking the myelin sheath of nerve fibers in the brain and spinal cord, resulting in plaques that affect motor, sensory, neurologic, cerebellar, and emotional functions.

Typical Antipsychotics

Antipsychotic agents that can cause extrapyramidal symptoms (EPS) and primarily treat positive symptoms of psychosis.

Atypical Antipsychotics

Antipsychotic agents that treat both positive and negative symptoms of psychosis without causing extrapyramidal symptoms (EPS).

Tricyclic Antidepressants (TCAs)

Antidepressant agents that block the reuptake of norepinephrine and serotonin in the brain, with a clinical response seen after $2-4$ weeks of therapy.

SSRIs (Selective Serotonin Reuptake Inhibitors)

Antidepressants that block serotonin reuptake in the CNS without blocking dopamine, norepinephrine, cholinergic, or alpha1 receptors, causing fewer side effects than TCAs.

Lithium

A mood stabilizer used for bipolar affective disorder with a therapeutic serum range of $0.8-1.2$ mEq/L; levels greater than $1.5$ mEq/L produce early signs of toxicity.