Central Nervous System and Neurological Medications Lecture Notes

Flashcards covering CNS drugs, including stimulants, depressants, anesthetics, anticonvulsants, and medications for Parkinson's, Alzheimer's, and psychiatric disorders.

Attention-Deficit/Hyperactivity Disorder (ADHD)

A condition characterized by inattentiveness, inability to concentrate, restlessness, hyperactivity, inability to complete tasks, and impulsivity, associated with serotonin, norepinephrine, and dopamine levels.

Narcolepsy

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

Amphetamines

CNS stimulants that stimulate the release of norepinephrine and dopamine while blocking their reuptake; they have a half-life of $9-15$ hours.

Modafinil

A drug that increases wakefulness in clients with sleep disorders like narcolepsy, though its mechanism of action is not fully known.

Methylphenidate

An amphetamine-like drug used for ADHD and narcolepsy that is generally more effective than amphetamines; it should be given $30-45$ minutes before meals and at least $6$ hours before sleep.

Anorexiants

Drugs that cause a stimulant effect on the hypothalamic and limbic regions of the brain to suppress appetite.

Analeptics

A subgroup of CNS stimulants, such as xanthines, whose primary use is to stimulate respiration.

Insomnia

The inability to fall asleep or remain asleep, occurring more frequently in women and with increasing age.

Short-acting hypnotics

Sedative-hypnotics useful for achieving sleep and allowing the patient to awaken early without lingering side effects.

Intermediate-acting hypnotics

Sedative-hypnotics, such as butabarbital, used specifically as sleep sustainers for maintaining long periods of sleep.

Flumazenil

The specific antagonist used for benzodiazepine overdose.

Triazolam

A short-acting hypnotic with a half-life of $2-5$ hours that can cause adverse effects like 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.

Ramelteon

The newest category of sedative-hypnotic (melatonin agonist) and the only major one approved for long-term use in chronic insomnia.

General Anesthesia

A state where the CNS is depressed, pain is alleviated, and consciousness is lost; it can be achieved via balanced, inhalation, or intravenous methods.

Local Anesthetics

Drugs characterized by the suffix "-caine" that block pain at the site of administration by preventing conduction of nerve impulses.

Spinal Anesthesia

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

Four Stages of Anesthesia

The sequential stages consisting of 1. Analgesia, 2. Excitement or Delirium, 3. Surgical, and 4. Medullary Paralysis.

Phenytoin

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

Ethosuximide

A succinimide used to treat absence seizures with a therapeutic range of $40-100\,mcg/mL$; it works by decreasing calcium influx.

Carbamazepine

An iminostilbene used for tonic-clonic and partial seizures with a therapeutic range of $4-12\,mcg/mL$; it has a toxic interaction with grapefruit juice.

Valproate

An anticonvulsant for tonic-clonic and absence seizures with a therapeutic range of $50-100\,mcg/mL$; it requires liver enzyme monitoring due to hepatotoxicity risk.

Parkinson's Disease

Also known as "shaking palsy," it results from a deficiency in dopamine due to the loss of neurons in the substantia nigra.

Carbidopa-Levodopa

A dopaminergic combination in a ratio of $1:10$; carbidopa inhibits dopa decarboxylase to allow more levodopa to reach the brain.

Selegiline

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

Entacapone

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

Rivastigmine

An AChE inhibitor that increases acetylcholine at cholinergic synapses to slow the process of Alzheimer's disease.

Aducanumab

An IV-administered IgG1 monoclonal antibody that reduces amyloid plaques in the brain for mild Alzheimer's or dementia.

Myasthenia Gravis

A chronic autoimmune neuromuscular disease where antibodies attack ACh receptors, leading to muscle weakness.

Neostigmine

An AChE inhibitor used for Myasthenia Gravis that must be given on time; parenteral doses must be accompanied by atropine sulfate.

Multiple Sclerosis

An autoimmune disorder attacking the myelin sheath of nerve fibers in the brain and spinal cord, resulting in plaques.

Typical Antipsychotics

Antipsychotic agents like phenothiazines that treat positive symptoms but can cause extrapyramidal symptoms (EPS).

Atypical Antipsychotics

Antipsychotic agents like clozapine and risperidone that treat both positive and negative symptoms without causing EPS.

SSRIs

Selective Serotonin Reuptake Inhibitors that block serotonin reuptake and are more common than TCAs due to fewer side effects.

MAOIs

Monoamine Oxidase Inhibitors that inactivate norepinephrine, dopamine, epinephrine, and serotonin to treat depression.

Lithium

A mood stabilizer for bipolar affective disorder with a therapeutic serum range of $0.8-1.2\,mEq/L$; levels above $1.5\,mEq/L$ indicate toxicity.