Neurological System Part 1

Neurotherapeutic drugs

help to fix physical issues, typically because something is incomplete

Psychotherapeutic drugs

help to fix mental issues, typically adding to what is already there

Benzodiazepines

CNS depressants most commonly prescribed for sleep, anxiety, seizures, alcohol withdrawal, and anesthesia and are highly addictive

Examples of benzodiazepines

temazepam, alprazolam, diazepam, lorazepam, chlordiazepoxide

Common ending for benzodiazepines

medications ending in "pam"

Action of benzodiazepines

enhance the effect of GABA, calming down the CNS

Use of temazepam

sleep disorders

Side effects of benzodiazepines

drowsiness, dizziness, confusion, amnesia, anxiety, respiratory depression, tolerance

Antidote to benzodiazepines

flumazenil

Withdrawal manifestations of Benzos

paranoia, panic attacks, muscle twitching, hallucinations

Contraindications of benzos

alcohol, opioids, other Benzos, pregnancy, other depressants

Examples of non benzodiazepines

zolpidem (Ambien), zaleplon, eszopiclone

Use of zolpidem (Ambien)

short term treatment of insomnia

Side effects of non benzodiazepines

dizziness, drowsiness, confusion, diplopia

Contraindications of non benzodiazepines

children, suicidal ideation, hepatic or renal disease

Most common centrally acting muscle relaxant

baclofen (Lioresal)

Most common peripherally acting muscle relaxant

dantrolene (Dantrium)

The action of baclofen

enhance the effect of GABA, reducing muscle elasticity

Uses of baclofen

spinal cord injuries, cerebral palsy, MS, muscle injury

Side effects of baclofen

drowsiness, dizziness, nausea, constipation, withdrawal

Tip to remember baclofen

"if you pull your back out, you need baclofen to fix it"

Action of dantrolene

prevents calcium release, inhibiting muscle contraction

Specific side effect of dantrolene

malignant hypothermia

Side effects of dantrolene

liver failure, decreased muscle strength, prolonged diarrhea, malignant hypothermia

Use of methocarbamol

relieve the discomfort caused by acute muscle or bone injury

AED

anti epileptic drugs

The 3 drugs commonly used to treat seizures

phenytoin, carbamazepine, and valproic acid

The hydantoin that is used to prevent grand mal seizures

phenytoin (Dilantin)

The key side effect of phenytoin

gingival hyperplasia

Side effects of phenytoin

gingival hyperplasia, diplopia, nystagmus, steven's Johnson rash, hypotension

The therapeutic range of phenytoin

10-20 mcg/mL

The iminostilbene used for seizures and bipolar disorder

carbamazepine (Tegretol)

Adverse effects of carbamazepine

visual disturbances, fluid retention, rash, bone marrow suppression, daytime effects, grapefruit juice interaction

The medication used for seizures, bipolar disorder, and migraine headaches

valproic acid (Depakote)

The drug used to treat nerve pain and migraines

gabapentin (Neurontin)

The medication used most commonly for local anesthesia

lidocaine (Xylocaine)

The benzo used for general anesthesia

midazolam (Versed)

The opioid used for general anesthesia

fentanyl (Sublimaze)

The medication that is used as a neuromuscular blocking agent

succinylcholine (Anectine)

Mode of action for lidocaine

blocks the conduction of pain impulses in a localized area

Side effects of lidocaine

hypotension, bradycardia, spinal headache

The barbiturate used for general anesthesia

thiopental

Action of thiopental

enhance GABA

Location that thiopental should be administered

IV into a LARGE vein

Antidote for respiratory depression caused by opioids

naloxone

Fentanyl and MAOIs taken together will cause...

hypertensive crisis

Mode of action of succinylcholine

blocks acetylcholine at the neuromuscular junction, causing skeletal muscle paralysis

Most noteworthy side effect of succinylcholine

malignant hyperthermia

The two classes of drugs used to treat narcolepsy and ADHD

amphetamines and methylphenidates

The amphetamine used to treat ADHD and narcolepsy

Adderall

The methylphenidate used to treat ADHD and narcolepsy

Ritalin

Important side effects to monitor with Adderall and Ritalin

decreased appetite, weight loss, insomnia, hypertension, tolerance, and dependence

2 drugs commonly used to treat Parkinson's

levodopa/carbidopa and selegiline

Action of levodopa/carbidopa

dopamine agonist, increasing the availability of dopamine

Side effects of levodopa/carbidopa

drowsiness, dyskinesia, tics, orthostatic hypotension, dark urine, sweat, psychosis

High protein meals decrease the effectiveness of this medication

levodopa/carbidopa

This chemical interacts badly with MAOIs

tyramine

Anticholinergic side effects

dry mouth, dry eyes, urinary retention, constipation

Action of benztropine

acetylcholine antagonist, decrease tremors and muscle rigidity

The cause of Alzheimer's disease

neurons degenerate resulting in too little acetylcholine

This cholinesterase inhibitor is used to treat Alzheimer's disease

donepezil

The action of donepezil

stop acetylcholinesterase from inactivating acetylcholine

The cause of migraine headaches

dilation and inflammation of blood vessels in the brain

This serotonin agonist is used to treat migraines

sumatriptan

Delirium tremens

alcohol withdrawal delirium

Alcohol withdrawal peaks at

24-48 hours after last drink

CIWA assessment

tool to assess alcohol withdrawal

This med is used for aversion therapy for alcohol

disulfiram

Opioid withdrawal peaks at

1-3 days

This drug is used to replace opioid dependence

methadone

This drug is like methadone but is safer

buprenorphine

This medication is used to decrease the cravings and discomfort of withdrawal

bupropion (Wellbutrin)