NURS 3114 Wk 3 CNS Medications & Oral Calculations

Benzodiazepines

Slow the CNS down

Lorazepam (Ativan)

Benzodiazepine; management of anxiety disorders and anxiety associated with depressive symptoms; PO/IV/IM

Diazepam (Valium)

Anxiety, seizures, muscle spasms, alcohol withdrawal; PO/IV

Midazolam (Versed)

Benzodiazepine; used for sedation, acute treatment of seizure clusters; amnesia affect

GABA

Benzodiazepines enhance the effects of ______ in the brain

Paradoxical Response

Occasionally, instead of calming down, the patient may become: agitated, anxious, excited/restless, aggressive

Flumazenil (Romazicon)

Benzodiazepine antagonist used to reverse sedation and overdose effects of benzodiazepines

Zolpidem (Ambien)

Nonbenzodiazepine Hypnotic; used for the short-term treatment of insomnia

SSRIs (Selective Serotonin Reuptake Inhibitors)

Keep more serotonin available in the brain

Serotonin

A neurotransmitter involved in mood, anxiety, sleep, and emotional regulation.

Serotonin syndrome

Mental status:
Agitation • Confusion, restlessness

Autonomic:
Fever, sweating, tachycardia, BP changes, diarrhea

Neuromuscular:
Tremor • Hyperreflexia • Muscle rigidity • Clonus

Severe cases can cause: Very high temperature • Seizures • Severe rigidity • Organ failure → death

Sertraline

SSRI; Major depressive disorder; obsessive-compulsive disorder; panic disorder

Fluoxetine (Prozac)

SSRI; Major depressive disorder; obsessive-compulsive disorder; moderate to severe bulimia nervosa; premenstrual dysphoric disorder

Lithium

Helps stabilize extreme shifts in mood; bipolar disorder; causes fine hand tremors

Haloperidol (Haldol)

Antipsychotic; schizophrenia; severe behavioral problems; acute mania

Extrapyramidal Symptoms (EPS)

Blocking dopamine can interfere with normal movement

Acute Dystonia

Sudden muscle spams, eyes may roll upward, neck/jaw spasms

Akathisia

Restlessness, pacing, constant movementand inability to stay still

Parkinsonism

Tremors, rigidity, shuffling gait, slowed movement

Tardive Dyskinesia (TD)

A movement disorder characterized by repetitive, involuntary movements, especially of the face and mouth

Neuroleptic Malignant Syndrome

A potentially life-threatening reaction to antipsychotic medications, characterized by muscle rigidity, fever, autonomic instability, and altered mental status

Antiseizure medications

Prevent or reduce seizure activity, decreases excessive/abnormal electrical activity in the brain

Phenytoin (Dilantin)

Antiseizure; Gingival hyperplasia and nystagmus + ataxia

Lamotrigine (Lamictal)

Antiseizure; onset seizures and generalized seizures

Levetiracetam (Keppra)

Antiseizure; focal (partial) onset seizures treatment in adults and children

Sumatriptan

Triptan; treat an active migraine, cause cranial vasoconstriction

Barbiturates

Seizure control, sedation, anesthesia-related uses

Amitriptyline

Tricyclic antidepressant; increase serotonin & norepinephrine activity, used primarily for depression; may have other uses

Trazodone

Miscellaneous antidepressant that is very sedating and may cause priapism— a prolonged and painful erection

Buspirone

Anxiolytics; used for chronic anxiety with a low abuse/dependence potential

Caffeine

CNS Stimulant; A central nervous system stimulant that temporarily wards off drowsiness and restores alertness. It is commonly found in coffee, tea, and various energy drinks

Dextroamphetamine

CNS Stimulants; A central nervous system stimulant used to treat ADHD and narcolepsy, increasing attention and reducing impulsivity

Methylphenidate

CNS Stimulants;

Atomoxetine

Nonstimulant ADHD medication; A selective norepinephrine reuptake inhibitor that improves attention and reduces hyperactivity without the stimulant side effects

Carbidopa-Levodopa

Parkinson’s medications; A combination medication that increases dopamine levels in the brain to manage symptoms of Parkinson's disease

Amantadine

Antiviral and antiparkinsonian medication; It is used to reduce symptoms of Parkinson's disease and to treat certain viral infections; may cause confusion/hallucinations and othostatic hypotension

St. John's Wort

An herbal product commonly used for depressive symptoms; lots of drug interactions; can cause serotonin syndrome

Valerian

An herbal product that helps with sleep/sedation

Kava

An herbal product used to treat anxiety and relaxation; liver toxicity