CNS medications

barbiturates; phenobarbital

sedatives; stops seizure activity

• stimulate the inhibitory neurotransmitter (GABA)

• harmful to fetus during pregnancy

• do not discontinue abruptly

• sedative effect

• respiratory depression

benzodiazepines; lorazepam (ativan)

anxiety, sedative, stop seizure activity, insomnia, pre anesthetic

• bind to GABA

• paradoxical reactions in children and elderly

• dose dependent

• respiratory depression

• no alcohol for 24-48 hours

NCS stimulants; methylphenidate (ritalin, concerta)

adhd

• stimulate brain. blocks reuptake of norepinephrine and dopamine int presynaptic neuron

• contraindicated with MAOI

• high abuse potential

• psychotic or manic symptoms

• gynecomastia

• raynaud’s

• priapism

anticonvulsants; phyoin (dilantin)

seizures, tonic clonic, psychomotor (temporal lobe)

• interferes with sodium channels in the brain causing reduction of sustained high frequency neural discharges

• do not stop abruptly

• avoid other CNS depressants

• monitor glucose

• gingival hyperplasia

anticonvulsant; levetiracetam (keppra)

seizures

• Unknown MOA

• monitor for suicidality

• stevens johnson syndrome

• toxic epidermal necrolysis

• coordination difficulties

anticonvulsant; gabapentin (neurontin)

seizures; neuropathic pain

• Unknown MOA

• somnolence

• behavioral abnormalities (psychotic symptoms, suicidal ideation, irritability, aggressive behavior)

antiparkinsons’s (carbidopa/levodopa)

carbidopa prevents levodopa from being broken down before crossing the BBB and then it can convert to dopamine in brain

• do not take with antacids

• do not stop abruptly

• risk for melanoma

• dyskinesia

• neuroleptic malignant syndrome

• psychotic behavior

antiparkinson; selegiline (eldepryl)

blocks the breakdown of dopamine by inhibiting MAO-B

large dose may inhibit MAO-A (metabolism of tyramine in the GI tract)

• orthostatic changes

• sudden urges

• hallucinations

antiparkinson; amantadine

Unknown MOA

• do not take with OTC cold mediations

• nausea

• dizziness

• insomnia

• anticholinergic effects

• impaired thinking

• edema

• suicidal ideation

cholinesterase inhibitors; donepezil (aricept)

mild to moderate and severe dementia

• prevent breakdown of ACH by ACHE and increase the avability of ACH at cholinergic synapse

• 1 in 12 patients benefit; benefits only ;last a short time ; protien bound

• bronchoconstriction

• bradycardia

• drug interactions with anticholinergics, 1st generation antihistamines, tricyclic antidepressants